What can the state do, if my sister-in-law can't find 24 care for my mother in-law?
The hospital got a social worker involved with my mother in-law 's situation. She has dementia and was brought to the hospital 2 times in the past 3 weeks. The hospital will not release her until my sister in- law finds her 24 care:
The SW can seek a court order, and that is the only way the hospital can refuse to release her to the family. It does not happen very often, and there has to be clear and convincing need for the Judge to order Protective Custody.
TX, after my father's second fall, he decided to beef up his walker in case he fell with the walker. The rungs are metal, the walker isn't exactly soft and it could easily do more harm than good if he fell on it.
I did some research and asked some DIY friends, we went to Home Depot (or maybe it was Lowe's), and got some pipe insulation - thick foam insulation. Then Dad wrapped it around the rungs of his walker.
It looks like something from an Arnold Schwarzeneggar movie, but it would help break the impact if he fell with it.
Well, that's it, Jeanne. I just don't think that a fall or two is all there is going on. You can do things to try to prevent a fall, but it is just not possible to eliminate them completely. I briefly considered bubble wrap after one fall.
I just wonder why the hospital felt it necessary to recommend 24 hour care after only the first fall. And refusing to release her after the second? 'Course there's a difference between falling down the stairs and falling between the bed and the toilet. I wonder if MIL uses a walker or rollator.
Ah, I reread the original post. MIL does has dementia. Many families, either from denial or from ignorance, do not realize the extent that dementia is disabling. They assume Mom or Dad can get along OK with lots of reminders to help her poor memory. Most people with dementia cannot live safely alone, even with "mild" symptoms in the early stage. They may get by for a while with in-home help on a part-time basis, but probably not for long.
Being in an ER (or any part of the hospital) can be extremely traumatic for a person with dementia. Their symptoms may appear much worse than they normally do.
If the family thinks Mom can still live alone, they need to get her PCP and/or the doctor who treats her dementia on their side, or find other doctors who agree with them, and also retain an attorney. Personally, I think that would be a waste of effort, because even if the ER did overreact because of MIL's exaggerated symptoms, she is legitimately going to need round-the-clock care soon. Might as well face it now.
I told our kids early on, if something happens to me your dad CANNOT live alone. He will try to convince you he can, and he can be very convincing. I'm here with him 24 hours a day and he gets by fine, but believe me, he would not be fine on his own!
I hope none of this sounds like a criticism, Ann. I assume everyone is doing the best they can with what they know. But it is time to ratchet concern up a notch or two and learn more about dementia.
I agree, txcamper. My husband did fall while I had my hands on him! There are lots of reasons for falling in the elderly.
The fact that the hospital recommended continuous care the first time she fell leads me to wonder what else they observed. Does she have dementia? Was she dehydrated? I took my mother (who lived alone at the time) to ER after a fall and all they did is check her out, pronounce her OK, and send her home. If hospitals routinely demanded round-the-clock care for every senior who falls we couldn't build nursing homes fast enough!
So I suspect there is quite a bit more to this story.
I just want to say that unless you stand (hover) over the MIL every time she is on her feet with your hands on her body, she can fall. They can fall if you're in the same room. They can fall in an instant. In fact, I think they can probably fall even if you do have your hands on them. When their feet get tangled, when their knees get weak or painful, they can fall.
What I'm saying is, not all falls are due to lack of care or attention.
Jeanne, excellent suggestion to get an attorney involved if they disagree. I would add that even if they don't disagree, it wouldn't hurt to have an attorney involved or on standby just to protect their interests.
The social worker will find care for her. It may not be in a convenient location but it will meet the requirement. I assume that when her family finds a better placement they could move her. But if the state takes on guardianship everything is going to get very complicated. My advice is that they work very hard with the social worker. If they disagree that Mom needs round-the-clock care I think they had better consult a lawyer.
I suspect there may be some protocols that require hospital staff to report certain situations, such as child or elder abuse. A visit so soon, if for the same reason, might fall into that category.
This is what I would do, because you're going to be up against authorities with more power than you have.
1. If you can move her in with you or SIL temporarily and provide 24/7 care, that would solve the immediate threat and give you a chance to address a more permanent option. I emphasize though that this would best be considered ONLY a temporary situation. I suspect MIL needs more care than you could provide.
2. If you can't do that, is there anyone who can stay with her 24/7, perhaps hiring home care during the day and a family member staying at night? Again, this would be a temporary situation while looking for a facility if she needs one, which I suspect she may.
3. Begin looking for IL, AL, or senior housing, memory care unit, or other, depending on MIL's medical and mental situation. With dementia, that as well as the fall might be the guiding factors.
4. Document everything you do if you start calling facilities - date, time, name, phone number, person with whom you spoke, conditions precedent for admission, waiting time, etc. Be prepared to show that to the hospital or the state that you are in fact addressing their threats.
5. Ask the hospital social worker and discharge planner for as much assistance as they can offer - turn the tables on them and get them to do some leg work for you. You can be vague in terms of what you ask for, just get them working - they probably have some insight into local facilities, but still do your own homework and inspections.
