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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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I hope you get a medical power of attorney.
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I get a bad feeling reading this. You really do have to have the HIPAA paperwork there to show them (medical POA papers usually cover this) - without it, they would not even reivew Mom's meds with me so I could catch problems and mistakes. They seem to think you can take care of mom without any real authority or information and don't seem to care very much how it works out as long as someone comes to take her off their hands. Mom may be saying to them "don't tell my daughter, don't tell my daughter" and if she has not been deemed incompetent they have to take that as revocation of the MPOA.

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...
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My heart goes out to all of you. We must have been very lucky, because when my mother fell and cracked a bunch of bones, doctors, hospitals and social workers talked to me about her problems and prognosis and we worked together to come up with a good solution. There were times I thought they were being very bureaucratic, but in the end, they really took care of her. She's in an ALF now, has gained ten pounds and is much clearer mentally. It helped that my mother was willing to follow the advice of her doctors, and maybe, also, that she lives in a small town---she had been seeing the same primary care doctor for many years.

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.
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Once your Mom is declared unable to care for herself, you should be able to invoke the POA. When my spouse started having problems with his dementia, our attorney came out to the house and asked him some questions, then she invoked the POA for me. Once that is done you should be all set with all the medical staff. You might want to let the Social Worker know that you do have the POA and are waiting for their evaluation to get it invoked. When my MIL was placed in a nursing facility, it was the Social worker who looked for one with an open bed and got everything in place. They might put her in the first place that has on open bed because this would be considered and emergency situation with your mother not able to be home alone. But once she is placed you can contact a Social Worker in your area and see about finding a facility closer to you and have her transfered. Good luck.
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Somebody needs to go to the medical hearing. Any reason for drawing this particular line in the sand?
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I'm sure you have your reasons, but why would you want to have to move her twice, once to the facility the hospital chose and then again to one close to you? is it lack of time?
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2much2cover - thank you for your insights; you are right I need to get a diagnosis first and prognosis in order to arrange for proper care. This wked was a nightmare. When I talk to mom; she sounds very coherent (but I'm certain it is because she's had full time care, supervision, nutrition, group interaction, etc.proper med management) -- all of these definitely point to "full time care in nurturing environment" helping her thrive. Going back doesn't seem like a good idea with the hopes she'll follow thru. I HATE taking away her independence; but I feel if I don't, I'm just postponing the inevitable and this will drag on.

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.
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sharirose, Our culture VERY highly values personal independence. HIPPA laws were passed to protect individual privacy (aimed at practices like hospitals selling the names of new parents to baby product marketers) and established rules about what medical staff could do with patient data. The patient, consistent with our value of personal independence, must consent to sharing information. I own my medical data I get to say who sees it. This sometimes backfires, but the intention is to protect privacy.

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.
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If you want info about HIPPA (which was enacted into law in 1996, (LIKE I THINK ABOUT 12 YEARS BEFORE OBAMA WAS ELECTED)

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.
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Is this what HIPPA and the Obama care are doing for the patients? It sounds very cruel and inhumane. If someone does not approve of a party being in the exam room with them they can verabalize it. If they cannot , I guess we need to prove they want us there. Who wants to die alone with your spouse or child outside the door wanting to comfort you. A dog or cat would not be treated that way. People need to write their Congressmen (most are worthless) and Senators (same goes for them). What a blooming mess Thanks for the heads Up! That is why I love this site.
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Okay found AMD (advanced medical directive) learning a new acronym every day on this site :)
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sunflo2, My understanding was that a POA only allows you to act under their direction? Is it possibly a durable POA which from what I understand, does empower you to make decisions once she is found unable?

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.
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You are in such a very tough spot. Whatever you wind up doing, I hope it will be as successful as your mother allows.

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.
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Thanks everyone; I've talked (via phone) to my mom everyday and she is sounding better but still insisting that she go "home" and adamently refusing to go to a wonderful memory care facility I've located near me. The Dr has not called me and I have let hospital (behavioral center) where she is located now that I will not pick her up until i speak with her Dr and they are willing to put in writing that she is not capable of living on her own and taking care of herself. We are in a "circle" at this moment. I have the POA and AMD in hand. I went to her home and there were several things, bills unpaid (some), uncashed checks from months back, expired food, neighbor reports of leaving garage open, house unlocked, confusion, wandering the yard, etc. that are occuring with increasing frequency.

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.
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My dad, years ago wanted me to go in to see his doc with him. The staff would not let me even though he was saying I want her to come with me. I never made it in. The doc I have now will not let my MPOA come in with me. The doc said I was young enough to understand what was going on and I didn't need anyone to come in with me. I think it's time I change docs.
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That is correct about the HIPPA. I have to sign that form for every clinic and dental visits. When you check-in, and don't put anyone's name down, and something serious happens, they cannot call your family. Their hands are tied.

