Help! Why would they admit mom to psych unit for 7 days but let her go on the 2nd day?

Are you believing your mother that she is being discharged? Do know that you can refuse to take her home. Call the social worker and tell them that you cannot mentally or physically care for her in her current condition and she must have the full range of tests ordered by the MD. As to why they wouldn't stick to a plan, no patient can be held against their will and she is free to leave at any time if she is not on a 5150 (72 hour hold) or another hold. You may need to consider placement and this is the time. Refuse to take her home and say she must have placement, that she cannot return to your home.
Certainly none of us on Forum can suggest "why" in this matter. It is a question for the doctor.

Alva is right. If mom went voluntarily, then she can leave. But you can tell the hospital bluntly that it would be an unsafe discharge since you cannot care for her. Refuse to take her to your home. ( presume that she lives with you?) Be persistent in your "unsafe discharge - no one to care for her. They will try to guilt you but keep refusing and they will have to find placement for her.

Otherwise, I am so sorry you are going through this. Our system is so broken. I went through so much with my mother and the system doing nothing about it because she’s competent. Such bs!!

If you mom is screaming in the highway, can’t you call the cops on her and have her taken to the psyche ward of a hospital? Refuse to let her come home so they have to place her.

Back in 1978 my mother was making harassing calls all hours of the day and night to her in laws. They had her arrested and she had to spend 30 days in a mental hospital. After 30 days they let her come back home. They never did find out what the mental illness was. She still had mental illness right up until she died.

However, she never called her in laws again and she never broke the law again.

So, what did you do? I was thinking Baker Act her. I think that is a 72 hour hold at least.

She wasn't released from the behavioral unit on day 2 after all. I think this is day 5 and she is scheduled to talk to another doc in 2 days. I have received only 1 phone call from a doctor. His comments were "probably dementia, assisted living, no driving". She had an MRI yesterday because a CT scan showed an old stroke, atrophy, and some small vessel changes. Detoxing from alcohol.
I would guess vascular because of the CT, but her symptoms seem like alz, so probably both?
She says she is taking fewer meds. She still cries constantly, fears for her life, has mad delusions, nightmares, hallucinations, and seething anger. She can't remember how she got in the hospital.
So I guess this is as good as it's going to get.
My sister and I are trying to figure out 24/7 in-home assistance. (Mom's house, NOT our houses.) I'm going to start buying lottery tickets like a desperate person.
They don't tell you to get ready for this.

I noticed you put detoxing from alcohol. Does that mean Mom is currently detoxing from alcohol use or that her old stroke was caused by alcohol use?

Are there medicaid programs in your state that will pay for Assisted Living?

Call the hospital and start talking to the discharge unit about what the next step is. I assume they will eant to send her to rehab; try to pick a place that can seemlessly turn into long term care placement (has the right level of care and will accept Medicaid after a period of private pay).

And no, she cannot live with you. If they suggest it, shut the idea down immediately.

Are you and your sister willing to accept responsibility for procuring 24/7/365 help? Who will be paying for this? Please do NOT spend your own money (neither you nor your sister)!

This is your chance, as has already been noted -- GET HER INTO A FACILITY. Tell them she does not have care at home. You say it will destroy her? The way things are now, she is destroying YOU.

Is she Medicaid-eligible?

If EVER I’ve read a story here that cries out for a secured (locked) Memory Care unit, this is it.

A doctor has recommended it, you have no logical reason to think she’d do well at home no matter how many aides you found, and unless you hired a rotation of SAINTS, you’d have walk out, quick quits, and lapses in her supervision beginning day one.

In a Memory Care, medications would be structured, as her time would be.

If she’s an active alcoholic, the chances of finding this kind of setting, ESPECIALLY RIGHT NOW, are even harder than typically, but the bottom line is, you and those who love her are not trained for this kind of problem behavior and cannot reasonably expected, EVER, to be personally responsible for her care.

YES, refuse to take her home to her house or yours, and see what is recommended for her by people who are trained to find placements for difficult clients.

DON’T “go get her”. Whether she’s considered “safe to discharge” or not, be water on stone- “I can’t take care of her” and say that over and over and over.

Plan for YOURSELF AND YOU CARE.

Contact the nearest NAMI chapter in your area. They will give you better advice on how to deal with your mentally ill mother.

If she's crazy then you should talk to her Dr and leave her there.

Tell both your mom,, Dr and them you are sick and she doesn't have a safe place to go to and they will have to keep her a few more days

Don't let her move home... get her into memory care! Tell her it's temporary if you must. She won't be safe at home even with 24/7 caregivers because she needs a locked facility

Chronic mental illnesses are often untreatable, but behavior managed through medications.

**You are NOT obligated to take her back, and you can refuse to have her back. This would force them to place them like in a group home where she can be better managed. I would absolutely talk to the social worker there and tell them that.**

Some states have residential treatment programs (SRT).

