Hospital forcing me to pick up mom with dementia.

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Hospital forcing me to pick up mom with dementia.

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ER wanted to release my mom but I couldnt take care of her anymore. I asked to talk to hospital social worker who helped me find a place for her. She was transported that same evening.

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Hello Tiredmomma!
I have been where you are, aside from my dad was still living and taking care of my mom on his own, while hiding it from my sister and I. I finally opened my eyes as Dad asked if we could move closer so I could take care of them in their "golden years," Did all the right things, took mom to the doc as I had done before and got nowhere. Finally I forced my way into doctor appt with mom, where she had been telling everyone she was fine and nothing was wrong and I let it all out. Made a plan to get her meds, etc. and just to see how it goes. 3 days later, she had a stroke and from there, we just took over. Check with your county office of aging. They often have help with applying for different aging programs and also something called the "New Choice Waiver." This is a waiver that will actually pay for your mom to be in a memory care unit where she will be safe, as apposed to being with your family which is unsafe for you and your family. I suspect you have now had an appointment with your elder care attorney and they have explained these options. The New Choice waiver is from the state, thru Medicaid and at some point there is a waiting period. In my state of UTah, the waiver is automatic if your mom stays in the hospital for 3 days, then goes to a rehab center for 90 days, then this will pay for her Assisted Living. If she has nothing, the Medicaid should not be a problem. If she does not go in the path that I explained, you can still apply and wait it out. SOmetimes self pay at the Assisted living center is the only way you can do it. It is very expensive, but hopefully you can get one that will actually take care of her. I moved my mom twice to find the right fit. I was lucky, my parents had money so they were able to pay out of pocket for the center and it was a juggle to take care of Dad who was now in the hospital and move mom who was thrashing around and trying to escape form the the Assisted living center. My experience from this waiver is my mother in law and the fact that I am a landlord at an elderly Public Housing community. I have worked very closely with all these types of assistance and it is so frustrating.
Don't let them push you around. You are on the right track. Please post an update of your situation after you attorney visit.
Best of luck!

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The OPs mom is NOT in Utah therefore the waiver your mother qualified for is not an option here.

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Just a quick thought - we went through this with my grandmother about 2 months ago. Our original plan was that she would be transferred to a rehab facility after her hospital stay, and from there we would try to transition her into a nursing home. Well, Medicare denied the rehab stay because she was hospitalized for congestive heart failure, and that condition had stabilized. So we got the call on a Thursday morning that they were discharging her that afternoon. We met with the hospital social worker who explained that hospital stays and Medicare coverage deal with physical things that are treated and resolved and because my grandmother's dementia is the ongoing issue for which we were seeking a long term care solution, the route we were seeking was not available. BUT - the social worker's assessment of my grandmother was that she would likely be an appropriate candidate for a Memory Care assisted living facility. AND, the facility she had in mind offered respite care that would allow us a moment of breathing room to figure out a more permanent solution. Within a half hour, the rep from the facility was there at the hospital, explained our options, assessed Grandma, and got the ball rolling. We chose respite care with the option to transition into a regular resident. That afternoon, Gramma was transported by the facility to her new room in the memory care unit. Two weeks ago we signed the paperwork to make it her official residence.

The moral of the story is that you need to stay calm, and enlist the experts that are available to help you discover options. Sort through them and ask every question you can think of. I don't know why the OP's hospital wasn't more helpful, and I don't know why these options aren't part of the initial conversation as a general rule. It would certainly make things easier.

It would be lovely if we didn't have to become so aggressive just to get the answers we need to make good decisions. But, that's not the reality. Advocacy for your loved ones - and yourself - is not an easy road, and it's essential to be tenacious while traveling it.

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Hi my mom was in the hospital for two days for a painful tailbone fracture. She came home last night. My brother and I pleaded the hospitalist doctor to trans her to skilled nursing facility to rehab her broken tailbone. Doctor said no she is going home because Medicare now has a new law that if you are stable they will not allow for skilled nursing care. Physical therapy will be done at home. He said i need your mom's bed. How cold! A couple of years ago when mom had emergency hernia surgery she was sent to nursing rehab for two months and sent her home. Medicare has become more and more stingy

