My 81 year old friend is the the hospital for mixing up (she took too much) her dementia and high blood pressure medications. After five weeks in the hospital, she is doing very well on the dementia med they are giving her. She is very aware of what happened and able to hold a coherent conversation. We are only allowed to talk to her on the phone due to COVID. The hospital assessment she was given five weeks ago determined beginning stages of dementia. Based on that assessment, the doctor reported to social services that she needs to be in assisted living. Shouldn't she be reassessed? Should I seek another opinion? Social services wants me to be her guardian as soon as the courts open back up, so if she needs assisted living, I need to be looking for a place. She is in great physical shape, but does need help organizing her bills and checkbook. She also gets confused with the controls to her heat pump.
You can call the local agency and ask to speak to someone about this issue. They may not be able to assign a social worker to do case management right now but these folks, in my experience, are a great resource.
I think the SW is assuming a lot. Medicaid usually does not pay for an assisted living. It depends on the State. Als are usually private pay. Medicaid pays for Nursing homes. So if friend has no money, the only option is a NH unless ur state has waivers for ALs.
Yes, your friend needs more care. Not sure how old ur but I am 70. After being POA for Mom and now a nephew, I would not take on the responsibility of guardianship. The other option u have is that you tell the SW you cannot take on the responsibility or expense. Then it will be up to the SW to petition the courts for a guardian for your friend. The SW will be able to get things done that will take you longer for you. Shre is just trying to get someone else to do her job.
She may need some help for a while and she may need help from now on, it all depends on what she has and how well she is cared for, like mismanagement of meds and improper nutrition can be life changers. Help her find what she really needs and how to get that, unfortunately her wants are not the most important thing. Nothing wrong with her needing help, we all do occasionally.
Can you tell us where you are geographically?
You will have total control of your friend's person and finances. You will have to file a report each year as to how her money is being used. You will need to make sure that she is safe (as in, If she decides that she wants to leave a non-locked AL facility, you are responsible for the fact that she has become endangered).
There is something here that is not adding up. You are describing someone who needs a little bit of help. The professionals are urging a level of conservatorship that basically makes this person your child.
I think you need to investigate further what her needs are.
The State, or a facility can become her guardian, as an alternative to you
The nurse that will evaluate her if she goes to a certain facility was once the nurse of the doctor from the hospital that suggested that home.
I don't know where to go for help.
Being someone's guardian means that you are RESPONSIBLE for every aspect of their life and there are pretty stringent reporting requirements. Is that what the social worker is asking you to do?
In that case, the switch must have a pretty clear sense that your friend is no longer competent to run her own life.
I am not taking this lightly and I want what is best for her.
When you said "stringent reporting requirements," can you explain that more?
And she can't manage her heat? How does she manage her stove?
Does she need Assisted living or does she need an Independent Living facility and someone to help with paying bills and sorting meds?
You need for someone to figure out what level of care she needs. You can get a needs assessment from her local Area agency on Aging or one can be arranged through the hospital discharge planners.
What she can no longer do is live alone and manage her own meds.
What kind of assessment was done initially? In most states, a very thorough assessment of cognitive, reasoning and self care skills is done before a declaration of incompetence is made.
Has a lawyer been appointed yet or is she retaining one? That is who can answer these questions
I don't know what kind of assessment was done. The doctor at the hospital has told the social worker she needs to go into assisted living. The social worker contacted me. She wants me to be her guardian and start making plans. Once I am the guardian, can I meet with the doctor and get a better idea of what is going on? I think A Needs Assessment would help me understand. Who arranges this? One assisted living facility said they would assess her, but would this be a good source? I would hope their assessment would be accurate, but could it be biased?
I really appreciate you taking the time to talk with me.
This is such a huge step-going to assisted living. I just want to make sure it is the right thing. Should there be another opinion?
First her doctor prescribed "Dementia Meds". I do not know what they are, but he would not has prescribed them without a valid reason and likely an in office assessment.
The hospital has had 5 weeks to observe her and have assessed that it is no longer safe for her to live alone.
Why are you thinking a 3rd assessment is needed?
I will tell you a story, my brother in law has Paranoid Schizophrenia. He was diagnosed in his early 20's, he is now almost 70. When he was living on his own, he could not manage his medication, he would go off the rails, eventually be put into a Psychiatric hospital. While in the hospital he did well. He did not have to grocery shop, prepare meals, do laundry, remember to shower or change his clothes. His medication was delivered on schedule and he stabilized. Then he was released, generally a gradual release, but sometimes he went from the hospital to an apartment. And everything fell apart again.
Now I know your friend does not have a mental illness, what she has is worse, her brain is slowing losing its ability to function. Unlike my BIL, medication will not hold the symptoms at bay. Each day she will lose a bit more of her cognitive ability.
It is incredibly hard to accept these changes in our friends and family. Please listen to the professionals and try to accept what they are telling you. They are trying to prevent an disaster from happening.
That said, if she was prescribed "dementia meds" that she mixed up, didn't she ALREADY have a diagnosis of dementia before the assessment that took place at the beginning of the hospitalization?
Being able to hold a coherent conversation does NOT mean that she is able to live alone. She must be able to prepare meals, tend to appropriately dressing, toileting and bathing herself to the standards of the community and make decisions that keep her safe (locking doors, not wondering in the middle of the night and inviting stranger in, taking appropriate care of finances).
It sounds like she is unable to do at least some of these "activities of daily living" and requires support. Dementia is a progressive disease.
Does she recognize her difficulties?