I took my mother home last night, the social workers at the ER reached out to APS last week and I got an order from the courts to take her home because she had no medical reason to be in the ER.
I have an emergency hearing on next Tuesday because of the APS call from the hospital. My question is two fold, what exactly happens when the state takes over? My attorney has told me that community guardians are overworked and understaffed so they do cut a lot of corners when it comes to care.
What experience do others have with community guardians. My attorney told me it is a coin flip and it is extremely difficult to switch them.
I am also afraid they are going to try and use that my mother is doing well against me, has anyone gone through that? Where they try and frame your parents well being as a reason to not give up because their quality of life is not going to be the same. How did you navigate that situation.
I am in my 60s, the family has money, and my brother handles my mother’s finances. I was able to find an excellent MC for my mother so I am not responsible for every aspect of her care. I can not imagine taking on the care of a loved one with dementia at the age of 23 with no one to help and no funds! I wish you had the opportunity to focus on yourself as you entered adulthood.
I can not comprehend what you are going through but I really admire how well you have been handling everything. I can only hope that the judgements go in your favor and you can have your life back while finding the best solution for your mother. Please remember to take care of yourself during all this as well!
The person is placed in a facility that can manage their care. And they may have to place her in the first facility that has an opening.
If the person has financial resources those resources will be used to pay the facility for the care.
As to the facility itself...Yes many are understaffed.
What is difficult is if your LO has few assets and they are relying on Medicaid. There are fewer "Medicaid beds" and trying to transfer from one facility to another can be difficult as there are waiting lists for "Medicaid beds"
If you can not care for your mom they can not make you personally, physically take care of her. What you would do as her Guardian is place her where she will get the care that she needs.
But as her Guardian you will have to keep meticulous financial records, medical documentation and you will have to provide a document at least 1 time a year as to her status.
Being a Guardian can be time consuming and it can be expensive if you can not do this then she will have a Court Appointed Guardian. You will have little to say as to where she is placed. I would like to think that the Judge and the Guardian appointed would take where you live into account.
Thank God for POA, with my two family backups when I could no longer help Mom until she passed away at 95. I truly believed our faith helped us survive!
Put your oxygen mask on now!
When we petitioned to get guardianship of MIL, we had to provide a care plan on how her needs were to be met. We were told if there were any changes or problems arose, we were to return to the court for further instructions. THAT was our only option as guardians and was an expense we were told upfront would be ours to pay.
IMHO, your only option is to return to the court for further instructions.
What if OP has a serious auto accident and ends up in ICU, or permanently disabled/paralyzed? What happens to Mom then?
Or, what if OP has a serious accident and dies? What happens to Mom then?
What I gather is that Mom must have one-to-one care mainly to EAT. She can bathe, toilet, dress herself. She can't communicate well, because she speaks her own (homemade) language. OP says without one-on-one, the problem is Mom "wanders off/gets into trouble." Isn't that the hallmark of MC, to keep patients from wandering/escaping at all times? The primary reason for placement in MC?
I would also think if Mom needs total help to eat, she would be fed similar to other dementia patients that require help eating (such as to prevent choking)? Thus, in between meals, she can wander the locked floor she is on, that prevents her escape, right?
How does Mom now attend adult programs during the day, which usually serve snacks or lunches? Must OP attend with her the entire time? Can Mom drink water or juice without OP holding a cup for her? Must it be the OP only, and Mom refuses an aide? If Mom eats 3 (assisted) meals a day (say 3 hrs), what about the other 13 hrs a day (21 hrs. less 8 hrs. sleeping)? Does Mom require a sitter those hrs, mainly to prevent wandering? The MC already prevents that with lockdown conditions. Thus Mom does not REQUIRE one-on-one 24/7?
These are all reasonable arguments that could possibly get Medicaid to drop the one-on-one requirement that is preventing Mom's placement.
Just throwing this out there to possibly help OP's case.
In her case, it seems a psychiatric admit would at least get her some observation, calming meds and/or a diagnosis to admit her into Memory Care. Since a doctor needs to order the placement, at least you would have someone with the authority to admit or recommend an admit for Mom.
If a public guardian is assigned, there is no reason you cannot help your Mom, as you are able, after that.
Even if the behaviors are a sign of depression or anxiety current treatment goals and methods exhaust non pharmaceutical options first. This is where the problem comes into play. She does very well with assistance and that one to one. She goes from a 2 to a 6 or 7 in terms of ability to engage and function.
While I don't appreciate the tone of burnt yes medications are not used to make someone easier to place if they need a one to one to function that is what they need to function and a facility should accommodate that but reality unfortunately does not align with the ideal.
The guardianship makes this complicated because I am legally obligated to provide her with proper care and if I cannot it is my duty to do so. So if I cannot get her placed using her MLTC I have to wait until she progresses to a point where she can. Yes, in theory if I let something happen to prove she is unsafe it is a catch 22 cause it is my job to make sure she is safe.