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.
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sunflo2 I had a similar experience and lucky for you I can help you understand better, as I found out the hard way myself, I will gladly share what I know, because it's all a big pain in the ...you know what!!!!
. 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!!!!
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Update. Can't get much info from current hospital; other than they want to release her and are putting high pressure on to release her next Tues -- whether or not I can secure care for her!. I don't have POA yet (lawyer didn't have signed copy nor electronic copy...absurd); I have to drive 6 hrs each way this wked to try and find a copy in the house and hope it is signed and in order. I'm looking at a memory care facility nearby my home tomorrow; but they only have one semi private bed open (at least they have been helpful). I'm trying to move as quickly as possible; but they aren't giving me or the planned memory care facility any info on her condition; limitations, etc. I asked about the outcome of the competency hearing and they corrected, that it was a "court hearing" not a competency hearing. I asked "well what was the outcome"; we can't release that info; when are you coming for your mother?. They want me this weekend; I refused and said I didn't want to upset my mom by seeing her and then having to leave again and come back to move her. They let me speak to mom; and she sounded good --although angry they won't release her. She thinks she's going home; I told her that she probably won't go back home;( I also requested that they start preparing her for that -- but it seemed to fall on deaf ears) -- she didn't like that and said they were holding her and waiting for me to pick her up; she also complained that she has been in her same clothes for 5 days and doesn't have any change of clothes. They aren't giving me any info; I'm wondering if she is bathing? are they laundering her clothes (at least underwear). I'm pretty fed up. PS. I asked if she is "incompetent" and in need of full time skilled memory care based on their eval. The case worker wouldn't confirm but just read thru the LPN's evaluation from this morning (to me it was inconclusive) and although they gave me doctor name; they wouldn't put me thru to him and just read from nurse's notes.
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Like yours, everything that was set up in their last years in their home as a supportive service, they cancelled as soon as whoever set it up drove away. One brother actually established 12 hours of care a day for a couple of months. MIL would refuse to allow the workers to cook in her kitchen, clean her house or feed FIL who was a double amputee (legs) The only thing she would allow them to do was change FIL's diapers.

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.
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I can see your concerns, I wonder who has called for the hearing and what kind of hearing is it? I really recommend that you get some calls out there and find out what is going on.

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.
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Thank you so much for your insight and experience (hope this turns out as good as yours). Yes there is a "hearing" on Wed I've been told. I don't have any more info and hoping a social worker will call me today. That would only be 48 hrs for eval and my mom can easily snap out of it. I find the longer she is "socialized with people" and nourished; she can be much more coherent and "normal" (although over the last 3 mo she continuously talks to herself or has two way conversations with herself) I don't even know at this point if she is in a geriatric psych unit. Her neighbor called me last night to give me more details. He called because she was disoriented, incoherent when he approached and she was trying to drive out of the driveway. She was uncooperative w/police when they arrived and tried to help -- so much so that they had to handcuff her to take her to hospital. It must have been extremely traumatic for her. Luckily I have her primary Dr name and attorney -- ready to pass that along to social worker if they call. My hope is that they keep her for a couple weeks for further workup (health and mental); and declare that she can't go home. I tried to research and she could possibly voluntarily agree to assistance and then report back for reevaluation -- that will be awful because she always agrees for help when I've offered; then I set up service/support and she cancels. I can't be there to supervise and make sure the services happen. When I dictate that they can't let her cancel without notifying me -- she refuses to let them in the house.

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.
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Sunflo2,

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!
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Thanks Ladee. Update. I didn't hear back today from anyone; so called to track what was happening down. I found out that she was transferred (via county services) to another hospital facility 3 hrs away under "temporary detention order"; they told me hearing on Wed. They said "she had exhibited psychotic behavior". I don't know what any of this means or the implications. I called the med center I was referred to but they can't release info or confirm if she is indeed there. I can't understand why noone would notify me that she was transferred. Granted; my mom may have said she doesn't want me to know anything. But this seems extreme. I left my number with the med center to call me if they are looking for a "contact". I asked if they had contacted her primary care doctor as part of the overall evaluation -- but again; no one can give me answers. I don't know if she will pull herself together and end up getting released; or they will contact me to help get her placed in an appropriate care facility maybe near my home. I sure hope they don't send her back to her hometown where there is noone to support her.
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Sounds like this is the 'deal breaker'... for me personally, I would call the ER and explain what is going on and that you want her placed.. if you explain the situation they will be less likely to discharge her back home... good luck and prayers for this one... let us know what happens...
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