What to expect after a call to APS?

Do you have to call APS? Can’t you first go through the hospital social worker? They are used to these situations and are very helpful. Then the physician can provide the paperwork.

Facilities are too expensive to do private pay. Who can afford that? Certainly not the average person. Work with the social worker and her physician.

I know someone that is going through this right now. He’s a friend who has colon cancer and recently had a stroke. He has lived alone all his life. He never married. No children. No living siblings. One nephew that lives in another state.

I recently went to see him in the hospital with another mutual friend. His doctor was there in the room examining him. His doctor told us that he needed to speak to the next of kin.

Well, his nephew travels with his job and we could not reach him. He’s a diver and he only sees Bill a couple of times a year.

Our friend, Bill gave the doctor permission to speak to us. We have been friends for 25 years. So the doctor said to us, “He’s not going home.”

Bill asked for one of us to be his POA. We both declined saying that we did not want the responsibility.

So the doctor responded to us by saying, “If I do not hear from the nephew I will make arrangements for him to be placed in a nursing home because he cannot live alone anymore. He had a stroke and needs supervision.” Bill is a little older than my friend and I.

Bill’s nephew finally returned our call and said that he could not take on the responsibility of being POA for his uncle. So the doctor will place him. We told the doctor that we will be happy to look at some of the homes that will be suitable for him. That’s all we will do, other than visit him once he is settled there.

This is unfortunate for Bill but it’s his only viable solution. He can no longer care for himself or his apartment. It’s a tough situation.

Best wishes to you.

Whoa.... learning a good deal from you all today; thanks, may need it sooner rather than later.

Whenever a doctor says XYZ about your mother, simply state: "Put that in writing because I am POA and must have a paper trail." If they won't put it in writing, then it doesn't exist.

Katiekat makes a good point: her diagnoses are listed on all her medical and hospital records. They cannot bill Medicare without diagnostic codes and justifications for tests and treatment.

Medicare billing brings me to my next point: Follow the money. When any doctor says XYZ, let them know that you will be following up with Medicare about billing and that you need her diagnoses and treatment plan in writing to verify billing.

Because she has been diagnosed with dementia, it is up to you as POA to inform the social worker and case manager at the hospital that she cannot be discharged to home and that she must be placed in long term care. No one can force you into caregiving for your mother.

She sounds seriously noncompliant and it's just a matter of time before an ambulance must be called and she's going back to hospital. Let it happen and let the hospital place your mother in a nursing home because, at that point, the doctors will have to put it in writing why she cannot live at home anymore.

Maybe in your State you need referral letters from doctors? In my State, my mom's diagnosis (dementia) was listed on ALL her medical records. This was pointed out to me by the social worker. They even did a mental status exam in rehab and followed her mental status as well as her physical progress. They made the arrangements for her to enter an assisted living facility. All we needed to do was get a current chest x-ray on her (easily done at her pcp).

So, Thanks for the clarification.

I sincerely hope that APS can find a way to get your mother into care.

Consider resigning POA and allowing the State to take guardianship. If APS "threatens" that, say "yes, PLEASE!".

If she ends up in the hospital again, proactively go to the discharge/social work department as soon as she is admitted and tell them what her situation is at home and that you have no control due to her refusals.

SoVery I understand completely the experience you are going through with the medical professionals and I don't quite know the reason why they don't offer more help. They just seem to give an accusatory look or tone. I went through a similar experience but thankfully in my case my father was amenable to nursing home care so that cleared half the battle. If your Mom refuses to go to a NH I guess calling APS may be he best way to go. Just remember, there are limits to what you are able to do as far as caregiving.

Her doctor can qualify her for nursing home, have you talked to him/her? Have you tried to get her into a NH yourself yet? How are her finances, does she have enough to self pay? If not, start planning to apply for LTC Medicaid. Please keep us posted, most of us here are in the dark as far as having APS come out. I almost had the experience but got Dad into a NH through the hospital before that could occur.

I understand why we have some of the crazy laws we have, (to try to keep people from abandoning their loved ones and taking their money) but wow, it has really made things DIFFICULT for families who have a loved one with dementia.

Can you even get a person into a nursing home without a doctor's letter? It seems it takes an injury or serious illness to get someone into a nursing home and they have to go there from the hospital. Dementia alone won't put them there.

It seems they really try to push families to deal with the dementia patient at home. This is impossible when people have to work full time and need their sleep cause we know those old folks like to party all night.

IF you move in with the person and the dementia gets so bad that you cannot manage it and you try to leave, you can run afoul of the law being charged with abandonment.

Have you or your brother requested an evaluation through the Area Agency on Aging? It's a little bit less than the nuclear option of APS.

When mom was hospitalized, were the discharge planners apprised of the fact that she lives alone?

Your mother is currently living alone I assume? Who is the POA for your mother. Does anyone have guardianship over your mother? Does anyone WANT it? If you assume guardianship that can mean a legal fight in which your mother would be assigned a lawyer.
If APS finds your mother to be not safe they may have her transported to hospitalization. This may be the easiest option as you could get a social worker on her at once. But there must be a gathering now of what resources she has, etc. And if she is completely uncooperative I am not certain myself that I would pursue any of it including guardianship; I would rather the state take over, albeit her finances and her placement are then out of my hands. I would not know how to proceed with someone completely uncooperative. Your mother is definitely beyond the level of care where she can be alone at all. She needs 24/7 placement now. But without POA and guardianship this may not be in yours and your brothers control.
Hope you will update us and wishing you the best. I have no idea how it will go for you and people seldom update us to let us know how these things work in their area, so know any information you can give US is greatly appreciated.