Hi. I've been reading the forum blogs for over a year now. Thank you to everyone for thoughtful insights. I'm finally in need of some suggestions myself.
My mother lives alone in a different state. She has been diagnosed with dementia to include short term memory issues, delusions, impaired decision making etc by her primary doctor. She strongly recommends assisted living or memory care.
Mom was admitted to the ER after she was found at a local store confused and unable to find her car (she still drives herself to a long know grocery store.) She was admitted overnight and I'm flying there today. The doctor there wants to discharge her with home health aid assistance stating that she is competent to advocate for herself. They even allowed her to execute of medical POA listing me as such.
My mother is adamantly against ASL or strangers in her home. I had hoped to use the ER visit as a springboard to memory care but getting discharged will make her believe that she's fine.
Am I once again stuck trying to convince her that MC is best and getting nowhere? And waiting for the next shoe to drop? I'm waiting to talk to the inpatient doctor too.
Be careful trying to talk her into a facility, she could decide to withdraw the POA. Many have.
If you know that she will not allow aides to come in and help and that is one of the recommendations from the doctor at the hospital.
Her Primary Care Physician would be the one that I would trust to know mom. She has more contact with mom, she knows how much she has declined.
Others will give you more info but....
If the doctor thinks mom is competent why the POA? As far as I know the POA is active only if/when the person can no longer advocate for themselves either long term as in a situation like dementia (or other medical reason) or in short term like going under anesthesia or other temporary situation.
I would think if her primary does not think she is competent, she is unable to safely live at home you should be able to place her in Memory Care. (Not sure if you need more than 1 Dr to state that she is not competent.)
I would suggest while visiting that the evaluations need to be done by a good neuro-psych so that you will have the primary doctor's letter and the evaluation letter of a good neuro doc. You will then need to admit your mother to memory care if she is not safe and competent in her own care.
The PROBLEM I see, however, is a BIG ONE. She made you MPOA AFTER one doctor already said she was not competent to do so.
And there is no general POA which means you needs social services help to get emergency guardianship. A medical POA often is not enough to get a patient admitted to MC if she doesn't wish to go there.
And yes this would have been much easier from the medical facility.
You may be forced into the ER Dump situation:
When you arrive there it will be clear to you whether she is competent or not.
If not, call EMS. You can lie like a rug for all of me: tell them you arrived by flight and found your mother confused, that she needs transport to the ER to be checked for stroke or whatever. this will get her transported over her protests.
Once she is there you go let them know they discharged her home and you found her in dire unsafe circumstances. Ask for social services. Tell them she was found unsafe at home and use the specific works UNSAFE DISCHARGE OF A CONFUSED ELDER which you are considering reporting to JCAHO (the hospital joint accreditation board).
Get her admitted. Get a neuro psyc consult. Get papers and letters. Get a guardianship (temporary) with the help of Social Services (they can often do with a call to a judge). Can be made permanent later. And get Mom safely placed.
If you find your Mom competent when your visit it is a whole other story. I sure do wish you the very best. It is dreadful to try to manage any of this from out of town. Near to impossible. Hope you'll update us.
I also think it's risky to make up a story about what happened; so doing might come back to haunt you. It may take some waiting, but a legitimate ER dump should be possible.
Is your mom familiar with modern facilities? So many older people remember the facilities of the past.
Have you thought about bringing brochures of newer facilities for her to see? She could see that they are attractive with many amenities.
I hope that you will be able to convince your mom to enter a facility so she can be looked after properly.
Best wishes to you and your family.
Sister took action right away to get him to memory care. It was a matter of support from his doctors and documenting how he'd been living. I shudder to think what might have happened to him if he'd been allowed to keep living at home with no aides.
I don't believe that talking to your mom about this is going to help. She has dementia, and you can't reason with dementia patients. Be prepared. Stick to your guns.
Mom is no longer the boss. You are. The dynamic has changed, and her brain disease will keep her from understanding the situation. She may say that she hates you, etc. etc. etc. That's the disease talking, and you'll need to do what's best for her.
Good luck with this difficult problem.
My brother and I had to swoop up his father and wife, she had dementia, although not doctor qualified, he had more wrong with him than I can list, including cancer.
We just laid it out to them clearly, if they wanted our continued help this is what had to happen, he was the boss and said yes. We moved them into AL in AZ (we live in Fl) as a bridge, cleaned out their house, no easy feat as they were hoarders, got it ready for sale in 8 days, sold it in three. Went back to Fl and found them an AL near us, moved them.
He died a year later, she is now in MC, exactly where she needs to be.
The roles change, we had to take over for our mother as well, another ultimatum, she fought us for 10 years about going into AL. She had a very slight stroke and was afraid to be alone at night, lived 700 miles from us. That was it, we swooped her up, cleaned out her house, sold it. That was when she was 94, she is now 98 and love being in AL. Who knew!
With dementia, the child becomes the parent, the parent becomes the child. Not my rules, just how it works.
Best of luck to you, hope that you can get it all worked out, doing what is best for your mother.
Be glad they got a POA done so take full advantage of it, and for your mother's safety decide to place her or not. If she does indeed have dementia (and it seems pretty clear that she does), she cannot make a decision on this, so don't try to convince her -- it won't work.
It was the hardest conversation of my life and her understandable reaction is something that I will never be able to forget. The next week will be tough but my head knows it's the right thing to do even if my heart breaks for her.
The journey continues but at least I know she'll be in a safe location.
Most providers don't have a clue what that means. Even if he gives a referral, it often means limited to possibly 3 hours or so a couple times a week to help her bathe, etc. Definitely use the reason she was brought to the ER in the first place as the reason she should not be sent home alone unsupervised. I'm not sure about ER discharge, but I believe you can appeal to Medicare that she is being discharged inappropriately. Be thankful she did the Healthcare POA if that was not in place before.
Best of luck to you both!
Most of her financial stuff and her house are in a trust and I'm the executor. I've got most of her bills squared away but thank you for the reminder about SSA and medicaire. I'm also her POA and MPOA.