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My Mom suffered a stroke on May 5, 2020 during Covid pandemic. Thankfully she did not contract Covid at hospital. However, upon discharge from hospital my brother chose to send her to rehab/nursing home. This was the worse decision. Instead of rehab helping Mom, they neglected our Mom causing more physical injury. In less than 24 hours at this horrible rehabilitation center, she fell and contracted pnuemonia from next patient in her room. She had to be rushed back to the hospital. Thankfully she was covid negative. She was discharged again from hospital for 2nd time but my Brother without our Mother's consent nor my knowledge chose for a second time to send our Mom to another nursing home. Our Mother is coherent and does not want to be in a rehab/nursing home. She eats mechanical food and only needs physical therapy which she can get at home. She lives with my sister and father. (Sister denied living at residence to assist brother to place her in home when she spoke to social worker at hospital.) He is keeping me, the 3rd sibling in the dark. Again, My Mother is coherent and is being held against her will at this facility. She has endured horrific trauma during this past month which no human being should endure, but yet thankfully is lucid and coherent. How can I get my Mom released to her home with medical care to be given at her own home especially during this pandemic? Social worker at present rehab advised me that she will not discuss anything with me since I am not Health Proxy, POA, nor was I placed on next of kin list at this present Rehabilitation Center. This is breaking my Mother's heart and mine as well to hear and see her suffer. No one should be held against their will. This is ABUSE. Again, She has endured so much this past month and yet, God bless her, thanks be to God, her will and determination to live and go home has been medically proven with her eating mechanical food, talking and walking. I have tried to call my siblings and they do not take my calls nor my Mom's. I send my Brother text messages and he is dismissive. Whom can I ask for help? Attorney? Mediator? Please help us. Thank you for reading this and God bless you. I look forward to your replies.

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Is your brother POA? Would mother like to change that?
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Faith1127 Jun 2020
Yes, she does want to.
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Is this temporary to help her get stronger, rehab many times is. Strokes are very hard to recover from, needs for physical and occupational therapy. Is sis just plain tired from having the 24/7 responsibility for mom? Does sis need a break? What help does sis get with mom?

If mom is not incompetent she can change her POA to you, but then you may very well have responsibility for her 24 hour care. Would you be willing and able to step up?
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Sorry to disagree - always more to the story - but disagreeing with what Mother wants does not equal abuse in my book. Sorry I also don't understand why your heart is breaking. Stroke survivors need rehab most of the time. Yes a fall was very unfortunate. If she is falling in rehab she would also fall in her home.

I think the big question here is can Mother look after herself independantly?

If yes & Mom is fully lucid, coherent, walking, talking then she could discharge herself & call a cab home, right?

But if not, then those caring for her, ie your sister & father get a say. A big say. If they don't feel they can look after her needs yet then they say no. Which they have done.

Why do you think your Mother's wishes to go home override anyone else's? Including a medical opinion to go to rehab?
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gladimhere Jun 2020
I agree, this is not abuse. Someone is watching over mom's health and making sure she gets the care she needs.
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Sorry if I am too blunt or harsh tonight... I have a bossy Mother so am probably clouded by that.
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gladimhere Jun 2020
Beatty, I get harsh and impatient too. We all do.
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Stroke survivors need intensive rehab.

Sounds as though father (who is elderly himself) and your sister provide care. Sounds like they are burned out.

Have you provided any of mom's care? Do you know what her needs are? Are you willing to take over as POA and provide mom's care?
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gladimhere Jun 2020
It is hard for those that do not provide the care to think LO's wishes are all that matters. Without rested and healthy caregivers the quality of care suffers.

Instead they should dedicate themselves to helping instead of criticizing and accusing.

What is mechanical food?😳
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I think she means " mechanical soft" which is a dysphagia diet term for food that are chopped or easily separated.
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Are you ready, willing and able to care for your mom?  Have you offered that to your brother?  Your sister has every right to say, I cannot handle this, and mom will not be safe at home.   I am sorry, and I can see you care about your mom but if she is not safe at home without others caring for her, unless that other is YOU, you need to accept that mom is going to stay at  the facility.
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Faith1127 Jun 2020
Thank you. Your feedback is appreciated.
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Thank you all for your responses. To those who feel I am harsh and critizing..if having a heart is being critical than so be it. I own it. I care for my Mother along with my Sister who lives with them. During this difficult time of co-vid pandemic, no one should be in a facility feeling abandoned against their wishes without their loved ones alongside them to make sure that they are indeed receiving the proper medical care. That is Abuse..EMOTIONAL ABUSE! MENTAL HEALTH is everything to recuperate. I have a registered nurse whom is waiting for my Mom to be released from Home to tend to her during the week. Unfortunately, because I am not Health Proxy the rehab does not want to meet with me. Rehabs are money making businesses...it is all about the MONEY. I will pursue other Avenues to see that my Mother is released obtaining medical care at home.
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FloridaDD Jun 2020
You can go to court and try to get guardianship.  But unless YOU are willing to take on the care hours when nurse not there, I don't see what can be done.
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Faith, only your mother can change her health care proxy and poa. If she wants this, SHE has to initiate it. Your brother's hands are tied.

I'm not saying this is the case here, but some parents have been known to complain to each of their children about how heartless the others are, stirring the pot and creating drama.