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Hello Tiredmomma,
I had a very similar situation. I had taken my mom to the ER and her BP was almost 200/100. She had become a 2-person assist. She was scheduled to have a TAVR procedure in 2 weeks. The ER told me at 9:30 pm that either I remove her by midnight or I would be arrested!! I demanded a social worker and together at 10pm drove to about 2 group homes to see if either would accept her in their care for just 2 weeks so she’d get proper care, nourishment in order to bridge the 2 weeks until her surgery since I couldn’t manage her alone at home. We did find a place and at midnight we’re checking my poor mom, who also had dementia, into a group home that she did not want to be in. It was the most horrible experience of my life and hers! It got worse as the next day the group home didn’t want to keep her. I won’t go into all the details but the next two weeks were horrible and my mother eventually went into a hospice on a Friday night and passed away 3 days later on Monday. That was almost 4 years ago and I remember it like it was yesterday. Health care In this country today is disgraceful. So, in answer to your question, can they do that, my answer would be yes.
I wish you the best of luck in dealing with your beloved mom. It’s not easy to find solutions especially if you’re on limited income. Sometimes we have too much to qualify for aid when these situations come on suddenly and we haven’t had time to take necessary steps in advance but not enough money to pay for the exorbitant rates that facilities charge. Sending hugs and love your way that you’re able to work things out.

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I am so sorry for you to have to go through that. You are right that health care in this country sucks. I have a feeling it is going to get worse. that sound so traumatic to your mom. You worked hard all your life, the time comes for you to retire with dignity but you cant. I have worked in nursing room and it is not pretty there. wake you up at wee in the morning and some people are not nice.

(5)

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Tired Mom, be sure to mention that you will report any "UNSAFE DISCHARGE" to JCAHO. Hospitals fear this a whole lot. A social worker will be assigned. Hope you will update us. Also notify her doctor you will report this.

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Time to find a nursing home/assisted living that can take care of her, do a spend down on her money and when you are able apply for Medicaid or if able Veterans Benefits.

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I assume that she is on Medicare. Health insurance will only pay for X number of days in the hospital and they dictate when a patient must be discharged.

Long story short, you need to find a temporary place for mom to go that is safe. I don't know all of the details, but if she has become dangerous, why have you not already found a place for her before it turned into a crisis situation? Surely, you saw the signs.....

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She tried but was unsuccessful. For people with little assets and income it isn't easy to call up the local NH and move in. Nursing homes wouldn't take Mom because she is ambulatory (that's what she said) and private pay assisted living/memory care cost too much.

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I have a background in hospital case management. I have never heard of calling the police if you don’t pick a patient up. The most they can do is charge her for room and board. If insurance stops paying the patient gets charged while other placement if found. If she is not medical stable see if you can appeal her discharge. If you don’t want to take her home you don’t have to but if she is medically cleared the next leave of care needs to be found. Either you do that or they will.

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Right, that is the way it is supposed to be done.

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Just a suggestion, set your answers to newest first. This way you see any updates from the OP. Also, quickly look for replies from the OP to answers. Sometimes there is more info.

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Problem as I see it is some people are not reading (much) beyond the original post. Setting to newest doesn't always help if you haven't read the first 80 comments and potential replies! OP could reply to a post from 2+ days ago, but it doesn't show up among the "newest."

The suggestion I've made is people need to, at the very least, skim through the responses, and make note of additional input from the OP. It would be even better if they read all the posts, because people keep posting the same things over and over - don't mind the repetition for useful comments, but when they don't bother to read that mom's income is over the Medicaid limit, but way under the MC cost AND she has and hasn't had any home or assets, yet keep telling OP to find AL and/or apply for Medicaid. OP isn't exactly stupid, clearly she has checked the cost of a facility and has checked with Medicaid..

READ people, READ!! Spend a little more time reading, and it will likely cut down in the time it takes for you to respond!!!

(this isn't the only time - I see this all the time in other threads)

(2)

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Broadly speaking, most of us are living too long past the time when we are self supporting/self caring. The family members who still are, are not earning enough to provide for themselves, their kids and their elders as well. You cannot save for your old age while earning minimum wage. The idea with social security was that it would be only a few years between the time you had to stop working and the moment you dropped dead mowing the lawn. A VERY different world.

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OMG yes! I have an aunt who is 97 and has had dementia for - get this - 20 years. I don't get it. And my mother is 86, has CHF and other health problems, requires lots of attention and doctor visits (the elderly use significantly more health care than the average adult), is becoming less independent (although she still drives, but not as much, and she should not be driving, but that is another matter - over 85s are more dangerous drivers than teens). She is always wanting to go to the ER. Won't take her anxiety meds because she's afraid she won't wake up, and on and on. But let's make them live as long as possible! Who cares if they are living productively, happily, if they are lonely, outlive their family and friends, but make doctors, health care pros and pharma companies rich. That may be an exaggeration, but I often wonder to what end are we living longerrrrrrr?

