Health Care Directive Issue.


My mother is in an assisted living facility, she has been there for 3 years. Has done well and I LOVE the staff and feel she has been taken care of very well. I don't work outside of my home and I visit with my mom 3-4 times a week, as well as take her to ALL of her appointments. I pop in whenever I feel like it at any time and the facility knows me and knows I'm there frequently.
I was on vacation for 10 days, but right before I left, I had to take mom to urgent care, she was showing signs of extreme sudden confusion, she had a UTI, the first one she has ever had. She was put on a 7 day antibiotic and off I went on my vacation feeling confident that her facility would take good care of her.
While on vacation my sister, made frequent phones calls to check up on mom. She felt as if mom was not given the care she needed. Example: mom wouldn't come out of her room for meals, so they brought them in to her, they at times had to sit with her because she wouldn't eat, they also assisted her in eating or she would just leave the plate sitting there. They pushed fluids in her throughout the days. My sister felt they should have encouraged her more to come out of her room. She feels they just left her there. I feel they did their best, and she refused to come out at times. I know they cannot "force" her out of her room, she still has rights as a patient. I also believe, she was a bit depressed because I was out of town and not there as I usually am.
Her confusion hasn't gotten any better, her words come out as jibberish. It's been almost 4 weeks since the UTI. Her assisted living facility has recommend that mom be moved to memory care, because her level of care has gone up since she had the UTI and she has wandered out to the parking lot once and wandered out of her room in the middle of the night, and was immediately redirected in to her room, has flooded her kitchen area, forgotten how to wipe after using the toilet and that's just a few of the major things.
My sister came across some articles about the facility that mom is in, accusing the facility of neglect and abuse as well as a wrongful death lawsuit. All within the last 2 years.
My sister would like to move mom out of state to where she lives. My sister works full time, her husband is retired and preparing for his 3rd knee replacement surgery . I don't see how this would be a good idea, as they cannot oversee any of her care as well as I can, since that is basically my "job".
I would like to keep her where she is and move her to memory care, the staff knows mom and mom is familiar with the staff, even though she does not know them by name and probably forgets them in between them coming in to assist her. But I really feel that mom does know them, she sees them everyday and when they see mom and say hello, mom beams with a huge smile.
Despite the articles my sister has read (and I have read them as well) I still feel mom has gotten great care where she is and would like to keep her there.
There is another memory care facility in my area I could move mom to if that would ease my sisters mind. And we have not found any negative complaints anywhere.
But at this point, I believe that my sister feels I don't have mom's best interest in mind because I would like to keep mom where she is, despite the complaints we have read, when I can move her to another facility where we have read about no complaints.
I feel mom would do better in transition where she's at, because she knows everyone and is familiar with her surroundings. She has been over to memory care side numerous times, although she doesn't like it and says the people aren't real and scare her. It would be the same situation in any memory care, there will be patients that are lower functioning then herself.
I am her number 1 Health Care Directive. As far as I can tell, I have the ability to make all decisions for mom, this sister who want to move her to another state is number 3 directive, I've got another sister that is 2nd on the list, but isn't involved at all. Sorry so long!!
Any opinions or suggestions??

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I've never heard of this but I'd talk to someone there to find out more about it. I would also find out how you can talk to someone else there during that period. I'd find out specifics about the agenda for the 2 week period and once you're ready then you need to have a talk with mom and let her know that you will be checking on her as often (according to what you arrange with the facility) and that as soon as the 2 weeks is up you will be there so much that she'll be asking for a reprieve, hehehe. This will probably be harder for you than for her but since she's shown objections about it I think It's probably reasonable. It'll take some adjusting and she'll be forced to find the good in it if you aren't around. Please keep me posted on how you're doing.

mrsribit, do you have any opinions on the 2 week transition period? I've been told by several staff members that I need to stay away for two weeks, I don't want mom to think I have abandoned her.

Kat, I'm glad you have the confidence on this facility. You're a great daughter. This will work because you are there for her and can ease the transition when the 2 weeks is over.

Thank you all so much for your encouragements. I have decided to keep mom at the same facility, and move her over to memory care. I took my husband over to visit the mc side and he loved it and sees no reason to look further! So, it'll be done next week.

Chatykat582, if you are medical proxy or medical POA on your mother's Health Care Directive, you do not need your sister's blessing to do what you feel is in your mother's best interests. I am very glad that you have her blessing now, because that will eliminate some of the stress of the situation, but be aware that you have been assigned responsibility and authority and your mother needs you to carry it out. Stand strong!

I am sorry to hear that your mother has declined to the point of needing more services than she can receive where she is in the ALF unit. It sounds like you have two viable options: the memory care unit in her present facility or the other memory care unit in town. The notion of moving her away from your sphere of influence is not worth the text it takes to type it.

Good luck to you as you embark on this next leg of caregiving journey.

Just go forward with this move. I'm glad she was seen by the doctor. That gives a better idea of her situation. You can't let sister's indecisiveness control the situation. You are the constant that mom needs. Be strong and keep coming back to talk to us and we'll give the support you need. The one thing that will help even if sister's concerns are founded, the healthcare professionals know you are watching know that you will speak up if there's anything that needs to be corrected. You're in my thoughts and prayers. Sleep well Kat. By the way my name is Kathi. Good to meet you.

Mrsribit.... thank you for the encouragement. When I returned from vaca, I had mom retested for the UTI and she was clear.
I took her to a neurologist yesterday and he said he would have expected her confusion to have at least gotten back to baseline by now, so he doesn't expect it to get better and has recommended that I listen to her Assisted Living facility and move her to memory care.
Yes, I do think my sister would be one of those disgruntled family members, as she doesn't seem to think anyone does a good job in caring for mom.
I believe guilt is what drives my sister, she is not here and thinks she can do a better job.
I did receive an email from her this afternoon stating that she had reconsidered and realizes that I only want what best for mom and will take good care of her. So as of now I have her blessing to move her to memory care in the facility that she is in now, which is half AL and the other half is MC.
But who knows how she'll feel tomorrow!! Thank you so much!!

To start with ChattyKat, has she been see by the doctor to understand why she is doing so badly after being treated for the UTI? She It sounds like she may still have the UTI or maybe something else?
Aside from that I wouldn't let mom go with #3 sister because I think that the reason mom has gotten such good care is BECAUSE you have been so attentive. If she isn't being visited by sister she probably won't get as great care there. I think something else is motivating sis. Even if not she is not being realistic about what it means to care for her. Talk to an elder care attorney and find out how you can protect her.
I would also like to add that accusations don't mean it's true. Many people that don't visit feel guilty when their family member isn't doing well and feel that they have to blame someone. They don't know what care is given. You don't know what the background is for the accusations. And it could be because of a specific caregiver. If this is the case it may be handled already.
Your sister is likely to be one of those disgruntled family members herself if you don't watch out for mom.
You are very sweet and loving. You are doing everything you can to help your mom. Don't give up. And you aren't long winded. You did a very good job of explaining the situation. Please let us know as things progress. We want to be here to support you. Take care of yourself Kat. :o)

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