My Mom forced into nursing home by state not by family. Any advice?

You haven't said if u have Power of Attorney for Financial and Medical? If not, I would do it once u are back in the states. A living will and do not resuscitate would be good to. Without the medical no one has to talk to u unless your Mom has put u down as such. This is the law. When it comes to the facility they probably put her where a bed was available. They have a doctor on call. I would have your Moms primary call him to question the med change. I agree, the SW must have thought your Mom was not able to care for herself. Diabetes is tricky and needs to be controlled. Maybe your Mom is not capable at this point. So sorry you have to deal with this so far from home.

One thing about diabetes, you said that the high numbers were because she stayed up late and forgot to take her morning meds. When they took her to the hospital, they most likely did an A1C test on her. If her sugar was controlled most of the time, this test would have shown that. It covers the last three months average blood sugar levels. If they felt she was in such danger that she had to be forcibly removed from her home it was based on much more then her only missing her morning meds, but rather a history of not taking her medication or watching her carb intake. Hopefully everything is ok now, but if you're still over seas you might try to get her home by agreeing to hire a visiting nurse (insurance might cover it) or at least someone who can pop in on her a few times a week to be sure her sugar is under control and she's got the right foods in the house.

Good Luck!

Sir, What did you find out? Is your mom back home? Any of us could be in her shoes one day.

Hi, I am just going to post one more time on this thread.
I was in my mom's room one day when she was walking unassisted but with a cane, as is her usual habit, between her bed and the bathroom. Her feet got tangled and before I could get to her, she fell, hitting her head on the nightstand. After I assessed her for breaks and cleaned up the blood, DH helped me get her up and into the car, where we took her to the ER. They took a CT scan and checked her over good for breaks, and then had to sew up a cut over her left eyebrow. The plastic surgeon on call did the stitching and today you can hardly see the scar. But her face looked like she went 10 rounds with Mohammed Ali.

Old people have very thin skin and thin blood. They bruise and cut very easily. This fall happened when I was in the room with her, putting clean clothes in her drawers and getting her up and around. Yes, I felt really guilty that I wasn't close enough to try to catch her, but to tell you the truth, she might've pulled me down with her if I had tried. People get old and frail, accidents happen whether or not anyone is watching. We would all like for our parents to live forever (well, maybe not everyone) and certainly we wish for them to be healthy and happy.

If it were possible, I'm sure you would have a job where you weren't so far away for so long at a time. I'm sure you are your mother's biggest advocate. The only way to keep them totally safe from accidents would be to wrap them in bubble wrap and never allow them out of bed. That's not good or healthy either.

Good luck with whatever you decide to do.

Sounds like things are under control or in process at this posting.

I would just add that you need to have a POA to make decisions and you should make sure that PCP, hospital, police, EMT, neighbors and caregivers have your contact info on file + HIPPA signed by mom, and know you want to be involved and can legally make medical and financial decisions for mom.

I know this SW seemed over zealous, but that's their job to look out for welbeing of patient or elder. The first thing they likely asked was who had legal authority POA and HIPPA to make decisions on moms behalf.

Glad you wrote because this is a valuable lesson to all of us distant caregivers.

^^^ typo: take some time to read this section

WorriedSon, if you plan to take care of your mother full-time when you return home, or have friends take care of her, I suggest everyone take some time to reason this section from the Aging Care website.

https://www.agingcare.com/Living-With-Family

Babalou is right, falls happen everywhere. Ask your mother what happened. Talk to the nursing supervisor or director of nursing. There is a protocol whenever a patient falls, an incident or accident report should be filled out by the staff. I know you're worried, but I have seen many black eyes and sutures on the head following a fall. Have you tried to get in touch with the office of the Ombudsman? If your mother tells you she was actually assaulted by a staff member or another resident, I would be very surprised. Most nurses aids and orderlies are generally good people who are way underpaid for the work they do. To risk harming a patient who has the capacity to report such a horrific crime would be foolish. In my nursing career, I found abuse to be subtle, but these individuals were always found out and fired. Good luck with everything, Sue

Are you saying you think someone assaulted her? I've seen the results of falls (both elderly and not) that resulted in a black eye. What does your mother report happened?

I will not post a picture but this is not a fall. This is a black eye with stiches over her eyebrow. I have no choice now but to fight to get her out of there and placed somewhere safe.

