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I have no authority unless mom is declared incompetent and they won't do that because they know I won't let them abuse medicare with her any longer. They held her hostage at the hosp. for 4 wks with nothing major wrong and now the social worker is being difficult and accusitory. Any ideas?

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Castoff, your in a sticky position and you should be very careful. I have a similar situation involving my siblings. Enlist all the proffessinal help you can get, make the first steps towards speaking with Adult Protective services and make VERY clear to the that you will by NO MEANS accept the RESPONSIBILITY without having the complete AUTHORITY to carry those responsibilties out. If the state or SS wants to take control of your mom, you don't have to walk away, you can still be with her and keeping a very close watch so that YOU can then Threaten THEM with any missteps they might make.
Don't let anyone intimidate you, not even your mom.
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The same thing happened to my Mom. She had a panic attack that the ER doc "diagnosed" as a heart attack. They made her wait in the ER for 7 hours while they found her a room. Then kept her for 10 days (9 days longer than she needed to be there.)
When you are in the hospital, your primary doctor is in charge...even before specialists, such as cardiologists. Mom's PC doc claimed she needed to talk to the specialist before discharging her. The Cardio said he had to talk with the PC doc. One day when I was there the PC told me that she signed the discharge papers but left the hospital w/o doing it. The nurse tried for 2 hours and could not reach her by her pager.
I finally had enough and called the head nurse and told her that my mother was leaving that day. She was snarky and told me that if I did that w/o the proper signatures, it would be AMA (against medical advice) and Medicare would not pay. I told her to call her Chief of Staff and have him sign for the PC (she wasn't aware that I knew he could do it.) I think she faked a call to him and he never got back to us. Finally, a kind nurse, who was fed up too, finally got ahold of the missing doc. She gave persmission over the phone to discharge Mom. What a nightmare! And you are correct: you are held hostage. Unless your primary doc gives the okay in writing you are not going anywhere. I actually had to threaten a law suit before the head nurse could come to Mom's room.
Of course, hospitals encourage this. They bilk Medicare and LOVE you if you have a good secondary ins.
I hope someone in our forum, who has worked in a hospital, will chime in and give us a better way to see that our loved ones are not detained unnecessarily. We do not need the exta stress.
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I work in a rehab facility in MI and we do not threaten our family members. Not really sure what they are threatening you over but I would not walk away. If she really is incompentent has no one has been deemed her POA then please try to get guardian through the court system and then you can make her decisions for her legally. If you want to take her home to stay by herself and the Rehab facility does not feel that she is safe then they may call Adult Protective Services so that they can follow up. It is only her choice if she wants to go home and there is no legal gaurdian for her. The rehab place cannot force her to stay there. They can only inform you that they are recommending 24 hour care for her to be safe at home. Let me know what happens.
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There may be a Medicare and/or Medicaid fraud hotline you can call in your state - check their web site. At the hospital, there may be a patient family represenatative and/or a number to contact with grievances should be posted. If you don;t feel safe using that, for fear they will retaliate, maybe go some other route, but at my hospital the reps are genuinely good at what they do and often resolve concerns beneficially for all involved - of course that's presupposing some degree of good faith on the part of the hospital rather that nothing but profit motive. It could be they genuinely feel she is making enough progress in rehab to justify the stay, and would not do as well in subacute? They do have to be able to document progress...
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In this very convoluted medical world, you have to be very careful what you say. They hold all the cards and they know it....where else are you going to go?
I have told my Mom countless times not to say inappropriate things, even jokingly, because it can be misunderstood. Also, if parents do not like what the child is doing, for whatever reason, they may attempt to get back at them by siding with docs and others who give them attention or agree with them. They think that they are being a "diva" when in reality, their behavior may end up causing them (and their caregivers) some unpleasant problems.
I get tired of being wedged in-between taking care of my Mom 24/7 and dealing with a medical community who treats caregivers as if they are the enemy. We are not the enemy, we are advocates and if someone is keeping their eye on them they cannot get away with shoddy service.
I just spent the last three days trying to get services for my Mom in our new town. I was referred, given more phone numbers, or incorrect info. It struck me that the only people benefiting from these public programs are those working for them.
I am just disgusted with it all...so as usual, I will have to figure out things for myself.
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Dear Traveler,
