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My mom will be returning home from skilled nursing today. She fuss and threw a fit until she was able to leave. The facility is recommending 24 hour care with PT and OT and medicine management but she says she can do it on her own. She can't do it on her on and she is pushing her family away. My mother is in a wheel chair and not sure how she became unable to walk, but my mom has been paranoid, delusional, she has bad behavior and it causes her to stay up with no sleep to stay on the look out for I'm not sure what. She fell asleep in a chair trying to stay up because she thinks someone is making her go to sleep, so she fell out of the chair. She could not get up. She thinks some light is beaming on her knees and other areas, or something is trying to get her. To me that's a red flag for mental impairment. So this is going to be challenging but just not sure as to how to care for her and make sure she goes to the doctor, take her medication, not unplug the phone, open her door for home health and family members. I'm worried that she is going to barricade herself in her home. It's hard to get her to sign anything to gain guardianship over her.

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This is a case where guardianship sounds like it is in order. You do not have to have her sign anything to get guardianship. You petition the probate court. You will have to have doctors submit something saying she is incompetent. It is generally expensive to get guardianship and can be paid from your mother's money. You can get guardianship without legal counsel, but you may find it easier if you do it through an attorney. Good luck with all this. You sound like a caring person, so I'm sorry you are having to go through this. Huge hugs.
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I agree about getting guardianship, but, why would the NH send her home to a place where she does not have adequate care, when she can't walk? Hmmm......

I'd consult with an attorney about your options. Are you the only family available? I'd ask about what your duties will be as a Guardian. It's a lot of work and she'll likely resist care. It's tough and stressful. You can ask the court to have someone else take over as Guardian, such as the county or another person.
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I suggest you get a mental health evaluation immediately. For some reason, healthcare workers never consider mental health. They always go for "memory issues" and alzheimers. Try to find someone who specializes in geriatric psychiatry. Who knows, if you get your mother's mental health stabilized, she may make a complete turn around. Being paranoid and seeing and hearing things is a red flag. Best wishes!
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Have her examined before she leaves. Contact an elder law attorney (www.naela.org) to ask whether she should be discharged home (her behavior may have influenced the nursing home's decision), whether a guardianship would be appropriate and how to get one in your state.
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Sounds like your mom has alzheimers and is heading into a later stage. I would recommend trying your best to get her to a doctor/ neurologist first to have her evaluated. The neurologist can test her ability to comprehend without her even knowing. Then file for guardianship through the county clerk. They will send over a guardian at litem to determin if she is incompetent. Then tackle getting her into a facility. Take it one step at a time and make sure siblings are on the same page. If your siblings are not on the same page you need to act alone and quick for your mom's safety.
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Has anyone checked her for a UTI?
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Good idea, Pwberg. While it's like there is more going on, this is certainly something that could contribute to her issues. She shouldn't be discharged from the nursing facility in this shape. I hope that you have a lot of support, realfayth. This is going to be an awful transition and you'll need all of the help that you can get.
Take care,
Carol
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I see a lot of different answers here, but I question competency for self care in her home. Have adoctor evaluate her mental status, find an elder law attorney, and consider court filings to become her guardian if she is not competent. Hold on, because this is where the party starts!
