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She hasn’t even been at the facility long enough to establish her care plan or get her meds scheduled. Each additional hospital trip adds to her confusion. I’d like to just take her home but need resources and breaks. I’d also have to quit my job.
Skilled nursing facilities have gone away from the "zero falls" policy because it is unreasonable. Clients with cognitive issues and mobility issues will most likely fall - in their facility or at home. Instead, they embrace a "no injury" policy of protecting clients most at risk of falling: super low beds (almost lower to level of mattress on the ground), no side tables, thick mats next to beds, alarms that ring when a client tries to get up unattended... The goal is to prevent injury, a realistic goal.
Talk to the facility where your mom is at to see what measures they are implementing to prevent injury. Also ask how they determine which clients that do fall need to be seen by a doctor. In my hospital, we fill out forms when anybody falls. If the person who falls sustains an injury, then he or she is evaluated by a doctor - only after the nurse does a thorough examination and has significant findings of injury.
I just realized that I added more to my post, however, the new material did not post.
Is your Mom in pain? Like pain that is so distracting that she cannot concentrate, every movement is painful, cannot sleep well because the pain wakes her up, she cannot do exercises because it just hurts too much and affects her focus?
If so, fix the pain first. When my Mom hurt her hip (from a fall), I told them that we had to deal with the pain. Unfortunately they didn't believe me and I didn't know any better. After 3 months, I was told that the hip fracture was healed that she should have no pain from it. However, after 3 consecutive weekends at the ER, an ER doctor finally told me what he thought I already knew. It was that my Mom was suffering from severe arthritis. The realization that my Mom was a drug addict was when they administered OxyContin to help the pain and it didn't touch the pain. So my Mom and I spent the next month working with other drugs, and CBD, to reduce the arthritis pain and also eliminate the drug addiction. I could literally tell that mentally, she was getting better as she was able to focus for longer periods, understand what I was asking her, and have interest in the world again. Some of what I thought was dementia, disappeared or was reduced.
Then we started PT to help strengthen her muscles to reduce the pain of the arthritis further and get her physically able for her legs to hold her weight. A total of 3 months from the time the doctor told me about the arthritis, she was no longer completely dependent upon the wheelchair and we noticed that her muscles rapidly increased in strength where she could walk with her walker, but rarely fall (like she fell once a quarter if even that).
So, if your Mom is in intense pain, try and reduce the pain first as that might be what is holding back your Mom's recovery.
My mother was falling at home 5-6 times a week. My Dad was her sole caregiver and put her into respite care, while there he died. She did fall a few times when she first entered the facility but never injured herself.
She is still in the care facility as there is no way I could provide the level of care she needs. Even if I quit my job, I would need support as I am not trained to provide the level of care she needs. As she ages, this level of care is getting more intensive.
Caring for someone is incredibly hard, emotionally, physically and financially if you need to quit your job.
If you want to care for your mom, be prepared to put you life completely on hold. Even with support it will be virtually a 24/7 job and getting increasingly more difficult. I know I couldn't do it as I have a full-time job, kids, husband and I want to enjoy this stage in my life by traveling and taking part in my kids activities. I also know that my mother is better cared for than I could do at home so for me it is a win/win situation.
Good luck whatever you choose as there is no ideal solution for everyone, only what works for you.
It seems from your post that mom is not improving her quality of life by going back and forth to hospitals and rehabs.
Hve you considered placing mom in a memory care unit and requesting a hospice consult?
The hospice team will come see her in memory care and give her extra attention and physical supports, as well as managing her meds to make sure she is comfortable.
I they find she has anxiety, they may be able to medicate her for that so that she is less restless, and that may keep her from falling as frequently.
I realize hospice is a very personal decision, but it sounds like mom is not benefitting from hospitalizations and rehab, so I'm presenting it an option to consider.
Plus, remember that she cannot gift you money to make up what you lost by not working. If she has to be admitted to a facility, Medicaid will do a 5 year “Look Back” to see where her money was spent. If they don’t like what they find, they will make her private pay for that amount of money before they begin paying.
