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My friend's grandmother is in a caregiving facility, she wants to get out, she was diagnosed with dementia. He wants to take her out, the insurance people have allowed for him to take her out every so often so she can get used to it. He is trying to fulfill her wish of taking her out of that place. Her son and daughter don't visit. Does he need a power of attorney to get her out? He wants to take care of her. Does he need power of attorney to take care of her? How can he get a power of attorney if she has been diagnosed with dementia? She still remembers him, remembers the house, and is pretty much interactive the great grandkids. What can my friend do to enhance his grandma's living situation?

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You have to remember that the elder is not the person in control here so "she wants to get out" is a moot point. She is in the NH for a reason and that is round-the-clock care.
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nature 73. Thank you. Will look into Center for Medicare and Medicaid. We have used the Ombudsman Program and they sent me to the the Licensing Agency regarding failure to administer eyedrops. The Agency the Facility used to complain about me found Mother and I have a good Mother - daughter relationship. They treated me fairly but I am reluctant to use the Agency the facility uses as the Administrator brags in public that she has the system stacked in her favor and that she does not worry about anyone.
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All I see is that American system is broken & not going to be fixed soon - this will lead to working poor [who are taking care of loved ones] & very rich who are sucking $$$ out of system into their coffers as they 'invest' in these place
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daughterlu - sounds like you're in a really tough situation. Have you contacted Center for Medicare & Medicaid Services? Long term care facilities are surveyed annually, but will come in unannounced based on a complaint. The facility then has a limited amount of time to correct the problem(s).
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Grammyteacher, all I can say is God Love You. There is no way I could have worked and took care of my Mom too. I get too overwhelmed. But all remember...this woman has three small children. That in itself is time consuming and then add to that an adult you have to care for. It all sounds logical until you have to do it. She should be kept where she is. Just visit a lot.
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I have a very different bend. I and 24/7 caregiver for my mom in stage 7 Alzheimer's. It can be done in home without paid caregivers. I am blessed to work mostly from home and have supportive family. When I have meetings my husband or daughters take care if mom. Your friend would need to understand and be totally prepared. Let me start by saying I am caring for my mom out of unconditional love and will continue until she leaves this world. Here is how my life runs. I get up at 5. Do a couple hours of work. Get mom up at 7. I go into her room, say good morning, set everything up, her tooth brush, her pad (diaper), wipes, gloves, bag for old pad, clean clothes, wheelchair (she has been immobile for 2 years).... I change her pad, (she has a hospital bed). During this process she is usually yelling at me, calling me names, etc. I tell her each step as I do it, talk in a calm voice, tell her I love her. She needs to be cleaned up and dressed. It can be quite messy. I brush her teeth and hair. Teeth are challenging as she doesn't remember to keep her mother open and often bites the brush. At this point my mom it double incontinent and her body isn't always remembering to poop. I have to balance meds to keep her going but not too much and loosing potassium and vitamins, also too much fluid. This took some learning and trial and error. I am blessed to have a daughter who is a nutritionist in a nursing home, a daughter who is a speech language pathologist specializing in feeding, and a son who is a doctor. They trouble shoot with me. Once she is dressed I wheel for to the kitchen and fix her breakfast which I hand feed her, she hasn't been able to feed herself for about a year. She then is moved to a recliner. We have alternate pressure mattress pads on both her bed and recliner. We need to change her position every 2 hours, change her pad every 3 hours. I feed her 3 meals and 2 snacks...she only eats a little bit at a time. We also give her 2 ensure plus per day. We bathe her 3 times per week and wash her hair once a week. It takes 2 people to bathe her. My mom really enjoyed me caring for her early in the disease, but as it progressed, her dislike of me increased. It is the disease. You have have to be prepared for all that can come your way, financially, physically, and emotionally. My mom is in my home now, but we cared for her in her home for years first. She started saying she wanted to go home, when she was still staying in her home....we decided to move her because it made our life easier...we have more support here (her house is 45 minutes away). If your friends gma is saying she wants to go home, just understand that she may say that even if she is in her own home. In home caregiving is possible and can be good for the patient, but the caregiver needs to be totally prepared for all that it involves. And remember, this condition progresses....it only gets worse until they leave this earth.
