BettyD Asked May 2012

What rights does an elderly person have when their doctor has signed papers for her to go to Assisted Living and she can't live by herself?

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What other choices does she have? Would her Medicare or health insurance she has, pay for a person to come live with her, and be qualitied to give her the meds she needs and meals and everyday care she needs? She is 76 years old, has dementia, glaucoma, and wears hearing aids. She had her drivers license taken away, and had to sell her car. She still bowls 2 times a week. But yes she is forgetful on her meds and can't remember if she took them or not and then goes and takes them again. She does not want to go to a Assisted Living Home. All of her kids live in other states and she doesn't want to go live with them either. Can her Dr. force her to go to the Assisted Living Home? Does she have any choice in this matter? What choices does she have? She lives in California, and I live in Michigan and I'm asking what are her choices?

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jeannegibbs May 2012
If she can't or shouldn't be living alone, what choices does she have? That is determined in part by her financial circumstances and her health.

How severe is her dementia? Does she need 24/7 supervision, or just help with specific things? If she had a nurse come in once a week and set medicines up in a weekly pill container, would that solve the meds problem? If she had meals on wheels deliver once a day could she microwave something for the other meals? Would she remember to? My mother gets by with these kinds of supports plus children visiting every few days, but she would not be safe totally on her own. On the other hand, my husband with dementia would not be safe on his own no matter how many supports were in place.

So the first question to answer is, what would make it safe for mother to continue living alone? If the realistic answer is "nothing -- she can no longer live alone," then the options are to bring someone in to stay with her (several someones in shifts) or place her where someone can keep an eye on her all day.

Whether an assisted living place is suitable depends on her exact needs. Many ALFs have "memory care" units which provide more support.

Another option is residential care or a "foster home" setting.

If she needs skilled nursing care, a nursing home may be the best option.

In addition to what she needs, what she can afford is a consideration. Unless she has specific Long Term Care Insurance, her regular health insurance or Medicare may not cover much of what we are discussing.

What assets does she have? What is her monthly income? (SS, pension, etc.) Would these cover the monthly costs of around-the-clock in-home care, ALF or other long term care facilities? For how long?

If she needs financial assistance to obtain the care level she needs, then applying for Medicaid is the logical next step. In addition to Medicaid, there are often other programs available by the county or state.

How do you find out about all the programs available and choices she has? Start by researching CA aging services on the internet. When you have a feel for what that is like, call and set up an assessment interview. Would it be possible for you or one of your sibs to spend a week with her to help get this process started and also to see for yourself how she functions?

It is hard to oversee the care of a loved one long distance. Another choice might be to move her into a long term care facility near one of her children. In that case you would go through the internet research and making an appointment in that state.

Even if she can no longer live by herself, she does have choices. Some of them are limited by what she can afford.

Good luck to you all!
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195Austin May 2012
If she goes into AL she will not have all the care she needs-aides will not be able to give her the meds and she will be responsible to get herself to the dinng room etc-the doc does not seem to be very informed about what is best for her. I would look into nursing homes and then she could be probably admited medicaide pennding and the social worker would be able to start the medicaide paperwork. When going into AL you have to put up lots of money up front and the monthly rent will be as high as 3 thousand dollare a month and with dementia she would have to hire 24 hr. a day aides besides. Social services in her county may be able to help with the planning-but it sounds like there is no time to waste since you know the doc said she can not live alone-that takes any responsibilty off the doc and puts it on your family-so the doc is coverng himself-he could admit her to the hospital for 3 days and then you would have a social worker evaluate her for placement-the fact she can not take her meds by herself would be good reason to admit her and then she could go to a nursing home for rehab and they would take it from there-your consern should not be about being forced into AL but immediate care for a person who for safety should not be living alone.
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