Worriedson, I really do understand that you feel anxious and worried about your mom, BUT falls happen everywhere to elderly people...at home she would have fallen and unless she had round the clock aides, no one would have known about it until someone stopped by. An unwitnessed fall requires a trip to the ER (at least in the nh my mother resides in) which I think of as a good thing, because at home, my mother would have fallen and declined being looked over. In my mother's case, she fell getting up from her chair (she had forgotten that she was supposed to wait for assistance). Her roommate alerted staff. Mom thought she had "just slipped". At the hospital, they discovered a serious heart issue had caused the fall and ultimately she needed a pacemaker. Just something to think about. Did the nh call to tell you about this in other words, are they communicating with you?

In just 4 days of my mother being in the "care" of this nursing home she had a UN-WITTNESSED fall that was so bad she had to be sent to the Trauma center and receive stiches to her face. She looks like she was punched in her face. But yet I am supposed to sit back and relax because she is being taken care of ?................

well, that's not been our experience and so it's a shame that it's the way it's going.

txcamper, it IS the norm. It is an incestuous, consistent cycle in Tarrant County, TX, and other counties are catching on.

Well, good then. Your mom is being taken care of in your absence and, after all, isn't that the important thing? So, guardianship is a pretty big step.

HOWEVER, before you make that very permanent step, you should read this brochure put out by the state of Texas: http://www.dads.state.tx.us/news_info/publications/brochures/pub395-guardianship.pdf

It explains all the pro and cons of guardianship, the fact that there are different levels and what the guardian can and cannot do. He will, essentially, own your mother and can restrict your involvement in her life should you have a falling out. He will have to petition the court constantly for things and prepare statements. It is work, it isn't cheap, and in most cases is forever.

There are options, many of them are outlined in the brochure. Please read it before you do anything or make any decisions you may come to regret in three months when you return home.

Hope everything works out for you and your mother.

Thanks everyone for all the suggestions and kind words. To answer some of the questions asked :
I have been in contact by phone with my mother every day since she had her high blood sugar incident.
This was caused by her staying up too late one day and missing her morning meds.
She was taken to the ER when one of her neighbors came by to check on her.
After her stay at the hospital she was sent to rehab for a week and then dropped off at her house. No follow up.
While at rehab they took away several of her meds. Why I have no idea but the only meds they allowed her to keep where her insulin and her blood pressure meds.
This caused her to feel ill and one of my friends that assists her took my mother to the hospital.
During all this time I was in touch with the doctors and nurses. They would even call me at my office number here in Afgh, to give me updates. I spoke to the case worker at the hospital and she told me that other than my mother being diabetic she see's no reason to keep her away from her home.
Fast forward to now:
New social worker which I have never spoken too until last night.
Believe me when I say that I trust my friend when he tells me that this SW's only motive from day one was to get my mother out of her home and into a NH.
Talking ( or trying to talk without being interrupted constantly ) by this social worker makes it clear to me that my friend is being honest with me.
Every answer she gave me for any of my questions involved telling me to hire a attorney. She would not even give me a number to the probate court.
She also claims she had no idea how to contact me. Very hard to believe since I had called her a couple times and left voicemails on her cellphone. Not to mention the fact that the nurses at the hospitals where she was seen also had my contact info. So too did the 1st case worker my mother had.
I am very sad to say but the more I see what is going on the more it seems to me this is being run as a business and not something with the patients best interests in mind.
Currently I am working on having a close friend petition for guardianship while at the same time seeking legal counsel.
Thanks again every one.
I am sorry if I missed some questions asked of me but I am operating on very little sleep for the last couple of days.
I truly appreciate all the input and advice from every one here.

OhMyGod, you are certainly playing the role of Scaremonger today, aren't you?

I'm sorry if you have had a bad experience, but fortunately that is not the norm.

Well, it's been 42 hours since we first heard from worriedson. Hopefully, he has found answers to his questions. I hope he gets back with us.

One cannot contest placement once you are stuck in a facility. You have limited or no access to a telephone and you are assured this is a temporary situation (while the home is possibly being sold to a friend of APS at below market price. And of course, the nursing home resident is not told what attorneys might help or given access to money to pay the attorneys. It is a hellish nightmare. There seem to be no legal safeguards for the elderly, even if they are well educated or have legal experience. APS knows snd says they can do whatever they want.

