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This seems like the only option left at this point and I feel bad about even considering it, but Mom can no longer be left alone for any length of time. She's fallen a few times, but not enough to warrant a hospital visit. We tried again having a caregiver come to the house when we would be away, but she refuses to answer the door even though we have tried to explain what is going on. We also tried having the caregiver come while we are home, however she will just go in her room until she leaves. Her Dr. has been of no help since her last visit and actually suggested she be seen by the nurse practitioner next time she comes. COVID doesn't help the situation, as it just makes things so much more difficult which we get but cannot continue on like this. TIA

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No. I have not had to do an ER dump. I can’t imagine it but I realize sometimes people feel they are that desperate. Are you wanting your mom to be evaluated or placed in ALF or NH?
Help us figure this out.
What is it that you want the caregiver to do? Is it to call an ambulance if she should fall? You can get cameras and check on her from your phone. You can get a medical alert system. A pendant or wrist band if she will wear it.
If I felt she couldn’t be alone, I would just have the caregiver stay while I ran my errands. Actually I would probably have a housekeeper instead with the understanding that they would call me should anything happen. Your mom would get used to the person being there. If she goes to her room, is there a problem with that? Does your mom have dementia? Is she shy? I had a housekeeper come and help me at my mom’s home. The housekeeper would take her a snack or comment on a program my mom was watching. After awhile my mom relaxed and the housekeeper could come and go with no problem.
Give us some feedback on the situation and perhaps someone will offer information that is helpful.
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This is a last measure to be taken ONLY when everything else has been tried. There is nothing good about it. BUT....................
As a nurse I of course saw it over and over again, and often of course legitimately done. You cannot know the results of a fall without ER transport into hospital and xrays.
Yes, it does make it more difficult in Covid times, but the important thing is to ask for a social worker at once and to say "I will not accept my mother back in my home; she is not physically or mentally safe there or am I physically nor mentally able to care for her. She will need placement".
THEN you must NOT buy into the "We will make this work together; we will get you help". They will not. Simply say she will not be accepted home and to discharge her would amount to an unsafe discharge. They can arrange guardianship (temporary emergency) much more easily than you ever could (call to the judge) and can find placement. NOT placement approved by you but placement THEY choose. Be clear in your own mind that once you do not take her back she may be moved to State Guardianship and they then have control of her monies and her placements.
This is the devil's own bargain. Nothing good about it. It is a last ditch emergency effort to find placement for an elder you can no longer care for.
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BurntCaregiver Oct 2020
They won't have to sign over guardianship of the mother on a social admit. My friend's family who had to do this with her grandmother did no give over POA or conservatorship to the nursing home. They will try to get it of course, but don't ever give in. Just because a person is unable to babysit an elder 24 hours a day, does not mean they are incapable of still looking after their interests and making their financial and health decisions.
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If you bring your mom to the ER and tell them that there's no one to take care of her at home, she can't be on her own, and that she needs a 'social admit'. They will admit her to the hospital and keep her there until they find a nursing home for her to go to. You can bring her to the ER even if she isn't injured or sick. It is the last resort, but the hospital will take her. They will send a social worker to talk with you after she's admitted. A friend of mine had to do this with her grandmother because there was no one who could care for her 24 hours a day. The hospital found nursing home placement.
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Empica Oct 2020
My elderly aunt developed a habit of calling 911 wanting to go to the ER due to anxiety only to insist on being released once she got there and since I’m her emergency contact I’d get the call to come pick her up. Once I got the call during the middle of a raging storm and when I told the ER staff that I couldn’t come pick her up due to the bad weather conditions and that it also wouldn’t be safe for her to go home to an empty house in the middle of a stormy night, they said she was competent to make her own decisions even if they were bad decisions and they were going to send her home in her nightgown in a wheelchair van DURING A TORNADO WARNING! I warned them I would hold the hospital responsible, asked for staff names in case anything happened to her after being released under those conditions and lo and behold they kept her overnight for observation. Months of drama have continued since that incident - social workers and her doctors have not been helpful.
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We would like to get her evaluated for dementia and possible placement in a NH which was about to start before all the COVID hit but now her Dr. thinks a NH is no place for anyone. We did try the alert bands but she's not into those and refuses to wear one. She will not bath, wash her hair or change her clothing daily and since she lives with us can definetely see failure thrive and can see the decline in just a few short months. We put her meds out for her but normally find them all over the floor even though we watch her take them. Its now reached the point where we feel she needs more and better care than we can give. Her going to her a room is not a problem but it does create a problem if shes sleeping 15+ hours a day and not drinking or eating when she clearly can. It seems like lately she doesn't know she has to eat and drink.......Since most of the family is back to work we do not see what she does while we are not there.
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Lyecats Oct 2020
Is there the possiblity you can find an assisted living facility? This is an intermediate kind of place where the residents have more freedoms.
In Florida, we have lots of "aging in place" campuses that cater to the changing needs of the elderly, perhaps mom could be persuaded to visit a place like that to see the benefits of making a move.
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Yes. It can be done, but its a shame we don't have a better system in place, and its a shame the Doctor's and nurses don't really help. I had the same experience with my father's Dr's. I think it's because they know there is no easy answer. I ended up in a desperate state and cried out to his Dr. asking what can I do and she said "Take him to the ER, it is YOUR decision" She said it twice and emphasized "Your decision" as if to say she is not telling me to do that. I ended up calling 911, I think it is better to have the ambulance transport rather than bringing her yourself. Once at the hospital you are going to have to stress to the case manager and social worker you are unable to provide a safe environment for her anymore. You are unable to be with her 24/7. Please follow AlvaDeer's advice. Also, when you call 911, make sure it is somewhat warranted, like after a fall, or perhaps if she seems overly delusional. The only other option (other than being able to place her in a NH or memory care if that is doable, and unfortunately for many it is not) is to contact APS or a state social worker, but I really don't know how that works or if it would work in your favor or not. I have not seen any narratives of going that route.
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rovana Oct 2020
What if the home the elder wants to return to and live in is the elder's own home?
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If she has fallen more than once, it's time for an ER visit, which will immediately provide your mother a hospital social worker employed to arrange her post-hospital location.

