How to get Mom into a nursing home against her will?

Hi Feathersmith, I'm sorry you are in this position. It is a tough situation, especially when mom is still with it enough to be uncooperative and unwilling.

You can't just call 911 or the ambulance for any reason, there must be a somewhat valid emergency. What worked for me is my father kept trying to put his jacket on and kept trying to walk out the door. I called 911 because I was frightened by his behavior. I told the policeman what was going on and he thought it would be best to have him evaluated because he "didn't want to be called 3 hours later to search for an elderly man with dementia wandering the streets". So off he went, and once in the ER, the next day (actually it might have been Monday, and I called on Friday night) I met with the SW and case manager at the hospital and conveyed to them the situation at home wasn't good for either of us for him to be there anymore. They held him and found a facility in about a week or so. So, you need a good reason to call 911, maybe after she falls, or maybe she wanders away, or for some other reason that you suspect she may need to be looked at by a Dr.

Once she is there at the hospital, there is a possibility that things may not go as you would like. The hospital may try to send her back home. That is a very real possibility. At that point you may have to resort to tactics that may seem unappealing or undesirable and are not easy to do if you really want to have mom placed. You are going to have to battle with the hospital case manager and you might have to have APS get involved. You are going to have to be persistent and consistent and unequivocally and forcefully state to them that you are unable to safely take care of her anymore. You may have to fight, so you are going to need to stay strong.

You can also try contacting a SW before you do all of this. You can have mom's Dr. send a referral to the affiliated hospital or health group network.

Keep us updated, there are a lot of knowledgeable people here that can help.

Bring her to the ER by whatever means you can get her there. If it's by ambulance, then tell the paramedics on the phone that you are doing a 'Social Admit' for her at the hospital and cannot get her there on your own. Also that she will be a hostile transfer.

The more commonly known slang-term for a 'Social Admit' is an 'ER Dump'.
You follow the paramedics and when everyone's arrived at the ER you ask the nurse to send down a social worker because your mother needs a 'Social Admit' (be sure to use this exact term).
When the social worker comes down to talk to you, tell them that you cannot provide adequate care for your mother anymore. That you will not be her caregiver anymore. They will make all kinds of promises of unlimited homecare and resources if you take her back, but will deliver on none.
If you take her home, you are assuming responsibility for her. So don't do it.
The hospital will admit her and keep her there until they find an available bed for her in a memory care facility.

My mom did not have a serious injury, but had not gotten out of bed, nor eaten when I bought food to her. She lived by herself, took zero help and suggestions from anyone, including Adult Protective Services. They had been working with her for a few months after I alerted them to the mild cognitive decline diagnosis mom received 3 years prior.

I called 911 and reported her as unresponsive to me, laying on her left side in bed and could see her breathing. Awfully compassionate EMTs arrived and ultimately took her to the ER. Mom always believes a professional rather and me, so they had a MUCH easier and pliable woman in mom, at that time. She was not stable enough to walk by herself and without eating, they said it would be a good idea for them to find out why. She agreed with THE EMTs. Had I suggested it, there would have been NO WAY she’d have responded positively.

I stayed out of the EMTs way as they dealt with mom so she didn’t think I was ‘interfering’, even though I am POA & have medical directives. Mom has Medicare and is Medicaid pending. She eventually went to LTC from rehab from the ER.

Wishing you strength to make the call and in returning to caring for yourself.

Your giving Mom a choice and there is none. She is not competent to make informed decisions any more. If Mom has money of her own, use it to place her in a nice Long-term care facility that takes Medicaid. When her money is almost gone (2 or 3 months worth) you apply for Medicaid.

If Mom only has her SS and some pension, then I would visit some LTCs and ask questions. First do they take Medicaid. Then see a Medicaid caseworker and start the application. If Mom has no assets, it should be fairly easy. In my state you have 90 days from date of application to spend down any assets, get info needed to the caseworker and find a place for Mom. For my Mom, she had 20k. I placed her May 1st, she paid for May and June. I started the Medicaid application in April. By June I confirmed the caseworker had everything he needed and Moms Medicaid started July 1st.

If Mom ends up in the hospital allow her to go to Rehab. While there, have her evaluated for 24/7 care. If its confirmed she needs it, then tell them you cannot care for her any longer and she will need to go to LTC. Where I live Rehab and LTC are in the same building. So very easy to transition someone from Rehab to the LTC side. You can refuse to take her home with the hospital, too, just say she needs LTC but easier if done at Rehab.

Yes, Feather, you must now begin to care well for yourself. You know it is time to step back from caregiving to concentrate on YOU and process all that has affected you emotionally over the last several years.

’Maintaining compassion’ is difficult day in and day out! Your mom has been blessed by you and the care you’ve provided.

As you recognize waning compassion, please see it as a signal and opportunity to make alternative care plans for mom.

