What’s your opinion on letting the elderly make decisions for themselves even if they are the wrong ones?

How many hours/day will the aide be there? If she was in a NH, seems like she might need around the clock care? She must be legally mentally competent?

I skimmed your previous posts, and saw that she has not lived with you. I also saw this: "I do her for shopping, cleaning, cooking and laundry when I can."

Are you going to do this for her still? Or are you going to leave her to figure everything out? I understand your frustration that after getting her into a NH, she now wants to undo all of that and come home.

As long as she's mentally competent, she can make her own decision for an unsafe discharge. Will you and/or H be driving her home from the NH? If you really don't think she should be leaving, let her make her own transportation arrangements. Do you think she has told the NH that you and/or H will be doing things for her?

I would have her tested for cognitive impairment and memory loss. Don't walk away if she mentally cannot make sound decisions. If she has no PoA, then the county should be called in to become her legal guardian in the facility. If this happens, then you will be able to walk away from all her care and decisions.

The first step is to have facts. This would mean knowing if she is competent or not.

Don't help her move, don't aid her at all in leaving the facility. If she talks about it change the topic. Do nothing and see how far she gets.

I worked hard to help my jerk of a stepfather-in-law apply for Medicaid. He had Parkinsons (6'5"), his wife (my MIL) had dementia and memory loss. They lived in a house with stairs. And were completely broke and in debt. SFIL thought I and my family were going to be his care solution. I told him it wasn't possible. He refused to sign the Medicaid form. I told him if he didn't sign the form I'd report him to APS and allow the county to get guardianship of him. He didn't sign. He became a ward of the county. He was transitioned into a facility and was protected and got medical care.

She is mentally competent. The nursing home said she is in her right mind.

When you say “come home”, do you mean come back to your home or her home? Is she mentally capable of taking care of herself 24/7? Is she there strictly for chances of falling and struggling to get around? Have you and your husband been assigned as POAs?

There are many questions to be asked when thinking about moving in or out an elderly person to a nursing home. Why was she moved there in the first place? If she is not safe to be on her own, 24/7, then a nursing home is a better option. There are different levels of nursing homes that you all could consider, too.

As children of elderly parents, we all have a responsibility to keep our parents safe. Sometimes there is a struggle between safe and happy. Talk to your local office on aging (or ask the staff I’ll at the home for information on that). They can be immensely helpful if you take advantage of the help. In some states, if you have been assigned as POA, you can’t just wash your hands” of a frustrating situation like yours. You could even be charged with neglect if things go wrong for that parent.

Good luck. My parent went into an assisted living and was very mad at us when we told her she couldn’t come home. Her incontinence got so bad that she had ruined all the furniture and carpet in her room as well as other areas of the home. We gutted her room to start over and then she decided she wanted to come back home. We told her that her room was no longer there because her incontinence forced us to get rid of things. She argued back that she would “just come home and stay in one of the other rooms and then pee on that stuff”. That was when we realized that we had made the right decision to move her out. Her logic was no longer there, yet thes will to come back was fierce. She got mad at first but we pretended not to hear it. We visited extra often at the beginning, always helping her to fix her room there just like she’d like it. She slowly gave up being mad at us and now she no longer talks of coming home. She has even made a few new friends! Most of all, we don’t have to be frustrated with the situation anymore, and our minds are at ease since we know she is safe.

Well, when and if this plan to go home blows up, how will you get her back into the SNF on Medicaid???

You have to truly stick to your guns on wiping your hands clean of your involvement with her care in home, because it's highly unlikely a CG 5 days a week will suffice. What about the other 2 days, and the hours nobody is there Monday thru Friday??? An elder who requires 24/7 care in a SNF is not going to thrive with part time care at home. So leaving mom to make her own decisions knowing it won't work only leaves YOU back at square one again when she's floundering and you're asked to pick up the slack.

When you discuss her discharge plans with the SNF, do let them know your true feelings on the matter and that you won't be available to caregive when the aides don't show up or on the days they don't work. See what they have to say and go from there. If your mother doesn't drive and is depending on you to do everything for her at home, and you aren't planning to do so, I wouldn't agree to her coming home. And I don't blame you for NOT doing the in home caregiving after spending months getting her approved for long term placement with Medicaid. Sometimes, an elders wants aren't aligned with their needs and that's when we have to step in and override their wishes.