I've suspected from past instances that there might be some cozy relationships between some, especially nursing home that was twice recommended to us but which has a very bad reputation.
This just happened again last week. One of the facilities suggested was one I had toured a few years ago and considered somewhat of a dump then.
6. Mobillize the family to help; the sooner you get away from the threat of state intervention the better. Their involvement will most likely cost you far more than you ever realize, including if they seek guardianship proceedings.
Good luck; this is an unsettling story but one from which those of us still caring for parents living independently can benefit - one day we may be in your SIL's situation.
My mother in -law was living at home by herself. She fell last week and my brother in-law took her to the hospital. The hospital had it one record that she was there 2 weeks ago. The family was told before she was discharged 2 weeks ago to find 24 care. They failed to do so, so when they brought her to the hospital last week, the hospital got in touch with a social worker. They hospital won't let her leave until they find 24 care. They are looking for home care or a nursing home. I was just wondering if they can't find something soon, what will the state do?
If you give more information, you'll get better responses, but in short, the hospital is responsible not to allow a patient to return to an unsafe situation.
Where was your MIL living before the hospitzations? Can she go back to that facility or home?
What were the reasons for the hospitalizations? Was your MIL injured in some way that might have been prevented had she been with someone?
I think any governmental intervention would be dependent on your MIL's state of dementia, her condition when admitted, most recent living situation and other medical and mental issues.
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I did some research and asked some DIY friends, we went to Home Depot (or maybe it was Lowe's), and got some pipe insulation - thick foam insulation. Then Dad wrapped it around the rungs of his walker.
It looks like something from an Arnold Schwarzeneggar movie, but it would help break the impact if he fell with it.
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I just wonder why the hospital felt it necessary to recommend 24 hour care after only the first fall. And refusing to release her after the second? 'Course there's a difference between falling down the stairs and falling between the bed and the toilet. I wonder if MIL uses a walker or rollator.
Being in an ER (or any part of the hospital) can be extremely traumatic for a person with dementia. Their symptoms may appear much worse than they normally do.
If the family thinks Mom can still live alone, they need to get her PCP and/or the doctor who treats her dementia on their side, or find other doctors who agree with them, and also retain an attorney. Personally, I think that would be a waste of effort, because even if the ER did overreact because of MIL's exaggerated symptoms, she is legitimately going to need round-the-clock care soon. Might as well face it now.
I told our kids early on, if something happens to me your dad CANNOT live alone. He will try to convince you he can, and he can be very convincing. I'm here with him 24 hours a day and he gets by fine, but believe me, he would not be fine on his own!
I hope none of this sounds like a criticism, Ann. I assume everyone is doing the best they can with what they know. But it is time to ratchet concern up a notch or two and learn more about dementia.
The fact that the hospital recommended continuous care the first time she fell leads me to wonder what else they observed. Does she have dementia? Was she dehydrated? I took my mother (who lived alone at the time) to ER after a fall and all they did is check her out, pronounce her OK, and send her home. If hospitals routinely demanded round-the-clock care for every senior who falls we couldn't build nursing homes fast enough!
So I suspect there is quite a bit more to this story.
What I'm saying is, not all falls are due to lack of care or attention.
This is what I would do, because you're going to be up against authorities with more power than you have.
1. If you can move her in with you or SIL temporarily and provide 24/7 care, that would solve the immediate threat and give you a chance to address a more permanent option. I emphasize though that this would best be considered ONLY a temporary situation. I suspect MIL needs more care than you could provide.
2. If you can't do that, is there anyone who can stay with her 24/7, perhaps hiring home care during the day and a family member staying at night? Again, this would be a temporary situation while looking for a facility if she needs one, which I suspect she may.
3. Begin looking for IL, AL, or senior housing, memory care unit, or other, depending on MIL's medical and mental situation. With dementia, that as well as the fall might be the guiding factors.
4. Document everything you do if you start calling facilities - date, time, name, phone number, person with whom you spoke, conditions precedent for admission, waiting time, etc. Be prepared to show that to the hospital or the state that you are in fact addressing their threats.
5. Ask the hospital social worker and discharge planner for as much assistance as they can offer - turn the tables on them and get them to do some leg work for you. You can be vague in terms of what you ask for, just get them working - they probably have some insight into local facilities, but still do your own homework and inspections.
I've suspected from past instances that there might be some cozy relationships between some, especially nursing home that was twice recommended to us but which has a very bad reputation.
This just happened again last week. One of the facilities suggested was one I had toured a few years ago and considered somewhat of a dump then.
6. Mobillize the family to help; the sooner you get away from the threat of state intervention the better. Their involvement will most likely cost you far more than you ever realize, including if they seek guardianship proceedings.
Good luck; this is an unsettling story but one from which those of us still caring for parents living independently can benefit - one day we may be in your SIL's situation.
What were the reasons for the hospitalizations? Was your MIL injured in some way that might have been prevented had she been with someone?
I think any governmental intervention would be dependent on your MIL's state of dementia, her condition when admitted, most recent living situation and other medical and mental issues.