You do not even have to be her POA...the court system can appoint her one (visiting justice go to psychiatric wards).

Sorry you’re sick in bed with all this trauma going on. But you have to act by either calling psych ward or doctor or social worker. Sounds like she’d be better in a facility. Good luck to you.
been there

I’m afraid you’re setting yourself up for another world of trouble by trying to provide 24/7 care in your mom’s house. What will you do when a caregiver doesn’t show up? Quits? Has Covid? My parents had 24/7 care and it was still a small nightmare. Put Mom in a facility. If you don’t have POA, get her to sign a paper. Maybe lots of papers so she’s confused about what she’s signing, sell her house and use the money for the facility until mom can qualify for Medicaid. (Maybe she can qualify now?) I’m saying a prayer for you. Stay home. Stay in bed. Research facilities for mom. Be safe.

Key word here is she went 'voluntarily'. She goes in that way, can refuse care, and be released. You need to talk to doctor again about involuntary placement so they can do testing he wants done and get her meds corrected.

There's a really good chance she may also be lying to you. Call the unit nurse and tell them what she said and that there should be an order to do X and X and that you DO NOT plan to come pick her up until the orders/tests have been completed.

Speak directly to her physician and explain to him that there is no possible way for you to take care of her because you have your own health conditions to take care of and that is a priority. Enlist the help of a social worker that can advocate on your behalf.

Otherwise, what do you mean when you say you are afraid to call the psych ward because it would start “safe to discharge” ball rolling. What did you mean by that?

Is she normally competent with some crazy moments like my mother? Or is she not competent at all? Can she take care of herself when she doesn’t act irrationally? Or erratically?

We need better laws to protect mentally ill people. The hospital always sent my mother home when she was in there even though I explained she was a hoarder and wouldn’t bathe or shower or change her clothes. Heck, a year before she died she was sleeping downstairs in a folding chair in the bathroom. I told APS about it and doctors and her family doctor. They couldn’t stop her from doing so.

I’m afraid it’s a broken system we live in. But don’t give up and keep talking to someone until they listen.

If running around on the highway doesn’t warrant doesn’t warrant being in a facility and getting help, I don’t know what does.

Talk to the staff at the unit and ask what it going on. She may be trying to leave Against Medical Advice. If she is not a considered a threat to herself or others, she may be able to leave. Encourage the staff to keep her there for the duration of your illness since you can not care for her in your home.

"UNSAFE DISCHARGE" Its hard enough being a caregiver without throwing mental illness in the miss. And if I was a CNA I don't think I would want to care for someone with a mental illness and then throw Dementia/ALZ onto that.

As suggested, find a facility for Mom. If it means a NH with Medicaid covering her care then so be it.

So sorry you are dealing with this. And thanks for the update.

"She's been crazy for over a year."

Okay, you've been aware of this for a year. What has been done about it during that year?

"This morning she left message, "I hate it here." At noon she left msg, "They're letting me go. I have to come back tomorrow to pick up a prescription. The doctor will call you."
Another pill???
...
If she's telling the truth, why wouldn't they keep her and stick to the plan??"

Whatever she says regarding being let out, it could be fabricated. The crying and hysterics is just to get you to do her bidding. Don't rely on anything she tells you.

"We are trying to find 24/7 helpers for when the hospital launches her back out. I'm afraid if we were to say, "I can't pick her up or watch her", it would destroy her. She already begs and sobs on every phone call. She understands what's happening."

Does she really understand? Begging and sobbing is just to get sympathy, mostly. If she's been "crazy" for a year, she doesn't understand. In a later comment, you report the doctor mentioned dementia. If that's the case, she doesn't know, she doesn't understand and won't stop begging and crying. Neither will she be "destroyed" if you say you can't pick her up or watch her. Better to NOT say that. If you do, she will fixate on YOU as being the problem. Leave it at the doctors' decisions. Doc says you need to get well. Doc says you need time to heal. Doc says >whatever<. 

"She lives in a house that she owns."

Tagging this along with looking for 24/7 help - can she afford that? Facility care is expensive, however it is MORE expensive to keep someone in a home and hire 24/7 care. The amount of time and energy needed to keep that scenario rolling smoothly is going to be a challenge for you. Care givers call in sick, no-show with no warning, bring in virus, etc. Also, if she has dementia, simple AL is NOT the answer. She would require memory care, which is locked down so she can't wander, ending up screaming on the highway. AL does NOT monitor residents 24/7, so she could just walk out.

"If the system doesn't improve, we are going to have an avalanche of demented people in a few years."

We already HAVE an avalanche of dementia going on. They anticipate it is just going to get worse.

"She wasn't released from the behavioral unit on day 2 after all. I think this is day 5 and she is scheduled to talk to another doc in 2 days."