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Be sure your siblings are on the same page as you when it comes to guardianship and who gets it. Diane Dimond has written a series of articles about the losses individuals and families suffered when the siblings could not agree and the private guardianship industry took over a person's life and estate. Make sure the lawyer you speak with is not a professional in the guardianship industry if your siblings do not agree on how to help your mom and who should get guardianship. All the best to you at this difficult time!
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If she returns home without sufficient outside care, then it will be an accident/crisis waiting to happen, the high probability of a disasterous outcome.
It is often hard for adult children to confront the situation that their parent can no longer care for themselves. In this situation, you will not be able to act in her best interest by yourself. You need an evaluation of her mental status and elder law attorney. A guardianship is a painful and expensive process, but you may not have a choice.
However, I agree with others that you need to have her physical health evaluated: UTI, medication interactions--only a physician can pinpoint if there is an underlying physical condition. On the chance there might be an underlying condition, you need to find that out before you engage (pay for) an elder law attorney. If you look for an attorney make sure the person has experience in obtaining guardianships and is familiar with the court procedures in your jurisdiction. An attorney will speed up the processes required to ensure that your mother is cared for appropriately. Good luck.
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The advice to check for a UTI is great. I asked to have my mother checked for UTI at the nursing home frequently. However, from what you wrote, I think her delusions go beyond a bladder infection. I could go on and on about my mom's delusions. As time went on and her dementia worsened, I didn't even try to rationalize them. She was receiving excellent care so I knew her claims of everything from spy cameras in the heating ducts to a young man who could walk through an invisible door in her wall to have sex with her were based nowhere in reality. And having said that, and from reading your post, there is no way your mother should be released from the facility. I no of no facilities, nursing homes or rehabilitation hospitals who don't have some sort of liaison or social worker who can counsel and advise family. Ask your mother's therapists or nurses. I never had to get guardianship status for my mom. I dealt solely with the NH staff and they always called me with any issues. If she is discharged back to her home, her facility is no longer responsible for her, YOU are. I fear that, should something happen to her, Adult Protective Services could be called on you.
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I wonder what happened. It's been 9 days since the original post. I hope things are going well.
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RealFayth, how are you doing? Did your mother go home? Is she walking now? What have you and your siblings decided? Were you able to get a mental evaluation? Was she better when she got home? Let us hear how your family is managing.
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I am assuming she was in the hospital prior. Call them and see if on admission she was tested for a UTI and check with the NH. If not, u may need to do it. And reason for wheelchair. The NH probably had a lot to do with it. My Mom can walk with a walker but between thearapy sessions, they made her sit in a wheelchair. Then told us she wouldn't walk again without help. Back at the AL she was walking again with her walker unassisted. It may have been better to have left Mom at the facility. They could have done an evaluation for long-term care. Mom could have been put on a med to calm her down. You will not be able to care for her 24/7. The stress will get to u. Finding people to work around the clock is going to be hard. As posted, ur Mom needs a full evaluation. Get her to her primary right away. He can test for a UTI which is serious in the elderly.
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Are you sure she's really delusional, or is she just taking precautions to some reasonable degree? We don't know that maybe someone at the facility may not have given her a sedative, they'll make you sleep for several hours after taking it once it takes effect.