How is this organized? In the U.S., hospital social workers are employed to arrange hospital discharge (post-care) locations.

In a typical larger hospital each floor/wing has its OWN social worker. For example, Denver Swedish separates but connects its social workers: its ER Department has a social worker, its 7th floor Neurology unit has a social worker, and its 4th floor Acute Care unit has a social worker, etc. Each separate social worker is assigned patients on their floor/wing. As the patient is moved from the ER onto different floor(s), their social work file moves with the patient to the next department social worker.

As an example. If a patient is transported to an ER due to a CVA (stroke), after that patient is stabilized (scans, tests,etc), the patient is next moved onto the 7th floor Neurology unit. As the patient is admitted into the new department their social work file moves with the patient into the new department, etc.

Which means after your mother is transported to the ER, you'll need to contact the social worker within the ER department, to clarify that your home is not a safe place for your mother to be discharged. UNSAFE because it has stairs and [insert danger here] Which, ideally should, result in the social worker arranging for your mother's discharge into the type of facility an M.D. orders.

After contacting the social worker you will need to maintain daily contact, to ensure that facility arrangements are being made. The social worker and nursing home will arrange to have the nursing home salesman to stop-by the hospital to interview/meet with your mother.

Working with the hospital social worker(s) is the safest legal option; your mother likely will qualify for Medicaid (and Medicaid long-term care), each U.S. state has separate determination criteria. Colorado for example, excludes one home and one car, and has a set amount of "cash" $2,000 allowed.
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rovana Oct 2020
What happens in the case a patient who is competent, but not able to live safely alone, decides to return to their own home? Could this be a situation where OP wants to get parent out of their parent's own house which is no longer safe? If so, why would explaining that discharge to OP's home is unsafe? How could this be handled to force elder into care?
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You can’t make someone leave their home to go to a facility if they are competent. Even if they have fallen. If they have their mind, they can refuse to go anywhere. An ER dump won’t work either.
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NeedHelpWithMom Oct 2020
You tried it Elaine. I remember that.

Did your mom date after your dad died?

Once as a joke I told my husband’s grandmother that she should marry again!

