Dear Family Resource,
My family is in a tug-of-war over our mother’s care. Mom is 82 and in a Rehabilitation Center recovering from a stroke which left her with limited use of her left arm and leg. She’s getting physical and occupational therapy but when she gets home she’ll need help. The problem is my siblings and I can’t agree on what to do. One brother wants mom to have a full-time live-in caregiver and because he’s offered to pay, he thinks the decision is all his. My sister and I think mom should go to a retirement home for a while where she’ll get help with things like laundry and won’t have to cook or clean. My youngest brother wants to move into mom’s house and “help out.” This brother is unemployed and not very responsible and the rest of us are worried that if he moves in, he’ll just mooch off mom and never move out. What do you think we should do when mom gets out?
~Siblings at War

Dear Siblings,
Your mom is lucky to have children who care about her, but it seems to me there’s something missing in the picture, and that is “what does your mom want?” Have you and your siblings spoken to her about this? She may know that she’ll need help when she gets home and may have her own thoughts about it. The Rehabilitation Center (also known as a skilled nursing facility) serves as the transition between hospital and home. Their discharge planner will speak with you and your mom about what she’ll need, once home, in order to continue her progress toward greater mobility and independence. Providing a list of equipment needs and information on home therapy is part of their job. They’re not going to release your mom until she’s ready, and the transition will be more clear after you meet with the discharge planner.

If your mom is making good progress, she will be discharged home with skilled care, most likely a physical and occupational therapist, with additional help to be provided by family members or a home care agency. While it’s possible they’ll recommend that your mom initially have 24-hour help, as a skilled nursing facility, they’re unlikely to recommend that she move to another facility (retirement or nursing home) before going home.

As you suggest in your letter, it’s also probably not a good idea for your younger brother to move in with her. The last thing your mom needs is someone she has to take care of. Your other brother wants your mom to have a caregiver. I think this is something worth discussing. At Family Resource Home Care, we work with people like your mom every day. The beauty of our services is your mom can choose a caregiver with whom she’s comfortable, and the caregiver can work just the number of hours your family decides is needed. At some time if your mom needs more or fewer hours, that can be arranged with one phone call. But one step at a time.

Right now I urge you, your siblings, and your mom to meet with the discharge planner at the Rehab Center. You may find that most of your questions will be answered. And if then you want to consider home care services for your mom, please give me a call. I’d be happy to help you explore your options.

~Family Resource