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First of all, I do not want to put my parents in a nursing home. I just want to do what is right for them. How will I know when it is time?

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Kaye has posted several times with no response to questions asked. I have asked at this thread that she please respond to some of the questions we have asked and fill out a more complete profile.

https://www.agingcare.com/questions/i-feel-so-drained-but-its-my-turn-for-days-to-watch-my-parents-how-do-i-get-motivated-to-go-tomorrow-469706.htm
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disgustedtoo,

Your term 'nanny-slave' is the truest description of elder caregiving for a parent I've ever heard. It is perfect.
I have so much admiration and respect for you coming right out and saying that you don't want or expect your adult children to be your caregivers. I wish every parent thought as you do.
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First you need to understand the different levels of care in different types of senior facilities. All facilities are not the same, lots of options and lots of prices. Your parents will need to be assessed by the facility staff to determine what their needs will be.

Mom had a good fit in a no-frills AL, she didn’t even want to use the in-house salon and enjoyed the activities and shopping trips. Her fees were $4300 a month in central Ohio.

Independent Living is basically a senior adapted apartment, often in a complex that has multiple levels of care available. The rooms are fitted to a person using a walker or wheelchair and have adapted bathrooms. The residents may be able to opt into different services like laundry or housekeeping and access to the dining room and activities. These are self pay, no Medicare or Medicaid. We had hoped to get Mom into one that was for low-income payers with rent based on income. Definitely no-frills but with a 5 year waitlist.

Assisted Living is for seniors who are pretty independent but need, or would like, some level of supervision. They get meals, housekeeping, laundry service, activities, medication administration, and other services depending on the facility that may or may not be included in the fees. They usually have minimal staff levels as residents don’t usually need a lot of physical help. This is self pay, Medicare does not cover fees and most facilities don’t accept Medicaid Waivers unless the person has been a resident for 2 years. My mother did well here with some dementia and mobility issues.

Memory Care is for people who have serious mental declines and/or may not be safe unsupervised. These are often attached to AL facilities and are not covered by Medicare or Medicaid. Residents are all levels of physical abilities and ages. Staff has additional training and higher patient to aid ratios. Multiple types of monitoring are used depending on the facility.

Skilled Nursing Care is for people with serious disabilities who cannot physically care for themselves and may or may not have memory/dementia issues. These are often paired with Rehabilitation services because of the higher staffing levels, specialized training, and nursing supervision. Medicare might cover some of the fees, especially if in rehab, and all are required to allocate a number of Medicaid beds.
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Kaye55: Imho, my mother was adamant about living alone in her own home seven states from mine, with a whole host of ailments. I moved in with her. She had a case of food upset, prompting an ED visit and then went to the nursing home.
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There is a very simple answer. Take stock of the entire situation - what is their behavior, their needs? How are they impacting you and your own quality of life and others belonging to you. Are you able to put up with what is happening or is it beginning to harm and destroy you - the high responsibility? You need answers and then you take each situation and truly think about it. In the end analysis, no matter who or why or what the relationship is, if YOU are being harmed negatively, and no solutions exist, that is when you have to place them. It is YOUR turn to live your life now - they have lived their lives.
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BurntCaregiver Sep 2021
Riley2166,

There is never a very simple, one-size-fits-all answer to any of it. If there was no one would be in a support group like this forum asking others for advice. If it was so simple there would be no need for groups like this.
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I never thought my dad would end up in a nursing home because no one in my family ever had. How naive I was! He lived independently til he was 96 and then lived with us for a year. He was extremely easy to take care of , never complained or asked for anything. After a bad infection he ended up in the hospital then in a nursing home. Of course we both wanted him home. But now after three weeks there I see how much better off he is there. 24 hour nursing care, other patients to socialize with, great food, excellent staff ( except for head nurse🙄) . I am thinking that I should maybe have brought him here earlier because he is getting better care there even though I tried my very best.
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disgustedtoo Sep 2021
Always good to hear POSITIVE news from someone about NHs. Too many come on here and relentlessly bash them. Yes, many have a bad reputation, but there ARE good places out there! It is up to US to check them out first, to weed out the bad places, and then continue to ensure they are getting good care.

