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I can no longer care for my husband that has dementia in the way he should be cared for. Financially we are not able to provide the in-house care that he needs while waiting on Medicaid to determine if he is eligible. In spite of him not having a medical emergency I need to take him there and go from there if this is at all possible.

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You're going to have to LIE if you're not already where you sadly may be heading. That's a decision only you can make. IF you are desperate enough, you're going to have to try out for the next academy awards. Most people will NOT go to these lengths.

You would have to make it all up. Such as "My husband has been telling me his chest hurts. He was sweaty and nauseated. He had trouble breathing and his color got bluish; now he can't even remember ANY of it".
This MAY get him EMS transport to the hospital for EKG and blood testing to rule out heart attack.

The fact is that getting someone admitted to care works better and faster from admission to hospital because of the Social Workers there access on weekdays.
However, today the social worker him/herself is going to try to shoot him right back home. Because honestly they care about getting him out of there more than they care about anything happening to you. Honestly, these days I think no one cares what's happening to you.

You should research the words ER DUMP yourself before you attempt anything this desperate. And know ERs are now onto it.

Other way out is that you yourself are hospitalized with sx. of a nervous breakdown and/or suicidal ideation. Because he can't be left alone he may have to be admitted himself. That's the time to tell social workers you cannot do it anymore. Know that any such diagnosis will FOLLOW you. Your medical records may in future be accessed. This is very risky stuff. And is honestly done by folks who ARE desperate.

So I am telling you that this is DIRE and you must--frankly--be willing to do just about ANYTHING to accomplish it. I would, instead recommend the following:
Call APS? Tell them you are desperate and frantic and cannot go on, that you are at the end of your rope and request a wellness check for you both. Tell them you no longer feel your hubby is "safe in my care". Don't elaborate. If they say "just what do you mean" tell them you no longer have capacity to know What in the world you DO mean.
They may be able to expidite or help you do so.

The ER dump used to work. I don't think it does any more. They are onto the desperation of the populace. You're better to know that, while today you feel desperate, these feelings are much like weather fronts that come and go. Get help from anyone who WILL help in whatever way they can. Consider respite care no matter how full the charge card is. And then keep plugging away the slow way.

Try aging life helpline at www.aginglife.org to ask about your desperate circumstances.
Consider speaking with volunteers at Alz.org. Ask doc for emergency psychologist appt.
AARP has an advice hotline. Facebook has support groups.

988 is the suicide hotline if you ever do need to make a call to them. Be CAREFUL on this one. They can pretty much trace you as soon as you are on the line. Take care what you say. Give your situation briefly. Tell them how long and how difficult. Tell them you are currently having anxiety attacks and you are feeling desperate (as you have told us) and you are afraid of what "Might happen".
They are going to ask you if you feel you could harm yourself/anyone else.
That's the time for a long pause and a lot of crying. Then a drawn out "I hope not. I don't think so. I don't know. I am just so desperate right now".
They are going to try to get help to you at this point, so be willing to accept it if you are in need.

I have seen it all as an RN. I have seen caregivers also say nothing, and actually end up dead or in the dire straits I list above. Please take good care. Get support for yourself now. Please update us.
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NeedHelpWithMom Jun 1, 2024
Alva,

I think your assumptions are correct.

We have had posters on this forum, who have stated that they have tried to do the ER dump and were not successful.

Some posters make an ER dump sound easy. In reality, it isn’t a simple matter.
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I have been in enough ER's to last me the rest of my life if I never have to set foot in one again, and I can tell you here, in NY, in my personal experience, I have seen hospital ERs release patients who were CLEARLY mentally ill, with NO ONE with them, and NO ONE at home to take care of them (I've overheard the conversations, HIPPA be damned - those curtains between bays don't keep sound from traveling) with nothing more than a voucher for a taxi ride. I have seen nurses and staff actually CALL the cab companies themselves if the patient lacks the wherewithal to do it themselves.

I've also had family members who were admitted to the hospital get asked by the nurses and admitting staff "so, who do you live with?" They aren't trying to make conversation - they just want something to type in the category under "patient lives alone?". Just so they can release them back home. I never, ever had someone at the hospital ask ME as the person with whom mom lived if I was up to, able to and/or willing to be her caregiver. Even telling a doctor at point blank range, when she wanted to release my mom - who couldn't walk 10 steps, much less be able to make it into our home - that she was an "unsafe discharge" I was met with disbelief and derision. I had to threaten this doctor with legal action if she released my mother when my mother was clearly - ***CLEARLY*** - unable to be able to walk any distance whatsoever.

The point is hospitals - at least here in NY - are also overworked and understaffed. Especially in the ER's. People who can't get into their own doctors' offices when they're ill - I mean, my husband was told by our doctor that it would be 2 weeks before they could see him when he had cellulitis on his foot - and can't or don't want to wait head into the good old ER for their treatment. Just a few weeks ago I ended up in the ER with my husband for a kidney stone - he's had them before, he just needed the Flomax, and of course it was Friday night, so no getting in touch with his doctor - and we waited for over *8* hours just to get him into a bay to be seen. And that's with a simple diagnosis, easy to confirm and easier to treat. So, I don't think an "ER dump" is going to achieve what you are looking for, unfortunately. I agree with the others who have stated here that if there's nothing medically wrong with him, they'll "rubber stamp" him right out the door, regardless of whether you are there or not.