Trust me no one would have put up with this woman’s crap but I thought that she would leave us alone if she had a new love interest! LOL. She was out of the box crazy!

Maybe you can fly your mom to Wales to be with Paul’s dad! Hahaha 😂 He could take her to his betting shop, whatever they call them in Wales!

I just posted on Paul’s page about his dad. His dad drives him crazy!
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You can still place her in memory care now. What will bringing her to hospital accomplish? You want them to place her? Does she need to be seen by doctors or are you just trying to get her out of the house. They are not going to search for a good place for her; they will put her in a place with an available bed? They cannot keep her at the hospital for long if nothing is really wrong they can treat.
i don’t think you said how a facility would be paid for. Medicare does not pay for nursing homes.
I suggest you look around and find memory care facilities near you and contact them. Yes, she is at risk due to Covid but she is also at risk not taking her meds and not eating.
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Lvnsm1826 Oct 2020
She would need guardianship to put her in memory care against her will
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I think AlvaDeer posted wise advice and a “script” for what to exactly say to the hospital social worker in the ER. The key is to get in touch with the social worker as soon as possible... do not wait around.
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I had a similar situation with my 90 year old mother with Dementia. She is fiercely independent and needed help but would lock the caregiver out of the house and refused to cooperate. I told her very sternly that it was either the caregiver staying with her or I would place her in a nursing home and the choice was hers. I made it clear that was her only options and I told her that daily. I had to be very tough. She did allow the caregiver to stay but was not not very happy about it but did cooperate. You have to take control - Do you really want an ER to place her in a Facility ?
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Place her in Memory Care.
Suggest you start looking and if mom needs application for Medicaid begin that process now.
An "ER" dump is not fair to your mom, the hospital staff
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FloridaDD Oct 2020
It sounds to me like mom wont go, and they need help in getting her there
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" Her Dr. has been of no help since her last visit and actually suggested she be seen by the nurse practitioner next time she comes."


Does your mom's doctor not think she needs to be placed in a facility?
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Surprised that some suggested memory care to solve the poster’s problem. Right off the bat, MCs are expensive and are private pay. Also, the cost depends on needs. More needs = more money. Not everyone can afford several thousand $$ a month. And then not every MC has availability. Those that have availability might be far away or have poor service. I have visited MCs that I would not even let my pig to live in, much less my parents or spouse.

Re the poster’s problem with the caregiver, I had those hide-in-rooms too. It took a while for the agency to find the right match (for now), but I am glad I fired the lazy ones.
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sunshine45 Oct 2020
AKA Haileybug

Not all Memory Cares are private pay.

I do agree with you that some are not a Go To place.  Sadly, in an ER dump, that may be where a dumped family member ends up at.
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We purchased a door knob hanging lock box for the house key off Amazon so the caregivers could enter and leave as needed (updated info with local police to have notes on address with code to access in case of emergency). We also installed Arlo security cameras inside and out to monitor movements and visitors. I could check throughout the day to see if they were safe and not in trouble. This allowed our loved one to remain at home for almost 5 more years before being placed in a facility. The worry eventually consumes you. Wishing you all the best in finding a solution.
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InFamilyService Oct 2020
We are using the NEST system now and its great. My aunt has three cameras installed with audio and visual.
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I ordered a life alert necklace for my mom, with it comes a lock box for your front door with a code so emergency workers can get inside. She was reluctant to wear it but I explained to her that it made me feel better about her safety when I was out. She also is a fall risk. So that could be an option for you to know she is covered when you are out or to give the code to a worker to come in as well. I realized that for my own sanity and ability to be out doing things that I want to and need to do to LIVE MY LIFE, I would have to insist on this. It gives me a sense of peace knowing she is covered while I am out. And it works, she has pushed the button by mistake in her sleep and the paramedics were at my door at 4:00 am. They also have ones that can detect a fall and the button does not need to be pushed. A lot of Medicare plans pay for this. If not, it runs about $30-$40 per month depending on your plan. I hope this helps🙏🏼 Tammy
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ExhaustedPiper Oct 2020
Tammy, do you mind sharing what system you purchased? Thanks!
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Get a key box like realtors use and caregiver can get in at anytime
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InFamilyService Oct 2020
We also used a "lock box" to allow caregivers to come and go for my parents and an aunt. It has been a tremendous help. Dad passed but mom has a life alert necklace in case of a fall or emergency.
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Personally I don't see anything wrong with having the caregiver come while you are at home and letting you LO go into her room. So what if she doesnt want to socialize with the caregiver. Are you worried something might happen while she is in Her room? At least there is someone in the house to make sure she doesn't get out. If something did happen while she was in her room... I am sure the caregiver could listen for any noises that might indicate a fall. She may eventually come out of her room. What about Adult Day Center? They are open here although I know many of them are not open. The Housekeeper solution sounds like a good idea as long as she knows she is to keep an eye on your LO. Let us know what you have decided and Good Luck.
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Kittybee Oct 2020
I had this thought too. As long as someone is in the house and monitoring the overall situation, then let her hide in her room.
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Having help come is probably best. Second best is respite in a residential facility.
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You could check local assisted living facilities to see if they have respite care. COVID may be preventing respite care but it’s worth a try. I used respite care once for my mother and hospice paid for 5 days but your mother would have to have a qualifying condition for hospice. Good Luck.
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First, think through what you're looking to accomplish with an "ER Dump."