Sending a dementia patient to rehab in a SNF is an exercise in futility, really. You cannot successfully 'rehab' a person with dementia b/c they cannot follow directions or remember how to do prescribed exercises, etc. As far as falls are concerned, they cannot be prevented ANYWHERE, even in your home with you there 24/7. The very nature of dementia is the patient can't remember not to do certain things, and they have no sense of danger or what it means to be 'safe'. So they fall. My mother fell 95x in Assisted Living and then Memory Care AL, and it wasn't anyone's 'fault'; there was nobody to 'blame' except her, due to dementia making her forget she was unable to walk or that she needed help getting up or in/out of bed, on/off the toilet, etc. Falls happen, no matter where they're at.
It sounds like your mother would benefit from a hospice evaluation if you'd like to keep her out of the hospital. There comes a time when hospital visits just ADD to the issues the elder faces, and rehab cannot happen either. Then what? Then hospice comes in to help you care for mom at home. But if you quit your job, then how do you pay your bills? If mom qualifies for hospice, you may be able to get her admitted into a hospice facility; you can look into that. Does she qualify for Medicaid? If so, you may be able to get her admitted into a Skilled Nursing Facility, not for rehab, but to live and to be cared for there 24/7.
You may want to sit down a Certified Elder Care Attorney for an hour for guidance with the Medicaid process, and/or to discuss your options with mom. It was one of the better decisions I'd made with regard to caring for my folks for 10.5 years.
How bad is your Mom's dementia? I would not recommend one of the necklaces as I was told that if she fell, most people with dementia wouldn't even know or remember to press the button.
We did try an Apple watch (there are others on the market now) that did fall detection. However, the better way would be to either get her strong enough to prevent the falls or get her assistance so that someone is watching her at all times.
Your Mom needs PT, physical therapy, to help figure out what areas of her body are not strong enough and to get onto a plan to try and strengthen those areas.
For the daytime, I placed my Mom in senior day care where they had her at the highest level, meaning that whenever she attempted to get up, someone rushed over to help her. At night, we used an agency whose only purpose was to prevent falls at night. I still bathed her, cooked all her meals, etc.
After 3 years, I placed my Mom into a Memory Care unit, as she was becoming more and more incontinent. In the Memory Care unit, I paid for an extra level of support to ensure she didn't fall as much. I got to the point where the uncertainty of having a nightly caregiver, plus my Mom complaining that she didn't want to pay someone to just watch her, was too much for me.
The cost of memory care, in a semi private room, was less than daily daytime adult care, 9 hours/day of caregiving, HOA, food and electricity. Then there was the intangible cost of dealing with the caregivers being sick and dealing with my Mom's complaints. Even though she is in a MC unit, I still oversee her exercise and brush her teeth.
Be realistic with what you will be able to do. Your Mom cannot live in a place by herself any longer. Good luck to you!
How about buying one of those "Help, I've fallen and I can't get up," necklaces? She has to be able to help herself, because even private care cannot prevent falls (they go to other rooms, answer the phone, spend time in the kitchen and may walk the dog or even do shopping for her).
No matter how much you are willing to give up, you cannot be the antidote to aging and physical deterioration: it is the inevitable if you don't die young.
Be realistic about what you can take on. Your mother's health is likely to decline as she ages, both physically and mentally. Do you know how to care for a person with progressing dementia who may need to be hand fed soft foods or thickened liquids and need help with managing incontinence? My mother "forgot" how to walk as her dementia advanced. Staff at the memory care unit where she was living took her around in a wheel chair. Even though she was a small person and weighed 90 lbs, it sometimes took 2 people to transfer her from the bed to the wheel chair, if she wasn't helping and was a dead weight. She may get better, more professional care at a memory care facility.