Thank you for posting this!
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The difference between home careand a licensed facility is 8 hr shifts. If you only had to care for your parents for 8 hours a day, you could probably do it standing on your head. The staff at LTC or MC facilities, for the most part, go home after 8 hours, and can pursue other interests.You don't have that luxury. Even though it breaks my heart, I will.place my husband when I can no longer safely care for him.
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Frances73 Sep 2021
That’s a great point, the staff works a shift and goes home to relax. You are on call 24/7 to an elder in your home.
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Permanent residential placement depends on you and your parents' condition(s):
1 - Are you physically, emotionally, and financially capable of caring for your parents 24/7/365?
2 - Do you have a supportive group of family members, friends, members of your faith community... that will take over care of your parents for hours or days if needed?
3 - Do you and/or your parents have enough finances to pay for home health aides for 20-40 hours a week? If you are working full or part time, you may need paid help to care for them while you work.
4 - Do you and your parents get along well and share similar values and views? If you do not get along well now, it won't necessarily get better when they live with you?
5 - Do you have your own retirement, and long term care needs, secured? If not, you may do better to work full time for more years rather than care for them full time.
6 - Generally, your loved ones' need full time residential care:
when their care requires professional care or care you are unable to provide,
when you can not get enough sleep (7-9 hours every night) because of round the clock care,
when your health deteriorates so that you must prioritize caring for yourself,
and when the financial or emotional burden becomes to much to bear.
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I cared for my mom in my home for 2 years. Alzheimers . Then she was in MC for 7 months up until a month ago. In May one day she just quit walking. That was a game changer. I toured several homes. I was referred by the Hospice nurse to one of the oldest but she said they provided good care. I placed her and I have never felt better about her care. If she was home with me she would be bedridden as I would not be able to lift her. Yes Hospice would probably get a lift and I could lift her from her bed to transport chair. The bathroom is too small to get the lift in so I would be changing her briefs in bed. At the NH she goes to the salon to get her hair styled. She goes to Bingo. Church services. The food is delicious. I go everyday for several hours and have lunch with her. One piece of advice. If you decide to place her in a NH ..be sure you have 2 or 3 months of self pay so you can choose the NH of your choice. Then apply for Medicaid once her money gets down to $5000. Or below. Otherwise you will have to find a Pending Medicaid NH and it may be substandard. Don't bash NH's. Yes ..state your experience ..but don't stereotype them in the " horrible category. "
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Frances73 Sep 2021
Note, Medicaid does not pay for Assisted Living, only Skilled Nursing Care.
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Kaye55,

I read your profile and would say the first step should be stop having guilt for having feelings. Being a caregiver to one needy, elderly person is absolutely exhausting and you're doing it for two.
You deserve a freaking medal for that.
To make the decision for placement in a care facility, everyone's needs must be considered, including yours.
You're obviously exhausted from being the 24/7 caregiver to your parents. You want to run away too. You know what comes after bone-tired exhaustion and wanting to run away? Resentment and bitterness towards your parents who you love. These feelings very quickly turn to hate and even abuse. Of course no one wants that to happen and people never believe that it can happen in their situation, but it can and it does.
How about trying some hired caregivers to help out with some of it? That could work out for you.
Also, start checking out different care facilities for your parents. These places often have very long waiting lists for placement. It couldn't hurt to get them on a few of these lists.
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Frances73 Sep 2021
That was my reasoning for getting Mom intomAL. And in reality I was still on call 24/7 for emergency room visits, trips to medical appointments, shopping, etc. and just visiting.
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Are they mentally competent. If so, you can't put them anywhere. They have the right to live in unsafe conditions if they do choose. You can try to convince them otherwise, but you can't force them. If they aren't competent, then they probably should not be living on their own.

Unfortunately, you may not be able to judge their competency level unless you are monitoring them closely on a daily basis. Old people (and now I are one of them) have ways of hiding their deficiencies.

Nursing homes are for those unable to do much of anything for themselves. If you don't think your parents are capable of managing in their home, there are options. The first step could be an apartment in a senior facility or independent living facility. Many of these provide a common dining room. In some of these facilities the staff would be attuned to noticing when it's residents could no longer function in this environment. A step up is assisted living where staff can assist residents with some activities, but the person still has some independence. Then there is memory care for those who are mostly ok physically, but suffering dementia. Nursing homes are the last step.

For each type of facility - even nursing homes, you will find those of high quality, those of low quality and everything in between.

Do not judge solely on a facility's appearance. At the same time, no facility will be perfect. Examine how they address their mistakes. Focus on staffing - how are staff trained, ratio of staff to residents, staffing on all shifts, staff turnover, etc.