Worried son, it sounds like the people who were helping her let you down. If they had been going there, they would have let you know APS was involved.
APS would have had a hearing before a Judge. Mom would have had a court appointed lawyer and a professional evaluation before being committed. They would have gotten reports from her MD. Something happened to your mom and your helpers were apparently not helping.

Typically - I'm not saying there is never fraud or a profit motive going on - APS will only act if a person is a very clear and present danger to themselves and others. As already mentioned, the three people who think she is "fine" could be mistaken - it is very common that some recognizes familiar people and can chat amicably, but lacks the judgement or short-term memory to manage on their own. One thing to ask yourself is if she had financial or other assets that were tempting enough for others to try to seize control over. Another is if she is functioning well enough, why is she not contesting the placement herself?

If you still face a stone wll of silence in trying to get in touch, another possibility would be to get online, hire a geriatric care coordinator and give her the mission of getting your Mom to sign a HIPAA form so you can get medical information. By default you'd think her son could get information, though, unless there is a spouse or another sibling who had been caring for her? Typically APS *wants* a family member to take charge if possible, as long as they are not part of the problem in the first place. I am sorry you are going through this and hope it all turns out for the best.

Ohhh. I have experience with Adult Protective Services in San Antonio. This is where I live. Mark Smith is a fine Probate Attorney who also handles situations like yours. He has an excellent paralegal. You ideally want someone certified in Elder Law. If your mom's home was "cluttered" and she had paths to get through the rooms or too much paper (unopened mail), APS callls this a trip or fire hazard. Almost anyone can put a frozen dinner in the microwave. But she probably needs help w/ laundry & getting food from the grocery store. APS is the adult equivalent of Child Protective Services. I am home now but if I see people coming to my door I don't know, I am better off not answering it. And because i have good insurance, they wanted to keep me in rehab, saying my front steps to my home were a problem. But i have a 3 wheel motorized scooter with a ramp going into my back door, to avoid an ugly ramp out front. APS thinks they can do anything and they pretty much can. And I had 3 sweet dogs waiting for me to come home. Your mom needs to walk as much as she can and get back her strength. Tell her to demand rehab. But she may not get it. Incontinance is the #1 reason women are placed in nursing homes. Their beds become wet and they can't put dry sheets on the beds often enough.

This is very disturbing. I was a nurse for 29 years, working primarily with the elderly in nursing homes and at home. For anyone to be removed from their home by a social worker, adult protective services had to be involved. Sometimes a patient will be placed in a facility until they are satisfied that returning home is feasible and safe. For such drastic measures to be taken there must be more to this unfortunate situation. HIPPA laws are strict. If you are not specifically named as a contact who has permission to discuss your mothers healthcare, you can't even speak to her doctors. What you could do to get that access is call your mother and see if she can give verbal permission over the phone. You should have any information about your mom such as her date of birth, address, health conditions, and anything else that may help convince the social worker that you are a relative. Good luck to you. Sue

What bothers me is what the state considers "incompetence" - someone who is physically unable to sign their name may still be competent to give assent. An inability to speak does not mean someone is incompetent. They consider you incompetent if you don't know what day it is, but how many times do "normal" people need to check? Do we always know the date and what day of the week it is? How about asking what year it is - in January??? Being unable to spell "world" backwards signifies nothing. If they know how to spell it frontwards and know what it means, they are competent - but that's not how physicians giving those tests see it. It's not right.

I was re-reading your original post and your follow up post. A couple of things jumped out at me.

Your statement: "I am my mother's only SON". Do you have sisters? Are they a part of your mother's caregiving? Could they be?

The part about arresting the friend. Was he belligerent? In my limited experience with social workers, I've never seen one threaten jail to someone who was trying to get along. You see, your friends, helpful as they may be, probably don't have any legal status. So, they are essentially useless in an emergency. And out of control diabetes is an emergency. If there is no one at home to give the level of care deemed proper for the situation, then your mother would be placed in a facility (not necessarily one that YOU would choose even given a choice), but a safe place for her to stay and get stable.

I know you are mad at yourself for not being there for her when she needed you. But with the job that you hold, what ever it is, being out of the country for months/years at a time means that you and your mother needs to make sure there are some legal guardians stateside that can help her make decisions. You can do temporary POA's I believe, that can be rescinded when you return. While you are talking to a lawyer, ask about that. Hopefully you will retain an attorney that specializes in senior law and not one that is essentially an ambulance chaser "out to get the bad guy".