Is she going back to her home, or to your home.

Don't invite the inevitable disaster into your house if you're even considering the latter.

Even if the NH said she's competent, that does not mean it is true. She needs a true and full evaluation by someone qualified. Do YOU think she's competent? Or are there obvious gaps in her abilities? If there are gaps you really can't leave her totally on her own cuz she just won't be able to do it.

I would let the facility know that you are 100% NOT in favor of her going home. If you don't think she's competent, give examples.

If you agree that she is competent, I support you walking away. Sometimes when my mom wanted to do something I thought was stupid, I would just not help and then the idea would fizzle out since she could not plan and execute the plan.

Good luck

Everyone is deemed competent until proven otherwise. To make decisions - both good & bad.

But family know family best.

What is your gut instinct telling you about MIL's decision making skills?

Are there any medical issues or mental health issues that could be effecting cognition?

I would start there.

If zero concerns, sure.. stand back. *Dignity of Choice*
MIL can go home. Call it Plan A. Is always best to try the 'least restrictive environment' first (social worker told me).

If there ARE concerns.. to be continued maybe.

The right to make poor decisions isn't really a matter of opinion, it's the law. Here in the UK it is one of five priniciples underpinning the Mental Capacity Act 2005, which outlines how these issues are to be managed; and you are sure to find exact equivalents in your own state's legislation.

Hence it also isn't a matter of letting your mother in law make this particular unwise decision. You can't stop her. But you are absolutely right that what you can do is make your own decisions about how far you will go to support her in it.

I strongly disagree that setting boundaries for what you will and won't do is the same as "wiping our hands clean" and leaving her "on her own."

It strikes me that if you are participating in discharge plans you are there for a reason: because she explicitly cannot make decisions on her own. If she did not do the paperwork for Medicaid and placement because she couldn't, then she cannot do the discharge plan either.

Because my mom lives semi-independently in her home, I am not familiar with placement and discharge, but my gripe would be with the NURSING CARE FACILITY and not your MIL. I presume your MIL no longer drives. She is placed in a nursing home and I presume she does not have a credit card or cash. Does she have the simple ability to call a cab, tell the driver where she wants to go, and pay them when she arrives? Does she have the ability to get food? Clean her home? Perform all the basic ADLs? Call for help in an emergency? If the utilities are turned off at her home, is she able to re-establish them? Does she have the skills and ability to pay her property taxes and all the bills to keep water/electricity/gas going? When an appliance breaks, can she get it repaired? Can she manage her basic care to schedule and attend Dr appointments? During the hours no one else is there can she call for ourside help if needed? If there was a physical disaster (fire/flood/freeze) would she be able to evacuate to safety and sucessfually repair damage to her home?

I understand you are discussing partial skilled nursing/unskilled care assistance, but there is SO MUCH MORE to fully independent living than a caregiver during the day M-F. I knoe. The above list are all the things I do to support my mom because my mom cannot live completely independently on her own and she understand the limits of her abilities and appreciates my support.

It strikes me that if the answers to all of these questions is YES your MIL should not have been placed in a facility. If the answers to any of these questions is NO, then documenting this for the record is NOT WASHING YOUR HANDS. Rather it is doing the due diligence needed to care for someone when they are unable to care for themselves. Refusing to enable is not the same as doing nothing.

Ideally, you choose to continue to work to document your MILs skills, abilities, and needs for all the things that independent living requires. Ideally, you learn to set healthy boundaries for what you are or are not able to provide to her on the LONG list of needs. Ideally, you understand those needs and refuse to enable when it is something you are unable or unwilling to do. But, I'm my humble opinion, none of those things are "washing your hands."