First get her out of that facility. Whether it's another facility or at home but get her out of there. Things shouldn't happen this soon in a care facility. Not knowing your personal financial situation your going to have to find possible private care. At least 2 people if possible or even 2 and someone who is an on call person whether it's family or whoever just in case you need someone in a bind or if your caregiver calls off for an emergency if you continue to work. Agencies are ridiculously expensive now. I would look for private care or use an agency for a few hours a day if you have to but they are really expensive for an entire day for an entire week. When I was working I had two private caregivers and an on call person.. the pay was manageable. But a lot of course depends on your and her financial situation. As far as being a fall risk she shouldn't be left alone at the facility. Sounds like you might need to hire someone or get a family member to be with her in the room as if she were at home. Some of these facilities don't pay proper attention to the elderly especially with dementia. If she has proper care around her in the facility or at home she would not be a fall risk. She just needs someone who knows what they are doing and can care for her properly that has experience with fall risk and dementia patients. Anytime she has a fall or accident she should be examined by the doctors there. If you quit your job you have to have your ducks in a row or at least find proper care and if it's affordable do that at home. People think these facilities will always do the right thing and they just don't sometimes. And you can't monitor what's goin on there and they can tell you anything. I've been through it and I had a caregiver go and sit with my mom in the facility until I got off. They would lie and say they did things they didn't. They would not check on her as they should have either. But with no one checking and being there they can say anything and report they did things they didn't. It's a tough situation but you need to assess your financial situation and what you can do and then the care you can provide privately or through an agency. If you do quit still bring in someone to get some rest. I've been home over 14yrs and just lost my job last year. Being home is more stressful than work. Work was somewhat of a rest place to get a breather. But you'll need someone you can trust to give you a couple of hours or more even if it's a few times a week just to keep your sanity and wherewithal. A close family member that knows the situation your in and knows you all and you trust is the best case scenario. And you could pay them something that is fair and reasonable. I hope this helps but I would say preparation and proper thought is key. It's a tough decision to quit working but in some cases it's what has to be done.
All the best and Good Luck!! I hope you find peace with everything and things work out for the best with both of you.
So sorry about your mom situation…I’m with what everyone else here says.
If mom is a fall risk, she’ll be a fall risk EVERYWHERE, but a bigger fall risk in a house which is not built or designed around a dementia senior. Something super valuable I learned on this forum also is that home family caregivers do unpaid 24/7 work ( usually ) that requires a paid TEAM in other facilities. It’s unsustainable.
My mom is a big fall risk and needs help to the point where she needs supervision literally every waking second. For this reason and others it is literally impossible for me to care for her in my place. She’s in a small facility where I LOVE the people, and even then she’s fallen a few times. Her last fall happened when a poor caregiver used the restroom. Mom probably looked like she was resting, the caregiver went to relieve herself, then up and down mom goes. They called me feeling horrible but honestly there is no way to prevent every single mishap and certainly people need to use the restroom!
Your best bet might be to find a facility designed for seniors like your mom ( easier said than done I know! ) and work on mitigating fall risks within that facility. With mom in a facility you’ll still have your hands full.
Sometimes there are no good choices, it’s about picking the least lousy option. I really wish you the best!
I'm so sorry that you and your Mom are experiencing the pain of dementia. It’s an unfortunate fact that hospitals are not good places for those living with dementia. If I were you, I would put mom in a memory care facility with a do not transport order. That means she will be receiving care at the facility and cannot be transported to a hospital without your permission. The only reason for a transport would be a severe bone break, etc. Anesthesia of any kind means an automatic decline and should be avoided. I have experience with this situation with my father who lived with and suffered from Lewy Body Dementia. I would keep her comfortable, safe, and away from any hospital situation. Hugs.
If your mom is a fall risk, she will be a fall risk no matter where she lives. If she falls while in their facility, they have to have her looked at by a dr to make sure nothing is broken. If she falls in your home, you will be doing the same thing. I don't think quitting your job and bringing her home is going to solve anything, but it will make your life more miserable.
