My experience is not unique, I am sure, but I share it with you to give you a "heads up" on what you might encounter in a similar situation.

As a bit of background, in 1988, my Mom lost my father to Multiple Myeloma after 42 years of marriage. They were very close and from my perspective had what I would define as an "ideal marriage". Dad was a World War II veteran and they had worked very hard to take care of each other and their immediate and extended family. They had raised two children and built a successful manufacturing business. Mom was fortunate to be in a sound financial position after Dad's passing.

After my Dad's early demise (age 63), Mom greeted life head on with a great attitude. She was active in her community, church and Sunday School, helped take care of her grandchildren, and counseled with others who had lost their mates. She sold the home that she and my Dad had lived in, and built a new house which was located closer to her family and friends. After living by herself for ten years, Mom met and married a fine gentleman in 1998 who was retired from IBM and who had lost his wife to cancer. Unfortunately, after only three short years of marriage, her new husband succumbed to cancer. Mom always said that she felt blessed to have had two fine husbands but my thoughts were "Losing two spouses to cancer - Life is not fair!"

Mom carried on with her life, weathering the inevitable changes that occur as we age including back pain from scoliosis, arthritis, a hip replacement, and severe hearing loss. She lived independently with only minor changes to her daily living routine. As the years progressed, she reduced her driving to only short trips during the daylight hours. In 2008, Mom suffered a minor stroke and had a stent implanted in a coronary artery. She was prescribed blood thinners and was under the care of her general physician and cardiologist.

In the spring of 2015, Mom got up in the early morning hours to go to the bathroom. It was only a short distance, but she tripped and fell hard on the tile floor. Realizing she was bleeding profusely from a head wound resulting from the fall, she phoned my sister, who lived only a mile away. My sister and her husband came to Mom's house (sister remarked later that "it looked like a crime scene with all of the blood") and transported Mom to the emergency room where her wound was attended to. My wife and I were called and arrived shortly thereafter. Mom's hair was a matted mess of red blood over her white hair but we thought "Mom will be ok, she always has been".

After a few days in the hospital and apparently well on the road to recovery, Mom was transported to a rehab facility for an anticipated two week stay, to make sure she was ready to move back into her home. Her blood thinner was reduced because of her fall, due to concerns that additional bleeding might occur. After just a couple of days in the rehab facility, her vital signs went awry and she was transported via ambulance back to the hospital.

After admission into the hospital, the diagnosis was that Mom had suffered a stroke, due at least in part to her blood thinner modification. The most serious effect of the stroke was an inability to swallow. A feeding tube was initially inserted through her nose and ultimately into her abdomen to provide the sustenance she needed to survive. The feeding tube was considered a short term solution with the hope that her ability to swallow would return with therapy and healing. It was at this point that my family came to the realization that our mother would likely not be able to return to her home and carry on independently as before.

After 10 days In the hospital we were told that Mom needed acute nursing care. Before discharge, a case worker provided us a list of possible nursing facilities in the area. This was uncharted territory our family so we scurried about, calling and visiting facilities which we thought might adequately meet her needs and which were also geographically close enough for us to be able to visit her regularly. The list was helpful to an extent but certainly lacking in information which might guide us in making an informed decision.

From the list provided and our research and site visits, we chose an acute nursing care facility. Mom was transported there and we visited daily. Her rehab was limited to 100 days so we knew that we would have to research options and make a decision on a facility that was best available to provide for her for this next phase of her life.

We contacted a trust officer at a major bank who assisted the elderly and their families. She provided us the name of a "concierge" to help us navigate through the morass. He was very helpful. He facilitated visits to independent living, assisted living, and skilled nursing facilities that were reasonably close.

Our situation was complicated due to Mom having a feeding tube. In general, the only facilities that will deal with a resident who can't feed themselves are skilled nursing facilities. We weren't ready to go that route so explored other alternatives. Ultimately we chose an independent living facility which would allow Mom to live in an apartment style setting. They offered a cafeteria with prepared meals, general housekeeping and an onsite company that provided caregivers who could help Mom shower, administer her medications and provide general help. Their ability was limited though regarding the feeding tube and we had to improvise with my wife, a cousin, and a caring provider who went above and beyond her responsibilities to clean the tube on a daily basis.

After a few weeks Mom recovered enough of her ability to swallow that the feeding tube could be removed. This expanded our options and enabled us to view the independent living arrangement as at least a mid-term solution. We felt fortunate that Mom didn't have to go into skilled nursing, at least not yet.

This is a long message, but even so doesn't describe the assortment of actions, deliberation, emotions, and decisions that Mom and our family encountered during this process. We have certainly learned to be nimble, prepare for the worst and hope and pray for the best.