Good luck and stay safe.

WorriedSon79, besides your mother having diabetes, what other health issues does she have?... your profile said general age decline but that could be anything from minor to very serious.

When was the last time you had spoken with your mother? When was the last time you had actually seen her, or have you been using computer to computer face communications. As others had mentioned, an elder can have a medical emergency very quickly.... if you haven't spoken to your mother recently maybe her memory had slipped and she had been telling the social worker she lives alone and no one comes to see her. It could be time that your mother needs 24/7 care.

Honestly, I am really surprised that you had mentioned where you work, especially since you are overseas. One has to be careful as it is too easy to connect the dots.

LOL! Thanks txcamper for giving Terryjack the credit! :) This is a good community with some really fantastic caregivers!

If you don't get a satisfactory solution with the ombudsmen, you should call your congressman and/or senators. This is one of the situations where they can actually be useful.

Terryjack suggested the long term ombudsman. Just wanted to give the proper credit. Those purple butterflies all look alike!

I imagine that you are worried, being so far away, having to deal with state agencies is at best - not good. I would not hire an attorney at this point but look to a good friend or family member that is willing to do the footwork for you - you will need to know this all anyway should you decide to hire an attorney later. Dealing with these people by phone is difficult, frustrating, time consuming and more often than not gets you nowhere. I would make sure that your advocate has the proper consent forms signed by both you and your mother giving them the authority to discuss her and her medical and social issues, have them make an appointment to visit in person with the social services director at the nursing facility where your mother is - that is going to give you the answers to your questions and give you what you need to know to proceed - make sure to give your advocate a list of questions that you want answered, why did they feel they needed to place her and what needs to be done to get her released, etc. I think from what you say that her placement had to do with her mismanagement of her medication for the diabetes and this is very common with seniors - many take the medication when and how they want and do the same with diet. It could be a simple fix, your mother needs to be evaluated to she if she is able to be trained to take her blood sugar readings, medication and dietary changes to maintain her diabetes by herself or that she needs some in home help with it, or indeed needs to be in the nursing facility. Have your advocate take lots of notes along with phone numbers and names. I would think that a primary care doctors recommendation was required for them to place her in nursing home, so that would be the next visit, and again an in person visit is going to get much more information than trying to deal with folks over the phone. Since you are so far away but want and need to know what is going on - I would have your advocate request email addresses for everyone possible - so you are able to continue any dialogue with them - email addresses are not something that doctors - nursing homes etc are readily willing to give out, but I have found that a good reason (you being out of the country) and a bit of persistence can indeed get the emails. The emails are great because then you have a record of what is being discussed.

In the meantime, your mother while she may not be happy, is safe and has no choice but to remain where she is for now, and by getting things started now you may be able to resolve the issue quickly once you return.

Should you need more help - be aware that this state agency is there to help,

Ombudsman

Contact Us

The Office of the Ombudsman is ready to assist the public with issues or complaints about health and human services programs, agencies or personnel.

If you have a problem or complaint, we encourage you to first discuss it with the person, program or office involved. Many times they can explain a specific policy or correct the problem immediately.

Clients who need assistance or information about local resources or program are encouraged to:

Call 2-1-1 for access to information about health and human services in your community including information on the location and phone number of your local agency offices.

If you have problems or complaints about a state agency health and human service or program that is not resolved to your satisfaction, there are four (4) ways to send a question or file a complaint:

Call:1-877-787-8999 (toll-free). People who have a hearing or speech disability can call any HHSC office by using the toll-free Relay Texas service at 7-1-1 or 1-800-735-2989.
Online: Online Submission Form (only works in Internet Explorer)
Mail: Texas Health and Human Services Commission
Office of the Ombudsman, MC H-700
P O Box 13247
Austin, TX 78711-3247
Fax: 1-888-780-8099 (Toll-Free)

As you can see, they also recommend starting with the agency to see if you can resolve it, I would call the 800 # to get an email address as well for them and cc them on any email discussions that you have with the nursing home, health and social services etc, they do seem to pay a bit more attention knowing that the office of the Ombudsman is involved.

Good luck, I would tread carefully at first, your Mother is under the states care and that decision was made by someone who was following the rules. You owe it to yourself and your Mother to find out all the facts prior to proceeding.