90 yr old mom with dementia found confused and taken by police to hospital.
Last pm; neighbor reported my mom to police trying to drive. (Mom diagnosed with dementia; living alone and refuses all help/assistance set up for her). Her confusion and dementia episodes have been escalating over last yr. Police took her to hospital for eval. I'm daughter; IMO, it is in her best interest to get placed in AL or Memory care facility. To date, family has been unable to persuade her to go this route. Mom refuses all in home assistance to date. I live long distance (6 hrs) and work full time in travel job. Hospital called last night and she was in Emergency for eval. I'm hoping this is "precepitating event" to get her placed in care facility. I don't want to intervene; because I don't want to interfere with the process; I want them to place her in care facility and then I'm hoping once she is there; I can take it from there and move her to a care facility close to me so I can visit/ongoing monitoring. My question: Should I call the doctor or hospital at this point; wait for them to contact me?; will they possibly release her back to go home? (police and neighbor said she was talking erratically and talking on the phone to herself so they thought it was a psychotic episode); I told them to take her to hospital. I'm afraid if I get involved; they'll just release her and I won't be able to move her anywhere (I'm designated POA - but she won't let me invoke any power to date and claims if I try to do anything she will remove me; I'm confident she will if I had to go to court over this). She is coherent about 50% of time -- so she could easily fool the doctors into letting her go back home and take care of herself again. I see her about every 6-8 weeks and talk to her every other day --some good days; some bad days (no coherency). I know she is not eating or drinking properly. Appears to take meds okay. Pays her bills and is bathing (decent hygiene) herself and house is in order (though she doesn't clean).
Her primary care physician is no longer allowed to give me info. He knows situ and he and his social worker (in office) say there is nothing I can do until there is a precipitating event. I'm hoping this is it -- but looking to you dear friends for sound advice.
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Are you saying there will be a hearing on Wednesday? That seems odd.
My MIL was taken for a geriatric psych evaluation after she ran out of her house hysterical with fear one morning and the neighbors called the police.
She was medically evaluated and transferred to a geriatric psych unit for evaluation. She was held there for 2 weeks. I don't think any person with dementia can fool anyone round the clock for 2 weeks.
We were not in the same state so I kept daily tabs on her by calling the nurses station each day. MIL had only given her sister's name as a contact for them to release information. Her sister gave me the "code word" that enabled the nurses and the social worker to give me updates.
They did treat MIL for a UTI, which probably brought on the crisis. She was diagnosed with vascular dementia and the doctor's opinion was that she was not able to continue living by herself. They gave us the date they would be releasing her from tje geriatric psych unit and we traveled to Mississippi to be there when she was released.
The social worker and the administrator of the nursing home where FIL lived were a bit reluctant to hand her over to the unknown son from out of state - especially since she told them she didn't want to go with us. We understood her feelings and informed tthem that we were not who she thought she would see picking her up. Her middle son had always been the sun in her firmament. She was deeply disappointed. She had always truly hated me and resented my husband's devotion to our family. Her true "sun" always put her before his wife and of course, his wife made it clear that she did not support MIL being moved to their state. So it was us who showed up.
That's how we handled it. We kept close contact during the crisis and evaluation stage and made plans to move MIL and FIL to a SNF near us when she was declared unable to continue living by herself.
Good luck!
Actually, all this is a relief because it starts the ball rolling. I've wished for this (although not the handcuffs) for quite some time so she will be in a safe, secure, healthy environment. My hope is that they will dictate she can't live alone and they will keep her long enough for us to arrange for her transfer to a memory/Alz care facility near me. I don't want to move her twice -- if they send her back home; we won't get her out again and this will just be a set up for greater paranoia and barracading herself in.
I'm still baffled why I wasn't contacted especially since they moved her so far from her home. ; I know I was on the police contact list.
It was a huge relief for us, prior to getting the piece of paper with the doctor's evaluation results and recommendations, we had no way to take over her decision making and get her safe. She is a candle "bug", a fascination for fire came with her dementia.
The geriatric evaluation solved everything for us.
Her dementia was the main problem, but the brothers didn't agree that she had dementia. She had always been difficult, not bright and a messy housekeeper.
. The bottom line is THE LAW. By law your Mother is responsible for both, medical and financial reasons, for her own behalf. This is the case....unless she is found legally and/or medically incompetent.
Her healthcare information is protected by a law called HIPPA. Unless your mother verbally agrees or signs in writing on a "HIPPA form" of which, either case will grant her permission to release her info. ((they have the forms at the Dr's or hospitals, or whoever is caring for her)) So In order for her health information to be released to anybody that's not her, it's law a do this, so they will not tell you anything otherwise.
