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My mother is in a nursing home. She seemed to be doing well, but recently things have taken a turn. She has started not really getting out of bed, not dressing, and barely eating. I have talked to the nurses and I went in to check and it is quite obvious she is not being taken care of. I have asked but they say they can not force anyone to do anything they don’t want to do. It’s frustrating because at the old nursing home she was at they did force her to get into the shower even though she was crying. I hate to say it but tough love always worked best for her. She doesn’t have dementia but I am trying to get her put into a locked unit where everything is more “encouraged”. I hate to say it but she can’t just sit around and do nothing her whole life. She says she’s in pain and everything hurts, but the doctors have found nothing wrong. The questions I have are #1.) can they force people to do things they don’t want to do if it’s for their own good? I wouldn’t ask but she can’t just not bathe, stop getting up, etc #2.) How can I get her into locked unit? Would she need a psych exam? A year ago when admitted she was found to be of sound mind (and got every question on the test given correct) but I can’t believe just sitting around doing nothing and not bathing is a psychological sound thing to do. Can they do this in house (a doctor or psychologist in the facility already?) And just transfer her to the unit? Or can they just put her in there without an exam maybe with the recommendation from a nurse? That would be preferable sooner rather than later so that she can start bathing again. 3.) She keeps saying she wants to leave ama but she can’t walk because she has a “touch” of arthritis and refuses to see PT. She also doesn’t have an apartment or any money anymore. I’m afraid they’ll just let her leave and she wouldn’t have anyplace to go! With all of her other issues (not bathing, walking, etc) she shouldn’t be let go. Is there a way I can block her from leaving?!?! 4.) Should I get guardianship? Like I said she doesn’t have anything wrong with her physically other than she just won’t walk. She is of sound mind and I’m afraid if this went to trial, she would fill them and then where would we be? If she did a psych exam here would we need to go to trial? I’m sure she wouldn’t just let me be her guardian. She’s very stubborn! She wants her freedom even though she has no money etc. I just want to know how I can prevent her from blocking my request for guardianship.



Also, sorry if this sounds harsh, I just really want what’s best for her.



Please help!

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Step one is diagnosis.
I am afraid someone with a "touch of arthritis" claiming not to be able to walk, yet saying she will sign out AMA does sound like someone with some dementia or very severe mental illness.

Without a diagnosis you cannot get guardianship.
I doubt that the facility would discharge her on her own.
Be certain you do not enable discharge by taking her into your home, or by moving into her.

Something is clearly wrong here if you are talking about memory care but claiming there is no dementia.
I would start with asking for a good neuro-psyc evaluation of your mother.
If she has dementia you may be able to get temporary guardianship through a social worker, who in some states can call a judge. You would then have to pursue permanent guardianship.

While they cannot force a person to take a shower they can do a bed bath as cleanliness is required for health.

Other than her bit of arthritis, what other conditions does your mom suffer from?
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Rogerwyatt7890 Apr 2, 2024
How do you do a hands up Imoji? I love your post. My mother was in the hospital for 10 days and got 2 showers and they did not even wash her hair. When they did give her a shower finally she frieked out and yelled and screamed because she thought the guy giving her a shower was trying to drown her.
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Your mother sounds seriously depressed if she hasn't developed dementia over the past year. Speak to her doctor about her behaviors and get her evaluated for cognitive impairment, but strongly suggest antidepressants as a first step to see if they help motivate her to move out of bed.
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She sounds seriously depressed . My Great Aunt wouldn't get out of the bed for 3 years . They Put her on anti depressants and she started walking again and socializing and enjoyed the Last several years of her Life .
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Why is she in the nursing home? From your description she does not sound as though she does not have some type of dementia or Alzheimer’s. Behaving in an illogical and unhealthy manner is a huge red flag. You need an evaluation, not an opinion, as to her mental acuity. She should be seen by a mental health professional.
Guardianship is different in each state but never easy to obtain. It usually takes an evaluation and written statement as to her mental status by three different doctors; a psychiatrist or psychologist, and two different medical doctors. If you have all of that, you file a petition. There will be a hearing, not a trial, and the judge will have to ascertain whether or not guardianship is warranted and whether or not you are the best person to be her guardian.
Start with the mental health evaluation and that should give you a more clear understanding of what you need to do next.
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Avon3356 Apr 2, 2024
Do you know if there’s a way to get them to admit her to the closed lock down unit before that? Just wondering. She needs to be taken care of quickly. She’s starting to smell pretty rough. Do you know if she can maybe be transferred after a mental evaluation? Sorry this is my first time going through all of this and I’m just very confused.
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I am wondering if this is a similar situation to the ‘right to rot’ for people who choose to live in squalor. You want your mother to ‘be different’ because you think (quite reasonably) it would be better for her. She doesn’t want what you want. Is forcing her to co-operate actually possible?
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Avon3356 Apr 2, 2024
I am not familiar with that term. Sorry, what does it mean?
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Is Mom in assisted living now or a nursing home? Both my mother and father in law were in 2 different assisted livings . Both refused to shower . Both had dementia. You mention Mom took a test a year ago and got every question correct. That does not mean she does not have dementia now.