You don't need to have her declared. Find an estate planner or other lawyer to help you get Medical power of Attorney. (If mother can still sign her name.) With this tool you can tell them all to go to hell as long as your intent is to provide quality medical care. Once in the system, 'they' will do their best to find something new and charge Medicare for it. Voice of experience. MPOA takes some time and a little $'s but it is worth it in your time and frustration when they won't do what you know is right for your mother. Until I had that documentation 'they' did what they wanted. With MPOA they do what I want. (and you don't have to go through the horrible process of having them declared.)
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Whomever,
MedPOA, if given, is a great tool for one to direct the care of a patient if they are in Hospital for an extended stay and are not being given appropriate care resulting in a timely release. If Mom won't give it to you, you really have nothing to say.
Luckily I had it prior to her hospital stay of 3 weeks. First it was Alzheimers, then a bladder infection then it was related to her Diabetes, then it became needing a pacemaker. Surgery, even on an 84 yr old woman, even not invasive, they don't come back completely from the anesthesia so that was the culminating stroke (which she had and no one noticed because of the Seraquil) that had me overrule the doctors and get her released. It took 2 months to get a neurologist to take her off Serquil but I was able to do it with proper legal documents.
I don't know what you mean with the "taken down by her" reference. I can only assume I was responding to something in the text.
Discharge plans, you need one. Ours was 24/7 home health care. (Which was already in place. Fortunately we could afford it.)
Unless you have the papers, you are at the mercy of the Doctors & Hospitals. You should know what is best and be an advocate.
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"The taken down by her" reference is that mom has a very deep seated hatered of me, apparently because I don't do absolutely everything for her lazy royal self. Taking me to her grave with her wouldn't be a problem for her. I don't fool myself into thinking she cares anymore. Adult protective services sounds like a great alternative that I hadn't thought of. I have MPOA only in the event that mom is incompetent or unable, and if the docs won't declare her nuts I have no authority to stop their abuse of the medicare system by/through her. Of course they won't as it would remove the golden calf so to speak. The routine is that they bilk medicare for as much as they can & then drop her back in my lap all queen like and spoiled beyond belief. She then expects the same treatment from me that she gets from numerous servants daily & is pisssed when it doesn't happen. I've considered resigning many times but the bank won't even allow me to take my name off of her accounts. Have you ever heard of such a thing?
So it's a battle of wits and will. So I trust GOD to keep me safe from her abuse and all that goes with doing the right thing. I'll also be speaking to an attorney. I do not want guardianship in any way.
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Thank you all for your thoughts and advice. Please continue to do so.
Mom does need rehab at this point. The reason she needs it is because she was held hostage at the hosp. for 4 wks. and bed confined. She was also babied which she greatly enjoys. They pureed her food & mixed it with milk so she wouldn't have to chew (she hasn't worn her dentures since she got them 12 yrs ago but manages VERY well on a soft diet), she's just plain lazy with dillusions of royalty.
I had asked once again for a geriatric psych eval to determine if she is competent (I know she is not from 15 yrs experience). The social worker called and told me he had had two outside docs verify her sanity but none of the nurse staff ever saw any. He said he was "Sorry to dissapoint you, but your mother is competent". I replied that I was NOT dissapointed but relieved to now that she was just wicked and not crazy. He then explained how I was "responsible" for her and if she continued to injure herself he would have to assign guardianship. WHAT? This guy is more nuts than she is.
I explained all this to Mom yesterday during my visit. Whether or not any of it sunk in I do not know, but she could have landed herself in a world of crap thinking she was manipulating myself and the medical profession. Poor dillusioned old woman thinks she's smarter than anyone else and we are all pawns in her little adventure.
I am NOT responsible for her or to her and WILL NOT allow myself to be ruined by her or the greedy doctors she thinks she is fooling. She and the doctors have backed me into a corner. The drs & NH know that if I were given any authority I would put an end to this little game of their's. I have gotten no response from the hotline as yet.
I must protect myself and not allow myself to be taken down with her. Alone and without authority I cannot put an end to any of their criminal activity. Do I have any other choice?
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Medical POA would sure be good if Mom would give it to you!

If not, can you be specific about:

1. what are they doing with Mom that you want them to stop doing?

2. what do you what them to do that they are NOT doing?

3. what could they do to you personally, i.e. what do you mean by "taken down with her" ?

4. what is the current "discharge plan?" - i.e. where do they expect mom to go after rehab, and at whose expense and with what care, equipment, and services?

That might help us see exactly what the real dilemmas in the situation really are, and maybe be better able to help.
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