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Call 211-- the county has a facility where those who must use Medicare to pay are welcome. Sometimes not the best care. But their depends will be changed. They will be fed, bathed, and tucked in. THEN you can look for a good place with memory care that will care for your loved one. But you will have to find the funding. My mother used my father's time in the military to get the aid and attendance program-- which now pays $1127 per month. Don't panic. Don't give up. Start at the beginning and fight the good fight ! Good luck, God bless you.

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You have no idea if the OPs county has a facility for Medicare patients. We need to remember that.....every city, county and state has different facilities. We don’t all have the same things. The OPs mother needs LTC and Medicare won’t pay for that so I doubt there is a county facility for Medicare patients. Maybe you meant Medicaid? If so, not every county has county-run facilities.

(7)

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My mother took a taxi home from the hospital. If your competent they will send you home by taxi. They did this twice with my mother. She goes to the hospital once a week so far in February and the month is not over yet.

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Yup!!! They send them home. Doesn’t matter if you say unsafe discharge or failure to thrive, or she lives alone and weak and feeble and can barely walk. If she has her mind and is competent, she’s going home.

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Yes cricket they send them home in a yellow cab!! The yellow cabs with the casino signs on top are parked all day and night in front of the hospital. It is absolutely legal for the hospital to do this. They did it to my mother twice this month. The ER is her 2nd home. Her winter home.

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I used to call the ER 'club med" for my father when he was still living on his own. He would got to the ER about once a week. When they couldn't track me down they would call him a cab (provided he remembered to bring money with him) and a few times the local police would transport him.

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Rovana, you are right!! We are living too damn long!!! 95 is too friggin long!!!!

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When I told the case manager it is easier for you to find a facility for her to go to than it is for me, she looked at me with 4 eyes and said to me “who told you that?” I said her primary care physician. She just changed the subject and said she was competent blah, blah, blah.

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Grrrrrrrrr! Don’t you just want to scream, Elaine? I’d like to see how that woman would feel if she were in your shoes. I bet she would be the first to be screaming bloody murder, right?

(4)

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Elaine,

It’s ridiculous. The hospital should be ashamed of themselves for sending your mom home alone in a cab. I don’t give a crap whether it’s legal or not. It’s an awful thing to do to your mom and you, her daughter!

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Needhelpwithmom, I really don’t know how those hospital workers sleep at night knowing what they do!!!

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Nor do I! When will this insane nonsense end???

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Bootsiesmom you are not exaggerating at all!!! The doctors and pharma companies are getting RICH off the elderly living to be 109, 101, 102, 103 and counting!!!!

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Right? And in addition to making sure those folks enjoy their high salaries off the backs of the elderly, it's up to us to figure out who is going to take care of our loved ones and what that looks like.

(3)

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Yes Needhelpwithmom I did feel like screaming!!! I was very polite at the hospital and held back my anger until the woman called me from the hospital and said “Are you going to let your 95 year old mother get in a cab all alone?” Yeah, I saw red!!! I SCREAMED at her “ Are you going to let my 95 year old mother go home knowing it is an unsafe discharge AND failure for her to thrive home alone?!?!?!?!? Year, I went ballistic and was screaming!!!

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I don’t blame you one bit, Elaine. I am polite too but enough is enough. She hit on your last nerve and pushed all of your buttons. How could you not lose it? I would have lost it!

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Joanne, my answers are default and already set for newest first. Aren’t everyone’s default setting newest first?

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Mine are

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If She makes so much money why not hire senior care companions to sit with her at home and give you a break. As far as becoming dangerous her primary doctor should prescribe medication if neccassary,maybe she has a uti? Also i see hospitals usually TRY to talk family into putting in nursing home, Anyhow something doesnt add up. Thats teh prblem with these message boards, we only get one side and we only get limited information yet you want everyones advice.

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It was stated that she's in later stages of dementia. There aren't always medications that can or should be used and often don't work. I know there were some living in mom's MC who were "painting" the walls with poop. HIGHLY annoying, time consuming and gross, but benign. In OP's case, the mom has been threatening and dangerous - I wouldn't want that in my home and my kids are grown/on their own! OP has young child(ren) who have been threatened with harm. NO way would I want that woman back in my home, medication or not. Responsibility or not. Normal caring for kids or adults is fine, has challenges, etc, but with dementia, all bets are OFF!

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If she makes too much money, she can just be self pay. Call hosp back and talk with social worker to get help with placement. Call her doctor as well. Let both of them know you no longer have a home that is a safe place for her. Call the Ombudsman's office in your area to tell them what is going on.

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There is a huge gap between making too much to qualify for Medicaid and that amount being enough to pay for 24/7 care. Most people barely get by, this OP can not care for her safely at home. This is a much bigger problem than most of society knows, but as those of us baby boomer caregivers age it will become a complete tsunami.
I’d appeal and continue to appeal. Even after they assign a social worker, it still can be a cab. Do your homework.