If mom has the finances for AL, give yourself a pep talk and begin the process of moving her. Your quality of life matters just as much as hers. And keeping her reasonably safe matters most of all.

If she doesn't have the money, and you think that she'll qualify for Medicaid for long term care, call 911 for that next fall (I hope you're not lifting her from the ground yourself - how old are you? Protect your back). There could be conditions underlying the falling.
Once you get her into an ER, it's still a process. The ER doc has to admit her. You must hold the line about there being no one at home to care for her. Hopefully, if she is admitted, she'll be discharged to rehab, where real attention will be focused on whether or not she can live safely on her own.

It can work, but proceed deliberately and don't waiver; with your mom or the healthcare folks.
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I would leave a key in a lockbox for the caregiver so she can go in; they are insured and work through agencies so will be safe. It is tough for the person to accept they need help so you have to frame it as if the government requires that she is safe at all times so it is necessary that someone is there when you are not. We find making up stories to satisfy our mother works (not always but just keep trying) and she has no choice but to eventually accept. Even if she sits in her room, at least you know she is safe. Let the caregiver do their job and she will give in. They always do. Good Luck tia. These are very hard times for us in this situation.
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Sadly I have had to do this twice since the hospital sent him home saying he was doing amazing. He does belong to the veterans hospital currently he is getting more testing done and the clinicians there have been super helpful And admitted him to their hospital room I am currently waiting to hear back from some other long-term care homes which I’m praying will work out this time
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one more thing. We put in the RING camera in her kitchen and front door, it has helped us so much - we see and understand everything that happens when we are not there - you can put it in the kitchen and living room (not in bedroom or washroom or private area ie where she would change). I love this camera, it changed our lives (and no i don't work for them) You can feel safe with caregiver too because you see and hear everything. It puts all the pieces of the puzzle together for you. I promise you will love it. I put one in for my mother-in-law too and she is so happy because she sees her husband with dementia when she is shopping and feels so comfortable that he is safe.
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GAinPA Oct 2020
Glad to hear about your use of security cameras. When I was taking care of my mom in her home, I used cameras and door sensors to monitor her safety. I was so happy that I had made the decision to update her computer & WiFi network to make the setup possible. Before the cameras, I used an IPad positioned in her kitchen, but she had to accept the session. I also had smart plugs to turn on a series of low light string lights positioned at floor level because at the time, the IPad did not support night vision. Stick up motion detection lights allowed her to take her night time bathroom trips. It was a series of trials and errors, but it kept her for at least a year she would not have had in her own home. Many people will object and bring up privacy issues. But when the front door alert went off at a time she normally was sleeping, I was able to check my phone to see her naked standing in the front door because of the full moon shining through the small window in the door. She was repeatedly opening the door and setting off the porch light to find the source of the “light”. I immediately drove to her house (10 minutes away) and reassured her. Covered the small door window. Next day we put up stick on vinyl on the window of the front door leaving plenty of room for her to look out without the entire neighborhood viewing her upper torso!
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I can't imagine leaving my mom (dumping her off somewhere). I don't even like the term ER DUMP. If your Mom is not abusive to caregivers, but just isolates herself, that is better as she will have someone nearby. I can't imagine she'd be happier in a foreign environment (hospital) after being left with strangers by her family. It sounds like you are at a desperation point, and a social service agency for the aging might be a resource that can help you. Good luck!
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Is there a government social agency -- something named "adult protective services" which could help. If you explain to them that you can't care for her and she can't care for herself, maybe they know how to move her to a nursing home.

