Please, advice needed.

Background concerning our mother:  She is 80, was diagnosed in 2010 with alzheimers and, after a few changes, is currently on aricept 10mg daily.  She is physically healthy except for severe osteoarthritis with both knees well past the need for replacement and rheumatoid arthritis.  She has ALWAYS been an independent, head-strong,  never wrong personalilty.  She, long prior to mental changes, has never recognized the need for nor agreed to designating a POA or living will.  To relinquish such control isn't our mother.  She has also, throughout our lives, let us know that she WILL NEVER go to a nursing home; it is a fear for her.  She loves her "things" and her home is very important to her.  Although her short term memory is poor, she has lived at home alone and writes her checks and does quite well with her personal tasks.  Two of us alternated giving her medications each day and preparing evening meals; although we  (3 daughters) have been on pins and needles knowing that she was a high risk for falls and that it was just a matter of time before something would happen.  A little over 3 weeks ago it happened, she fell suddenly in her home just a few steps behind me (I was carrying groceries in).  Trip via ambulance to ER, total hip replacement the next day, stayed with her around the clock d/t confusion and aggressiveness (we expected), transferred to rehab hospital for about 2 weeks with little PT education retained d/t poor short term memory.  She needs 24/7 observation primarily because she will do as she wants, let go of walker etc, in her mind she is fine and doesn't need help.  Often forgetting when and what even happened.  I brought  mother home with me and hoped that she would eventually accept living in my home; again, she is very high risk for falling plus she is still healing and under hip precautions.  However, she has been relentless in demanding "I want to go home, I need to go home I have things to do, you can't stop me I'll show you, I don't need any help" along with periods of crying, anger, letting go of walker etc.  I feel like I'm keeping her prisoner in my home.  Because of her short term memory, we put her off each day by telling her she will be seeing her physician "tomorrow" and that she has to have someone with her 24/7  for now and that she has been with me only a day.  This doesn't stop her actions but, eventually, by end of evening she starts settling down some.  What do we do.  She is far from forgetting her home; and when she says she wants to go home  she means her physical home not her childhood.  There are only the 3 of us; one works nightshift and babysits grandchildren on off nights, other is on disability herself, and me.  We don't want nursing home plus the way mother is they would be calling us all the time to stay with her for safety or would just medicate her to a zombie.  Please, any advice is appreciated.  I'm wearing out fast.

Thank you for the suggestion.  No, we haven't because we didn't know; will call and check into tomorrow.  Until the accident, mother had been able to continue life in her home.  So very independent, she just can't accept that as she is getting older that she needs help and how big a safety risk she is.  Today she had a near syncope episode with me walking behind her; if I hadn't been right there to hold here upright til DH could come and assist me in getting her onto bed, she would have hit the floor.  As soon as she felt stronger her first words, as always, were "I want to go home; take me home".  She didn't even realize what had happened or how dangerous it was for her.  When we talked to her about it she still denied she needed the help.  We girls just keep saying that we'll take one day at a time and we'll figure it out.  We just want to keep her safe; but she's not going to be happy.  Again, thanks for input.  Guess it helps to just vent a little.

HenryC, I have to agree with interstategar that your Mom should go into a nursing home. My Dad passed away 2 years ago from Alzheimer related medical problems ( he was 83 ) and we had no other choice but to
put him into a nursing home the last year of his life. He ended up getting around the clock attention that he needed, and we could not provide for him at home. Just a word of advise, please pick a GOOD nursing home.
Do you homework and check ( online ect ) to make sure the home does not have many complaints against it and check what complaints have been filed with the state, if any, against that home....
Good luck to you and your Mom!

Henry C ............

Please don't think of what you may do or need to do for your Mother is in any way cruel. Finances may limit your choices, but let me tell you a brief story of my Mother - who was diagnosed with severe Dimentia nearly two years ago, and who did suffer with it (unknown to me) for many years prior to that:

Her first 15-months, after the diagnosis by her Primary docter, was spent at home with a 24/7 caregiver thru an insured and bonded agency. The cost of that was approximately $5000. per month - and, of course, the cost of operating her home, food, clothing and her insurance costs added another $2500. per month onto that. Mom never did get used to her having to buy groceries for the live-in caregiver ... but, I think you can picture that! And yes, medicare offered no assistance!

Nine months ago, after leaving the hospital again (from an episode at night at home) - the hospital staff Psychiatrist said she must be admitted into a facility that had registered nurses on staff - and she cannot go back home. The caregivers did not have the medeical expertise that she needed at this stage of her dimentia.

I looked at 6-places from a modest-priced nursing home ($5000.+ per month in this area) to several nicer homes with a separate dementia wing ($6000. to $7500.+ per month). What I found, and where she went, was a small facility that specialized in Dimentia and diseases affecting the mind with a maximum capacity of 60+ patients between 4-buildings. The caregivers there have been very good, and the programs very well structured with lots of small games played that excercise the mind. Encouragement to participate (not my Mothers greatest attribute) is very strong - and a patient just sitting in their room for a length of time is really not allowed. Each of the 4-small buildings has 2-building pets - typically a dog and a cat or two dogs. And the caregivers often bring their own children to work with them ... all positives to an aging mind. And - all the residents/patients have entertainment come in about 6 times a month .... in other words, somethings to live for!

This Dimentia Assisted Living home does cost about $6000. per month, and it is not available for Medicaid!!!!!!! Whereas, many of the nursing homes will have x-number of beds that are approved for Medicaid. So ....... that's where it comes down to finances. In my case, Moms money will be virtually gone in 6 to 8 more months - so her house just went on the market. When sold, it will allow her to stay another two years or so at this facility. Only then, will she go into a Medicaid facility! 

Other background:

Mom said for years "I will not go into a nursing home"!

Grandma (her Mom) died in a nursing home 20+ years ago!

Mom is 95 years old .... and was driving until 2-years ago!

Yep .... my Mother is "head-strong"! 

Aren't they all???