It may be that your MIL is competent to live independently now. But, keep this list. Medicare/Medicaid does a similar assessment that includes social and emotional wellbeing, safety, and security - things I didn't even touch on in my list and do for my mom daily) refer to thsee lists as tools in the inevitable change a long live brings. Your role is to continue to monitor these lists and ensure the support she needs. That does not mean you doing everything. It does mean getting her to the living situation that is approx to her skills and abilities. *warning, there are BAD nursing facilities, too. So, placement does not mean the job of monitoring and making decisions is over.

Love is not doing everything.
Love is doing what is best for someone's physical, emotional, mental well being to ensure they are safe, secure and as healthy as possible on a daily/weekly/monthly basis - which encludes the maintenance of their physical surroundings as well as their person.
Love is not enabeling.
Stay engaged to ensure all those things are provided - whether she is at home or in a facility she will continue to need you to monitor and support.

I wish you luck on setting appropriate boundaries and expressing frustration to the appropriate place- the nursing home.

Update? Did MIL get discharged from the NH?

What type of health or other condition does your MIL have that landed her in the facility in the first place?

Safety, safety, safety......
Is it SAFE for MIL to live alone?
An aid 5 days a week is not 24/7 care, availability, and as with any " in home " care there are sure to be challenging times.

It is not unusual at all for new residents in a facility to "want to go home. ". The conversation needs to be redirected to " safety" issues and, this needs to be the number one issue discussion at any meeting( s). You may say that you are " done", but the reality is that once / if MIL is discharged" home" , SOMEONE, will have to be assigned as POA for decisions and intervention as needed.

The question remains, about safety, prognosis. Strongly suggest that you not let MIL guilt trip or coerce you nor anyone about " going home" if in reality it is not a reality, and unsafe.

This situation has disaster written all over it. I would counsel the NH that they should carefully evaluate and consider her ability to make sound decisions and to live on her own. Unless she truly is capable of taking care of herself and all of her medical and other needs, this sounds close to an unsafe discharge from a hospital. Not exactly the same situation - but close.

I am coming rather late to the discussion but what forced her into the nursing home to begin with? Has she been declared incompetent by a doctor or a neurologist? If so, and if you are her POA and medical proxy, then you can legitimately discuss with the nursing home, their poor plan to discharge her because she wants to be discharged. If she has not been declared incompetent ,unfortunately, you have very little that you can do to stop this discharge plan. Nursing homes are not prisons - they cannot keep a competent person against their will.
I do hope if she's discharged it's to her own home and not yours. Discharge and placement in your home is a true future disaster for her and for you.
Please keep us updated

Everyone in a nursing home wants to come home. If they need the type of care that qualifies them for a nursing home, coming home is typically not an option. You have to have tons of money to pay for round the clock care and someone to manage that round the clock care because there are many issues that crop up. Or someone has to be willing to give up their life to take care of you. If she doesn't have one or both of those things, she needs to stay where she is.

Is she mentally and financially able to check herself out of the nursing home? If so, where would she go?

You've answered your own question. If your MIL is not mentally incompetent and is still in charge of making her own decisions, let her. You state quite plainly all the work you put in for months to get your MIL on Medicaid and into a nursing home. With all due respect, it isn't about you or what you've done for your MIL. Would you want to live out the rest of your days in a nursing home? My guess is no. I wouldn't want to either. So if it's possible for your MIL to not have to, then more power to her.
It's perfectly understandable if you and your husband refuse to become caregivers to her. None here can fault you for that.
In fact making sure everyone involved knows this is the best thing you can do.
Have a meeting at the nursing home with your MIL's care team and have her present there too. You and your husband speak plainly to everyone (including MIL) that the two of you are 'washing your hands of her' and refuse to help in any way. If this is truly your plan then make sure everyone is clear and understands. Especially your MIL. You would do well to have someone bring up the idea of AL living or an independent senior community if this could be a possibility for your MIL.
Also, I'm going to let you in on a little secret of the care industry that most people don't know. I know things because I was a caregiver for almost 25 years. I had a lot of clients recently discharged from nursing homes. A nursing home will insist that a person needs 24-hour care and supervision when they really don't. This is because a nursing home never wants to lose a resident that's already on Medicaid. Especially one that's easy to care for and doesn't need a babysitter 24/7 because they're out of it from dementia. Is your MIL a resident like this? If so then that nursing home is going to fight to keep her and is going to tell you that she needs all kinds of care when she might not.
If she's still with it and wants to try homecare then you and your husband should be supportive of this. Many of our beloved seniors are not willing to allow any kind of outside help because they expect their adult kids to become nanny-slaves to their needs and demands. You and your husband are very lucky your MIL is not like this and is on board with trying homecare. If she's already on Medicaid that won't change when she goes home. There are plenty of nursing homes. If she comes to need one again I'm sure you'll find her one. Make yourselves clear that you will not be her caregivers, then let her decide her own life.