Best wishes as you help your parents manage through this time.
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First, of all I’m happy u do not want to put them in a nursing home. I would say never. It’s sad , to me even though we never asked to be born by our parent’s but somehow manage to take care of us. Than when it’s there turn families say I can’t I’m busy I have a family so freaking sad. I know it’s tough but with Hod all things are possible. If they have. Home and worked all there lives they have funds to be taken care of. Ppl never take care of your family and love. Ppl usually give up when they have to leave what they haven’t always known. I would say duke it out. Remember what what u do comes back and if u have kids there watching and hearing what u do to there grandparents there going to say u did it so can we. Be wise snd loving and do ur best. Go to youtube watch Charles Stanley My fav Pastor and go to intouch.Org also, go to YouTube watch dr. Bernard on health dr . Klaper he’s also on plant base health. He’s on tele health he’s wonderful. Those foods play a role. I had an appointment with him he’s wonderful. God Bless you and your family.
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BurntCaregiver Sep 2021
Candyapple,

Taking care of needy elderly people is nothing like taking care of babies and children.
Babies and children progress in their independence. Elderly people regress as they grow older.
No parents who love and respect their children expect them to become their caregivers. The parents who actually love and care about their adult kids never want the lives of those adult children to turn into what elderly caregiving turns them into. We no longer live in the times when women didn't necessarily have to work a job outside the home so they could feasibly have an elderly parent or in-law living in the house that they help care for. In these past times people didn't usually live as long as they do now. Elderly people usually didn't live to the point where they became completely out of it from dementia needed to be cared for like an infant. They didn't live long enough to get so debilitated from disease or old age that they had to have someone caring for them 24/7. Unless a family is very wealthy, it's just not realistic today to make some caregiving situations work.
It's the selfish, narcissistic, uncaring parent that expects their child's life to be lived in servitude to them meeting every need and demand of old age, no matter how miserable and wretched a life it is for their adult child.
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To be put in a Nursing Home should be the last result.

Nusing Homes are not a nice place to be and are all understaffed.

Plenty of accidents happen in Nursing Homes.

The best place for Seniors is at their own home, just make it Senior Safe like Baby Proofing for Seniors.

Clear the Clutter
Use Night Lights
Install Handrails
Raise Toilet Seat
Seat for Shower
No throw rugs
Eany Meals
Grocery Delivered
Install Cameras
Use walker & Wheelchair when needed.
Last when they can no longer take care of themselves, hire a Live In.

Seniors are the most happiest and feel the safest and most loved being able to live in their own home.

Besides Nursing Homes being understaffed, they also tend to Overdose saying the patient is anxious, depressed, ect when it's to just med them to make their jobs easier and they're more like a zombie than the loved one you knew.
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Geaton777 Sep 2021
Hmm...my MIL is in a wonderful, faith-based facility that is well-run and she's doing better than we could have ever hoped for. It's not the newest or most expensive, either. I think you are completely romanticizing caring for people at home. Can it be wonderful? Yes! Can it also be a completely draining poop show? Yes!