My mom is 93 and lives next door to me. She has fallen 3x in the past 9 months (requiring medical attention each time). My elder aunt with advanced dementia has fallen in her own home 2x, breaking something each time. Someone was in the home with her each time, in one case my cousin was walking right next to her!
With dementia, she won't remember that she can't walk unassisted. Unless she goes to LTC where she is in bed most of the time and monitored more by medical staff, she will keep falling there. BUT, if you take her home, how will you move her from point A to B by yourself? Is your home 1-level living? How will YOU keep her from getting up from a chair? It is against the law to restrain someone, even in their own home or for their own safety. You can have the facility put her mattress on the floor, but once she's up and about for the day, then what? You'll have the same challenge if you take her home.
Does the admin think that LTC may be an answer? If so, your mom will need to be assessed by her doctor for this.
When you say rehab facility do you mean she was sent there initially after a hospital stay to rehab and move back home or do you mean a facility with the expectation she will remain there? Has she been living in a facility or has she been living at home? Unless this is where she came from, was living, maybe you would feel better about it if she were released to a different rehab. Being sent to rehab from the hospital means she needs services temporarily or hopefully temporarily that are best provided by healthcare professionals. If they were services that could be provided at home or by the facility she lives in believe me that’s what they would have pushed for so I would be very careful about considering taking her home and especially letting the hospital know you are considering it. If a fall was what took her there in the first place maybe they are still trying to figure out how to prevent her falls and she is likely to fall at home with you as much if not more than in rehab where they are trying to minimize it from various directions (PT, OT, meds, adjuncts…). I totally understand the urge to protect her, spare her from everything you can but it may be that finding the right rehab is the best way to do this and each time she is being released to rehab from the hospital you have the option to choose a different one, speak to the discharge coordinator about your concerns. If she already lives in a facility and is being released back to that facility there are other considerations in changing. Either way one thing you can do to try and help her transition confusion is spend as much time with her in each new place, hospital, rehab as you can. Just be with her, help the staff and get her comfortable with her surroundings and what’s happening, a familiar trusted face and advocate can go a long way in helping these shorter term transitions where they aren’t staying and are simply patients not residents, at least in my experience so far. Don’t quit your job but maybe take time off for family leave if you need to while getting her squared away. That’s what I would do anyway oh and make sure you are clear about the plan, what the doctors are thinking, talk to everyone including her regular doctors about what they are thinking and understand the reasons for everything be part of the team.
Elders fall in hospital & rehab due to unfamiliar surrounds, different lighting & noises, numerous medical issues, (TIAs, BP, vertigo, knees give way, heart issues, other reasons ++). With dementia, brain changes actually cause falls too (ie damage to balance & proprioception areas in the brain).
Depending on character, former habits & ability, many elders will attempt to climb out of bed or stand & walk from a wheelchair despite not being physically able to. They forget. Despite being warned, despite signs on the wall, despite being a double amputee (true story).
Grieve & weep over every fall. But know that even with your eyes glued to her every waking moment in your home you will not be able to prevent all falls, nor hold her up without dislocating her shoulder or injuring you both. Safer to lower to the floor.
Sorry for the doom & gloom ☹️
Be the best advocate for falls prevention strategies wherever she is instead.
If you decide to “…just take her home…” she will continue to fall, and you will either need to be beside her 24/7 or hire 24/7 staff.
If YOU are her 24/7, she will fall with you, and you yourself and/or both of you may be injured when that occurs.
You and she may have come to the point at which there is NO decision to be made about her care that will satisfy you or make her totally safe and completely comfortable.
When that point is reached, you need to attempt to determine “the best you can do.
Also, consider the fact that falls and subsequent hospitalizations may or may not be adding “….to her confusion….”. At 90, with previously diagnosed Alzheimer’s/dementia, she’s confused, and will continue to be, and although the rate of her confusion may have some ups and downs, her abilities will not improve to enough extent that she’ll be substantially different at home.
