Refusing MC/borderline

MonicaG

I have been doing everything for my mom (79) ALZ for the past 2 1/2 years. She just had a knee replacement a month ago and we got her in memory care by telling her she needs to stay in this place for rehab/therapy. The nurse from MC assessed her as borderline. I asked her what that meant. She explained that it means that if you look at my mom and talk to her for 2 minutes, you would not know she has ALZ. But if you talk to my mom for like five minutes, you realize, oh, something is not right. She can’t follow a conversation, she doesn’t know her address, she can’t drive anymore, she’s can’t cook anymore, she doesn’t do her finances anymore. So she’s been in MC for 2 weeks now and today she tells me she’s fine and ready to go home. She had maybe 3 PT sessions and she’s done. She’s all fine and ready to go home.The bottom line is, my sister and I don’t feel she’s safe to live alone. My question is, can a doctor deem someone not safe to live alone? I am the POA by the way. Would I have to go through guardianship? I’m feeling resentful that these decisions have fallen on me.

Ed1937

It would help if everyone knew what state you live in. Someone might have information particular to your state.

If you have DPOA, you should not have a problem calling the shots. However, depending on where you live, under certain rare circumstances it's possible that guardianship might be required. The difference between DPOA and POA is that when the person becomes unable to make reasonable decisions, the POA is no longer recognized. A DPOA (durable power of attorney) stays in effect. If you haveb't consulted with a CELA (certified elder law attorney), you should do that ASAP.

MonicaG

I live in Illinois. I’m going to research Durable POA.

Quilting brings calm

Monica - look at your POA document,  there is a section that indicates when it would terminate.    If it doesn’t say terminates when incapacitated or for any other reason, I think it’s durable. See the first page of the link below.  It describes it as lasting through incapacity unless limited. 

However, unless your mom is declared incompetent, she can override your decisions.  She could choose to leave the MC. 

As to the borderline comment, I think the nurse is saying that it’s borderline whether she needs MC level care or not.  Based on your description she definitely needs at least assisted living.  Or to live with someone.  

https://www2.illinois.gov/aging/programs/Documents/POA_Property.pdf

towhee

I agree the nurse probably meant borderline between AL and MC. From what you have described she could not live alone without significant support and supervision.

Do you have just the DPOA for property or also a Power of Attorney for Health Care? Often a POA for Health Care will specifically say the agent named has the power to place someone in a facility if a physician has said they are no longer capable of making healthcare decisions. Absent that, if your LO decides to revoke your POA, and is capable of doing so, you have to go to guardianship. 

A doctor can and often does advise that someone needs care 24/7. However, it is the POA and family who must have the legal authority and arrange that care. Exception being when situation is so bad that doctor reports to Protective Services, who in turn seek legal guardianship.

Try to buy some time, you could try saying the doctor said you need 2 more PT sessions, you need to be steadier, get used to new medicine, etc, you don't want to go home too soon, fall and break a hip do you? 

quartlow2

I don't know if it is different by State like others have said? My parents lived in Texas and their Dr sent MC a letter saying they should not live alone. My parents were in a private-pay facility. I'm not sure if that also makes a difference?

Rescue mom

Couple things I’m not clear about….will the MC where she is now keep her, let her stay? You can delay, using fiblets like “doctor wants you to stay longer,” or “we’re having work done at home, we can go when it’s finished,” often help.

Is she able to organize leaving? Can she go through the steps it takes to get away or escape? Most people in MC may say they’re leaving, but cannot carry out the process to actually do it. Most MCs are able to contain people who make just basic efforts to “escape.” 

I guess the blunt bottom line is, if you don’t take her home, and she can’t get herself home, then she will stay at the MC, which is what’s needed, right? (Given that you have the right POA). MCs are very accustomed to dealing with people who want to “go home” and the PWD usually comes to accept it, often like it, after some time passes.