Medicaid will pay if she qualifies financially. If not, contact an elder law attorney to figure how how to get her qualified.
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drooney Oct 2020
Adult Protective Services is part of your local Area Agency on Aging. Senior Center can help clients get in touch. APS can only investigate elders at risk and make suggestions as to the proper care options. Unless declared legally incompetent, elder can refuse any care or housing options. Nursing Home social workers can walk you through qualifying for Medicaid ( all about assets)
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We tried that. My MIL actually decided she was going to leave and "never come back". We do not have guardianship over her and we had been trying to convince her that a nursing facility or retirement home would be best. But she refused to go. We called the police who convinced her to go to the emergency room instead of going to "die under the bridge". They kept her for a full 30 days, telling us she needed to be placed in a long term care facility. But since she was refusing to go, none of the facilities would take her. After the thirty days, they said that she had "timed out" and they released her. She still refused to live with us and ended up being homeless again for a while. We took her to two different ERs after that, when we could convince her it was for her benefit. The doctors all admitted that she needed to be in a care home, but none of them would actually put her in one. She is currently living with a man unknown to us, who tries to get access to her disability and other benefits every once and a while. I have a good relationship with the ladies at the local SS office, and they have been vigilant to keep him away from her money. We are her benefit payees, and are authorized reps on all her accounts and with doctors. Thankfully, we got this all set up before her mood changed. We have been making sure her living expenses are paid, she gets groceries, sees her doctor and picks up her medication. It's been several months and she has now forgotten about all of it. She calls us happily and is excited now to visit for the holidays. Sometimes, the best you can do is the best you can, even if it's not ideal.
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Myownlife Oct 2020
That sounds like just such an unbelievably hard situation for you. I am so sorry for all you have gone through and continue to go through.
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Yikes! A nightmare..... scary, too, since my mom absolutely refuses to go to a facility, though she can do almost nothing for herself. "the best you can do is the best you can" - you said it.
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If you could have a caregiver come while you are there for short visits and get her comfortable with a particular caregiver she may get used to them and actually enjoy them. Sometimes a gradual change rather than a sudden change will work out better. Change is difficult for for all adults but is even more difficult and scary for elderly adults. Good luck!
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ArtistDaughter Oct 2020
Yes. My mom would fight the idea of anyone coming to take care of her. I started with a house keeper and she accepted that, so the caregivers who came eventually also told her they were house keepers, which they kind of were. That they cooked and did light housework made it believable, but they also could watch out for her and make sure the medications were put in front of her and actually taken. My mom eventually accepted that she needed caregivers. She now even accepts that she needs to be in assisted living. She had always said she would never go, but there she is and very much happier than she was at home.
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Let the caregiver come and get a baby monitor that she can watch your Mom while she's in her room and the caregiver can be in another room.
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Do you really think an "ER dump" in the present pandemic is going to help anyone? Hospitals are overwhelmed with sick and dying people from COVID and the majority of their energy and resources are going to treat those patients. Taking your Mom into that situation is just plain cruel--expose her to COVID, take resources, especially time, away from dying patients. Do you really have no other alternative? I think a lot of the ones sited below are great. Contacting Adult or Geriatric Protective Services in your county/state is a great place to start. Also try senior services for your county or town. It will take a lot of your time on the phone, but these people deal with these issues regularly and know what is available and how to go about getting help. Hoping for a reasonable outcome for you and your family.
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worriedinCali Oct 2020
She wouldn’t be taking resources away from dying patients. And very few, if any hospitals, are overrun with COVID patients.
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