I’m taking my mom out of rehab and heading back to Australia from the U.S. We will be reliant on a private care there. What am I in for?

In one sentence, if your mother needs 24/7 care, then NO, she cannot be left alone at all, ever, under any circumstances. That alone should tell you that your mother needs more care that you are able to provide her inside of your home. That she is incapable of flying from the USA to Australia on such a long and grueling flight, that your home is not equipped to care for a person in her condition, and that you and your family are in no position to be caretakers for her.

That may sound harsh; it's intended to. You are in WAY over your head with this undertaking and have no idea what lies ahead.

Why not leave her in the USA in the Skilled Nursing Facility or in a Hospice House, and be with her there? Take time off from work and keep the vigil with mom as OTHERS care for her during her end of life journey? That is the question to ask yourself.

Sending you some hugs and prayers as you try to figure out such a huge undertaking. My heart goes out to you in this difficult time. God be with you.

Kate, I am reading all of the responses to you after my own.
The more I read the more I know that no matter what your wishes are, or your Mom's, an attempt to do this falls into the category of wishful thinking.
I don't believe this will work for ANYONE,and that includes your Mom. Well people often suffer blood clots from plane journeys this long. Imagine your Mom with her complications, and what it would mean for her.
You are saying you are reliant on private care when you get her there.
This is all not going to work, imho. I encourage you to be realistic and to rethink this.
I am so sorry for what your Mom and you are going through. She should return to care in facility now. Whether you stay or attempt to go back and forth is a moot point. I think your plans won't work. I wish it were otherwise.

The Australian side, now it’s morning and I’ve just woken up.

1) My own personal experience was flying across the USA from New York, a day’s layover in San Francisco (which I thoroughly enjoyed), a long-haul flight to Sydney, unload again with short wait, then a 2 hour flight to Adelaide, then taxi home. Then jet lag. Where are you starting and finishing? It makes quite a difference.

2) On my long haul flight SF – Sydney, the staff refused to fill my hot water bottle to help my back pain – a health hazard for them. I wondered how they made tea and coffee. You don't get much personal service on a jumbo jet.

3) My MIL came from London direct to Adelaide (with stopovers where she stayed seated on the plane). She walked onto the plane (rode her bicycle the day before she flew, last time). She had to be removed in a wheel chair by a fork lift, an hour after landing in Adelaide. I watched this from the chain fence with my current BF, my ex waited inside with his current GF and the children, trying to find out what had happened to her. With a very rapid change of allegiances, the two men eventually put her in the car, took her out at my ex’s house, and toileted her (thanking heaven for my BF’s considerably greater strength), while I drove the children back. She was totally distraught.

So that’s the flights – have you checked this in detail with the airline? I find it difficult to believe that a standard flight would accept her.

4) I sat on the Board of the SA Royal District Nursing Service, which provides in-home nursing, but not long stints. Domiciliary Care provides visits for specific tasks, but not long stints. When I was involved, the Hospice (locally called Palliative Care, which has a different US meaning) was residential in a special facility. More recently, my ex-husband had the same level of care in a NH. I haven’t heard of in-home Hospice, but I’m now out of that loop. All this is State-based, with different agencies and systems in different places, and it changes from time to time. Getting your head around it is well known as a difficult issue.

5) If your mother is as ill as she sounds, she won’t be seeing much locally – just the interior of another bedroom, hospital, or NH. Who wants to get back to Oz, her or you? If it’s her, it is ONLY in her imagination. If it’s you, extending your stay may be a trial, but it’s far easier than the trip.

6) What arrangements have you checked if you have to be unloaded part-way through the trip, or if she dies during it? Or if the airline thinks they have to do an emergency landing? What are the hospital arrangements for the few potential plane stops along the route? What insurance have you arranged for the very very substantial costs that are risked?

I think that your family (including DH who has bought a hospital bed) have pictures in your head that don’t include the bad bits. I would not do this myself, and I really really ask you to think again. At a minimum, talk seriously to the airline, not just a ticketing agency.

I hope this helps you make a good decision, yours Margaret

Could I start by asking you what support system your Mom has in the USA? Because quite honestly I cannot even begin to imagine the acuity of the conditions you are mentioned for a move to another continent, another health care system, and that is even with those folks who are taking on such a thing being PERFECTLY well, hale and hearty, and wealthy to boot to say nothing of living in an area with an acute care hospital--and a big one at that.
I just can't begin to imagine where to start.
Margaret on our site is an Aussie and I am going to search her up and ask if she'll look specifically at your post.
I am a retired RN in the USA, and I will tell you right now I have seldom looked at a post and been so instantly overwhelmed. I would not be attempting this move. I might stay here, but with two teens I don't see how.
What prognosis do you have for Mom? What is her age? What is her general personality.
I understand your WANTING to do this. I simply cannot imagine how it can all be done.
That surely isn't to say it cannot be done. I just am having a difficult time imagining.

