I don't think that the SNF can just send him home- but this is primarily an insurance issue. He should get 100 days on medicare and on most plans. They can send him home early if he no longer needs skilled care but I do not think that is going to happen soon. If he needs skilled care and he has time left I do not think they are permitted to discharge him against your wishes (unless he is dangerous or a behavioral problem- something like that). Call your insurance and ask.

Whether he is better off at home is a judgment call. We had my Mom in for the full period it was covered because of the progress that she was making in therapy BUT she was okay with that. Not thrilled, but okay. She knew that the plan was for her to come home eventually, and frankly she was a little afraid of being home with an aide. The SNF was at least a known factor.

There are pros and cons of both staying at the SNF and going home. There will be less therapy and less interaction at home but more time with you. Less hands on medical care-- but a lot more actual caregiving. Now that you have had some time to think things through and come up with a plan (it will be imperfect and you will have forgotten stuff but it is a plan all the same) it is a tough and personal decision.

I know it is hard to communicate with Larry but a big part of the equation needs to be what he thinks is right for him right now.

I think that one of the hardest things as a family member and caregiver is to bear in mind that this is not our life. If I want my Mom to be my Mom and not just somebody I help take care of-- I have to treat her - whenever possible- like a thoughtful adult who makes good decisions. She is sometimes impulsive and can get confused - but when she thinks things through her decisions are rational. They may not always be what I would like (which would be to wrap her up in cotton so that she is never hurt again)-- but they are reasonable, and it is her life so her decisions matter.

This is even more important for you because Larry is your husband. You do not want to be just his caretaker - but his partner. If he is capable of understanding and letting you know his thoughts- I think his input has to be a critical factor. Talk to him about the pros and cons about coming home now versus waiting a month or two and give him time to think about it.

Glad you had a nice visit!

nun

One of the things I like about this site is that people with different ideas and opinions are comfortable sharing their thoughts - nobody is blasting anyone else for having "wrong" ideas, and you can disagree with someone without it being fatal. There are a lot of ways to approach the new life that happens when someone has a stroke, and I don't believe that there's a right or a wrong way. Different things work for different people, and I'm glad that there's a place that I can go to find out what other people have been through.

I've been talking with (well, actually, "to", not "with") Larry a lot about coming home, partly because I know he's not happy in the SNF, and partly because I want him to feel like he is involved with what's going on. It IS his life, even if he's not competent to manage it right now. I've learned to keep it upbeat and encouraging and to keep things to myself that might upset him, but I think he does want to be part of the process, even if it's in a limited capacity right now.

I like the idea of Web cams throughout the house...I'll try one in the bedroom and see how it works, and if it's good I'll see if I can get my friend to show me how to do it so that I can install them in the rest of the house. I can just picture myself with a whole bank of monitors watching everything that goes on all day! It's actually great having dual monitors, and I know I'll be more comfortable being able to keep an eye on things this way.

I've researched some of the local agencies, and did narrow it down to two. One of them told me over the phone the other day that they can provide someone within 24 hours, which is good; I suppose if push came to shove I could take whoever they can give me and then interview more over the next few days. At least I know that Larry will be cared for.

I did not realize that 48 hours is the norm. That seems like so little time! Jean, I do understand what you are saying though - changes come every day with Larry, and I see what you mean about not being able to predict what his condition will be a few weeks from now. The Hoyer lift might be the way to go; right now he can't pivot, so it's tough for Larry to use the transfer board and he needs a lot of help. A strong man can transfer him solo, but I would definitely need the lift. They did tell me that the insurance would cover that if that's what's needed, so that's a relief.

It's funny - Larry wants to come home, but does seem to understand that he needs to be where he is right now. I think he is concerned that I will have to care for him part of the time when he does come home, and that it bothers him to know how much this has changed my life. He is such a good man and a good husband, and he does not want me to have to do things for him that he knows will be tough on us both - I keep telling him that I love him and want him to come home, and that we will work it out together, and I hope that is sinking in.

xxxoo

..jm...