I really think you need to start with your husband's primary care provider. Put this out to him/her. Describe exactly what it is you are finding difficult. I don't mean "well, it's not easy because he's incontinent" or "he gets Sundowner's bad", I mean graphically and fully describe it: "He s***ts himself, then goes into it and smears it all over the walls"; he pulls down his pants and p***ses all over the floor"; "as soon as the sun goes down he runs around the house smashing things and threatens me"; etc. This is not a time to be "politically correct" in your descriptions, nor is it a time to be stoic in the face of a medical person. If HIS doctor won't listed, contact YOURS. Even if they can't directly provide you with help, they *** should be*** able to guide you to someone, some agency, that can help. But you can't downplay it, and you can't settle for some vague "we'll see what we can do" nonsense. You need real solutions, not platitudes, and you need to tell them that.

I really hope you can get the help you both deserve.
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Isthisrealyreal Jun 2, 2024
!!!THIS!!!

Nge, I completely hear you and fully understand. Your mom is fortunate that you are her advocate. Any person, regardless of anything, truly needs an advocate dealing with medical care in AZ as well. I bet it's the same everywhere, not enough staff in any department creates hard situations for everyone involved.
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I posted way back in the beginning of this thread.

The OP hasn’t responded to anyone’s comments.

Occasionally, threads on this forum become a debate between posters.

A respectful debate will present the opportunity to view a subject from various perspectives.

I find it tiresome, when threads start running amok, and posters become disrespectful. I find it pointless to argue just for the sake of arguing.

Most people aren’t offended by constructive criticism or an opposing view.

People are offended, if they feel attacked. Then, they will naturally defend themselves.

Some people get caught up in a conversation. Posters may compete to get the last word in.

Others don’t like confrontation, and they stay out of it entirely. To each his own.

We can be true to ourselves and still be respectful to others.

Depending upon an individual’s personality, it can be difficult for them to not want to drive a point home.

Nevertheless, I think everyone has had days when we wish that we would have kept our mouths shut. Plus, other days when we wish we had spoken up about something.

Overall, this forum is a wonderful resource for people to share their experiences with caregiving.
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Evamar Jun 3, 2024
Very well said NHWM
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You don't need to have a medical emergency to bring him to the hospital and ask for a 'Social Admit'. When you bring him ask in the ER if you can speak with a social worker because you need a 'Social Admit' (be sure to use this term) for your husband because you are unable to meet his care needs and you refuse to allow him back home.

They will send a social worker to speak with you. At this time the social worker will start telling you about countless and unlimited homecare resources that they will send if you will take him back home with you. This is a lie that they will tell you in the hospital because they don't want to be forced to admit him and they will be forced to if you refuse to take him back home with you.

The hospital will admit him and will keep him there until they find a care facility with eligibility who will accept him. You do not have to sign over any POA or anything like that either. The hospital will expediate the Medicaid process and whatever facility he gets placed in by the hospital will accept him even if Medicaid is still pending.

I hope for your sake that your assets are Medicaid-exempt and protected. Even if they are not, Medicaid is not unreasonable to deal with. They will not kick a spouse out of a shared marital home and leave them in the street because they demand all the income. They don't.

What a nursing home tries to demand is not the same as what Medicaid expects. Nursing homes and memory care facilities try to intimidate families so as to be able to squeeze out every cent they have up front. Ignore them and whatever nonsense threats they may make. Dealing with Medicaid is okay and when your husband gets his pending application approved, he will have a state caseworker. This is person you deal with. Not the business end of whatever nursing home/memory care the hospital puts him in. Good luck.
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AlvaDeer Jun 2, 2024
I didn't work ER, but sometimes floated there. I have NEVER seen this in all my years in hospital care. Is this new?
I have seen an admit where the wife stroked at home and was the caregiver, and hubby was admitted while she was in until they both went to placement, but I never heard of a social admit before.

I need more details.
Sending you a PM. Watch for me.
If this is possible then it kind of changes everything I know.
After you posted this I found this online. I truly learned something of tremendous value to me today! THANKS BURNT.
From online:
"A social admission is a hospital admission for which no acute medical issues are felt to be contributing; rather the patient’s social circumstances are felt to be the sole cause, be it the breakdown of home supports or the inability of the patient and/or family to cope with the demands of living at home1234. It is generally accepted by healthcare professionals to be a patient with no acute medical needs that is brought into a hospital because no safe discharge arrangements could be made at the time they presented2. Social Security Act §1814(a) requires physician certification of the medical necessity of services to be provided on an inpatient basis5."
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It's called lying, or if you prefer... telling a little fiblet. You just make up whatever you need to to get him there. A UTI is always a great go to.