If you have a POA and are her "health agent" (terms in a potential advanced directive if one exists); you can terminate both on your end. Just because both or at least a POA exists; one cannot be forced to be a POA or a health agent. Ditto for an accounts (Medicaid, Medicare, bank, IRS/tax matters, on and on) that you may be on as an agent (or in the case of a bank, in a joint account); you can waive off on all that too if you so choose. Then ask the NH and her, who will step in and handle all of this. Does she still drive (?). Can she shop, is it safe for her cook on her own. Can she manage her own prescription drugs? Can she clean her house (I assume "the going home means she is going back to her home and NOT moving in w/you)? How does the yard, laundry, on and on and on?

Not sure what landed her in the NH as others asked, but if she qualified for "long term nursing home care through the Medicaid program" she would have to meet both the income/asset limit in your state BUT ALSO the "level of care" needed for longer term nursing home care. So hard to imagine she'd meet both standards, if she really did not qualify -- aka need it?

Wondering if you have an update on whether or not your MIL managed to get herself home from the nursing home and how that's going?

If she is considered competent, let her make her decisions. If she makes a bad decision, let her live with the consequences.

Your third paragraph is key. If you are POA resign by letter now. Clearly she is well enough mentally to receive that letter as they are allowing her to make her own decision.
Make it clear that you understand that while she is mentally capable of making this decision you do not approve of it and make the clear statement "We will not be enabling this move in any way". Make it clear that your MIL will have what anyone else has, the 911 number. That you will not be cooking, cleaning, transit to appointments, shopping and etc. Make clear her finances and the cost to her and that you will not participate in getting her re-enrolled for in facility care. Make this clear to MIL and the Social Services and make it clear that you believe this to be an unsafe discharge due to history and your MIL general condition.
I think you need to be short, sweet and adamant. Tell them you do not approve of this move, and will not attend further discharge planning. That you want your opinions DOCUMENTED. When my brother contemplated moving home I told him what I would/could do, and what I could not. He tried some nights at home and then made his own decision not to do it, and sold the place. I was across the state. Sometimes that's the best place to be.

Letting go is often frustrating and frightening: whether it's letting go of a first bicycle ride, watching our teenagers go out unsupervised, dropping the kids off at college or letting go of our parents.............those are often sweaty hands and tearful eyes situations.

Now, plan your vacation and start imagining yourselves there.

Let go, with love.

P.S. If mom's plans don't work out, please call Adult Protective Services to help her with appropriate placement.

She made the RIGHT choice!!! Thank God she is getting out of there. You have no idea of the neglect and abuse in these places.

She tried it and realized it was NOT where she wanted to be! Smart woman! Good for you for listening to her on this. Just because you are old, does not mean you are stupid. She knows what is best for herself. I am so happy to hear she will be getting the care she needs right in her own home. That is the best solution.

God Bless you for listening to her!

Sunflowergarden: You can say that you are "wiping our hands clean of it. She's on her own now." However, this proposed plan of her's is flawed from the get go because it's highly doubtful that you would be heartless individuals when she comes 'arunnin'.

You say ‘come home’. Does that mean she’s coming to your home or going to her own home?

Hello Everyone!

Thank you for all of your replies. She has been home about a week now and is doing well.

Slightly mad we’re not jumping and doing more for her, but setting firm boundaries.

Her aide was able to do 8 hours a day. 730-1230 and then 6 to 9.

As of now, she’s managing okay and no “crisis” has happened…. Yet!

My only thought now that she is home...
Just make sure she is safe! Blessings for you and yours!