To make the blanket statement that facilities "tend to Overdose saying the patient is anxious, depressed, ect when it's to just med them to make their jobs easier and they're more like a zombie than the loved one you knew" is reckless and heartless to the OP. My MIL had to go through some adjustments to her meds and has been backed off of most of them. Perhaps the the medical attention your LO received in her one place was sub-par but please stop painting all facilities as awful. Do you think it benefits the LO if they are less depressed and anxious? Of course it does. You are certainly entitled to your opinion about only your own experience with a single facility. I can attest that our experience was completely opposite of yours. So, who is right? Do you see my point? Currently I have 1 LO is LTC, 2 aging in their home with part agency aids and part family hands-on care, and 1 living next door to me. I am going through a spectrum of care scenarios but I would never tell a OP "do this or that" and that's all they should consider.
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I just placed my Mom in a nursing home. It was very difficult but I have been surprised at how much better she is doing compared to the care I was providing as solo caregiver in my home. Although I did my best, I can see now how she is better with a proper structure, a crew of people working shifts rather than just an exhausted me 24/7, and having social interaction with PT, nurses, aides, etc.
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JSunny Sep 2021
I totally agree with you, I have been caring for my husband for 8 years and I am totally burnt out and am placing him soon.
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Nobody “wants” to put their parents in a nursing home. Even though I had an abusive mother, I didn’t want her in a nursing home. But most of us, we we start out caring for an elderly relative, don’t have a full understanding of what it’s REALLY like to care for a sick, elder that needs 24 hour care. When I first stepped in to manage my mother’s care, I had a lot of fantasies about how things would go. I pictured happy visits at her AL, bringing her out to my home for holidays, and a peaceful death in her beautiful room with a view of the mountains that I decorated with care. I even thought some forgiveness might happen - duh. The reality was declining cognition, multiple health issues, swatting at the staff, non-compliance, violent reactions to any visits or contact, her hiding feces in her furniture and so on. She was constantly falling and she had hallucinations. My gut told me that the AL could not manage her needs. Ya think!? Communication was poor with the staff and even her hospice providers. My stress level was through the roof. Despite our bad relationship, I knew my mother never wanted to be in a nursing home, but she also never planned for her aging or thought she would would have advanced dementia. I moved her to a nursing home where she has gotten excellent care and therapy. She was discharged from hospice. Not that this is a perfect arrangement. There is no perfect arrangement. I still need to be involved to insure she has a voice. But it was the right move. It was time. You will know when it’s time. Everyone loves to bash nursing homes and how horrible they are. Taking care of the sick and elderly is not pretty. The staff at my mother’s nursing home include some real caring professionals. Read some of the nightmare stories on this forum about caregivers who are in crisis trying to manage care at home. They are ready to set themselves on fire! These are not easy decisions we have to make as adult children. I have to laugh, because as I am writing this answer, an ad came on tv for a local senior services business and a man holding a fluffy dog said, “call me to age in place with style and grace.” False advertising is all I can say.
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disgustedtoo Sep 2021
Again, another honest, positive post.

"Everyone loves to bash nursing homes and how horrible they are."

It isn't everyone, just a sad few who sing the same old tired song. It really gets tedious. Voice your opinion, fine, you feel home care is best. That's YOUR opinion and your right to say, but stop there. Painting every facility as some kind of prison death camp is just plain WRONG.

"I have to laugh, because as I am writing this answer, an ad came on tv for a local senior services business and a man holding a fluffy dog said, “call me to age in place with style and grace.” False advertising is all I can say."

Got a laugh from me as well! I don't watch TV, so I haven't seen that, but I would call it deceptive advertising. SOME elders can age in place, nicely and gracefully, with help, either from family or hired care givers. BUT, many can't or won't.

Thank you for taking the time to post this comment!!!
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From personal experience, I would go to very extreme measures to avoid nursing home. Way too much to say in this answer. I went to the best I could find , I thought, it was very staffed up to patient ratio, bright atmosphere, etc. ended in an utter nightmare. I thought quitting my job to and find a lesser one would be too much stress with a mortgage, etc. that would have been a walk in the park from what we went through. I thought finding someone to help care for in home would be too expensive. What I would not give to be able to do that now. There are situations a nursing home must be considered. But it is an awful existence. And now you never know when they will prevent family from being with their elderly loved ones and then the elderly are terribly isolated and confused. I am sorry I do not speak affirmation for a nursing home. But I have learned to speak the truth and maybe help one person. No matter what you decide, it will be very taxing physically and emotionally. But it can also be one of the most endearing. Do what you believe is right and do the best you can, every day. And you will be glad that you did. Think out of the box. God bless!
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tboudreaux1982 Sep 2021
I agree. I had horrible experience
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When they need more care than you can provide, it’s time. When they aren’t safe where they are, it’s time. When you’re so exhausted, burned out, and becoming resentful, it’s time. When your own health is at risk, it’s time. When having professional care around the clock is needed, it’s time. And it’s okay
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pamelac Sep 2021
So much wisdom here in so few words from Daughterof1930's answer!! It's was a heart-wrenching decision to put Mom in a NH, but for me, A.) she was not safe without 24x7 care, and B.) my time, energy, and resources were so sapped, I couldn't do it all any more without risking my own health. And if I got sick, we'd both be sunk.
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My mother has told me this when its gets too much for me to take care of her to put her in a nursing home. Talk it over with your parents to see how they feel about it. Sometimes finding an assisted living place where they like it that can transition to a nursing place is great. Also start looking now for a place even with your parents so they may pick it when they are ready for it or you can't take care of them.
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Time for what?
You don't want to put them in a nursing home. Great, please don’t. You want to do the right. Great, do it. Possibly there is more to your statement that I’m not aware of. But ...
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Daughterof1930 Sep 2021
Of course there’s more to it or the question wouldn’t be asked, not to mention a whole story can’t be told in a paragraph. Placing a parent in a NH is an often heart breaking decision made only because it’s in the best interests of the parent. Sometimes, like with my mom, there was absolutely no other choice. Telling people “please don’t” is guilt inducing and unsupportive in an already sad life circumstance. We’re here for support and sound advice, not judgment.
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I repeat what others have said, at this point it's not so much about your parents, it's more about you. You're already worn out. How much longer can you properly care for them, and at what health cost to you? Caring for someone means being able to provide for their needs physically, clinically and safely. It doesn't mean SOLELY providing for these needs. Whether you want to place them in a care facility or not becomes weighing their needs against your tolerance to care for them. There should be no guilt involved. If you're at the end of your rope and cannot provide the care they need without affecting your mental or physical health, then caring means finding an appropriate facility for them.

