How can I utilize the medical system to physically move mom to a facility

bugujo · July 24

I am an unable to sleep regarding my mom's dementia and steady decline. It has been deemed by the neurologist provider, that she needs a higher level of care which I have known for sometime now. I am a nurse, but, am the daughter in this situation. My brother has been staying nights with her for over 2 months now but still works a FT job and leaves around 3:30 a.m. We have had a caregiving agency caregiver come for about 15-20 hrs/wk. She refuses to shower, claiming she already does, doesn't wear her hearing aides, does not perform oral care which led to the extraction of 3 teeth, including one that was abscessed. She is incontinent frequently and has been beligerent about wearing incontinence products, is delusional, etc. on and on and on.

We had a plan in place several weeks ago to distract mom while the other person got furniture moved etc. into a facility. She did select a room but continued and continues to be beligerent and regarding going. She even threatened harming herself which led me to call the police for advice. She has since been placed on Prozac for depression. My brother backed out because he couldn't be part of the distraction or anything else to move mom.

I finally put my foot down with my brother and said mom needs to go. He still says he won't be a part of the process. He just wants alerted as to when she has moved. He agrees with me that she does need to be admitted and that he too is at the end of his rope. I contacted the facility where there are rooms available.
However, due to the care giver notes I read yesterday, I wondered if I can't take her to the ER and explain everything including all of the things we have tried etc. and basically get their help with moving her there. I wouldn't walk out and abandon her, but essentially, tell them we can't physically do it.

harshedbuzz · July 24

Can you privately hire medical transport and have her moved?

I wouldn't sweat the furniture. If the facility doesn't offer any, you could furnish the room with IKEA or a thrift store. It's going to get beat up anyway. Once she's settled, you could swap her stuff in.

HB

easy23 · July 24

I asked the MC and they had furniture for my husband's room. When I moved my DH to memory care I told him that we were going to lunch with some people that he knows. I never discussed it in advance.

When we got to the dining room of the MC the staff took him to a table with some other people. I left and didn't visit for 5 days.

I like the idea of hiring medical transport.

cdgbdr · July 24

I don't know what was in the notes, but if she's a threat to self or others, you could try the ER and let them know you cannot care for her safely at home. She might warrant a geriatric psych stay to adjust medications. It sounds like she would benefit from the right combination of meds.

H1235 · July 24

Welcome. If you can take her to the er, why can’t you take her directly to the facility? We will be moving my mom to a cnf soon (her money is gone) and I expect to face similar challenges, with both my mom and my brother. Here is what I’m thinking if my brother fails to step up and help. I visit mom and invite her to lunch. After lunch I drive her to the facility. I’m hoping staff there will help me get her out of the car if that’s an issue. I’m slightly concerned she might become violent (she hasn’t yet, but she is going to be furious). I guess I cross my fingers and hope for the best. Once I drop her off I will drive back to her current Al and pick up the things she will need. The cnf comes with a bed. I will need to bring a dresser, clothes and her chair. Even if your moms new room is empty, staff should be able to entertain her for a bit while you move her things. There must be some common area where she can sit while you do the move. You might also be able to sneak some things out of her house in advance, bring unused items from your house or ikea as harshedbuzz suggested. I imagine my mom will be very angry with me and I don’t expect that to change as time passes. My brother will be the perfect child that does no wrong , since he was not involved in the move, but that’s life. Sometimes things just aren’t fair. Brothers 🙄. I hope you can find a solution that works for you.

bugujo · July 24

Thank you all, I will look into medical transport. The level of care she was assessed for by the facility director was Residential Care, a step down from AL but not MC or LTC. However, that could change??? I am going to speak with a care consultant from here as I have previously. Back in November it was suggested that I call Adult Protective Services and report Self Neglect. At that time I wasn't ready, today, I AM!!!

H1235 · July 24

https://alzconnected.org/discussion/comment/248779#Comment_248779

I would be careful reporting her. If you are the DPOA they may hold you responsible for not seeing that she gets the proper care.

weareallunique · July 24

Do you have legal standing with your Mother- DPOA, guardianship, etc.?

You say "Residential Care, a step down from AL but not MC or LTC."

Homes can label their care offerings all types of things but RC doesn't sound like the right level for someone who : refusing to shower, brush her teeth, wear Depends, is delusional.

Will that RC care provide staff time to assist her in those areas? Can she just walk out out of that unit? If she needs 24/7 oversight then at most places that's MC .

Sometimes for marketing [i e commission] a care home will quote their lowest level and then after the PWD has moved in the family is told more care is needed - by changing the level or telling the family to pay for a la carte staff additions just for their LO.

Has your Mom been evaluated by a geriatric psych specialist? As mentioned above, seeing if meds would help her will open more options and make her easier to place and stay placed.

"She did select a room but continued and continues to be beligerent ~~and~~ regarding going." You'll probably never get her to "sign on" and even discussing choices or options is probably pointless at her stage- it will just create emotional issues since that level thinking is probably beyond her at this point.

Adult protective is mainly , because of budgets &staffing - only able to really handle people without assets , homes or family. Think homeless on the street or found alone- no food in their home.

If there are assets APS could go to court get an emergency conservator ship and then if approved assign the care oversight to a professional conservator and maybe a fiduciary for asset management. Each party : APS , conservator, fiduciary has their own lawyer that your Mother will be billed for and in the end family rights maybe cut off - time spent dealing with family issues [ visitation , talking to the home ] etc is billed so for ease and cost you could lose her to "the system." Undoing APS being inserted in your LO's life to that level would probably require getting [surprise] a lawyer of your own to have a court appoint you and or your brother conservator .

Another option to get you through this period is to ask an elder law attorney [ hopefully you have one that drew up the documents mentioned in paragraph one :) ] for a recommendation for a professional care manager to assist in getting your Mother placed- they may know of other homes and have had experience getting clients placed. If that doesn't work then you can bypass APS and file for conservator ship yourself.

I hope you get this resolved soon . It can take a long time for the caregivers to recover after the 24/7 grind of living with a PWD. I wish you sleep :).

SDianeL · July 25

I would move your Mom to memory care now so she doesn’t have to move again. Medical transport might work and tell her the place is rehab ( don’t tell her it’s MC) and tell her it’s temporary and that her doctor ordered it.

Anonymousjpl123 · July 26

agree with others re: furniture - truly, truly don’t worry about it! I would make the arrangements and tell her you are going there for lunch. They will take it from there. In her situation, less is more. I just told my mom I found somewhere better. She flipped out when we got there - it was awful for me, so jarring and sad - but she has truly settled in and I’ve never looked back. After a few minutes of her begging me not to leave and me feeling crap, they guided me out. Within a week she was saying it was great.

That may not happen - this was our 2nd MC - but just do what’s easiest re: the move. That had never failed me.

How can I utilize the medical system to physically move mom to a facility

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