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Welcome to CareNotes. In this special section we will feature a reader's letter and provide an opportunity for an interactive exchange that will help find some answers and possible solutions to concerns. If you wish to respond to this letter, simple follow the link provided at the end of the letter and add your comments and thoughts to our CareNotes Board.

This Week's Carenote - 05/29/09
My grandmother recently had her leg amputated and came home to my mom's house where she now lives. My Mom has vowed never to put her in a nursing home but I am concerned. Mom is almost 70 and will have to do a lot of lifting. None of her children live at home.  I do not want her to give up her life in the process of taking care of her mother. When we suggest paying someone to come in at least 3 times per week, she says that is too expensive.

How best can I suggest to her that a nursing home is the way to go without making her angry?


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Name: Jim
Location: Maryland
Date: 05/29/2009
Time: 01:36 PM


Since your mother is living alone and just 70 years old, taking care of your grandmother may be just what she needs. With some training and guidance from an Occupational Therapist and other professionals that can train your mother how to assist your grandmother your mom may be able to take care of your grandmother for some time . Since you don’t say why your grandmother had to have her leg amputated, I am assuming it was because she has diabetes. If your grandmother can not walk and could not walk before for any reason, then I agree on the nursing home idea. An amputation of a leg by itself is not necessarily a reason to go into a nursing home permanently. I believe you have left out some additional reasons, other than the leg, from this discussion. Your mom’s health? Your grandmother’s total health condition, temperament, etc.. Something is missing from this discussion. Your mother’s love for her mother is natural but lifting a person that cannot assist the caregiver is not rational for a woman 70 years old. This will put both of them in a nursing home. I have been in this exact situation and 18 days after I got my spouse into a nursing home I had a heart attack. I was lucky and had minimal damage but your mother may not be that lucky. Finally, your grandmother must be in a nursing home and need “skilled daily nursing care” to qualify and apply for Medicaid. Get a sheet of paper and draw a line in the middle and list the pros and cons of the total situation you are in and the results of the process of doing that will pretty much determine the action that must be taken to give all of you a longer life with good quality. Your options for a nursing home are few. Private pay which is about 9,000 dollars a month for a good one and unless you are very rich I know you can’t afford that. There are two critical items here that must exist before you can get MedicAID. 1. Need for “daily skilled nursing care” and 2. Already in a nursing home. MediCARE will only pay for about three months and then she will have to leave or she can be placed in a nursing home and be “in application” for Medicaid. Ask your local Health and Human Services office for the exact rules in your state. You should get an eldercare attorney but you need a really good one (perhaps one that “specializes” in elder care). I hope this gets you started because the leg has been amputated and life is moving on regardless of what you do and you have to start getting up to speed on the MedicAID world. Blessings and good luck to you.

Name: Caregiver to my precious husband for 23 yrs & now in heaven
Location: Fairfax, Virginia
Date: 05/29/2009
Time: 04:12 PM


As a caregiver for 23 yrs., I understand your concerns for your mom but I also understand your mom’s wishes not to have to put her in a nursing home. You indicated that your grandma just recently came to stay with your mom. If you or other family members live nearby, go visit and let mom have some respite; bring a meal, offer to clean house, laundry, make a meal. I would continue to pursue someone coming in 3x weeks. In time maybe mom will be more open. There are many medical devices that one can use to make transfers and ADL’s easier for your mom. Your mom may be a lot stronger (mentally, etc.) than you think. I just lost my husband in March 2009 and from June ‘08 to March ‘09, he was in a nursing home. I had no other choice. It wasn’t my choice but God will never put on us through more than we can handle. His ways are always perfect. I wish you well and God Bless.

Location: Ohio
Date: 05/29/2009
Time: 07:30 PM


Her Doctor can sign a paper so that if she needs extra care she can qualify- there are state/ County or City programs for the elderly where she can have health care aides come in to help bathe her and get her dressed etc.. if needed..Occupational therapy can teach your Grandmother and Mother how to move or a lift chair might be an answer... they have these lifts available for use in a tub or she can use a shower bench.... As for in home care- there are agencies that you can hire for as little as 2 hours at a time or a private caregiver ( former Nurse or aides ) who would work for around $12.00 per hour....Your Grandmother surely has Social Security or is on Medicaid./ Medicare... Local Council on Aging might be able to help you with finding a solution..that both your Grandmother and Mother can live with....Local High school girl might like to earn some money doing the cleaning etc...

Name: Paula
Location: Indiana
Date: 05/29/2009
Time: 11:49 PM


There probably is no way to suggest putting your grandmother in a nursing home without making your mom angry. Is your grandmother okay mentally and can she use the leg she has left? If the answer to both is yes, then your mom will just have to assist her to stand and won't have to do a lot of lifting. Maybe your grandmother could use a walker. If your mom can't afford to have someone come in occasionally to help, maybe you and your siblings could either physically or financially help. I quit my job five years ago to care for my mom who has Alzheimer's and every time someone suggested putting her in a nursing home, I got angry. I made her a promise many years ago that I would never let her go to a nursing home and I will do whatever it takes to keep that promise. Also, unless your grandmother has long term care insurance or Medicare will pay for it, nursing homes are extremely expensive. You might try having a calm discussion with your mom about her reasons for not putting your grandmother in a nursing home, then together try to work out at least getting her some help.


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