I noticed something else. Some of you are mixing up a NH. with a memory impaired unit. If they are physically fine but forget whether they have had lunch, they are NOT ready for a NH. NH are for people who are either just physically ill or both mentally and physically ill. My dad was fine as far as his memory was but he had end stage kidney disease. He could not walk. As I was dealing with a mother with Alzheimer's Their doctor put him in a NH. Later when mom became bedridden. he put her in a NH. My sister who had COPD and kept falling down was also put in a NH because she lived alone. These are reasons for NH. Not competency unless there is something else wrong with them.
My mom always ends up in Nursing Home. I had never even heard of memory care until I started reading on here. I wish I would have known about this. She just got out for second time the reason I would pick the nursing home, actually they we're both also short term physical rehabs too, so she would get stronger before she came home. But after a couple of weeks she'd start refusing physical therapy saying she couldn't use her legs. She always comes home weaker. Do you know if the memory care places have temporary physical therapy as well?
I have not read every answer but from what I have read it sounds as though the people who wrote them are under the impression that you don't require a doctors opinion in order to go to a nursing home. I have had three member's of my family in nursing homes. All were recommended by their PP. Unless a doctor says you need to be in a nursing home I doubt you can be admitted. It is not a hotel. It is for people who are not physically capable of caring for themselves. It doesn't matter who is paying. Does her doctor believe that there is some one at home to take care of this person? If there isn't than I am at a loss as to why he is refusing to have her admitted. Maybe you need a new doctor. Good Luck
Drs. Aren't the ones who send patients to nursing homes. When I had to have my dog put to sleep the vet said she wouldn't just kill my dog there had to be something wrong with her. There was and she did. Bad analogy perhaps but you don't give much information. A Dr isn't going to commit anyone unless they are a danger to themselves or others. Then it's to your local mental hospital not a nursing home. Is your Dr saying there is nothing wrong with mom? In CA I know that mom's primary care physician had to accept medcare Cal? In order for her stay to be paid for is that the issue?
The doctor is not the one who determines if your mom meets the criteria to be admitted into a nursing home when Medicaid may ultimately be paying for her care there. To ask about her undergoing a Pre-Admission Screening (PAS)assessment, to determine if she needs to be in a nursing home, contact your local Area Agency on Aging or similar organization in your state. Your mother, may refuse the (PAS). And, if she doesn't and is approved for nursing home care, she can refuse to go to the nursing home. The bottom line is----a doctor does not have the authority to make your mom go to a nursing home.
That is correct! Medicaid Long Term Care has Freedom of Choice. And for a Nursing Facility, a person must meet the Level of Care criteria. And if a person is of sound mind and does not have a Determination of Incapacity (to make his/her decisions), then someone cannot be "forced" into a nursing home.
HOWEVER, after reading and learning so so much from this forum, if a person needs nursing home care and that person could be admitted to a hospital (maybe a UTI? some other situation that pops up), then talk to the SW/CM/Discharge Planner and if the person meets the LOC for a nursing home, let him/her know that the person canNOT come back to the caregiver's home and "has no where else to go" and be firm about it.
Did you ask her doctor why he does not agree with nursing home admission?
Has the OP posted anything else since original post 2 weeks ago?
I would find another doctor at once - but first interview them to determine which one you feel comfortable with. I don't like the sound of this doctor. You have to take steps to protect yourself.
Also at least in CA unless your going private pay the patients primary care physician has to be a Medicaid Medicare? Can never remember which is which anyway he needs to already be (one of those two care or caid) accepted dr.
Why do you think she needs to be in NH? And what did he say for the reason he will not admit her? Anyone can go to a NH as self pay. If you are trying to get her there under Medicare or Medicaid, she has to meet certain criteria. Not sure if it's the same everywhere, but where I am she needs to be released from hospital to NH...not from home to NH.
You have to be pretty helpless and have serious medical needs to be eligible for nursing home placement. Perhaps your MD doesn't see your mother as being qualified for that level of care. Since there is a shortage of Primary care physicians, I doubt very much that he should be worried about losing a patient to the nursing home House Doctor. Also please look into costs of AL and Memory Care. They are not usually covered by Medicare. ( As is also true for long term care) Most assisted living facilities are private pay, but may have a few options for lower income residents.