The other option is attorney-in-fact acting as a, P.O.A., or her agent, and the fiduciary duty needs to be granted on these papers to take action in whatever the case is, then action can be taken "on her behalf" as PO.A...
The other option is Guardianship, I did not do this so I am not aware of all the details. I do know that if your Mother is in fact, found incompetent by law, and there is no party assigned guardianship by law, she becomes a ward of the state. This means I believe the state becomes in charge of her well being and her finances to pay for her care needs.
So the bottom line is your Mother needs care, either someone takes the drivers seat as her GPS, so she's not lost, or her Health and Finances and all other decisions, will be up to the Government in a need to act on her behalf!!!!
A man went to a private clinic for his dialysis. Something was seriously wrong that they had to call the ambulance and send him to the ER. Upon arrival, he kept telling them to call his wife. They didn't. For hours, he kept telling them, even asking to bring a phone and HE will call his wife. They refused. He was so angry with happened, he went on the talk radio to let us know what happened.
Another man got into a serious, deadly car accident. He was dying. His family found out but when they went to the ER, they would not admit anything about him - if he was there or not. Hours later of trying to see him, the ER finally let them - after he died and they had to contact his next of kin. The family were so angry that their loved one had to die all by himself and there they were outside trying to get in to be with him. They, too, went on the local news to alert us people what is happening with our hospital.
My 17yr old niece had severe stomach pains and went to the ER. They refused my sister, her mother, to go in with her. Even though niece asked if her mom can come too. They refused. The same happened with my bedridden mom who cannot talk - is completely vegetable state. Father had his Legal guardianship paper with him but they still refused him to go in with her. He had to wait in the waiting room. Then they called him and said that they cannot find anything wrong and so they will be releasing her - like 5 hrs later. Father got angry and asked if they took blood and urine test to find what's wrong? Did they check if she had bladder infection? So, they did the test...And she had infection. Antibiotic IV was given to her.
It's very important for everyone that when you go to the clinic or dentist and they give you this form to fill out - to remember to put your family member's name down. Otherwise, the medical community cannot contact them or allow them to see you - until you're dead.
Mom has been screaming at me on phone, agitated and telling me she doesn't want to go to "a home" and I can't put her there. Her LPN is telling me "she's doing better on meds" but over this weekend as she's found out I've been in her home without permission and am exercising POA -- she is livid. (Nurse reported to me that she had refused to take her meds this wked and was hiding in her underwear...and they think this is progress and she's getting better?!! ready for release? Release to what?) I don't think any judge in their right mind would revoke her POA on her say so (or however that would work) -- but i don't like making her unhappy. I know it is the right move to get her proper care, safe living but it is so emotionally hard to disregard her wishes.
In-home care doesn't seem a good option; long distance. I can't supervise and don't want the constant calls to change this caregiver, "we can't control her"; plus coordinate all the household maintenance issues; not to mention I can't imagine her ever giving me financial control (its in her POA but I don't think she understands that at this point).
I guess I'm just trying not to second guess myself and make the right decision. I know being nearby under skilled care is best answer but not the way she'd like it to be. I so wish she had listened to me this year and at least have in home assistance part-time, meals on wheels, etc. so we could've judged how that was and she'd be open to outside help. Now I can't trust that she would be or have the cognitive ability to accept and keep help. Comments welcome. PS. I have financial and medical POA.
So much of this rides on whether a doctor will say she is not competent to take care of herself. (And, if it goes that far, a judge will, too.) If she is "competent" she doesn't need any judge to revoke the POAs -- she can do that simply, herself, having a notary witness her signature.
If her doctors think she is competent (hiding her medications in her underwear), then I guess she can go home and take care of herself. Then you might want to call Social Services in her county, explain the situation, tell them exactly what you are willing to do to help mother (which might be nothing or visiting monthly or whatever) and that she is on her own but has very erratic behavior. Explain about her wandering and the police contacts.
It is clear you want the best for your mother. I wish this wasn't so hard for you.
We were fortunate in MIL agreeing verbally to the hospital giving us information and everyone cooperating during the period before guardianship was finalized. Sometimes small town common sense helps in these situations.
The piece of paper you want from the doctor makes all the difference going forward. That and other evaluations you can arrange for at her new location.
We drove MIL to our home stopping every 90 minutes. Each stop was either a fast food hamburger stop or a Walmart. Both would help her during the trip Especially the Walmarts. She loves Walmart and the similarity of the stores relaxed her - sort of recentered her when she became confused. We had her release paperwork with us at all times in case she had become upset and we needed to show anyone who might be concerned.