Good. Keep it that way. She should NOT be released to her own home nor should she be released to your home. She and you do NOT have the qualifications needed to address the concerns!

Hopefully this suggestion doesn't get lost in the shuffle: have them also do a urine culture and complete blood work. UTIs and other infections can cause dementia-like symptoms OR they can make the existing dementia WORSE!

"Detoxing from alcohol."

Does this mean she is detoxing now, while in the behavioral unit? If so, all the more reason to keep her there. That could take some time. It's also a good reason NOT to allow her to return to her home or yours. There will always be ways that she can get her hands on something, even if it's rubbing alcohol! Dementia and alcohol are a bad mix!

"I would guess vascular because of the CT, but her symptoms seem like alz, so probably both?"

Many people have mixed dementias, but the symptoms between vascular and alz are not really that much different. It really doesn't matter which, if it's between these two. The care and treatment are very much the same. Other forms of dementia are very different and the symptoms/treatments are different as well. If no conclusive evidence between vascular and alz, no worries really.

"She says she is taking fewer meds."

This can be a good thing. Often people are over-medicated. She should only be taking the ones that will stabilize her health, such as BP meds or diabetic meds (no idea what she was taking.)

To be continued in a reply to this post...

You need to immediately contact someone in the know in charge to see what is going on. Second, do NOT, no matter what is said or done, accept her back again. Stand firm, YOU are not able to take her back due to your own limitations. They will have to do something with her if you don't back down. Good luck. And talk with the doctors at one to prevent her from dictating things. YOU are the number one concern now.

You can say to your Mother that you may pick her up when the doctor says so.
Provided that there is a plan for ongoing support and she enters a rehab program to get the help she needs.
Home health might not work for the mentally ill, alcoholic.

Mother is still crying (etc.) translates to emotionally unstable.

You have more power than you think you have. The doctors do too.
By allowing her to be admitted voluntarily, they were protecting her rights.
A 5150 hold can still be invoked by the doctor if on day 7 if she is still presenting as unstable.

A hold can be extended to 14 days. It may be in her best interests to have her stay, voluntarily. Using persuasion, you can cooperate with her doctor by telling her that you will not be her caregiver at all if she leaves too early.

There are also rehabs for alcoholics, a usually plentiful resource. You and the doctor can persuade.

You can ask her doctor to keep her the 14 days. Because an AL will not accept a mentally unstable client. Instead, there are Board & Care homes who house the mentally ill in group homes. Try that.

It would be an unsafe discharge to her home without care and supervision.

Contact NAMI, and learn more about resources through their families with mental illnesses program, free. There must be online classes now. And, your Mom could get help from a peer-to-peer counselor/companion, who has had personal experience navigating the mental health system.

Again, Board & Care homes.

Look back to recent history.
You cannot survive your own mental health if you are influenced and in a panic by what your Mother tells you (is going to happen) in two days, or whenever.

Decrease your contact severely while she is under the care and supervision of the doctors and hospital. She can get better that way.

Otherwise, deep breaths.

I think you need to understand that, for whatever reason, you mom is no longer a "reliable reporter" of the stuff that is going on in her life. TRUST BUT VERIFY, as they say. Call the doc, the nursing station, whomever and say "this is what my mom is reporting to me. What do the docs say?".

This serves two purposes. One is that you get the ACTUAL story from the hospital, the other is that the docs get to know that your mom is not "getting" what they are telling her.

It is SO very hard to let go of the idea/fact of your mother as a teller of fact: this is something that we grow up with, right? That our moms are oracles of truth?

And all of a sudden, they aren't. You need to work through this, process this and come to terms with it.

Rusty, the mother lives in her own home. If mom refuses care in the hospital, she can hop in a cab and go home. That’s reality. That’s the world we live in.

you could call area agency on aging and tell your story. they may be able to give some respite.

if your mother is alcoholic you dont want her at home during detox. keep her in psych unit for 3 more days and find out if she is going to react to alcohol withdrawal there.

Rovana, no family members will not be charged with elder abuse or neglect. The doctors are sending her home. If the doctors didn’t think she was competent they wouldn’t have sent her home.

Just because someone has severe mental illness does not = incompetence.

I was told this over and over with my mother. Mentally ill people have RIGHTS. Good luck trying to strip them of their RIGHTS!

The only way you can send someone to a mental facility is if they are a danger to themselves or others. That’s it. No other way.

The DOCTORS are letting her go home, EVEN though she was screaming on a 60mph Highway.

Doesnt anyone else besides me think the mental health system is broken and failing the mentally ill and their families?

Otherwise: Imho, as your mother was in a psychiatric facility FOR A REASON, there is a good chance that what she verbalizes is an untruth. You should speak with her physician for verification of her story.