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Transition from hospital to nursing home most practical move for some

Dear Carol: My 83-year-old mother has lived with my family for two years, but her Type 1 diabetes and lung problems have been worsening. She also has severe pain from arthritis. Mom was recently hospitalized with a respiratory infection and took a long time to respond to treatment. They finally got the bacteria under control but she's very weak and her breathing needs monitoring. The doctor insisted that she should only be released to a nursing home. I asked if this was just a time for recovery but he was strong in recommending that she move there permanently. He said that she needs more nursing care than she can get at home. We have good nursing homes here, but I'm having a hard time coping with the change. Mom seems to realize that this is best, so I know that I'm the one who must adjust. Do people often go from the hospital to a nursing home as a permanent move?—KM

Dear KM: I'm sorry about your mom's ordeal in the hospital. That whole experience was obviously hard on both of you, and now the aftermath means major changes. For many of us, the need for a loved one to move into a nursing home triggers a significant grieving process. Try to give yourself emotional time to come to grips with this unsettling shift in your lives.

From what you've said, you are blessed to have quality nursing homes in your community. The doctor recognizes that your mom's overall health has slipped and, unlike many who use nursing homes for short-term stays, she isn't likely to get well enough to go back home.

The doctor's attitude about this move may seem harsh to you, but he knows that your mom is living with a combination of complicated illnesses. The respiratory illness has likely made her lungs much more vulnerable. Additionally, diabetes on its own is challenging to take care of. If she also is in pain from arthritis, her medications will have to be carefully monitored so that she has pain relief without interfering with her respiration. He's trying to do what is best for your mom's health.

From the information that you've provided, I tend to agree with the doctor. It's likely that by admitting your mom to the nursing home now you are preventing the trauma of a second move in what could turn out to be a short time.

Since your mom is happy enough with the move, she must feel safe and cared for. Visit often and get to know the staff. You will be your mom's advocate, and you can do the little extras for her that you know she enjoys. You are not giving up your role in her life.

Since professional caregivers are providing most of the hands-on care, you'll also have a chance to return to the role of a daughter rather than primary caregiver. It sounds as if your mom has adjusted and you will, too, over time.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carolbursack@msn.com.

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