I really hope the doctor cooperates.
copy and paste this link
hhs.gov/ocr/privacy/hipaa/understanding/consumers/familyfriends.html
which will lead you to this document
When Health Care Providers May Communicate About You with Your Family, Friends, or Others Involved In Your Care
sunflo2: are you saying your mother is refusing to give permission for medical professionals to discuss her situation with you? If not, then maybe review of the HIPPA laws with them might straighten things out. If she is refusing (but they called you from the emergency room?) , you can alway provide them with any information you think they need to know to make a proper decision on her behalf. You might want to get in touch with the social services staff at the hospital or whereever she is b/c they are the ones who are going to be involved in actual placement. If they are calling you to pick her up, it seems they have acknowledged you as an allowed contact or wouldn't they be in violation of hippa rules? Tell them you need her diagnosis in order to assist in determining safe and proper placement when they call you to "pick her up". I don't know what insurance she has but if you are not proactive in getting some information you might have bigger problems if they put her in a taxi and send her home. Let them know you are very concerned about her safety should they release her to her home. put it in writing if you have to in order to get them to listen.
We assume that adults are capable of independent living, unless proven otherwise. We have laws and agencies that try to protect adults that are considered vulnerable, but unless an adult is declared unable to mange their own affairs (incompetent) then the law allows them to make their own decisions -- even bad or unsafe decisions.
(None of this has anything whatsoever to do with so-called Obama Care, and none of it is new.)
I think we'd all hate to have our own independence interfered with, but the laws that protect us from that also make it very difficult for children to care for parents who don't want to receive care (even if they clearly need it). I would not want someone to easily be able to take over my affairs and tell me where I have to live. I would want them to have to prove I can't do it myself. I sincerely wish that this were easier for sunflo, but I do understand and respect the laws behind this situation.
They are sharing limited info with me -- LPN calls me and nursing asst and they tell me how she is and "she is doing fine"; wants to go home, etc. but no one will give me a diagnosis (I guess I haven't communicated what I want). They just keep saying to me "...and you'll be here Tues for the medical hearing" and I keep saying, "I will be; provided the Doctor calls me and speaks to me Monday morning and tells me she cannot live on her own and isn't capable to live at home anymore" I beg them for help in working with her to make her understand that she can't go home.
HIPPA, I agree with. But if they are going to call "next of kin" to get her released and discharge her from the system; then they should be more cooperative and provide info.
THIS SYSTEM (for this facility, her hometown, her physicians, etc.) HAS FAILED HER. I believe there are plenty out there with good outcomes and desires to do right by the patient. They haven't done this for her.
For others who may face this kind of problem in the future, here's something that worked for us. Over the last few years I built a relationship with my mother's primary care physician and his staff. I called from time to time to pass on information about her condition between visits that I thought they should have, and always took the opportunity to thank them for their care of my mother. I said at the outset I understood there were things they were prohibited from sharing with me, and that was OK. If she had an appointment scheduled while I was visiting, I asked her to let me go in with her, so that the doctor and staff knew me, and that I was well intentioned. Obviously this works only if your parent is willing to let you into the relationship. For those whose parents resist your help, or who have dementia---I'm so sorry. If it's hard in the best of circumstances, it must be hell for you to deal with all this.
When a person gives their permission for someone to aid and participate in medical care, they should be allowed to come in for the visit. HIPAA does not in any way limit that, but I have certainly seen silly overinterpretation of it, to the point of a parent being denied access to her minor child's records or refusing to give out information. Not knowing what state you are in or what the rules are there, it may be that they have (vs just THINK they have) some legal basis to insist you take Mom home with you, and it may be important to find an elder care attorney to straighten things out and help you get a guardianship if you want it, before you try to take over the care management of one very uncooperative person who has no understanding of why she needs your help!!
Now - one slightly better possibility - if the memory care facility might give her that one bed, the hospital probably WILL give information to them, as that makes them a participant in Mom's treatment plan, though you might have to present MPOA paperwork and and a release form. And, it makes no sense for them not to deem Mom incompetent, but perhaps the people at the memory care unit will be more willing to do so, versus looking at a geropsych person to do that. For some purposes, under my mom's POA provisions, I needed two physician letters stating she could not care for herself so I had a psych eval and the primary care physician do those for me and it all worked out.
Sorry you are going through all of this! It is a tough business, and you have to sort out the people who will really try to help versus those who are more concerned about keeping their tail ends covered than keeping you or yoru mom out of harm's way...