Coming Home
Bringing a family member home after a stay in a skilled nursing facility (SNF) or rehabilitation center, or directly from the hospital, can be an overwhelming challenge emotionally and physically. If you are going to be a caregiver either in your own home or your parent's, to minimize emotional overload you need a plan. I'm going to give you one. First, let me share my story, and then I'll recommend what to do.
My Mother's coming home tomorrow at 2 p.m. "Home" I've learned over the last three years is wherever your loved ones are. I have been traveling from my "grown-up" home in Virginia to my "childhood" home in California, looking after my 86-year-old Mother (only child of only children). It's been a joy, but whenever I leave one place, I say "I'm going home." This last trip I decided both are home -- so I now refer to them as "the ocean" and "the farm."
My mother's coming home tomorrow at 2 p.m. is real for her. This has been her main residence or second home in California for over 30 years. I've been a nomad in it as I have come and gone to look over her care and be with her in a beautiful (we have been blessed) skilled nursing facility close by.
But it struck me one night as I lay in my nomad state watching TV that she was doing the same thing several miles away, so why shouldn't we be doing it together? She has been in the facility for three years. They had taken great care of her. When I left to go to the farm after her first hospitalization, I worked hard to get caregivers for her at home who would care for her in my absence. She wasn't really sick, just immobile and afraid to be touched. She graciously growled at every lovely lady who came in, and I again knew in that moment, if I left, she'd kick them all out, so it was back to the facility, which kindly took us in.
Fast forward three years and she's been well cared for. Her mind is still sharp. Yet, she had come to the point where all she wanted was to lie in bed, be left alone, not eat (except for the chocolate I brought ever day) and said repeatedly she was living too long. In our care plan discussion, the lovely hospice social services lady, Paula, told me to be prepared, that it was not unusual for women to just start shutting down until they pass away.
Then a funny thing happened on the way to "home." My mother rallied. Three days before the scheduled departure I get a call from wonderful, Kit, the Head of Nursing. "I've got the greatest news. Mom has been up in her wheelchair, sitting in the Activities Room, taking all three meals in the dining room" -- which she had always called the "old people's room" and refused to go into, preferring meals in her room. I'm told the staff in amazement is calling this the "Awakening of Mrs. Lee."
Her front room with the ocean view is all ready to go, new bed (not a hospital bed, you need a special bed~more later), a lovely sofa bed to sit in by day and hang out with her all night if necessary, all my "little girl" furniture of which I was most proud has been taken away to make room for this new era in our lives.
My mother's coming home tomorrow at 2 p.m. -- from now on that's where I'll be hanging with one-half of my family at "the ocean." What joy.
I want you to have the same experience -- with or without the ocean. Here's what you need to do:
1. If your loved one is in a SNF, hospital, or rehabilitation facility, sit down about a week before you are planning to bring your parent home, listen and ask lots of questions!
2. If your parent is on hospice, hospice will offer a hospital bed at no charge. The standard in the industry says they are unbearably uncomfortable. If finances are an issue, you may have to take the bed. It is a blessing hospice even provides all that they do. If you are able to spend some money, I recommend checking into a nursing home bed distributor. Some of those beds are better than others. I worked directly with my "team" at the nursing facility (they have connections, you just have to ask and push) to arrange for a top-of-the-line bed to rent for $150 per month. The bed can also be purchased. The IMPORTANCE of this type of bed is that it moves the body in all different positions, crucial to prevent bedsores, and allows the bed to go all the way to the floor if your parent has a tendency to fall. Hospital beds don't go to the floor.
3. Hospice will also provide an eating table that goes over the bed for meals and holds drinks during the day, a wheelchair, oxygen, and a hoyer lift, which takes us to #4.
4. There are different sizes and kinds of hoyer lifts. You will want to talk to hospice about what they can provide, or check on your own -- Google "hoyer lifts" -- to find the right one for you. They will aid you in lifting Mom or Dad out of the bed and putting them in an armchair or wheel chair. You need practice, so ask the facility to show you how it works and practice with your Mom or Dad before they come home.
5. Finally, but equally important, finding caregivers to support YOU! You cannot take care of your parent 24 hours a day -- it is a physical and emotional impossibility. Watch out or the bed your Mom or Dad vacated might soon be yours! Reputable, trustworthy, bonded caregivers are the key. Ask your facility for whom they know to be the most trustworthy caregiving agencies. You will want to interview the caregivers and introduce them to Mom or Dad. If one doesn't work out, don't hesitate to ask for another. This is the most important step--you are entrusting your parent's life to another so that you can get out and have some recreation time, etc., AND you want someone in your house you can trust while you're gone. Put any valuables away. No matter how great we believe someone to be, we never truly, truly know them, especially in this setting.
You can do it. Loving your parent through this difficult time is a challenge, but will give you those special moments you will treasure forever. Corny to say, but love is a powerful thing, and serving your Mom or Dad at this time in your life is healing to them and a gift to you.
Jane Allison Austin, J.D./M.A., is an elder law attorney and elder care advocate in Southern California, who is passionate about guiding your family and advocating for your parents in managing the healthcare system and the laws that come with it. Visit Jane Allison at yourelderlawadvocate.com yourelderlawadvocate.com or join the conversation at twitter.com/JaneAllison twitter.com/JaneAllison ~~ What are your questions and concerns about elder care?