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If your friend persists in trying to 'spring' his grandmother from the facility, he will regret it deeply. Within a month he will be desperately trying to get her re-admitted. He may have good intentions, but he doesn't realize his grandmother is now not the person he grew up knowing. In spite of moments of lucidity, it will all go inexorably downhill and frankly, turn into a real disaster. She is better off with him visiting and checking up on her.
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I, too am taking care of my Mom. Have been investigated myself 3 times from false allegations that my Mother said and later recanted. The hassle of detectives and social workers is unbelievable. If your parent is in a home, leave them there. If it is a bad one, move them to another. I wish I never took her from her place. Now, I have her here- found out she could of had all the help, plus more if I had left her in her home. my mother hates it here and has from day one. Resentful every single day but doesn't want to leave. Been doing it for 3 yrs now and she has made it seem like 20yrs. No, she doesn't have demensia but fell alot which is why I moved her here.
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My Mother is in Personal Care. I am with her everyday from 8 am to 8 pm. she is happy there with me there. I would like her to come home with me. She likes it here too. It would be easier on me to have her here then commuting every day and having to deal with craziness of institutional care. . How she went from Independent Living to Personal Care is a crime. .The facility injured her in forced physical therapy, she went from the hospital to their health Care Center where she developed pnemonia without the assigned facility Dr. ever once stopping in to see her. We had to call 911. Back in I.L. for 3 months recuperating when false accusations against me were brought to get her out of her I.L. Apartment and in to the Health Care Center to be placed in PC. The Nurses Aid I left her with verified with me that Mother was in a dry bed when I left for the Dr. appointment and in a dry bed when she was called off the case and another Nurses Aid took over that morning. I was blamed for leaving mother in a wet bed on a pretext to move her to Personal Care. The cost is exorbanent especially when we needed a Nurses Aid through the night for 3 months. I took 16 hours a day. Among the faults is that the Kitchen can make great food that is served elegantly in Independent Living. The Personal Care food would cause riots if served in a prison. (Thanksgiving meal was a rare exception in PC). Staff can be impatient. The worst is that we are dealing with Mother's eyedrops have not been properly administered. An RN was giving my Mom the wrong drops in the morning and failing to give two doses per day on one prescribed eyedrop and giving the second eyedrop in the morning instead of at night. Mother had a visual hallucination which corresponds with a syndrome that that I wrote about as a question to AgingCare. I got good answers and confirmation that where Mother has had a decline in her eyesight since being moved to PC it most likely is the lack of care she is being given.in PC. We will be seeing Mother's eye Dr this coming week. Suggestions are that I ask him to make me responsible for giving her eyedrops. I never missed a dose in the 1 1/2 years I was giving her drops in IL. The point is the facilities, while a convenience for a family is not the same as a beloved parent or grandparent being at home surrounded by love. The time Mother and I spend together is a blessing. At home I could have assistance as needed. When a family cannot afford a Nurses Aid there is government assistance. I know a person who takes care of a loved one. They were hired by an agency and they are paid to take care of their family loved one. Are the facilities in answers above that different than where Mother is? or, do families assume good care? A parent with dementia might not remember bad things. How much time does the average visitor to a memory or PC unit spend with their loved one? An ombudsman might be able to direct your friend how to get his grandmother out of the facility. They have experience and knowledge in this fiel. They are mediators.
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My Mom has asked to go home, and I tell her the AL is her home. Gma is where she is for a reason. I had my Mom almost two years and I'm retired. Can't imagine how it would have been if I had a job.
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My mom also wants to move so I told I was looking but because of wheelchair any place needed special items, so she said 'what wheelchair' to which I responded 'the one you are sitting in' she looked down & said 'I don't need this' but she can't walk!

