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Posted June 20, 2008

Ask An Expert

Elderly Care: When Staying in Nursing Home Makes Most Sense

Q. My father is in need of 24-hour care in the form of a nursing home or possibly assisted living. He is now in skilled nursing and will be assessed again at discharge. He would like to return to his home, primarily to be with his dogs. He did have and could have again home health care up to 35 hours a week. The problem is that I have done most of the caregiving for the last five years. I have no sick days left for what will be increased doctor visits and housecleaning, supervision of meds, deep house cleaning, etc.

He is demanding and unappreciative and says I can do it all. He doesn't believe it will be an even greater burden on me. He has congestive heart failure, and has been in the hospital three times in three weeks. His heart is "at the end." He is difficult to deal with -- and I am exhausted.

I want him to go to assisted living if he qualifies, and if he doesn't, his only choice is a nursing home. He is refusing both options, no matter what the discharge assessment will declare. Please help me.

Claudine S., Alamogordo, New Mexico.

A. Your father does not sound to me to be someone who will be able to function at home with only 35 hours of home care. Nor does he sound like someone who could function independently in an assisted living facility, without a 24 hour, 7 day companion or aide.

My suggestion is that he stay in the nursing home, or if he is at the end, he should go to a hospice. It seems clear that you can no longer function as his caregiver.

This answer is provided by Jack Halpern, MPS, LNHA, an eldercare advocate and a licensed nursing home administrator. Halpern, a nationally recognized expert on eldercare issues, is the author of many articles on eldercare and nursing home abuse, and is the CEO of My Elder Advocate.

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