As for barricading herself in her home, maybe she has reason to believe someone is getting in or maybe someone has entered her home uninvited, and maybe the experience has scarred her mentally. Maybe she knows she's vulnerable and just needs to take extra precautions to protect herself at home.

As for not signing anything, my foster dad was the exact same way, and to some reasonable degree I don't blame them, I wouldn't want to sign away my life, rights, freedom or assess either! If she owns a house or anything else of value, I don't blame her for protecting it, so would I! Once a guardian takes over, there's no guarantee they'll  actually be honest, some of them turn into monsters, I've seen that happen. I guess you're up against a fight on this one because maybe the patient is much smarter and more competent than you may be giving her credit for! Kudos to her for what she's already doing within reason to protect herself!
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I am in the process of getting guardianship because my mother would never sign POA. She declined after she moved in and it has taken me forever to finally get to the point of filing the paperwork but i did it last week. If you have siblings meet with them and see if any of them want guardianship, if not the they all sign a waiver. I did this so this was already done when I filed the paperwork. I had the doctor do the expert evaluation for the courts and fill out the paperwork ahead of time. I had an elder lawyer and she told me 5000.00. So I checked with a new lawyer and he deals with guardianship and directives stated 800.00 if she does not contest it, 1500 if she does. My jaw dropped because I had heard how expensive it was. I can handle his cost. So different lawyers have different cost. Evidently the courts put a cap on it but lawyers can petition for more he said and they will get it because the courts approve it. Have things checked out with your mom such as UTI. It's hard when they don't want to give up the control, but it's obvious they can't do it alone. It's taken me awhile but I've learned a lot.
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Ditto with the above advice. Your mother needs to be in a mental care facility. You are going to eventually need to get legal guardianship and put her in a facility so why not do it now? With the number of caregivers she needs it will cost a LOT to keep her home. Every time one of them misses a shift, guess who will have to do it? You! And will they clean her home, do the yard work, shop, pay the bills, which she can't do? Eventually she will end up back in a care facility, so why bring her home and then have to move her again?
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Paranoia, mental health. I didn't know my mom had it. She got to the point even to distrust me, her daughter. It was painful, but now that she passed I recognize it as a mental condition. You got a lot advice to process. Breathe, take one step at a time. Best wishes.
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Good luck. Sounds similiar to our story. All the answers given are good. It all takes time to set these appts up. Most drs are 3 wks to a month out. Even if your insurance doesn't require a referral to see the new dr(s), their office will. I moved my Mom to assisted living because the wheelchair was a problem-my Mom was chair bound. Stat PT came in & in a few months she was walking again. She had a few UTI's (behavior changes, difficult to work with her, uncooperative). I stayed with her for almost a year things just kept happening. I had 24/7 companions with her because I couldn't trust my Mom. I lost my Dad during last 3 yrs & honestly, he would have been easier to have taken care of than my Mom. Nine (9) months passed & I moved her home. It is still touch & go no matter what she says, she lost about 15% brain cells from drugs given her. She still has companions helping her & my last few visits I've noticed she is aging slightly little by little. She is doing way better than NH & AL situation. My therapist says I should write a book for all the things I've learned. Take care.
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my mom had the fear of the POA as well; seen and heard too many things, even with kids

but I do wish, as well, people wouldn't just leave us hanging
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Before going for guardianship, make absolutely sure she really needs it because it may turn out that she may not actually need it if there something else correctable going on
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Hello real faith. All I can say is I am so sorry you are going through this but I want you to know that you are not alone in this type of situation. I have been fighting with my mother's doctors for the past 2 years over getting an evaluation done for her mental stability. But I was told that she has to give permission even though she has been acting irrationally and all the signs are there for everyone to see. She was in 2 nursing homes in 3 months but they sent her home because she really wanted to even with me living with her she should be somewhere where she should receive round the clock care.The second time, she was sent home under the condition that she would have home health come in. On one visit, I happened to be home. I almost died when I heard the way she was talking to the nurse. The poor woman shrugged it off but home visits ended abruptly not long after. I have been a whipping girl for the last few years. I was criticized just last week by some readers on this site for being inappropriate because I said I was discouraged because I am constantly being verbally abused and accused. She told one nurse that my husband and I had told her doctor to give her a shot to put her to sleep. I wish you peace and hope that you will find a solution to this. I can tell you are a compassionate person and are a devoted caregiver. Koko12
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It sounds like she has a type of dementia. My mom had to go into rehab at a nursing home. She got zero medical care. They completely ignored her. She sat in and slept in the same clothes and underwear for nine days. There is a lot more that went on. She came home worse than ever. Regardless, you have the medical records. See an eldercare attorney. You may just need a medical power of attorney and a power of attorney for her finances. This way you can demand she gets the help she needs. You can offer her that or the guardianship. POA's you work together. Guardianship she makes zero decisions. Dementia medication can help so much. You might be able to turn this around, but you must work quickly before she burns her house down, wanders away from home....
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The patient definitely needs a mental eval. Delusional behavior has taken over her mind and is a threat to her well being.
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Bring y
Ou concerns to her M.D., she may have dementia. People with dementia seem to see, hear and believe things that are not there and aren't true, but to them it is very real. I am going thru the same thing with my husband, he thinks the doctors are out to get him so they decided to diagnose him with dementia. This way, the doctors look good and get attention for diagnosing him. Find a Geriatrician psychiatrist who is familiar with diagnosing and testing people for dementia.
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