They think she had a seizure but can find no issues. She has dementia and is part paralyzed on left side. The hospital wants to send her home with pt only. There's no one there to care for her during the day. I want to refuse to take her home but the hospital said that it was abandonment. I don't no what to do from here. She is declining fast and needs more care than I can provide. What can I do?
Be prepared for a change of attitude, preceded by some quickly changing facial expressions. Standard of care is a legal standard considered in medical malpractice cases. Just the hint might cause them to be more realistic about the situation.
And don't let them bully you. Like RM, I'm really getting fed up with the manipulative tactics of hospital discharge planners and rehab social workers to shove off all the care planning on the family, and engage in a CYA move themselves.
I don't know the specific legal qualifications for abandonment, but I think your best option at this point is to state that you can't care for her, you need advice on how to get that care professionally, and ask for their recommendations. I.e., what can and will they do to help get 24/7 care, recognizing the fact that you cannot provide it. Turn the tables on them.
If they insist you take her home, ask if they'll pay you to stay home as you can't afford to quit work! (Sometimes you really have to be adamant in dealing with these people.)
And DON'T sign anything in the Discharge Instructions that commits you to provide care. I discovered that someone at the last rehab facility snuck in an "acknowledgment" in the discharge instructions that I agreed to provide 24/7 care for my father. That was never even discussed! And I read them before leaving - I'm still not sure how that into the instructions.
Of course I didn't sign them so it's not a valid assumption or commitment. But still, it really irked me, and it's on the list of issues to raise if we ever need care again.
Fortunately or unfortunately, the rehab facility is great except for the somewhat manipulative social workers. In the past I've been able to raise these issues prior to admission when the staff wants the patient and the Medicare dollars, so they've been worked out.
On the issue of having been unconscious, has anyone mentioned a syncopatic episode? She could have passed out, there might not have been any obvious cause, and that could be their assessment. Syncope was the cause of my father's falls. Despite cardiac and other post fall assessment, no determination was ever made what caused the blackouts.
You have to put on your body armor and say "that's not possible" a lot. GA is right - the doctors and therapists were terrific, but the discharge planner was a piece of work. Network with friends and family for feedback on NH - that helped us speed the selection process.
I don't know, and I don't want to depress you, but I wonder if that complicates things for you. You can certainly still refuse to collect her. But can you prevent their sending her home, I wonder?
Who found her unconscious, by the way, and what was that person doing in your house?
How long has she been living with you? Does she have another home of her own, or is this a permanent arrangement?
If it were me, I think I would:
take a brief leave of absence from work
take mother to see her GP
get an assessment of care needs done
find out what the options are
pick one.
Your mother has dementia, she is declining rapidly, you work (quite right too, no reason why you should have to give that up) and there is no one around during the day... Something's going to have to change anyway. Might as well make it sooner rather than later, don't you think?
And meanwhile, hospital is not a good place for a frail elderly lady with dementia. All things being equal you'd want her out of there as soon as possible in any case.
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