You don't mention what afflictions they have, if any. If they need round the clock care, a nursing home would be the appropriate facility. If not, and they have they assets to afford it, assisted living might be better. The term nursing home is percieved by the public very negatively. I wish the industry would rename nursing homes to better reflect today's facilities and remove the stigma associated with them.
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If caring for them has gotten to the point where you can not "take it any longer" if it is "wearing you out" you have reached the point where you need to do something.
"something" does not always mean a "nursing home"
You would look for a place that would meet the level of care that they need.
**There is Independent Living. I am going to assume that since they are with you and caring for them is wearing you out this is not an option.
** There is Assisted Living. Depending on what kind of help they both need this might be an option.
**There is Memory Care. If either or both have dementia this would be your best option. they will get the care they need in a safe environment.
**There is Skilled Nursing. This would be what most people would consider a "nursing home" This is for people that have medical problems that can not be addressed by staff of Memory Care, Assisted Living.
ALL of these are a far cry form what they might have seen 20 years ago.
Take tours.
Talk to people.
If you see families coming and going stop them and ask questions. If you see residents stop and talk to them. Go at a time that might not be "ideal" for a tour. Early in the morning, lunch time, dinner time. Ask to have a meal.
Ask the same questions that you would ask if you were placing your infant in a Day Care Center.
Look at the Medicare website and look at reviews and ratings. Check Social Media.
**And search to see if there are any smaller group homes that would be a good fit. They are usually smaller, fewer residents. But that has drawbacks as well.
**And look into the possibility of caregivers that will come in often enough that it will help you and take much of the burden from you.

I was told when I asked that question early in my journey that if you are asking the question then it is time.
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PatsyN Sep 2021
Couple questions? My mom's at home for now, 85, in wheelchair b/c stroke 10 years ago. I say she's 95 percent OK; it's the last 5 that really hurt--can't stand alone or anything that comes with that. 24/7 aides after my dad's death a year ago. My sister lives nearby, I'm 3 hours away and travel there Sundays and we're a great team.
1--I assume w my mom's stroke we'll be talking AL if we can't manage her at home at some point, not lesser levels of care, rigbt?
2--Is it "OK" to just drop into a facility uannounced to look around or am I likely to be turned around at the door?
Txs
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On your profile you gave more insightful information:

"Taking care of mom and dad and it is wearing me out. I am tired and I want to run away or to stop going to help. I feel so guilty for my thoughts."

The caregiving arrangement needs to work for both parties. It doesn't sound like it's working for you. It should not come at a cost to you. It should not be onerous. Do you think your parents would want you to be worn down to a nub for their sake?

Today's nursing homes and care philosophies are much improved from when your parents remember them. Those memories are what strike fear in most elderly. I suggest you tour a few local to you to get a sense that they can be pretty nice and well run. Often seniors thrive there because they have all their needs met, aren't feeling guilty for having LOs orbit around them, and have much more social exposure and activities.

Or, have you considered in-home aids to give you a break? Agencies can provide all levels of caregiving. If cost is an issue, you may want to contact social services for their county to see if they qualify for any services that would bring some relief. It's ok to just do a little research now so that you're not doing it during a crisis. May you gain wisdom over this decision and peace in your heart no matter what is decided.
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Kaye55, you know it is time when your parents need a village to help take care of them.

My own Mom went into a nursing home as she needed around the clock care by experts knowing how to deal with all the different types of situations. My Dad moved into senior living, and later he moved into Memory Care. That way I was able to return to being a "daughter". Caregiving is so very exhausting and I wasn't even hands-on. I don't know how people do it.
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