Against my own “common sense” and the advice of anyone who had the courage to speak up, I kept my mother in my home for 9 months, and it was a disaster for us both, and for her cherished grandchildren, and for my husband.
When I moved her to a local, award winning residential care center, she fell, was meticulously cared for, was treated well, enjoyed her life once again, and allowed me to live a life that was not my “normal”, but far closer than when I had lived her life with her 24/7.
You need to make a decision on her behalf that has balance for you both. Throwing your own life indefinitely into the closet to care for her isn’t “balance”.
Are you independently wealthy? And have enough to pay caregivers to help you at $30 hour to give you breaks? And also have enough left over so you could live comfortably the rest of your life? If so, it might work for you to bring mom home, but just keep in mind, besides the expense, you will basically be sacrificing your life and freedom for the rest of mom's life.
Please do not quit your job and do not have your mom move in with you. Caregiving is hard. It can take over your entire life with little or no reward and certainly zero monetary reward,. Have your mom evaluated by her PCP to ascertain whether she needs assisted living or memory care. In Colorado, the doctor has to perform tests and give orders to admit to either place. AL or MC are expensive. If your mom owns a home, sell it so she will have the funds to live in the facility. Her Social Security will offset some of the cost. Also, check the website for your state”s health department. In Colorado, the health department compares each facility by citations which is extremely helpful in selecting a good place for your mom. Another idea if a facility is not an option would be for her to age in place at her home and hire caregivers. This is expensive too. I strongly urge you not to take on caregiving yourself. Dementia is a difficult disease for both the patient and their families to cope with and it changes daily on how they deal with life. Very heart-wrenching and tiring for you to manage. Without a job, you will have no outlet. Please do not go that route. I wish the best for both you and your mom. Finding qualified care is the answer.
She is 90, falling can be a regular occurrence. If she has dementia coupled with other age related illnesses, memory care is most likely where she needs to be.
Giving up your job to become a full time caretaker is very risky at best, read around here, there are no resources to make up for a loss of income and not working will hinder your future, your mother will be gone and will have few options. It has happened over and over again.
There are times in life that we need to accept the reality of the situation and make the best of it.
My mother age 97 is in AL, my step-mother age 84 is in MC, they are where they need to be. For one I am not clinically trained for another, I will not give up my life for them, they are safe, they are well fed, they have activities and made friends, being with people their own age is also very important to their well being.
IMO there are not enough resources or breaks to make this a viable plan.
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Talk to the facility where your mom is at to see what measures they are implementing to prevent injury. Also ask how they determine which clients that do fall need to be seen by a doctor. In my hospital, we fill out forms when anybody falls. If the person who falls sustains an injury, then he or she is evaluated by a doctor - only after the nurse does a thorough examination and has significant findings of injury.
Is your Mom in pain? Like pain that is so distracting that she cannot concentrate, every movement is painful, cannot sleep well because the pain wakes her up, she cannot do exercises because it just hurts too much and affects her focus?
If so, fix the pain first. When my Mom hurt her hip (from a fall), I told them that we had to deal with the pain. Unfortunately they didn't believe me and I didn't know any better. After 3 months, I was told that the hip fracture was healed that she should have no pain from it. However, after 3 consecutive weekends at the ER, an ER doctor finally told me what he thought I already knew. It was that my Mom was suffering from severe arthritis. The realization that my Mom was a drug addict was when they administered OxyContin to help the pain and it didn't touch the pain. So my Mom and I spent the next month working with other drugs, and CBD, to reduce the arthritis pain and also eliminate the drug addiction. I could literally tell that mentally, she was getting better as she was able to focus for longer periods, understand what I was asking her, and have interest in the world again. Some of what I thought was dementia, disappeared or was reduced.
Then we started PT to help strengthen her muscles to reduce the pain of the arthritis further and get her physically able for her legs to hold her weight. A total of 3 months from the time the doctor told me about the arthritis, she was no longer completely dependent upon the wheelchair and we noticed that her muscles rapidly increased in strength where she could walk with her walker, but rarely fall (like she fell once a quarter if even that).
