Great suggestion, travelnut. HImom, it seems pretty obvious that she should go to a SNF after discharge. Has that been considered at all or discussed with the case manager? Travelnut is right that one of the benefits is multiple medical eyes on her for an extended period of time. In turn, those people maybe could talk some sense into the son.
The case manager and S didn’t sound like either wanted to advocate much on her behalf. The S and D have power of attorney. We gave him my BIL’s phone #, as he went through this with both his parents recently and was able to be sure they had appropriate placements.
It really doesn’t feel like the S has his heart into doing ANYTHING, just like when she fell 3 years ago and the S said she needed more supervision and made a half-hearted attempt to hire someone to come in a few hoys a day and get her a mefic-alert type bracelet. The S said she fired the person or had the person quit and stopped using the bracelet.
I’m only concerned that it makes my dad so sad to see his only remaining Sib being so neglected by her kids. My dad and bro tend to end up helping her as needed because her kids just say, oh well, she’s so stubborn so we can just throw our hands up and leave her to the kindness of others (my dad and bro and her one friend).
The case mgr and S were saying that if she wants to go home, that may be where she is released to, regardless of how unsafe! I was appalled but it really is S’s role, not mine or dad’s. So sad. Hopefully the S will do more but we are not very optimistic, given their past record.
The case mgr may have found your aunt sufficiently compos mentis to make her own call to live at home. Aiui, mpoa is when she is unable to make her own health decisions. You may need to make a step backwards and have them (re)evaluate her capabilities and ability to make “her own care decisions.” It’s a funky grey area. It’s part of why I can’t influence my mother’s decision to move.
She doesn’t even know she’s laying in a hospital bed (thinks she’s sitting in a chair), she lives alone on a hill and currently has no means of transportation (was driving against MD orders), no handivan NO bus service, has fallen 3 times in a month, most recently lay unconscious and unable to get up for 14 or more hours with NO memory of the incident. She has no regular MD because hers retired and she lies about continuing to see him. Talking with her for any length reveals she has NO short term memory. She’s stopped taking her various maintenance Rx–unclear if memory issue or refusal.
We have no standing, as she’s designated her S & D as her medical and legal reps, so no one else has standing (other than her if she’s found competent).
I’m stepping out of the picture and let her S take charge, tho he doesn’t seem to care much, sadly and is leaving Thursday. The retired D isn’t even coming, as far as anyone knows.
I’m sorry Himom - no one should be left like that. It seems almost like criminal neglect. We’re still listening to my mom complaining about her latest move where she’s clearly well cared for, it’s beautiful, everything she needs and she has tons of new friends and things to do. Yet, still will say things like being whisked away there without her belongings, or forced into a home, or …whatever the complaint of the day. If there weren’t 4 of us over ruling her, I think she’d still be schlumped on her couch in her pajamas around the clock with aides and barely making it through the day. Instead, she’s up and dressed and active. Sometimes you have to step in and do the right thing regardless of what the person thinks, especially if they don’t think clearly.
So sorry for how this impacts everyone, HIMom. Beyond frustrating. Usually relatives who don’t want to provide needed care themselves are relieved to have SNR stays as an option. Really highlights gaps in how elder care can be optimized. Having adult children as PoAs and health proxies is not always the best route.
@Himom sounds like the son has more of a conscience when it comes to his mom than your niece does. From your posts it sounds like your concerns need to be spelled out clearly to your aunt’s case manager and S. As others have posted, should not discharge her to an unsafe situation. Use the Medicare days properly. Your dad would also want to see his sister properly cared for.
Tough love is needed.
Interesting development with my neighbor’s mother - she is 80; got her BSN at age 60 (was married many years and in widowhood went after a new goal). Still working home health and goes on a lot of medical mission trips. Very strong willed and can be difficult. She moved ‘at invitation’ to another daughter’s home 6 years ago, although different stories on how that developed. They now have spelled out that she needs to move. Not handled with the kid gloves needed. So that situation is continuing to unfold.
H’s aunt (a nun) was active in ministry (with the last years in a rough neighborhood inner city Chicago helping teach home skills to moms just out of prison) until going back to the mother house and then to a nursing home facility when over 100. Died shortly before age 107, and would go around to ‘cheer up the old folks’ - even though she was clearly the oldest one there.
Stubbornness w/o reason is a difficult situation - and when the mind and body are going and person is deluded on what they are capable of doing and not doing.
I am sure it is painful for your dad to see his sibling deteriorate.
Hugs and prayers.
Sorry to hear about your aunt, HIMom.
H is at his parents. His D fell and is now about to be discharged into rehab. If he makes progress (he has fractured ribs and had mobility issues before the fall), he can stay there 20 days. The fear is that he refuses to try so that he can go home. Geriatrician at hospital made it very clear to H that neither his M or D should be living at home. We have been asking them to move for years (kindly with lots of help from us). They are very stubborn and unrealistic. They are 88 and 89, have multiple issues including short term memory loss, bad vision, arthritis, and COPD. They should not be driving, cannot maintain the home, have had several falls, and have spent most of their money. My poor H is there now on an extended trip. His sister is no help for her own reasons. H’s new job starts in 2 weeks. He is 56, so I fear that if he does not get started on this one, another will take a while to get!
I admit that I am very, very angry. I know it’s not kind and it’s not helpful, but my in-laws have made terrible choices and rely on us for everything (including money) even though we are a plane ride away. My H and his sister have not pushed hard enough for changes to keep their parents safe (not to mention off the road). This is the very predictable and awful scenario we all knew would happen.