Be realistic -- this is an impossible dream.

No commercial airline will let her fly, and a private air ambulance would probably cost $100,000.

It's time to make realistic plans and stop burning brain cells and money on a fantasy.

I would want a prognosis from her doctor. It sounds like they are telling you, in a round about way, that she is at deaths door. Is this true? Does she only have a couple of weeks left?

No matter what you do, this is going to be as stressful as you can imagine. You have to do what is the least stressful for you and not cave to her broken heart. We don't always get what we want.

What about her dying in transit? Can she sit in a plane seat for the entire trip? Can she get into a plane bathroom to use the toilet or are you going to have to change her? What about the other passengers? They aren't going to be understanding if she craps her britches and you can't change her. Are you able to deal with these issues? What if she panics and has a meltdown that causes an emergency landing and disembarkation at any close airport?

I only bring this up because you said you need to manager your stress and these are real issues traveling commercially with someone in your moms shape.

Will the airline even let her fly in her condition? Because you have purchased a ticket doesn't mean they will let you board the plane.

I would ask the doctor, "If this was your mom, would you do this?" If they say no, you shouldn't attempt it.

I am so sorry for your situation. Losing a loved is difficult and being half a world away from your home makes it that much harder.

May The Lord give you wisdom, guidance and comfort during this season.

It's wonderful that you want Mom home but start with the logistics of a 17-hour flight for an incontinent, somewhat fragile senior who's oxygen dependent(?). ~ Will you need a travel nurse?
~ Will the airline accept the liability of transporting someone who's seriously ill?
~ Has a doctor signed off on such a lengthy flight?
~ Have you looked into medical flights? They can be stupid expensive, charging thousands of dollars. But that price includes medical support on the ground and during the flight.
~ How comfortable would Mom be, having to sit at close quarters with strangers? (Thinking of the embarrassment of incontinence in a public setting)
~ Can Mom's dietary needs be met in-flight?
~ Are embolism stockings enough to prevent a blood clot on the flight?
~ How much stress will those 17+ hours put on your health?

Count the mental, physical, and financial cost. In an article about doing our best as circumstances change, someone commented that there's a gap between desire and reality. Sometimes desire has to yield to reality. Take a few deep breaths and consider the questions above if you haven't already. Others may suggest themselves.

Best wishes for you and your family.

I typed a long thing and lost it but raven pretty much covered what I had said.

Talk about stress! I really don't know how you are going to do this.
From what you wrote, your Mom is dying and you want to put her through this? I am flying economy to Alaska soon. The 1st flight is 3 hrs with a 4 1/2 hr layover and then another 6hrs on another flight. I dread having to sit 9 hrs on a plane. I wasn't made aware of our flights until we made final payment. I may have considered not doing the trip.

I cannot imagine a Doctor signing off on this. Or the airline allowing it. Mom is dying and I can't understand why u would put her thru this. Never heard of a kidney injury. If you mean kidney failure, Mom's kidney's are not functioning correctly. With that and her CHF she is probably retaining water. Which means water pills, which means peeing a lot. And do u plan on Mom sitting up for this flight.

I think it would be better you staying in the States and having hospice care for Mom in a facility. She has too much wrong with her for you to care for her in her home. Hospice in home the family does most of the caring.

Please consider this, added to all of the other valid comments you’ve received-

A time may come when there are NO GOOD DECISIONS to be made, no matter how much you OR your dear mother wants to return to Australia.

We all have dreams that we may never be able to fulfill, and owing to the very precarious nature of your mother’s numerous health issues, this dream can turn into misery in the blink of an eye. Then too, most of us, somewhere along the line while carrying for our cherished elderly either try, or consider pulling off the “miracle”.

How often that’s successful for anyone is impossible to guess, but in your mom’s situation there are so many many factors that can do nothing but impede your desire for her to be successfully returned home, and the “unknowns” not possible to consider, it just seems like doing your very best for her HERE may be the chance that offers you and her the best remaining time together.

I think in the long run that physically AND emotionally you’ll all be served best by choosing a safer, more conservative course.

Sincere thoughts and hugs to you and to her.

While your heart is in the right place, your definitely not thinking clearly.

What about Covid testing?
What about possible Covid quarantines?
What about Covid vaccinations -- yours and hers?
What about passport and visa requirements -- are you both already Australian citizens?
Are you prepared for the travel to possibly increase her problems and hasten her health deterioration? See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5288090/ for an example.

Sometimes we don't get what we want and are lucky to get what we need so forget about trying to take her back this late in her life and instead give her the best possible remaining time in the USA.