Nursing Home Dilemma

My grandmother, who is in her early 80’s, has taken several falls recently, has untreatable heart issues, and is suffering from mild dementia.  She still lives in her home with my grandfather, who has health issues of his own, but my mother lives only two blocks away from them, and I am just over 10 minutes away.  We have tried very hard to keep them in their own home, but we are rapidly approaching the point at which it is just no longer feasible, for their own safety.

Let me start off by saying that I am not a huge fan of nursing homes.  I’m sure there are a few great ones out there, and even in mediocre ones, there are some great nurses.  My grandmother herself used to be an LPN in a nursing home.  And there are certainly instances where the care that an elderly person needs exceeds what a family member can give.  But nurses tend to be underpaid, underappreciated, and far overworked.  I realize that many families are simply not capable of caring for an elderly loved one, and I don’t want to add to anyone’s feelings of guilt for this.  I’m merely saying that if it is possible for the parent or grandparent to stay with a family member, I feel that it is generally preferable to a nursing home.

Since I am a full-time nanny, and watch little Rose in my home, I would be capable of caring for both of my grandparents.  Since I have in the past cared for three of my husband’s grandparents, I have the experience to be able to care for them well, as long as they do not develop a more serious medical issue that would require hospital admittance.  But also, just being there 24/7 would hopefully keep them from doing things that would injure them, as my grandmother has done many times in the last several months.

Gran doesn’t want to stay with me because she “doesn’t want to be a burden”.  I’m pretty sure she doesn’t fully comprehend what a “burden” she is to my mother, who is still working, and to my grandfather, who is struggling with his own health, and even to the rest of us, who are constantly worried that the next fall will be severe enough to put her back in the hospital, or worse yet, make her bedridden for the remainder of her days.  Surely quality of life should enter the discussion.

Her family doctor has agreed that she really needs to be under constant watch (somewhat more than my grandfather is capable of giving), but he would have to admit her to the hospital for three days before her insurance would kick in and pay for nursing home care, and there’s not really a medical reason for a hospital stay at this point.  The logic of requiring an expensive stay in the hospital in order to get them to pay for the nursing home escapes me, but I guess the health care debate is a whole other can of worms.

Again I will say, I don’t claim to have the answers.  I guess I’d just like to throw this out to all of you, especially if you’ve had to deal with this situation.  At what point is it acceptable to intervene, and perhaps even go against your parents wishes by insisting that they can no longer live alone?  It doesn’t seem to matter that the doctor says she shouldn’t be alone any longer.  But she is an adult, and my elder, and we are all loathe to take away her perceived freedom and independence, however illusory they may be.  When is it OK to override what they want in the name of keeping them safe?

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