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Not sure I understand. If she has Medicare and is not able to take care of herself and you can't take care of her at home, then she is entitled to 100 day of "rehab" care paid by Medicare IF her doctor orders it. After the 100 days are up, then you have a serious problem. If she has "too much money", then she's stuck with paying privately. After her funds are drawn down, then she can apply for Medicaid. But she still must meet Medicaid's rules, i.e., inability to perform ADLs, etc. Medicaid may only approve her for six months and then re-evaluate her at the end of that period - depends on the state. She is entitled to keep her home (if she owns one and $2000 in cash assets - that's it - no more. You probably need an attorney.

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Just know that those 100 days of rehab care are not guaranteed. Medicare can and will pull that coverage at any time ( with48 hrs notice or so?) for a multitude of reasons. Or, sometimes Medicare only approves rehab for only a few days at a time and family never knows when it will stop. Then, trouble starts again because you suddenly have an unwell person who needs ongoing care who is again being discharged from an institution that is supposed to help. My hope would be that everyone gets their 100 days, but don't be counting on it. Some get their 100 days and some don't. Always be looking at and thinking about what will happen if the 100 days doesn't happen. Even if you get the full 100 days, the next plan needs to be in motion before that time is up.

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Tiredmomma. What happened today? Did she come home? Or at least did they try to send her home. If not today, hospitals usually push to discharge on Friday afternoon. Hopefully there is an alternative placement for her.

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Dementia itself is not a "justifiable" reason for hospitalization. The hospital will not get paid (by Medicare or insurance) for any non-justified hospitalization, so the patient will be released. It's a matter of money. Medicine has become largely controlled by business interest.

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She was in for psych eval

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Needhelpwithmom, thank you for defending me. I get so sick of justifying my actions to people who have no idea what is going on. Magnum pi you are more than welcome to come take care of my mother. You can have the house and the contents in it!!!

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You’re welcome, Elaine. Yes, people don’t have a clue how hard it is if they haven’t walked in those shoes.

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NO. they cant do that. well, at least not in new York. where I live. if you sign your mom out of the hospital you are than responsible for her and her bills. they can not force you to take her home and they cant force you to sign her paperwork either.
I would go to an elderly senior lawyer and see what your rights are.
don't let anyone force you into anything you wont or cant do. what they do is put them into a nursing home, rehab, or whatever they have room.
I took care of my dad 93, my mom also 93, both with major health issues for years. I also at the same time took care of my husband who has parkinsons, blood clots in his lungs, irregular heart beat, prostrate cancer( that's to name a few). my son was having marriage problems and I some how some way had to care for my two granddaughters also. . so if anyone knows what you are going thru its me. don't feel guilty for anything. you did what you did and for as long as you could. You don't have to explain anything to anyone either.
my father passed away in my arms, three weeks later my mom passed away also in my arms. I sent the grand kids packing since I knew that the parents were not going to live much longer and didn't want the them to witness it at such an early age.
I am still my husbands caregiver and that's ok.
it was hectic to say the least. I am still dealing with issues with my parents will, house lawsuit and four ex-sisters who refused to do a damn thing for mom or dad. didn't even go to the wake or funeral.
check your options first as you could be opening up a can of worms for yourself if you sign mom out of hospital....
good luck god bless

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Wow, lizzy

You have been through the mill too! So sorry.

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They can release her to a skilled nursing facility or rehab center and depending on what type of insurance she has, they will keep her at least 20 days. You need to get her qualified for Medicaid ASAP or use the money she has to get her into a facility and spend the money down on it until she is qualified. It takes forever - been through this and it is a mess, but do NOT sign anything as a "responsible party."

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Rehab isn't likely, she was in for psych eval.
Already queried Medicaid, income is over the limit.
She has no money to spend down (no assets at all, never had a house.)
Income $1400, MC $4000, shortfall $2600 (pull the funds out of someone's butt?)

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You are right Needhelpwithmom!!! We have a very broken system in New York State. I don’t know if it is everywhere or not. But luckily i won’t be charged with anything because I don’t live with her and she doesn’t live with me, she’s competent in the eyes of the law, and I don’t have guardianship of her. I won’t ever get arrested. My elder lawyer once told me just because someone makes bad choices doesn’t mean they are incompetent. The law is on the elders side. My advice, don’t live with an elder!!!!

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Elaine,

You got that right. You can’t let them drag you down. You just can’t.

The law absolutely protects their rights! It gets downright ridiculous!

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Hospital forcing me to pick up mom with dementia.

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