I know several folks, including my ex MIL who are in facilities on lockdown right now and their mental health is no worse than anyone else's during this time of crisis. Perhaps your mother's OVERALL mental health needs to be assessed. Depression following stroke is fairly common and in some places, an antidepressant and regular psychiatric follow up is part of the post-stroke protocol.
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FloridaDD Jun 2020
Very good points.  I think my BIL is clinically depressed because of lockdowns.  My sister wants to find him a tele-therapist.   We are all having a very tough time, but it is worse for people who have had a stroke. 

When my mom is not doing well, she thinks whichever sibling is not around can solve all her problems.  I feel for her, but we all know what is going on, she is desperate. 
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"I have tried to call my siblings and they do not take my calls nor my Mom's. I send my Brother text messages and he is dismissive."

Looks like you are in the minority. If siblings aren't taking your calls and the facility won't talk to you, where are you getting you information, Mom? If Mom is capable of making her own decisions, she doesn't need a POA. So there must be some cognitive decline for the facility to except your brother as Moms representative.

In your situation, looks like the majority rules. It may be wise on your part to follow suit or you are going to alienate your family. Mom is where she is because the doctors felt she needed therapy. You can sympathize with her but don't encourage her leaving. Tell her to do what she is told to get stronger. Don't say anything about coming home. It may not happen.

What I see here is a sister who is caring for TWO elderly people. Does she get help, does she get a break. Moms on a special diet, so Sister is fixing 2 separate type of meals 3x a day. You don't say how Dad's health is and how Moms was before the stroke? Maybe Sister is enjoying a little respite from caring for and living with two parents. Maybe caring for a stroke victim will make Sister's life even harder. Are you willing to devote most of your day caring for Mom if she returns home? House may need upgrades for her to live in her home. It is not what Mom wants now its what she needs.

If we seem a little harsh, sorry, but this is now Moms reality. And other people need to be considered when making decisions for her care. I will assume because of the Virus you have not seen Mom. If so, you have not been able to observe her. If you could, you may see why she needs to be where she is right now. Not being able to visit makes it hard on everyone.

I think at this point you need to be supportive of the decisions your brother needs to make. Its not always easy.
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Faith,

My dad had a massive stroke 5 years ago. I got the call to come NOW, as it was questionable as to whether he would make it through the night. He came through, but needed months of rehab. He would not have been admitted into the rehab if he had not needed it.

He told me there were a number of people in the rehab that complained all day, rarely did their exercises and just wanted to go home. But they also wanted the 24/7 support that they had at the rehab. Meals, aids at their beck and call, bathing support and more.

Dad did fall in rehab, it was no one's fault.

He was taught by PT and OT how to walk again, how to feed himself and more. He still does his daily exercised, but is much frailer now.

Keep in mind if you find a way to bring her home, it is not a matter of arranging for PT to come once a day. There is all the equipment that they use, parallel bars were used extensively in Dad's recovery, as well as the medical equipment needed to care for someone with mobility challenges.

As others have said if your mother is mentally competent, she can change her POA. But she cannot force your sister to continue to provide care.
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Your mother's health care proxy is not active unless she is no longer able to make her own decisions. If the social worker is saying she will only speak to the health care proxy, someone (not your brother- someone medical) has determined that your mother cannot make her own decisions. Your brother can't just decide your mom can't make any more decisions. A doctor has to do that.

A physician can write an opinion about someone's capacity. If she can communicate her wishes, understand and reason she has capacity. Your mother should request to be seen by a geriatric psychiatrist or psychologist to determine her capacity.

Your brother cannot unilaterally place her in care. Doctors determine whether or not someone needs placement. You can't just drop unwanted elderly folks off at a nursing home or rehab. They have to need care. Many elderly people do not agree that they need care when they clearly do. That, all by itself, can indicate a lack of capacity.

Try not to worry. It would be very good if your brother would share information with you but families are all different. Ask him if you can be included at the next care meeting at the facility. Maybe if you hear what the doctors have to say, you will get a better idea of what care your mom needs and feel better about her getting that care in a facility.
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We HAVE given her guidance, Shad. If mom is competent, she can change the documents and the OP can care for her mother on her own.

If she hasn't done that, perhaps the mother is adjudged no longer competent to make those changes.

The OP seems to be reasoning from a false premise that "all" the mom needs is home PT. She would be eligible for in-patient rehab if "all" she needed was at home PT.
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Faith, I am happy to hear that your mom is improving and that she will be coming home soon.

Well done being her advocate.
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I'm so happy for you, Faith. I hope you'll stick around on this site as you care for your dear mom.
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I hope you stick around too.

Sometimes strong views do pop up which your question seemed to bring out: Siblings that disagree on care, becoming the caregiving but not having authority (POA), possible mistrust? in the health setting or medical advice given - all really really hard stuff & all here!

I hope going forward that your Mother makes a full recovery. There may be a stroke foundation in your area for good support & info. My area even has a Stroke Survivor social group.

I have no idea if your Mother's pneumonia was viral or otherwise, but if it helps you, stroke itself is a risk.

From the net "It is estimated that 6–22% of stroke survivors will experience pneumonia. The primary riskfactor for pneumonia after stroke is thought to be dysphagia that allows aspiration of ingested food, liquids, or oral secretions".

My Mother is a stroke survivor too & although back on a regular diet she sometimes coughs after thin fluids. Posture & expanding the lungs on the weak side also increase her risk.

Hope the transition home goes well.
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I am glad it all worked out in your favor. If Mom is competent, I suggest when possible to have her revolk brothers POA and assign you. It will make things easier in the future.

Could you tell us how you were able to get around the POA?
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I want to second what Beatty said about pneumonia post-stroke. Happened to my mom and nothing to do with where she was, everything to do with post-stroke inhalation of food particles.
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