My dad has a medical directive that designates him as my mother's agent in case of her being incapacitated, he did it when she had a stroke 10 years ago (first day of a week long vacation, no less). I live with them. Well today the house smelled really bad and we discovered my mom had soiled herself and the bed really bad and so we washed the bedclothes etc, but the house reeks because she refuses to bathe. Its been months since she has and now this smell is horrible. She hates my dad, won't cooperate with him at all and she'll only talk to me for like 3 seconds before becoming combative and dismissive so I can't get through to her either. What can we do?? She refuses to see her doctor who won't do anything else without seeing her, and the last time dad tried to force her to go she scratched him hard enough to draw blood. I wish we could just call 911 and have them come and sedate her and take her away, but would they do that? She needs more help than either of us can give her at that point.
You and your father meet the ambulance at the hospital. Ask the nurse if you can speak to a social worker. When one comes down tell them that your mother needs a 'Social Admit'. That your father cannot manage her care at home.
Do not mention that you live with them. If they ask, tell them that you stay to try to help your father, but are not going to be doing that anymore. When they know a younger person (an adult child) lives in the home they will assume that you will take over the care.
Your mother is clearly incapacitated if she's clawing at your father and insists on sitting in her own sh*t for months. Not only is that completely and utterly disgusting, it is also dangerous. This poses a threat to her and to anyone else living in the house.
Your father can legally have her placed because he can't care for her. He has to insist that she is not allowed to return home and must stay strong and be adamant with the hospital that he will not care for her and that homecare is not an option. The social worker will make all kinds of promises of available resources and help if he brings her home. They will never follow through on it.
She needs to be placed, and an 'ER Dump' is the fact-track to getting that done. It sounds harsh, but this will get her placed.
The hospital will admit her until a bed is found for her in a nursing home. Stay strong and help your father.
You will have to make up something that will have the EMS folks transport her to ER against her wishes. They cannot otherwise take someone unwilling to go.
You will need to make up some symptoms of stoke or something otherwise as dire. Sudden change, loss of mentation, combativeness. Unable to arouse. Something big.
Even with that, it is uncertain the outcome of your ability to get EMS to transport her to hospital simply for being unkempt and living in squalor. Claim sudden mental change. Claim she will not let you in. Claim she is at risk and won't accept care or help. Claim mentation change. Anything you can come up with. In essence you are telling the truth.
If EMS doesn't work, and if they will not transport her for evaluation, try APS and report her as a senior in need who is combative and in need of transport for evaluation.
Once you convince SOMEONE to get her transported what you need is to contact social services at once (hospital discharge planners they are sometimes called, but request a social worker; tell them she cannot return to her squalor and that she is unable to care for herself. They may be able to get temporary emergency guardianship for your dad dependent on her dx. but let them know she would be UNSAFE DISCHARGE if they let her return home alone. That she must have a "neuro-psyc evaluation of her mental decline, probable placement in safe care, help with qualifying for Medicaid if needed and etc." That she cannot come to YOUR home as you cannot handle her, and she's uncooperative.
You badly need the support of social services here.
Be VERY certain that she isn't discharged into your homes or into your care. You have already had a taste of what that would mean.
I am so sorry. I hope you'll update us when you get her in for evaluation. And no, you cannot sedate someone against her will.
Also, if your Dad is her MPoA then he needs to read the document to see when his authority is active (or is it active now, since her stroke)? If so, this is helpful.
Your Mom is suffering from the cognitive effects of the stroke and maybe now even some dementia (if it turns out to not be a UTI). If your Dad is not capable of acting as her MPoA (and if she doesn't have a FPoA) then finding care or placement for her will become trickier. He has to consider that at some point he may be older and incapacitated himself to handle the MPoA role. Often, people pursue guardianship or conservatorship of their LO through the courts. If this doesn't happen then a possibe outcome is that the county becomes the guardian. Someone has to have legal representation in order to legally make medical and financial decisions for another person -- and for seniors both of these often happen at the same time.
Last year when my 69-yr old cousin with ALZ refused to bath and became combative, her son had to literally pick her up bodily and put her in the car to take her to the ER to check for a UTI (and he got scratched up as well, by his formerly very sweet Mother). She was in the psych wing of the hospital for quite a while until they found a combo of medication for her agitation, and a Medicaid bed in a facility.
There are solutions but they may not happen quickly. Hang in there!
To answer your question about sedating: I have read and heard that sometimes paramedics will do "prehospital ketamin administration" for "excited delirium" -- but this is really for people who are out of control and high on other drugs.
While there you tell the social worker that no one at home is able to care for her any longer and that she needs to be placed in the appropriate facility. They will then have to find somewhere to place her in.
Now they will of course try to talk you and your father into taking her back home with all kinds of promises of what they will all provide, but don't fall for it. Stand your ground and tell them in no uncertain terms that your mother CANNOT come back home.