Post #1
My MIL came to stay with us several months ago. During the initial week she was okay. For a few weeks, we managed to get her out of the house to do some activities. After the honeymoon period of those few weeks, she refused to go anywhere except for the grocery store and the doctor’s office. As time went on, she became more and more verbally abusive. She did not want to live with us. By then, she was saying she wanted to go back and live on her own in her house, but she hadn’t lived independently at that point for nearly 4 years (she had been living w/a relative). We were waiting on a neurology appointment to get an official diagnosis of dementia. She started yelling at us for short periods of time. Then for longer periods of time. By the 3 ½ month mark, she was yelling not just at us but at the wall for 4-5 hours. She refused to eat for three days, had started wandering out of the house, said she didn’t want to live, said she was going to kill herself, was hitting her head, hitting the wall, etc. She raised her hand to me once but didn’t hit me. She also grabbed a phone out of my hand and scratched my face. I hid sharp objects. We drove her to a local ER. They admitted her, and they spent the day doing various scans, bloodwork, and asking her questions. When they weren’t doing that, we stayed in the room with her. As soon as any staff left, she would rip into us ranting and raving about how much she hated us and didn’t want to live with us. A nurse would come in, and she’d revert into polite mode. The nurse would leave, and she’d rant at us again. She did this for @ 10 hours. However, the staff outside could hear her. They admitted her overnight to the psych part of the hospital. After a couple of days, they admitted her back to the “regular” side of the hospital but put an “elopement” sign on her door because of the wandering. She has been in the hospital for almost 2 weeks. They did lots of testing and a psychologist met with her. She was diagnosed w/severe cognitive impairment. A scan showed she had brain shrinkage. They said she would need 24/7 supervision of her ADLS and iADLs and functional mobility. They said that she doesn’t have capacity and filled out incapacitation paperwork. Last week a social worker met with us and said she would get the doctors to fill out the forms needed for placement, and she would investigate SNPs and ALFs concurrently. Well, as of today, all of the SNFs contacted (14) say they don’t have a room for her. The SW put down that MIL needed to be in a “secure” unit, so that probably limited availability. Two ALFs said they are open for placing her and could handle the wandering with cameras and bells on the doors. One of them I know is out of the question. The other sounded okay, but it is 45 minutes from our home and the area is not so great. The problem with an ALF is that my MIL is very limited on how much she can spend (she is on Medicaid) and so are we. I have a few concerns/questions that I will list in a second post since I’m going to run out of room on this first one.
What medications is she on? An anti-psychotic, I hope? Has she seen a geriatric neuropsychiatrist or a neurologist with a dementia specialty, who has written prescriptions, not just a psychologist?
My dad could only afford a run down facility but, it was a board and care and had a good caregiver to resident ratio. What a place looks like or what neighborhood is irrelevant if the care is sufficient.
I would suggest that you guys stick to the unsafe discharge, they will find her a place.
I would encourage your husband to let them medicate her. However it is needed to keep her from nutting out. This will help with her not being kicked out. That and her showtiming for strangers should at least give you guys enough time to decompress.
Please know that you can move her if another bed opens up at a different facility or if you are just unhappy with her care.
As far as others disagreeing with where she is placed, those that are not boots on the ground caregivers don't have a say, period. If anyone starts in, tell them that they can take her in or just stop the bs, those are the only choices they have.
God bless you for what you have and are doing, I would be stark raving mad if I had to deal with what you have.
Stay strong and choose your battles with her care, she is going to be a pickle no doubt, so you want to keep that in mind. If they are willing to put up with her, yahoo!
The hospital isn’t going to keep her much longer . You will need to pick the least bad option soon. At least Medicaid will pay for an ALF in your state .
Neither you , your husband or any other relatives should be paying . Pick a facility in your MILs budget ..
Pick the best of your non ideal facilities or allow the hospital to place her. Your home is an unsafe discharge.
1) The facilities that have responded are both in another county because of the cost. How will that effect us?
2) The ALF owner visited my MIL in the hospital. My MIL is very polite with people she doesn’t know and probably gave the owner the impression that my MIL would be “easy.” When we talked to the owner by phone, she made the comment that my MIL was a "bit confused.” We explained that she may become agitated once she spends more time in the ALF. She said the only time she has ever discharged someone is if they are violent. She was going to send us a couple of photos of the house and the residency agreement, but we haven’t heard back from her yet. My question is, and I probably know the answer to this, what if my MIL goes into the ALF and they want to discharge her because she isn’t a quiet person who is just going to watch TV or play cards? Can we refuse to accept her at our house? (Husband has POA).
2) I feel like we are starting to get pressure from the hospital for discharge. I’ve sent an email to the SW to tell her that we are trying to reach the one ALF and then go visit it. I’m also going to ask her to check into another county for their ALFs and SNFs (she already looked at ours and one other). It is still 45 minutes away but is an easier drive and we know people who live and work there who can also visit my MIL.
My question/concern: My husband does have POA, so I don’t know if that plays into refusing to have her discharged to our house if they can’t find an ALF or SNF that will take her. I’ve realized that I cannot have her at our house. I’ve dealt with lots of things, but the daily screaming for hours – often directed at me or my husband – has severely impacted my health physically, mentally, and emotionally. I’m still a wreck. I have my own health issues that have taken a back burner that are taking on urgency.
I told my husband we have to say that our house is an UNSAFE discharge. My MIL has emphatically stated that she does not want to live here. I’ve read on the board that hospitals will even send a discharged person out in an ambulance to the family’s home w/o notifying them. Ugh.
3) Even though none of them will let her live with them, we also have relatives who will be critical of any inexpensive ALF. That’s going to be an additional fall-out of all of this. We’re the only ones who stepped up to do this (and naively we thought we could), but we’ll probably look like the “bad” guys. I know it should not matter to me, but it does (but not as much as not having her live with us). Again, SHE is very vocal in not wanting to live with us. She thinks she can live independently in the house she gave up 4 years ago). Of course, none of those family members can/will help financially.