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AutumnSongbird Asked September 2018

How do I get my mother admitted to nursing home from rehab stay?

Here are the details: 82 yr old mom is rapidly declining. In and out of hosp/NH 4 times in just over a year. She has dementia and doesn't make good choices for her own well being which led to her developing stage 4 bedsore (refused wound clinic, refused to take vitamin, didn't stay off coccyx). She's now in an NH for rehab again after being released from one then going back in a week later. I cared for her at home but I am bipolar on SSDI and became depressed, anxious then suidical trying to care for her with 160 hours non stop. I cannot tolerate caregiver stress. She was readmitted to hospital with UTI then back to nursing home where she is now.


She is extremely confused at times and cannot articulate ideas she has about things at all at times, cannot do any level of care for herself aside from feeding herself and even needs foods very close to her even for that. She cannot stand well, they use EZ transfer to try to get her to stand (PT). She refuses PT now because of some delusion she has about something with her foot. Our home is a hoarder house that I've been gradually cleaning the last year but it's still a mess. She shopped her brains out and never did care for house. Stopped cleaning ages ago.


I know she wants to come home at some time though it seems she may not want to come home right now. I cannot tell due to her confusion. She knows I cannot care for her and she knows she has limited funds to afford home care. She knows she needs round the clock care (as best as I can tell she seems to understand this). I live with her and the home is in my name with hers. I have POA financial and health and we have an elder law attorney who is currently transferring funds so we can get her on Medicaid hopefully for October. We have just begun to consider guardianship too.


I read a lot about elderly who want to stay home or not go into a nursing home have the right to do so, but if they cannot care for themselves, are confused and refusing health care they need, are not even able to articulate thoughts in any kind of coherent manner, if their home is not 100% safe due to haording and some need for repair, and if the person whose care they would be discharged into is a disabled mentally ill adult who has stated that she cannot care for the mother at all due to her own mental illness, would it finally be accepted that this person NEEDS to be in an NH despite she might want to be at home?


I'm at a loss here because I have tried to talk to the NH caseworker and another person about her staying there and they always say if she wants to go home she can. End of story. She has made no improvement, has only deteriorated more. I just don't see how home would be safe or good for her in any way and am looking for thoughts about how I can get her into an NH where she will be safe and get the care she needs around the clock.

theoldbaker Sep 2018
Do you have power of attorney for her medical care? You should be able to get some help to do this from a medical social worker or a community on ageing office, or community health department. Have you spoken with her doctor or case worker if she has one? Not sure where she (and you) live, but here in Michigan there are resources that I've used to get more information on alternative ways to handle my SIL's as well as FIL's care.
Since she's demented I doubt she would be considered of sound enough mind to sign any legal documents including appointing you as her advocate. I had to have a doctor and a social worker at the NH facility where my non-compliant diabetic, double amputee, sister-in-law was placed, declare her incompetent so that I could activate the POA she'd signed a lot earlier. I didn't realize I needed to do that till she freaked the staff out saying she wanted to be revived in any way possible when she was supposed to be DNR! (Do Not Resuscitate)
She'd been hallucinating and fantasizing that there were Texas bugs in her room. Her Cena's were spraying air freshener to 'exterminate' them, and there were also 3 dead dogs under her bed. Her neighbor had brought a bunch of farm animals that had walked down the hall by her door. (Must have been an interesting thing to 'see'! )
Despite all that, the doctor in charge told me she thought she was competent! Wow! I also was able to enroll her in the county's hospice program later on when her nurses were not communicating well with each other, causing the administering of medications to be inconsistent. They meant well but were causing her to be constipated, etc.
Anyway, please start making calls to get so sense of direction toward a solution. I called all sorts of people and places, i.e. used my shotgun method, shoot anywhere and hope to hit the right targets! It's hard to get real help sometimes, but this forum is a good place to start. I hope you have a good support system to get you through this awful journey. Take care of your needs before anything or anyone else.- Best of wishes to you! Allison

JoAnn29 Sep 2018
Now is the time to place her into the NH. While in rehab, she can be evaluated. Like Ahmijoy said you and start the Medicaid application. Looks like you have a lawyer but I would question guardianship. If there is no one contesting your POAs then I can't see going for guardianship. Now if there is a threat that someone may try for guardianship then go that way. Its not cheap and the state gets involved.

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Ahmijoy Sep 2018
I don’t believe anyone here has ever joyfully run outside and happily cheered “I’m putting my (loved one) in a nursing home!! Yay!!!”

Of course you are hesitant to do so for your mother. But, on a gut level, you know it’s necessary. She has dementia and all it’s nasty symptoms; refusing care, no safe place for her to stay and bottom line, no one to give her the escalating level of care she does and will need. Can you in good conscience give up your life for her? It sounds like you almost have. You have recognized that you aren’t able to be a caregiver. Why keep tearing off the scab?

Speak with the social services department at the facility where she is now. Put in a Medicaid application. Let them guide you through the whole process. That’s what they’re there for. Good luck.

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