Is it because your mother is still legally "competent" and that is the sticking point with the doctor? Otherwise, the doctor doesn't need to sign off, it is the facility that makes the admitting dx, I think. If competency-the most basic, crucial legal status for an adult- is at issue, the doctor should/must be scrupulously cautious before deeming your mother incompetent- as she/he MUST be. If you are her health proxy (or legal one in the absence of a health one) important criteria must be met before your legal responsibility is "invoked." That medical determination can be revoked if the person's medical/mental status changes- as should absolutely be the case- but once the "proxy is invoked" it can be a slippery slope-and many an old person's basic human, legal and civil rights have been stolen from them illegitimately.
With my mother, it was when she was in the throes of a terrible UTI- and very delirious-that the proxy was first invoked. For many months following, this status was not again even questioned- and it could have been (there were docs who did not know my mother or me well enough to presume).
If forgetting if she ate or getting lost while driving is all that is wrong with her than she is not ready for a NH. NH are for people who can no longer do anything for themseves including but not necessarily only feeding, dressing, using the toilet. Most are bedridden. It sounds as though she may be a candidate for AL or memory care. Perhaps if you asked the doctor if he thought she was capable of living on her own, he would tell you what you want to hear.
We had same issue lawyer advised us to seek another doctor. This is for my Aunt who has dementia but her doctor says she’s fine. no she’s not fine. When you can’t remember if you ate your sandwich something is wrong. When you make a wrong turn and drive way out of your way and have no idea where you are and end up in a hospital something is wrong so seek another doctor that deals with the elderly
Nursing Home is different than Memory Care or Assisted Living. She may not need the Skilled Nursing care that a Nursing Home would provide. Ask the doctor about Memory Care or Assisted Living placement. If that does not work.. personally I would tell the doctor you will be looking for another doctor.
Shad, when my Mom went into a nursing home, she could no longer use her long time primary doctor. She had to use the nursing home doctor. Thus, her primary doctor lost her as a client.
Lyndadee, after reading your profile about your Mom, I am surprised that he won't sign off so your Mom could enter a nursing home. Maybe he feels that Assisted Living would be a better choice.
May I ask if this is an issue where your Mom would need Medicaid to help pay for being in a senior facility?
Why do you feel she needs NH care? Why does the doctor feel that she’s ineligible or inappropriate for the placement?
Does she have professionally diagnosed physical/emotional/cognitive issues that suggest the need for such a placement?
If you hold her POA, are you willing/able to have more diagnostic work done to confirm what you consider the need for more intensive care than she’s presently receiving?
It’s very frustrating to be made to feel that you’re not being listened to.
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HOWEVER, after reading and learning so so much from this forum, if a person needs nursing home care and that person could be admitted to a hospital (maybe a UTI? some other situation that pops up), then talk
to the SW/CM/Discharge Planner and if the person meets the LOC for a nursing home, let him/her know that the person canNOT come back to the caregiver's home and "has no where else to go" and be firm about it.
Did you ask her doctor why he does not agree with nursing home admission?
Has the OP posted anything else since original post 2 weeks ago?
Also please look into costs of AL and Memory Care. They are not usually covered by Medicare. ( As is also true for long term care) Most assisted living facilities are private pay, but may have a few options for lower income residents.
If competency-the most basic, crucial legal status for an adult- is at issue, the doctor should/must be scrupulously cautious before deeming your mother incompetent- as she/he MUST be. If you are her health proxy (or legal one in the absence of a health one) important criteria must be met before your legal responsibility is "invoked." That medical determination can be revoked if the person's medical/mental status changes- as should absolutely be the case- but once the "proxy is invoked" it can be a slippery slope-and many an old person's basic human, legal and civil rights have been stolen from them illegitimately.
With my mother, it was when she was in the throes of a terrible UTI- and very delirious-that the proxy was first invoked. For many months following, this status was not again even questioned- and it could have been (there were docs who did not know my mother or me well enough to presume).
She may not need the Skilled Nursing care that a Nursing Home would provide.
Ask the doctor about Memory Care or Assisted Living placement.
If that does not work.. personally I would tell the doctor you will be looking for another doctor.
May I ask if this is an issue where your Mom would need Medicaid to help pay for being in a senior facility?
Why does the doctor feel that she’s ineligible or inappropriate for the placement?
Does she have professionally diagnosed physical/emotional/cognitive issues that suggest the need for such a placement?
If you hold her POA, are you willing/able to have more diagnostic work done to confirm what you consider the need for more intensive care than she’s presently receiving?
It’s very frustrating to be made to feel that you’re not being listened to.