Currently exploring what they call NHTD wavier which allegedly provides 24 hour care for people that need that level of care but require more social intervention rather than medical.
I am really relieved that you have legal help. I think it is badly needed.
People as bad as or much worse than your mother are every single day placed into care.
Why that isn't happening here I can only wonder.
I do wish you the best, unamused.
Hope you will update us after the court date.
Like I said, invite them to imprison, house and feed you. At least then they will have to appoint someone else to Mom's guardianship.
If you're unable to be a competent guardian and find your mother a memory care facility, the state will. APS is trying to scare you because they don't want to use any resources for a case like your mother's. APS because of the current "government efficiency" nonsense going on in Washington is basically working on a budget of next to nothing. So, a senior like your mother who appears clean, well-nurished, and thriving is not going to be a priority to them even if you refuse to continue caring for her. You're going to have to get her placed youself, or if the court removes you as guardian like you've requested, they will find a place.
Find her a memory care facility and place her. You may as her adult child and next-of-kin have to keep her for a few weeks until there's an available bed in a memory care facility somewhere in your state. Or until your name is removed as guardian. So instead of paying big bucks to your lawyer who is doing nothing for you, spend that money you're shelling out on some temporary homecare until you get your mother into memory care.
Also, medicating a person to make them less co-dependent is abuse. This is not a valid medical/psychiatric condition which is why no doctor is helping you out. In fact, you should be ashamed of yourself that you'd even ask that. Elders with dementia are medicated for real conditions like anxiety, agitation, depression, aggression, dementia- related psychosis, and hyper-sexuality. Not because they're needy and their adult children think they're too dependent.
Find a care facility for your mother and place her. As I said, you may actually have to be her guardian for a little while until a bed becomes available somewhere.
Our OP has tried to place mom. Everyone doesn't want her. They say she would require one on one care and they will not medicate her against her will, and I guess this is falling into MENTAL incapacity and not physical as in dementia because she is exercising the rights that those with mental incapacity can use.
I think perhaps this OP is caught in a bit of an existential nightmare. Not sure.
That's part of the problem. They now have her in that position and won't let her go.
She will need court permission for everything and is accountable to the court and won't get out of guardianship and is unable to get mom off her hands even IF/WHEN she is ill.
That's guardianship for you and what I have learned I would never be one.
RealyReal filled me in on your past history here on AC, and that you were the one too ill to get Mom from ER.
And that APS intervened because of that.
That's unusual. Usually the Social Workers will scramble to get respite for mom. No ER can hold a patient because family can't get the patient. Nor will patient be admitted because of that. There is no coding to get a hospital paid for such intervention.
Looking like what "guardianship" would look like, I know little about it other than that a court appointed guardian is almost NEVER let out of the guardianship. That person can collapse and have a terminal disease and still a judge will not release that guardian. A POA can resign either by letter (if Principal is competent) or by court (if Principal is incompetent) but a guardian requires a Judge's release and it is almost NEVER given. The judge will just say "If you need help then hire a Fiduciary to help you").
I wish you luck. Hope you'll update us, and hope it goes well for you.
They coded her under altered mental status which did get her evaluated but none of the doctors felt using medication to make her less codependent was a proper use of medication.
Side effects did not outweigh the benefits. No place would take her because of her requirement for a sitter and when they took away her sit she did wander around so yeah.
Hospistal had no medical reason to keep, social workers could not place her, and I refused to take her home.
Which is why APS were brought it. Their hands were also tied thus why I have the hearing because objectively my mother is doing well in my care but I just cannot do it anymore. I was also informed unsafe discharge and ER dump are not the way to go about it now is also a factor why APS was called because the hospital felt I was trying to abandon my mother.
I had to do guardianship because my mother already lacked capacity when I took over and she had no existing POA.
She has no assets and I have barely been able to get my career off the ground since I started this fairly young.
Guardianship will almost certainly be awarded to the state.
The state will assign a Fiduciary to manage care, finances, placement, et al for your mother.
Your attorney will already have explained ALL of this to you.
Your best HOPE is to be very cooperative with the Fiduciary so as to HOPE that mom can be placed near to where you live, so you can visit and check on her freguently, and so that there is little chance (with your good behavior) of their attempting restricting your visiting. You will want to strive toward a working partnership.
As to whether the person you are assigned is good at their job and dedicated?
Who can know that EVER with any job? There are good and bad people in every single profession in the world.
That is why it is crucial for you to be cooperative.
I am sorry we aren't apprised of any of the details in your own private situation, but the Hospital or neighbor or some other entity has reported your case to APS. Most of the responses about APS on this page says "They don't do ANYthing". If they ARE doing something here (and court case date indicates that they are), then they must have cause.
You say "my attorney", so it appears you are represented. The law is the law and it will carry forward now. Be cooperative as you can be and answer questions as honestly as you are able, and above all, stay calm and polite.
Good luck.
That's what is happening in our world of care. The days of unsafe discharge and someone being sent to a facility by the hospital are ancient history. They can't get competent help either.