So, how does one get non-cooperative parents to move into AL? Can a geriatrician forbid a patient from going home?
What happens if my husband just comes home? Are there case workers at the hospital who manage elderly patients without local family?
I can get there to assist with downsizing/moving in early June, but I am going to stay here for my kids’ graduations (one HS, one undergrad). I am not a terrible person, I promise, just overwhelmed! I want to enjoy my kids now and not be so worried about/angry at my in-laws.
I really think the easiest course and the one most likely is that the ornery person gets her way, no matter how dangerous it is for her. I think that’s one reason her kids aren’t trying much at all.
I know it REALLY bugs my dad and my extended family. My aunt has managed to alienate pretty much everyone. She has a very sharp tongue and is NOT a nice person; she also holds grudges forever. We only try to be kind for dad’s sake. I believe she has ONE friend, dad, my bro and her S who care at all. It’s very sad.
HImom, the situation stinks. I keep reading your posts and thinking about FIL. We could not make him do anything. He is 95, we have tried to get him to stop driving, but as an example, if we sold the car, he would just go buy a new one. If she really is stubborn and determined to remain in her home, the kids may not feel they can make any difference because they never have, but they may not be seeing with clarity that she is now finally in a spot where she can be overpowered and forced to move to a safe place.
We read over and over and over about people who get the “help” button and don’t use it, they lay on the floor for hours with the button on their person and don’t push it. We also read about people who bring in caregivers and the senior fires them.
It is a very rough situation when the kids or other family don’t have legal authority!
The kids DO have legal authority but live in CA, 2500 miles away. Aunt sabotages anything she doesn’t like. If her car is taken, I don’t think she’s capable of obtaining a new one.
HImom – Sucky situation, for sure. I’d be sincerely tempted to write a letter (delivered, with signature confirming receipt) to the Case Manager, expressing your significant concern that Jane Doe is incapable of safely caring for herself:
- Her memory issues, including inability to remember who had visited her an hour earlier. Living alone and having significant memory issues will also have consequences for her following any medication regimen. If she can’t remember who she saw an hour earlier, how can she remember if she has already taken any required medication.
- Fall risk given her instability, especially since the last fall resulted in her being on the floor for fourteen hours until a neighbor found her, and this despite the fact that she wears an armband alert system which she apparently could not remember how to use. Fall risks are amplified by the need to shower, dress, prepare food, and carry food to the table.
- No ability to acquire food or get to medical appointments since she cannot drive and her home is located in an area with no senior transit.
I have found that sometimes, formal notice like this makes hospitals and nursing homes less willing to simply go ahead and discharge a patient with no appropriate care plan because they’ve formally been put on notice that the patient is incapable of living independently.
I am so sorry you’re trying to cope with this.
Thanks. Will think and discuss with dad. Not sure what the S and his mom and case worker are thinking (or if they do think). Seems pretty awful to us.
Usually, one person bringing a relative’s limitations to the attention of the team and discharge planner, while suggesting that they do not believe relative is safe and they view the hospital as responsible for an inappropriate placement, is enough to get elder to skilled nursing. (Perhaps her son doesn’t even know of this rehab option) If that doesn’t work, insist the planner or medical staff accompany you to the bed. Have elder sit up, try to stand, get to the bathroom, walk, etc. If she can’t, only skilled rehab makes sense. Also, all elders are prone to rapid muscle wasting and loss of strength post-hospitalization. This is a routine for most, even if they are not ornery and are with it cognitively. Regaining strength takes time.
Also, all hospitals have quality assurance offices. Their role is exactly what it sounds like. They are obliged to look into any concerns, complaints, or problems. I once wrote a teaching hospital QA a letter describing problems my mother experienced while on a unit there (egregious stuff-physical injury, being yelled at and told to wet the bed if no one answered her bell for 15 minutes, being sneezed/coughed all over by ill test technician who then kissed face after the procedure, having her arms rammed into a door frame while on a gurney and being blamed for the accident as she was rolled backwards). They chose to investigate 5 departments. The charge nurse cried (before the letter) when I told her what my mother had experienced. I did not involve QA until my mother was safely out of there.
Aftercare planners should be accountable for appropriate recommendations and well accustomed to steering the ship off the reef, even with reluctant patients and relatives. Yes, there are shades of gray and times when legally they don’t have the clout to connect all the dots. This may not be one of them.
I found out after the fact, that almost every state/county and lots of cities have some sort of Senior Counsel AKA Senior Life quality or something like that. They have people who will go investigate these drivers who should be off the road. The are the same people you report elder abuse to. And then the courts have the ability to make it stick that someone shouldn’t drive, or live alone. google it for your town. Also if you ask around at the courts, find out who the attorney is who handles guardianship by the state cases. They can tell you steps that are legal to lock someone up (for their own good). They do it all the time.
Another day,another UTI for my mom. Might be why she is so confused; I thought it was still results of the flu. She got right in to the Dr. though, so that was good.
Mahjfan, you are not a terrible person, ok? NOT. Don’t even think about feeling guilty for attending your kids’ graduations. That’s an order. 
Well, dad sees it as HIS role to get his cranky, stubborn sis to agree to rehab. I don’t believe she can walk, tho she was walking prior to her hospitalization. Dad also says he will have her car moved to his house so she won’t drive. He says the S can’t (won’t either) get her on board. Dad will be visiting her with S to get things moving forward.
At this point, aunt is not my circus, not my monkeys. My dad, on the other hand has decided it is his circus, so doubtless it will be ours too. 
Hugs
Thanks–things will work out, but it won’t be ideal with a difficult patient and physically and emotionally distant kids.