And then just make sure that you don't bring him back no matter what the hospital staff will promise. You tell them that he is an "unsafe discharge" and that you just can't care for him anymore. Period. End of sentence.
They will have to find placement for him.
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mstrbill Jun 1, 2024
Agreed. And if they start threatening with “abandonment charges “ or something similar, tell THEM to call APS. APS will look out for his safety, and fear not of being charged with any crime. It’s an idle threat with no weight, no prosecutor will bring charges against an elderly person who can’t handle taking care of a demented spouse.
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Hey Burnt-
Do me a favor and STOP telling me I don't know what I'm talking about.

I get you are in home care for 25 years.

I was a COP for 25 years. I dealt with ALL MANNER of domestic violence situations, things that would make your hair stand on end.

It is NOT a good idea for the OP to LIE and say she's a victim if she's not. For many different reasons.

THIS OP HASN'T EVEN SAID WHY IT IS SHE NEEDS TO PLACE HER HUSBAND.

The only thing she has said is that "I can no longer care for him the way he should be cared for".

It is the posters answering her who have come up with this scenario. NOT THE OP.

I think it is EXTREMELY DISRESPECTFUL OF YOU to CONSTANTLY tell people who disagree with you that they are stupid/morons/don't know what they are talking about.

Maybe you should come to an epiphany that, while you may have a valid opinion about something, SO DO OTHER PEOPLE.

So let's just agree to NOT respond to each other anymore, since you clearly think I'm an idiot, and I can't say I think much about you, either.
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BurntCaregiver Jun 3, 2024
@notgoodenough

The only reason I said you don't know what you're talking about is because you don't. Presenting an opinion with authority doesn't make a fact.

I have never called you or anyone else here an idiot, moron, or stupid. So why don't you stop over-dramatizing and falsifying things that have never happened or been said here.

I am not offering opinons here on what a 'Social Admit' is or how to go about getting one. I'm speaking in FACTS from experience with this. I also did caregiving for 25 years in the field as you well know, and operate a care agency. I would never have gone into business if I didn't know the ins and outs of this business.

One such 'in and out' is knowing when homecare is no longer a working option for a client or their family. Of course this way of doing business is an unusual model for a homecare business. The almighty dollar is not all that matters to me in business. I think this way because I have so many years in the homecare field so I've seen every care situation and family dynamic there is.

Sometimes, the 'Social Admit' aka 'ER Dump' is what a person has to do. Sometimes you have to say a person gets violent to expediate getting them the care they need. It's not pretty sometimes but unfortunately this is often the American healthcare system.

So you can go up on high and preach all you like about right and wrong but it won't do a damn thing to help the OP who's at the end of her rope caregiving for her demented husband who needs to be placed.

Taking my suggestions about a 'Social Admit' and mstrbill's advice in saying that the husband is violent and there's a child in the home, will get that guy placed.
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With dementia, a medical emergency will happen sooner or later. Be patient.
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AlvaDeer Jun 1, 2024
There sure is that, and I often say that as well, Fawnby.
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You are the only one who can decide what is best for you.

Just read your profile. You are caring for your husband and raising a grandchild. That’s a lot!

You are wise not to want to push yourself past your limitations.

Wishing you peace as you struggle to sort through this difficult situation.
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Have you contacted social services for your county to see if they can come in and do a needs assessment? It won't solve your problem but may help provide some in-home help until he either qualifies for Medicaid or has a medical emergency that gets him into the ER.

Also in the meantime, consider calling large local churches to ask if they have an Elder Care ministry. They may be able to provide some temporary volunteers. You don't need to be a member or evem a believer.

You can also try joining Nextdoor.com and posting an appeal for help. Depending on where you live you might get more > temporary < help than you know what to do with.

Calling your local Area Agency on Aging might provide other resources for you as well.
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The ER dump can work, but in some cases it depends on how you handle it. I disagree with some of the opinions below, but it is okay to disagree here. We’re all trying to help. The key word or question that needs to be addressed is safety. Is husband safe? Are you? Are you able to be with him 24 hours a day? Maybe you are not able anymore. Would that put his safety in danger if you were not there?

I agree with Geaton. Before sending him to the ER, contact AOA and tell them you are at the end of your rope and need assistance. If they don’t help, you can contact APS and tell them you can’t safely take care of him anymore. If all else fails, call 911 at the next opportunity, tell the police officer you’re afraid for his and your safety. Tell him your husband was trying to leave maybe. If the cop believes he’s a wanderer, he will likely have him transported to the ER simply because he doesn’t want to be called back to search for him later. The key is getting him to the hospital and getting them to do a social admit there. You need to tell the SW there that it is unsafe for him at home because you don’t have the resources or ability to look after him 24/7 anymore. Now if they were to send him home, you just have to keep sending him back, and call a state social worker. Eventually the message will get across and you will get some help. But how easy it is or how vigilant you must be will depend on the hospital and the people there.
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