Continued progress and strength on this journey.

First of all, never blame yourself for a loved one suffering from dementia. It’s not like the flu or a broken leg! It takes months or years to get them tested. My mom didn’t think she needed to see the doctor or answer any of the questions the geriatric neurologist asked her. Doctors were hesitant to give her a diagnosis of dementia. They called it cognitive impairment.
We had a professional caregiver everyday for 3 years. When she started to imagine people coming to her house at night, or people stealing from her, cooking and not eating, the next step was necessary. She would call 911 once or twice a week stating it was her heart. Even the paramedics told me she can’t be left alone. She needed help taking her meds, cooking, housekeeping etc. we did what we could. I was POA so I dealt with her finances. Not an easy task. She forgot to pay her bills, never opened her bank statements but accused them of never sending them.
I started to do her taxes only to find papers from 1986 mixed in with current papers. Had to search thru boxes for paperwork. After three years of organizing and reorganizing only to have mom mess them up again, I knew it was time. Enough! I couldn’t do it anymore!
So we began visiting and interviewing (8) facilities . Chose a new facility where we thought would be perfect. When she was suffering from anxiety and wanted to go to ER, we took her. In the meantime, her furniture was moved to her new home. We had her taken to her new home directly from ER.
She became aggressive, and attacked her aide. My mom never would have behaved that way. She tried to escape and made it once. Her care was subpar so we moved her to another more expensive Memory Care facility and loved it.
It was a hard journey and it wasn’t easy but it was what mom needed. Yes, there was guilt, but I couldn’t do it anymore. My mental and physical health were affected.
Thank goodness I found this site. It helped to know I wasn’t alone. Everything I was going through was exactly like fellow members. They helped me through a difficult time.
Sorry my post was so long. I hope it helps others know they are not alone.

No, you cannot reason with a person with severe dementia.
You tell her you're taking her for a ride (somewhere she likely would want to go - a garden, museum, lunch at a restaurant).

You want to keep her calm.

When you arrive, tell her you are visiting a friend there.

Comfort her as much as you can. Keeping her as calm as possible is key to an easy transition for everyone.

Remember to remember ... put yourself (your head / brain) into how her brain functions (parts dying, confusion, fear) and respond to her accordingly. You cannot 'think' react/behave according to how you think; you have to consider how she thinks and interprets change / behavior.

Smile, hold her hand.

When you are there (introduce her to staff as 'my new friends.'

I hope this helps.

Gena / Touch Matters

Your last sentence is important " you have POA and durable power of attorney". Proceed to find a facility that you choose , make arrangements for her admit into the facility THAT YOU choose and ,arrange transport ( facility Social Worker should be able to help ) .
do NOT try to reason with her ! Dementia patients cannot reason, make safe decisions, nor retain what is said to them. DO NOT try to EXPLAIN it anymore. For her safety, well being and your safety and well being act now. If while you are doing this, she falls, presents with any sign of illness, behavior changes etc etc, call 911 immediately, have them transport her to ER and, confer with Social Services there, refuse to have her sent back home . Have them admit her if necessary and then transfer her directly into a facility (
she is unsafe, your health will not allow you to continue care etc). Do not feel guilty, do not allow her to verbally abuse you or make you feel guilty. She needs 24/7 care in a facility , most likely memory care unit.

If your mother is as disabled and poorly functioning as you describe, it is no longer her choice.

As others have said, there is no "reasoning" left. Persuading your mother to agree to placement is not part of the argument.

You will be limited to facilities that accept Medicaid, but the choice is no longer your mother's.

Long term care, memory care, and home care aren't the only solutions. See if you have any adult family homes near you (especially ones that have several homes, including one that is lock down for agressive sundowners). I went that route with my dad and the place he first was placed in was really nice...he ended up being with only one other resident and a caregiver with a nice patio, his own room, being catered to, etc, etc. He was really happy there for a short time, but unfortunately he progressed to where he got really bad sundowners, became agressive (jumped through a window because she wouldn't let him go outside to go for a walk at midnight) and had to be taken to their lockdown residence where there were 5 other residents and two 24/7 caregivers. He still had his own room, regular meals, and much more care than if he had been in a place with 30-50 residents. Both places were within 4-8 miles of me so I could visit often, and (if he lasted that long....) would have allowed him to transition to medicaid....ALL their residents (for this one place at least) could transition to medicaid after 3 years of self pay.

If we had gone the other route (assisted living, or memory care) I feel he would not have gotten as personalized care, he wouldn't have been as close for me to visit, it would have cost more and the places I visited would only allow a certain percentage of medicaid beds...so no certainty that he could have transitioned to medicaid after 3 years.

That doesn't answer your question of how to get your mom there, but I did want to throw in the thought of an adult family home. They are actual houses in actual neighborhoods (maybe even in your neighborhood...?) and are a name rather than a number.