This could be dementia , and/or depression . Or she does not want to do anything anymore and wants to die .

With both my mother and father in law it took threats that they would have to go to a different facility if they didn’t shower . Both facilities waited too long in my opinion . But they kept saying they could not force them. They waited until the smell was unbearable.
I wish they had started with the threats sooner before they had let them get away with it so long that my mother and father in law got comfortable just refusing for so long.
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Avon3356 Apr 2, 2024
Yes, she’s has gone weeks without one. I’m just confused because at the old nursing home they did force her to shower. She was physically put in the shower chair and wheeled to the shower room. We had to move her closer to us but I had assumed this was the practice everywhere. Was told the only place they could do that was the closed lockdown unit. Very confused.
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Your frustration is completely understandable. And to answer your questions; based on what I know they cannot force residents to do things against their will. However, they should be more encouraging on these and be working with your mother to understand her reasons for refusing. Sometimes a person needs someone who completely understands them. Second, a doctor's evaluation is needed to determine if it's the most appropriate setting for your mom's needs. While a psychological exam might be recommended depending on the facility's policy, her recent change in behavior could be a reason for a doctor's re-evaluation, not necessarily a full psychological exam. Speak with the nursing home admin about their process for secured units and what evaluations might be required. And regarding about leaving the nursing home, they can't prevent her if they're mentally competent and insist on discharging themselves. However, they have a responsibility to ensure that your mom understand the risks and consequences of leaving without proper care. Maybe discuss these concerns with a worker and that they'd be able to intervene and help mediate a solution. Lastly, Guardianship is a serious step and should be a last resort. Taking away your mom's autonomy is a big decision. The court maybe hesitant to grant guardianship especially if she contests about it.
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Diagnosis is key, looking into/ruling out the big Ds;
Depression
Delerium
Dementia

What's the lack of moving about?
Arthritis pain not controlled? Or more?

Any stiffness / freezing / apathy?
Maybe add Parkinson's Disease to the list to look into/rule out.
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My mother started saying she was in pain and everything hurt when she was fairly young, like in her 30s. Despite that, she lived an active life of boating, swimming, dancing and cruising. She went to different doctors in the course of her life and some told her it was all in her mind. She had various ailments over the years, like a hernia, two hip replacements, broken bones, etc. She always said that everything hurt when they'd come around to her hospital room and ask on a scale of one to ten, what is your level? Always the moans, groans and complaints. So then she got dementia. She still always said that everything hurt. She kept saying it until she could no longer talk.

Clearly mom had things that hurt, like hips. So I believed that. But everything hurting - not so much. She always was one to want attention for medical issues. Since then, I have run into people who also claim that everything hurts, like OP's mom. At least one that I knew very well most of her life was eventually diagnosed with fibromyalgia. But she was another one who was always finding something that hurt and rushing to doctors to find out why. For instance, her heart at age 32 (no issue), her eyes at age 34 (no issue), etc.

Question: Are there people who actually have a problem with everything hurting all their lives? Is it real, or do they only believe it's real? Is there a possibly a hurt that they can't pinpoint to one area, and that gives generalized overall pain? Maybe their brain and nervous system is set up like that?

Just curious.
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First...she can't just leave. If she can't walk out, if she can't arrange her own transport out then she can't "just leave".

The facility can not discharge her because she can not care for herself.

Even if the staff at the facility can't get her to bathe have they, or do they give her bed baths?
Are they properly cleaning her after toileting? (If she is not getting out of bed I presume they are now putting tab briefs (aka diapers) on her.)

Is she on medication for the pain? Do the meds work? If so can she be medicated about 30 minutes prior to a shower? That might help with the actual pain she may be having as well as the anxiety of the anticipatory pain.

As to your Guardianship. I am sure if she appeared in court unable to walk, unable to do any of the ADL's and insisting that she can manage the judge would probably grant you Guardianship. He or she may order a Psych eval. though if she has not had one in the past year.
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Avon,
You say below that a doctor has discussed you mom with you and has assured you that she does NOT HAVE dementia.
That means you will NOT be getting guardianship, whether you want it or not.
If she is living in filth and not caring for herself then she may have some mental illness. I encourage you to read a memoir called Never Simple by Liz Scheier. She tried to intervene for her mother for years because the mother was mentally ill. She had the assistance of the city and state of new york and she tried for decades, all to no avail.

The court will not take a mentally ill citizen's rights for her. Basically we have a right to hoard (unless it causes infestation and health hazard for self or neighbors in which we will be issued notices to clean or lose the home. Your mother has rights, if not suffering from dementia to live exactly as she pleases, and trust me, being guardian is an onerous legal job which has much record keeping involved, and it is impossible to do without the cooperation of the person you are guardian for.

Quite honestly, given your updates, there is little you can do.
Not everything can be fixed.
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