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My mother has caregivers 4 hours a day. This is no longer working. She refuses meds, never bathes and is now incontinent. She pooped her depends and refused to let the caregiver help her clean up. She just put clean ones on over the old ones. She will not drink any water. She was hospitalized twice this year for dehydration. She has Rheumatoid arthritis in her feet and can barely get around but refuses to use a walker. I work lot of hours and can't deal with the nonstop problems and her nasty attitude. She was diagnosed with dementia in August. Its just not safe for her to be alone when caregivers are not there. There are several really nice NH near me that come with good referrals from friends with family that have been there for some time. My brother plans to call APS so we can get some kind of evaluation so we can move her. What happens after the call is made? The stress is going to kill me.

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Do you have to call APS? Can’t you first go through the hospital social worker? They are used to these situations and are very helpful. Then the physician can provide the paperwork.

Facilities are too expensive to do private pay. Who can afford that? Certainly not the average person. Work with the social worker and her physician.

I know someone that is going through this right now. He’s a friend who has colon cancer and recently had a stroke. He has lived alone all his life. He never married. No children. No living siblings. One nephew that lives in another state.

I recently went to see him in the hospital with another mutual friend. His doctor was there in the room examining him. His doctor told us that he needed to speak to the next of kin.

Well, his nephew travels with his job and we could not reach him. He’s a diver and he only sees Bill a couple of times a year.

Our friend, Bill gave the doctor permission to speak to us. We have been friends for 25 years. So the doctor said to us, “He’s not going home.”

Bill asked for one of us to be his POA. We both declined saying that we did not want the responsibility.

So the doctor responded to us by saying, “If I do not hear from the nephew I will make arrangements for him to be placed in a nursing home because he cannot live alone anymore. He had a stroke and needs supervision.” Bill is a little older than my friend and I.

Bill’s nephew finally returned our call and said that he could not take on the responsibility of being POA for his uncle. So the doctor will place him. We told the doctor that we will be happy to look at some of the homes that will be suitable for him. That’s all we will do, other than visit him once he is settled there.

This is unfortunate for Bill but it’s his only viable solution. He can no longer care for himself or his apartment. It’s a tough situation.

Best wishes to you.
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Whoa.... learning a good deal from you all today; thanks, may need it sooner rather than later.
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Whenever a doctor says XYZ about your mother, simply state: "Put that in writing because I am POA and must have a paper trail." If they won't put it in writing, then it doesn't exist.

Katiekat makes a good point: her diagnoses are listed on all her medical and hospital records. They cannot bill Medicare without diagnostic codes and justifications for tests and treatment.

Medicare billing brings me to my next point: Follow the money. When any doctor says XYZ, let them know that you will be following up with Medicare about billing and that you need her diagnoses and treatment plan in writing to verify billing.

Because she has been diagnosed with dementia, it is up to you as POA to inform the social worker and case manager at the hospital that she cannot be discharged to home and that she must be placed in long term care. No one can force you into caregiving for your mother.

She sounds seriously noncompliant and it's just a matter of time before an ambulance must be called and she's going back to hospital. Let it happen and let the hospital place your mother in a nursing home because, at that point, the doctors will have to put it in writing why she cannot live at home anymore.
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Maybe in your State you need referral letters from doctors? In my State, my mom's diagnosis (dementia) was listed on ALL her medical records. This was pointed out to me by the social worker. They even did a mental status exam in rehab and followed her mental status as well as her physical progress. They made the arrangements for her to enter an assisted living facility. All we needed to do was get a current chest x-ray on her (easily done at her pcp).
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So, Thanks for the clarification.

I sincerely hope that APS can find a way to get your mother into care.

Consider resigning POA and allowing the State to take guardianship. If APS "threatens" that, say "yes, PLEASE!".