So, if your Mom is in intense pain, try and reduce the pain first as that might be what is holding back your Mom's recovery.
She is still in the care facility as there is no way I could provide the level of care she needs. Even if I quit my job, I would need support as I am not trained to provide the level of care she needs. As she ages, this level of care is getting more intensive.
Caring for someone is incredibly hard, emotionally, physically and financially if you need to quit your job.
If you want to care for your mom, be prepared to put you life completely on hold. Even with support it will be virtually a 24/7 job and getting increasingly more difficult. I know I couldn't do it as I have a full-time job, kids, husband and I want to enjoy this stage in my life by traveling and taking part in my kids activities. I also know that my mother is better cared for than I could do at home so for me it is a win/win situation.
Good luck whatever you choose as there is no ideal solution for everyone, only what works for you.
Hve you considered placing mom in a memory care unit and requesting a hospice consult?
The hospice team will come see her in memory care and give her extra attention and physical supports, as well as managing her meds to make sure she is comfortable.
I they find she has anxiety, they may be able to medicate her for that so that she is less restless, and that may keep her from falling as frequently.
I realize hospice is a very personal decision, but it sounds like mom is not benefitting from hospitalizations and rehab, so I'm presenting it an option to consider.
It sounds like your mother would benefit from a hospice evaluation if you'd like to keep her out of the hospital. There comes a time when hospital visits just ADD to the issues the elder faces, and rehab cannot happen either. Then what? Then hospice comes in to help you care for mom at home. But if you quit your job, then how do you pay your bills? If mom qualifies for hospice, you may be able to get her admitted into a hospice facility; you can look into that. Does she qualify for Medicaid? If so, you may be able to get her admitted into a Skilled Nursing Facility, not for rehab, but to live and to be cared for there 24/7.
You may want to sit down a Certified Elder Care Attorney for an hour for guidance with the Medicaid process, and/or to discuss your options with mom. It was one of the better decisions I'd made with regard to caring for my folks for 10.5 years.
Best of luck!
We did try an Apple watch (there are others on the market now) that did fall detection. However, the better way would be to either get her strong enough to prevent the falls or get her assistance so that someone is watching her at all times.
Your Mom needs PT, physical therapy, to help figure out what areas of her body are not strong enough and to get onto a plan to try and strengthen those areas.
For the daytime, I placed my Mom in senior day care where they had her at the highest level, meaning that whenever she attempted to get up, someone rushed over to help her. At night, we used an agency whose only purpose was to prevent falls at night. I still bathed her, cooked all her meals, etc.
After 3 years, I placed my Mom into a Memory Care unit, as she was becoming more and more incontinent. In the Memory Care unit, I paid for an extra level of support to ensure she didn't fall as much. I got to the point where the uncertainty of having a nightly caregiver, plus my Mom complaining that she didn't want to pay someone to just watch her, was too much for me.
The cost of memory care, in a semi private room, was less than daily daytime adult care, 9 hours/day of caregiving, HOA, food and electricity. Then there was the intangible cost of dealing with the caregivers being sick and dealing with my Mom's complaints. Even though she is in a MC unit, I still oversee her exercise and brush her teeth.
Be realistic with what you will be able to do. Your Mom cannot live in a place by herself any longer. Good luck to you!
No matter how much you are willing to give up, you cannot be the antidote to aging and physical deterioration: it is the inevitable if you don't die young.
All the best and Good Luck!! I hope you find peace with everything and things work out for the best with both of you.
If mom is a fall risk, she’ll be a fall risk EVERYWHERE, but a bigger fall risk in a house which is not built or designed around a dementia senior. Something super valuable I learned on this forum also is that home family caregivers do unpaid 24/7 work ( usually ) that requires a paid TEAM in other facilities. It’s unsustainable.
