‘Just Put Her in a Home,' They Say
‘Just put her in a home,' they say.
Family, friends, co-workers (I still work full time), and health care professionals all mean well, and they have my best interests in mind when they tell me that. I know this, and I am grateful for them taking the time to listen to my stories of sadness, and for lovingly making that suggestion.
My response, at least for now, is a gentle, ‘Not Today.’
I am writing this article for you, my kindred caregivers, as I presume there are many of you struggling with this very decision just about every day.
This journey began for me about seven and a half years ago, and the last three-years-plus has been the hardest. As you all know, care giving for your spouse with dementia is a never-ending treadmill of balancing chores, medical care, ‘activities of daily living’ (ADLs), and in my case, working full time. It is an exhausting, thankless cycle of numbing drudgery, with very little to look forward to. Friends and family listen to my laments regularly (bless them), and continue to suggest that placement will be the best thing I can do, both for me and my dear wife.
Today, I disagree. Something may change (or happen) that makes placement necessary, so I am keeping an open mind. For now, I continue to kick that can further down the street as long as possible.
Why do I persevere? Am I trying to be a martyr? Am I so far gone that I do not see a way out? My reasons for waiting are mostly emotional, but there are some practical reasons.
The first reason I delay placement is simply my emotions - my devotion to my wife - and the terrible thought of living out my life alone in this house. Daytime is fine – there is my job to go to, and chores to do. But the nights – the awful, lonely nights. The thought of my wife being generally ok (except for the dementia of course), but not being here with me overnight, is far worse than dealing with her incontinence and keeping her at home. I really don’t know how others get over this part of placement.
My second reason is quality of care. My wife has outlived her original diagnosis/life expectancy by over two years now. Health care professionals have told me that the quality of care that I give her, along with the daycare center while I work, is responsible for her very slow decline and general good physical health. For example, if she has an incontinence accident, how long will it take a care home to change her? When she is here at home with me, I change her diaper right then and there, and she gets a whole shower and change of clothes. Her soiled clothes go straight into the washing machine, and I sanitize the bathroom. It is unrealistic to expect that from a care home, although I am sure they do the best that they can.
My third reason is purely financial, and I am sure this is a big one for most of us here. Medicare does not cover ‘custodial care’, so dementia patients are simply left out in the cold. Each and every online article, billboard, or TV advertisement that leads one to believe there is funding available for dementia care ends up in the same dead-end loop of brick walls. I summarize here: Choose from long term care insurance, veteran’s benefits, sell the house, Medicaid, or pay for it yourself. Same old choices, no matter where you read about ‘available sources of funding.’ The way I read these choices is simple: Pay for it myself until we qualify for Medicaid. Certified Elder Law Attorneys (CELAs) can certainly help you plan, and I have done so and can recommend this plan of action. However, no one else is going to help you pay for your loved one’s care no matter what you do; a CELA will allow you to keep what you legally can, but you will be spending much of your retirement savings regardless. My math shows that I will be spending it ten times faster than I was able to save it throughout our lives together.
It is in my best financial interest to delay placement as long as possible. The longer I wait, the more I can save up funds, and (I guess) the shorter her time in a care home would be. The day that placement becomes necessary may be a sudden event: A fall, a sharp mental decline that makes my wife unmanageable at home, or even the possibility of a health event in my life. Realizing this, delaying placement seems to be the right choice, since (in theory) I will be more ready when the time comes.
I also cling to the hope that I can care for my dear wife at home until the end.
My system of keeping her home, using the day care while I work, and calling my friends and family for support is working. I am sad and exhausted, but it is working. So I will not be placing my dear wife in a care home – at least Not Today.
With Love,
Bill2001
Interested in more discussions like this? Go to the Caregivers: Dementia Support Group.
Bill, I am printing this and placing it in my encouragement notebook! Thank you for writing this for all of us. I do hope you have a great start on a book with more details about your journey.