If she ends up in the hospital again, proactively go to the discharge/social work department as soon as she is admitted and tell them what her situation is at home and that you have no control due to her refusals.
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SoVery I understand completely the experience you are going through with the medical professionals and I don't quite know the reason why they don't offer more help. They just seem to give an accusatory look or tone. I went through a similar experience but thankfully in my case my father was amenable to nursing home care so that cleared half the battle. If your Mom refuses to go to a NH I guess calling APS may be he best way to go. Just remember, there are limits to what you are able to do as far as caregiving.
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Her doctor can qualify her for nursing home, have you talked to him/her? Have you tried to get her into a NH yourself yet? How are her finances, does she have enough to self pay? If not, start planning to apply for LTC Medicaid. Please keep us posted, most of us here are in the dark as far as having APS come out. I almost had the experience but got Dad into a NH through the hospital before that could occur.
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SoVeryExhausted Dec 2019
As she told my brother when he offered to have someone come in and do her hair, you think my hair is dirty! He explained that her hygiene was poor and sitting in soiled pants was going to cause a bad infection. He told her she needs to be somewhere that people can help her. She said you'll have to drag me kicking and screaming! She has enough money for cash pay. Her Dr retired at the beginning of the year. I found out 4 months after when I called to get her an appt. We switched pcp's. We saw her about 5 times. She saw that my mother clearly had many problems and couldn't answer questions. When we stepped into the hall out of my moms hearing I asked her for a statement on letterhead that my mother was incapable of caring for herself. She looked at me like I had 3 heads and was the worst person on the face of the earth. She said she has never heard of a Dr doing that. Sigh. Then she got so bad a couple months ago I set up for a Dr to start coming to her house. The mobile Dr made comments to me about her living alone. Again I asked her to write something on letterhead for me. She said she would have to ask her office manager. That was a month ago.
How can someone with a medical background just not give a flying $^%#@! About an elderly person who clearly cannot make decisions for themselves?
Wooo weeeee this forum is really cathartic. Thank you to everyone who post here. It is comforting to know I'm not the only one that has no life.
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I understand why we have some of the crazy laws we have, (to try to keep people from abandoning their loved ones and taking their money) but wow, it has really made things DIFFICULT for families who have a loved one with dementia.

Can you even get a person into a nursing home without a doctor's letter? It seems it takes an injury or serious illness to get someone into a nursing home and they have to go there from the hospital. Dementia alone won't put them there.

It seems they really try to push families to deal with the dementia patient at home. This is impossible when people have to work full time and need their sleep cause we know those old folks like to party all night.

IF you move in with the person and the dementia gets so bad that you cannot manage it and you try to leave, you can run afoul of the law being charged with abandonment.
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mstrbill Dec 2019
Have you ever heard of a person being charged with abandonment of an elderly person? I've never seen or heard of a case on the news or in the papers. There are limits to what all of us are able to do as far as caregiving and I think reasonable people and judges would see that too.
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Have you or your brother requested an evaluation through the Area Agency on Aging? It's a little bit less than the nuclear option of APS.

When mom was hospitalized, were the discharge planners apprised of the fact that she lives alone?
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SoVeryExhausted Dec 2019
Yes the hospital case worker knew everything. She tried to talk to my mom and get information at the hospital. I had stepped out to get something to eat. When I came back she asked who I was. I told her I was her daughter and POA. That she needed to talk to me because my mother would answer *no* regardless of what she asked her. She said *yes I was having a difficult time getting info from her*. At that point she had been in the hospital for 6 hours. She told the CW she had been there for weeks. CW advised in writing that she should be released to skilled nursing. The Dr who diagnosed her with dementia asked her if she wanted to go. You guessed it...she said no. So they called me to come get her that she was being discharged. I said are you kidding? Anyway I didn't see the notes from the CW until I had taken her home. That was my chance to transfer her to a NH. Nobody gives a $__t. My brother called the agency on aging. As I was told about here. He explained everything. He was a nurse for 30 years so he recognizes all the signs. You'd have to be a moron at this point not to.
They referred him to a CW with APS. They said they try to go out within 48 hours to evaluate. I too am part of that crappy club no one wants to be a part of. Taking care of a nasty bitter mother who never cared about her parental duties/love after insemination. Her job was done apparantly
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Your mother is currently living alone I assume? Who is the POA for your mother. Does anyone have guardianship over your mother? Does anyone WANT it? If you assume guardianship that can mean a legal fight in which your mother would be assigned a lawyer.
If APS finds your mother to be not safe they may have her transported to hospitalization. This may be the easiest option as you could get a social worker on her at once. But there must be a gathering now of what resources she has, etc. And if she is completely uncooperative I am not certain myself that I would pursue any of it including guardianship; I would rather the state take over, albeit her finances and her placement are then out of my hands. I would not know how to proceed with someone completely uncooperative. Your mother is definitely beyond the level of care where she can be alone at all. She needs 24/7 placement now. But without POA and guardianship this may not be in yours and your brothers control.
Hope you will update us and wishing you the best. I have no idea how it will go for you and people seldom update us to let us know how these things work in their area, so know any information you can give US is greatly appreciated.
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SoVeryExhausted Dec 2019
I have POA. I will be the trustee once I have 2 Drs letters stating she is not capable of taking care of herself. See my other post. Drs will not write a letter even though they diagnosed her with dementia. Maybe they are afraid of legal issues? She has the money for care. I want her somewhere they can take care of her 24/7 the home caregivers are not allowed to give her meds. Only suggest to her she takes them. I guess because they are not RN's? They are glorified baby sitters. Some are amazing. Some just take up space.
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