Parent in nursing home

[redrider90]

The first thing I do is walk in the front door and take a deep breath. If it smells from urine leave.  My wife was a Physical Therapist at  a decent nursing home. They had a small rehab unit and the rest was nursing home. And you never smelled urine anywhere.
 But the next level of care is if one has deep dementia/Alzheimer's then you need a facility within a facility. They require a special space that is locked from the inside and the unit is specific for high level care.
When a family runs out of money and Medicaid kicks in that limits availability as many places do not accept medicaid.

[Aaron D.]

Just some experience here-

Rehab is a flexible concept, keeping on rehab makes the business office of the home happy.

Long term-once you're off rehab, it's insurance/asset time. Many of the better places will say they don't take Medicare patients, but as you say, they CANNOT kick her out, and will, after much griping, make arrangements.

Just hold your ground. They know how the game is played, you can too.

[Sasquatch Jim]

  A brother and sister went to an assisted living home where they had recently installed their severely disabled father.
  A nurse told them to wait in some lawn chairs out side.
  Then she pushed the old man to them in a wheelchair.
  They asked him if the food was Okay and he answered that is was quite good.
  He began to tilt to one side and the nurse straightened him up.
  He began to tilt to the other side and she again straightened him up.
  They asked if any thing was the matter and he said, "No, they take pretty good care of me but this damn nurse won't let me fart!"

[krglorioso]

Such outstandingly good advice here.  I do want to amplify what Neverquit said about keeping the person in their own home with outside hourly helpers as long as possible.  This is an excellent option between keeping the person in your home and trying to cope, and bowing to the inevitable and placing them in a home.  Had I a relative needing such help, I would contact a school offering training for the Certified Nursing Assistant credential, or similar named occupations in other states.  These programs are rather brief, usually about 8 weeks, but can be a fine source of motivated, mostly young people anxious to "help people".  The going wage in Southern California is about $10-15/hour and even if you have to pay a registry, it isn't oppressively expensive. 

This should work well if the person can manage some functions but as the degree of decline increases, it may eventually come to full time residence in a skilled nursing facility (referred to as a "sniff" (SNF) and the advice re urine odor being a failing grade was right on the money). 

There does eventually come a point at which the most loving, dedicated relative can no longer manage a severely disabled person, especially if the person has moments of physical or verbal abuse directed at the family.  No feelings of guilt should accompany a careful decision to place a relative in a care facility at this point.  You gave it your best shot.  Now, it's time for shift workers to take over and deal with the problem for their 8 hour shift and then get their own relief, while you get yours.

Ralph