I have been caring for mom for 14 years now, however, it is becoming dangerous for her and my family. She is denied Medicaid. Makes too much money. The immediate issue is that the hospital is releasing her and when I told them she cannot come back here, they said either I pick her up or they will deliver her by sheriff. Can they do that?
1) OP's mom has advanced dementia
2) mom's been in the hospital for psych eval
3) mom's income ($1400) > Medicaid limit
4) mom's income way < MC facility ($4000)
5) mom has no house, no assets of any kind - no spend down or home sale
6) mom is dangerous to have in home with minor children (and adults!)
7) there is no Miller trust in NC
8) OP has appt with EC next week
9) OP did NOT dump mom at the ER or hospital
10) OP WANTS appropriate placement for mom
I've probably missed a few points, but the above covers most.
Rehab won't be an option, she isn't "recovering" from a treatable medical condition. Medicare is cracking down on ALL rehab, but this wouldn't qualify.
Mom can't afford LTC. Her income exceeds Medicaid limit in NC.
This is a place TOO many people are in (kind of like the donut-hole for Medicare drug coverage.) Income too high for Medicaid, not nearly enough for ANY kind of LTC care. SS is NOT going to cover the cost of LTC - it was only intended as a buffer for those with little or no retirement income. Not everyone has a great job with great benefits and ability to save large amounts of money to cover this kind of care. It's only going to get worse as more pensions go the way of the dodo bird (not everyone had one to begin with!) Sure, investments are great at the moment, as they were before 2008. We all know what happened then, eh?
The moral of the story is that you need to stay calm, and enlist the experts that are available to help you discover options. Sort through them and ask every question you can think of. I don't know why the OP's hospital wasn't more helpful, and I don't know why these options aren't part of the initial conversation as a general rule. It would certainly make things easier.
It would be lovely if we didn't have to become so aggressive just to get the answers we need to make good decisions. But, that's not the reality. Advocacy for your loved ones - and yourself - is not an easy road, and it's essential to be tenacious while traveling it.
Unfortunately, these types of situations are becoming increasingly common. There was a story this week that a N.C. NH discharged an elderly man with only 25 mins notice to his daughter due to nonpayment by insurance. They called her and told her to pick him up in 25 minutes. She was at work and unable to leave and explained that it was not possible. So, the NH arranged for wheelchair transport which left the disabled senior in front of her house. She found him crying and screaming and soaking wet from a passing storm upon her return home. They never notified her that they were transporting him. The medical system hasn’t been about people or caring for a long time. The best way to protect yourself is to have a lawyer because finding someone to help or intervene on your behalf is nearly impossible.
In the eyes of the law, your home is her home. She has had legal tenancy for over a decade. Worst case scenario, she returns...any time she is violent or displays a threat to herself or you and your family, call 911. Get video of each episode. It is possible to have her removed from the home for an involuntary psych admission. At that point you may have more leverage in refusing her return.
In my case, I had a very similar experience with my aunt with dementia. She lived in my home with my children and I but became increasingly angry and violent. One day she struck my daughter. I contacted every NH within 30 miles and was fortunate enough to find one that would take her. She was out of my house within 24 hrs. I packed some things and delivered her myself. The attorney was able to get her on Medicaid through legal spend down of assets, etc. It was awful so I appreciate what you’re experiencing. No one else in the family would step up and they in fact, made it more difficult.
Sending you strength and courage to get through this. Keep us updated.
I would call that person, and tell them you are recording the call (and do so). State the date, your name, your mother's name, the name of the hospital and ask that person to state their name. Inform that a copy of the recording will be going to your lawyers office.
Then proceed to tell them your mother can not be safely discharged to your home and that she has been violent in your home. Any push back and just state again- this is not a safe discharge to my residence at (say your address) for (mother's name).
If they keep pushing, repeat above and then say that is all you have to say and end the call.
See if that changes anything.
You keep saying...
She has dementia WITH behaviors (this is a medical term that should indicate to anyone who works in geriatrics, etc that the dementia has a danger component to it) that are escalating. Not only would she not be safe in YOUR home, you do not feel safe. As much as you love her, you cannot allow someone to come back in who has demonstrated such aggression to your child. And then go up the hospital food chain... say you have put a call in to an attorney as this staff member appears to be trying to strong arm you. Tell the next level up that you have told this person repeatedly that you will not accept responsibility for someone who needs far more care than you can provide because it would be unsafe for your mother, that you have made it clear that you can no longer continue to have the patient stay with you because of the DANGER they present to your MINOR children. That no one will be allowed to force their way into your home... you have been kindly allowing her to stay there, but between her increased needs and aggression to you and your minor children, it is no longer an option.
I might throw in that you are concerned that this facility may not realize it has employees that are possibly not trained well enough for their positions to be able to engage and assist their patients without resorting to threats. That could leave the hospital very vulnerable to lawsuits.
You would much prefer to work with the hospital (they through their contacts) to help get your mother settled into an APPROPRIATE environment. This should not be something they are unequipped to help with.
After you have been firm, reiterate that you both have the same goal, that mother is discharged to an appropriate environment that is safe for her and those around her. How do we work toward that goal?
You want to look reasonable, logical and calm to the hospital, the sheriff and the attorney you end up using. The hospital should be in a defensive position, not you.
The eviction type thing could be an issue, but keep reinforcing unsafe discharge and danger to minors. And keep your house unavailable to anyone trying to bring her back to stay with you.
I hope someone responds with more firsthand knowledge... I just wanted to throw out some language that might get results for you BEFORE something major happens. Best wishes.