Things Fall Apart-- Deciding on Long Term Care

Diva Sister in the Toyota Bread Truck

Well, Diva Sister got the good news from her doctor yesterday that she could be discharged from the skilled nursing rehab center.  Looks like she will be shaking the joint next Tuesday, god help us all.  Of course she's happy but, as her caregiver, I have major concerns about how successful going home is going to be.  In a previous post I mentioned a couple of assessments that are used by health professionals and family members to decide if a person is able to live safely and independently in his or her own home.  You may find these criteria useful if you're in the no win situation of deciding if your family member needs long term care:

ADLs--Activities of Daily Living- if you cannot, w/o assistance
1.  use the toilet
2.  eat
3.  dress
4.  bathe
5.  groom
6.  get out of bed
7.  get out of a chair
8.  walk
then you lack the capacity for basic physical independence.

IADLs - Independent Activities of Daily Living- if you cannot
1.  shop for yourself
2.  prepare your own food
3.  maintain your housekeeping
4.  do your laundry
5.  manage your medications
6.  make phone calls
7.  handle your own finances
8.  travel on your own
then you lack the capacity to live safely on your own.

Of course, deciding just how many of these activities your relative or friend must be able to do is an individual decision, but most assessments recommend that you should be able to do all the ADLs. I have been observing Diva Sister for many years and gradually handling most of these tasks for her.  I have not found a long term facility willing to go through all that I know about Diva's abilities.  So, on March 13 we'll load up all her stuff in the Toyota Bread Truck and head back to her apartment.  We have a 30 day window for the re-hab center to accept her back in long term care if things fall apart.  god help us all, they will. . .