For the daughter who promised
She made you promise. No nursing home, not ever.
It is 2am and you have work in the morning. She said never put me in a home, and you said okay. Now you are trying to learn whether this house can even hold that promise, and whether you can keep it without quitting your life.
This site is for that hour. It is not a ranking of nursing homes. It walks the question the way you have to walk it: what she needs, which needs this house can hold, and where it needs hands it does not have. Some of that is paper. Some of it is a person awake at night who is not you.
The keep-her-here ladder
What this house can hold tonight, rung by rung
The National Institute on Aging says the three most common places people die are at home, in a hospital, or in a care facility. So the question is not whether home is allowed but whether each rung below holds. Read the left side first; the right side is a question for her care team, not a verdict.
- 1
The stairs
This house holds it whenHer bed, a toilet and a chair are on one floor, or can be by the end of the week. A dining room with a bed in it is a plan.
Ask the care team whenThe only bathroom is upstairs and she cannot manage the flight even with help. Ask what equipment would change that.
- 2
The bathroom
This house holds it whenShe can reach the toilet with help, or a commode stands where she sleeps, and someone is there for the trip at night.
Ask the care team whenBathing and toileting need two people, or skin is breaking down. Ask who orders a bed and a commode.
- 3
The bed
This house holds it whenSomeone can help her turn, and there is room to reach both sides of the bed. A hospital bed can be delivered to a living room.
Ask the care team whenNobody in the house can move her safely. Ask what a home health or hospice team would bring, and what they would not.
- 4
Food she will accept
This house holds it whenMeals she likes, someone to warm them, and no rule that she has to finish. Small, often, her choice.
Ask the care team whenShe is not eating or drinking much and you do not know whether that is normal for where she is. Ask her doctor or nurse.
- 5
Someone awake at night
This house holds it whenA person is in the house from bedtime to morning so that you sleep: family in rotation, paid overnight help, or both.
Ask the care team whenNights bring pain, breathing trouble or confusion nobody knows how to answer. A sitter can be present; the answers come from the clinician.
- 6
A way to reach her clinician
This house holds it whenYou know who to call at 3am and the number answers. Her papers are on the fridge and in your phone.
Ask the care team whenYou do not have that number yet. Ask for it before the next discharge, not after.
One or two rungs that do not hold is the shape of the help you need, not the end of the promise. Medicare does not pay for 24-hour-a-day care at home or for help with daily living when that is the only care needed, which is why the missing rungs are so often bathing, meals and the night. In Missouri that gap is private duty care, paid privately, with no physician order needed for aide, respite or companion help.
The articles, in the order the night goes
Start where you are
The promise
In your wordspromise me no nursing home
She made you promise: no nursing home
A wish you can plan around, not a forecast. What Missouri lets her write down.
In your wordscan you die at home instead of nursing home
Can you die at home instead of a nursing home in St. Louis?
Yes, when hands, equipment and a care team are in place. Who arranges each.
In your wordscan a house actually hold dying parent
Can a house actually hold a dying parent?
The ladder above, walked slowly: stairs, bathroom, bed, food, the night, the phone.
Paper and money
In your wordshow to plan for dying at home
How to plan for dying at home in Missouri
The free Missouri Bar form, agent versus directive, and where the copies go.
In your wordscan i keep her at home without quitting my job
Keep her here without quitting your job
You cannot be the night shift and the morning employee. Who fills the hours.
In your wordskeep mom home last months
Keep Mom home for the last months: Veterans and homemaker aides
If she or her late husband served, VA aides and the Aid and Attendance add-on may cover some hours.
In your wordswhat do i need to keep dad home
What do I need to keep Dad home?
Missouri names three kinds of care in the home. Which one covers the night.
When the hospital calls
In your wordshospital discharging her, she won't go to a facility
The hospital is discharging her and she won't go to a facility
A planner names a nursing home because the hospital bed is ending. What to ask.
When the promise needs more hands than family
Tell us the town and someone will call you
This form goes to New Plan Care, the paid placement above. It is the only form on this site and it is not a match service. If you would rather talk than type, Call (314) 405-0887.
We ask nothing about her health; do not type any of it here.
Elsewhere
If the nights are about falls, Mom Keeps Falling walks that house. If she leaves without knowing where she is going, Mom Wanders is for that.