However 1 thing is the interaction with other people - mom says she is bored but I checked & she does 10 plus activities a week + any religious service of her religion - this young man won't be able to do that many with her so he should take that under consideration when he balances the issue

Promises are nice but sometimes they shouldn't be treated as carved in rock - we all have promised our kids things that we were unable to fulfill so to our promises to those with dementia which were said in good faith but life has a way of changing things to make following through on them unreasonable any longer
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The original question did not involve pets so I am wondering why people are responding to the issue of pets in care facilities.
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My Dad lived in Assisted Living/Memory Care and he loved it there... prior to that he was in the same complex Independent Living section. Both sections allowed a pet, so there were quite a few dogs being walked outside... either by the resident or if they were in Memory Care, by a dog walker.

Dad's senior living was so nice, I was ready to sign up for myself :)
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I struggle with this daily as my Mom doesn't understand why none of her children will take her in. She has been in a memory care facility for 7 months, after living with me for 10 months (!). She cannot walk far without falling and doesn't realize she needs her walker. Each time I bring her to our home I realize how difficult it would be (if not impossible) without 24 hour care. When she lived here, I had cameras in her room and the main living areas. She was walking better then. Now her gait is considerably more unsteady. Even then, when she fell, I could not get her up. I had to call the fire department many times. The disease progresses. All of them hate being in a memory care facility but it is the best thing for them if you can afford it. I visit her 2-3 hours daily and have hired one-on-one caregivers for another 4-5 hours most days. It's expensive but worth it if you can afford it.
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First of all, lotsofquestions says the lady is already in a caregiving facility. I doubt if she has any pets, but I do understand what you're saying since I feel the same way about my animals. Secondly, my mom (who had dementia) ALWAYS received exemplary care at her facility. In the three and one- half years she was there, I never had any issues with her staff or her care.

Having dealt with mother-in-law, father-in-law and mother who all had dementia, every one of them begged to go "home", but when asked, not one knew where "home" was. In my mom's case, she wanted to go home and live with her parents.

I do agree with you about the POA. And would also hope that one of the trusted relatives has their name on a joint account with the lady.
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Contrary to the majority, but here goes. First things first: Yes, in my paralegal opinion, he does need a power of arrorney. Would one of the relatives who is paying for the nursing home let you do this? If not, you're out of luck. Visit often and bring her some things from home to make her feel better. Also, if she will let you try to check that she doesn't have any sores anywhere. Nursing Homes are notorious for not taking good care of dementia patients because they can't complain effectively..

For those of you insisting on saying "nononono", try to put yourself in the patient's place. I'm 75, so can, easily: Perhaps she has a pet or more at home. I would rather you just kill me right off than put me anywhere that I can't have my pets with me. It is possible to have lesser skilled people caring for her than R.N.'s, with medical assistance on call. It takes a lot of screening and background checks, along with getting the grandmother's acceptance, but it's worth making her happier in her last days.

Please don't ALL be so judgmental; I've worked in hospitals, and I know what I'm talking about.
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As honorable as you make your friend sound, everyone is correct. Visit her often and leave her in the care facility.
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You have received excellent advice from the other posters. My mom passed last week. She had dementia and had been in a nursing home for 3 years. I suffered from feelings of guilt for a long while. I had friends who kept their parents in their homes. As my mom's dementia progressed, she became more and more delusional. She also became combative and started to wander off. The first step was an ankle bracelet which she promptly cut off. The next step was lockdown in the dementia unit. Taking care of someone with dementia is a 24/7/365 responsibility. Even with in-home health aides, whom he'd have to employ full time and can be pricey, it's still a monumental undertaking. In my humble opinion, she is where she needs to be. However, as for Power of Attorney, someone in the family should have it. Is he sure no one does?
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Unless your friend is willing to give up his life, his freedom, and spend a lot of money for caregivers I don't recommend the proposed action. I do 24/7/365 care for my dad who has some of the same symptoms described. It's exhausting and takes more than a little fortitude. I've done this for almost 4 years now. I'm keeping a promise, but it's very, very, very demanding.
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Lotsofquestions, there is a reason why your friend's grandmother is in a continuing care facility, she needs a higher level of care then what your friend can give. Unless your friend will be hiring and paying 3 shifts of caregivers to take care of his grandmother, and he sets up his home similar to that of a nursing home. My Dad had 3 shifts of caregivers from a licensed Agency and it cost him $20k per month.

As for Power of Attorney, the only way your friend can get POA is for his Grandmother to give him Power of Attorney, but she would need to be able to understand the legal document before an Attorney would allow her to sign on the dotted line.

If another relative has POA, your friend could get permission to remove Grandmother [which I don't recommend] and get permission to take care of her at his home. It would be much easier if he did have complete POA but it probably is too late now.

With dementia, Grandmother could be doing what is called "showboating" which means she is "acting" normal around guest, but once back at the continuing care facility, she could be confused and/or have "sundowning". Sundowning means in late afternoon or early evening the person gets really confused [my Dad had that].

Plus with dementia, it can progress quickly to another stage if a person is physically moved into a new environment, even if it is a house she's been in many time before.

By the way, it is very normal for an elder [with or without dementia] to want to move back home or out of a facility.... but in most cases "home" is where they lived as children. And in some cases the elder doesn't understand they can no longer live in and maintain a house on their own.
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If she is in need of 24/7 care and cannot be alone, that is why she is in a nursing home. Enhance her life right where she is. Your friend should keep working to support himself and not give up his life to care for her. If he takes her out, she won't like his place either. Honest.
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