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My mother needs 100% care, where should we go for care?

My mother had a stroke 4.5 years ago and is unable to take care of herself. She is bed and wheelchair bound, cannot feed herself, needs adult diapers, etc. Currently, she and my father are in an independent living facility with full-time private caregivers for her from 8 am - 9 pm. My father is independent. He is concerned about what will happen to her when he dies, specifically, where will she go?

Based on the research I have done it looks like a nursing home is the only option unless we move her home and have caregivers continue to provide the care they are providing now. Am I missing something? Is there another option? If a nursing home is the only option, is there a particular kind of home or type of services I should be looking for? My parents live in West LA.

Status: Open    Nov 21, 2016 - 06:46 AM

Senior Living Communities, Caregiving

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Dec 08, 2016 - 08:38 AM

Sounds like you are thinking ahead to the time when you would need to make some decisions for your mother’s care. That is good because it gives you some time to investigate the different possibilities available to her and think through what would be the best situation for your mother and the family.

It is probably true that the nursing home (skilled nursing facility) would be the best option for your mother. Most states limit the severity of the patients that assisted-living and board & care facilities are allowed to provide care to. One criteria is the degree of ability your mother has to assist with her care. For example, is she able to help when transferring from bed to a chair or is she a ‘total lift.’ The state’s Department of Health Services can give you information about the capabilities of the different types of facilities.

Regarding home care, there is a possibility that she may qualify for hospice services. Her physician should be able to help you make that decision. If your mother requires any skilled nursing she may be eligible for some visits from a home health agency. This would need to be ordered by her primary care provider. However, visits from this agency can be helpful in setting up a situation for your mother that will provide her with satisfactory care and not be too much of a burden for you. If you go this route, you have to be committed and realize that this takes a lot of energy on your part. Even when you have 24 hour care for your mother, it still creates a lot of stress. However, I have seen families who have carried through in this commitment and have been very satisfied that they did it that way

Regarding the process for selecting a nursing home. It is good that you're allowing yourself some time to investigate your options. I always suggest that you visit the places in the area that you would like to select. I would suggest that you look for a facility that is close to you or another family member, so that you will be able to monitor her care.

The Medicare website ( provides a feature called Nursing Home Compare, where you are able to compare the various skilled nursing facilities in a certain area. It compares their caregiver to patient ratios, how they have scored on recent state inspections and other factors.

When you do visit a facility, I suggest that you make a list of issues that you would want to check out about each facility, so you don’t forget something. Some of the main issues that I suggest is that you observe the residents in the facility. Do they look clean and cared for and comfortable? Does the facility look clean? How does the staff interact with the residents? What do the residents’ rooms look like? Do they have room for personal items?
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