My mom is a big fall risk and needs help to the point where she needs supervision literally every waking second. For this reason and others it is literally impossible for me to care for her in my place. She’s in a small facility where I LOVE the people, and even then she’s fallen a few times. Her last fall happened when a poor caregiver used the restroom. Mom probably looked like she was resting, the caregiver went to relieve herself, then up and down mom goes. They called me feeling horrible but honestly there is no way to prevent every single mishap and certainly people need to use the restroom!
Your best bet might be to find a facility designed for seniors like your mom ( easier said than done I know! ) and work on mitigating fall risks within that facility. With mom in a facility you’ll still have your hands full.
Sometimes there are no good choices, it’s about picking the least lousy option. I really wish you the best!
With dementia, she won't remember that she can't walk unassisted. Unless she goes to LTC where she is in bed most of the time and monitored more by medical staff, she will keep falling there. BUT, if you take her home, how will you move her from point A to B by yourself? Is your home 1-level living? How will YOU keep her from getting up from a chair? It is against the law to restrain someone, even in their own home or for their own safety. You can have the facility put her mattress on the floor, but once she's up and about for the day, then what? You'll have the same challenge if you take her home.
Does the admin think that LTC may be an answer? If so, your mom will need to be assessed by her doctor for this.
Floor low beds + chair alarms + increased supervision = less falls.
Very hard if not impossible to avoid all falls.
Elders fall in hospital & rehab due to unfamiliar surrounds, different lighting & noises, numerous medical issues, (TIAs, BP, vertigo, knees give way, heart issues, other reasons ++). With dementia, brain changes actually cause falls too (ie damage to balance & proprioception areas in the brain).
Depending on character, former habits & ability, many elders will attempt to climb out of bed or stand & walk from a wheelchair despite not being physically able to. They forget. Despite being warned, despite signs on the wall, despite being a double amputee (true story).
Grieve & weep over every fall. But know that even with your eyes glued to her every waking moment in your home you will not be able to prevent all falls, nor hold her up without dislocating her shoulder or injuring you both. Safer to lower to the floor.
Sorry for the doom & gloom ☹️
Be the best advocate for falls prevention strategies wherever she is instead.
If you decide to “…just take her home…” she will continue to fall, and you will either need to be beside her 24/7 or hire 24/7 staff.
If YOU are her 24/7, she will fall with you, and you yourself and/or both of you may be injured when that occurs.
You and she may have come to the point at which there is NO decision to be made about her care that will satisfy you or make her totally safe and completely comfortable.
When that point is reached, you need to attempt to determine “the best you can do.
Also, consider the fact that falls and subsequent hospitalizations may or may not be adding “….to her confusion….”. At 90, with previously diagnosed Alzheimer’s/dementia, she’s confused, and will continue to be, and although the rate of her confusion may have some ups and downs, her abilities will not improve to enough extent that she’ll be substantially different at home.
Against my own “common sense” and the advice of anyone who had the courage to speak up, I kept my mother in my home for 9 months, and it was a disaster for us both, and for her cherished grandchildren, and for my husband.
When I moved her to a local, award winning residential care center, she fell, was meticulously cared for, was treated well, enjoyed her life once again, and allowed me to live a life that was not my “normal”, but far closer than when I had lived her life with her 24/7.
You need to make a decision on her behalf that has balance for you both. Throwing your own life indefinitely into the closet to care for her isn’t “balance”.
Think about it. We’re on your side.
Giving up your job to become a full time caretaker is very risky at best, read around here, there are no resources to make up for a loss of income and not working will hinder your future, your mother will be gone and will have few options. It has happened over and over again.
There are times in life that we need to accept the reality of the situation and make the best of it.
My mother age 97 is in AL, my step-mother age 84 is in MC, they are where they need to be. For one I am not clinically trained for another, I will not give up my life for them, they are safe, they are well fed, they have activities and made friends, being with people their own age is also very important to their well being.
IMO there are not enough resources or breaks to make this a viable plan.
Good Luck!