I am determined, at all costs to keep my sweet hubby at home. However, I do feel and understand the exhaustion from Buggirl....sweet one what will happen to your mom when you are sick, hurt, or just emotionally broken? And trust me, this will happen to you at some unknown point in time. Your dad will find out quickly that there must be another solution besides the one he is choosing for you and your mother. I am on the verge of hiring a "helper" for a few hours a week just to give me some time to handle other things and to just breathe....perhaps this is an option for you both. There has to be an answer that works for your mom, your dad and you. Will be praying for you and your giving spirit many times this week.
Hugs...
I’m going to mix metaphors here, but your current situation is a “house of cards” with you as the cornerstone keeping it all shakily up.
Considering human nature, of course your dad is happy to have you keeping the cards standing. Why should he consider placement or extra help as long as you are willing to do what needs to be done? He’s tired at 86 and you’re the daughter, probably makes perfect sense to him!
You and you alone can decide what you can humanly do and what you owe yourself and your nuclear family. Placement may not be an option if your dad is firmly opposed, next step is arranging for/increasing private duty help at home- but your dad will probably resist that too, “strangers coming in”, “too expensive”, “why do we need that?”
Last thought- people in your mom’s condition are very susceptible to pneumonia, if this unfortunately happens and she is admitted to the hospital, the discharge planner (RN or social worker) will contact you pretty immediately after admission. You can tell that person all that’s happening at home and they will help you look at options- going home may be considered “unsafe due to family is unable to provide the patient’s required level of care”, which is true- you need 24 hours of rested caregivers to provide 24 hours of care.
I admire the many posters here who are taking care of their loved ones at home, but not all situations allow this. My vascular dementia husband declined to being super-volatile, profanely shouting insults and threats, refusing meds and meals, switching day for night. Family was afraid to come, I was afraid too- barricaded the door to the gun room with lots of heavy things, as he had hidden the key. I moved to the guest room and locked the door at night. Then he left the house at night and rang a neighbor’s doorbell, the neighbor brought him back. The next day, his PCP squeezed us in, sent us to the ER, they admitted him, 2 week stay- lots of tests, bloodwork, neuro and psych consults. I talked honestly to the discharge planner, he was discharged to assistive living and is doing SO much better with the structure of the environment and the help of 24 hour staff care. I am doing so much better too.
There is a lot of talk now about Work/Life balance. Think about things and don’t feel guilty about whatever you decide, but be aware- Dad will be happy to have you continue what you’re doing, so you will get pushback for any change, especially those that cost money. Could your husband be any help in talking to Dad about the effects on you and your family of what you’re doing and the need to give you some relief?
Usually it is financial. It is my understanding that Assisted living is charging $5,000 and up and Nursing Home Care is $10,000 and up. This is monthly and there are extra's like having someone do their laundry or if you take more that the number of pills that are allowed under your monthly fee. Has you dad though of hiring someone to come in an assist with your mother's care. Unfortunately, the care in a Home will not be the same as you can give her at home. You did not mention how old you are. What will your father do if you move? This is one of the most difficult times in a family. It sounds like you all could use a little counseling. Have you discussed this problem with your doctor? I wish you Good luck
Gina5009
So many difficult emotions to process. Life is change and impermanence. To accept that can help us find peace in the moment and find love and compassion in our hearts to carry on.
I am caregiver for my mom and my hubby who has Lewy Body dementia. We all live in the same home and some days it can be pretty challenging. I plan to take care of them at home but perhaps some day that will have to change. I hope not. Today my husband said to me, “You have been the love of my life. I am so grateful for you.” Wow - such highs and lows with caregiving but each moment with them is truly precious. It makes the decision to keep them with me so much easier.
I write the following with great respect and caring so please forgive me if this next bit seems out of bounds for you. I have not done it and don’t plan to but I believe in WA you can divorce your spouse and transfer all but some 5-figure # to yourself. I am not sure what that amount is but years ago I remember it being around $75,000. This allows you to qualify your spouse for Medicaid and get financial more assistance. You can still help her in anyway possible but perhaps not leave yourself financially strapped in your “golden” years. Thank you for sharing your post. It helps us all feel more connected to each other and the tough decisions we often have to make. We do our best and that is all we can do.
i think, more than anything, people keep their LO at home due to finances. nobody can afford it.