90 yr old mom with dementia found confused and taken by police to hospital.

Follow
Share

Last pm; neighbor reported my mom to police trying to drive. (Mom diagnosed with dementia; living alone and refuses all help/assistance set up for her). Her confusion and dementia episodes have been escalating over last yr. Police took her to hospital for eval. I'm daughter; IMO, it is in her best interest to get placed in AL or Memory care facility. To date, family has been unable to persuade her to go this route. Mom refuses all in home assistance to date. I live long distance (6 hrs) and work full time in travel job. Hospital called last night and she was in Emergency for eval. I'm hoping this is "precepitating event" to get her placed in care facility. I don't want to intervene; because I don't want to interfere with the process; I want them to place her in care facility and then I'm hoping once she is there; I can take it from there and move her to a care facility close to me so I can visit/ongoing monitoring. My question: Should I call the doctor or hospital at this point; wait for them to contact me?; will they possibly release her back to go home? (police and neighbor said she was talking erratically and talking on the phone to herself so they thought it was a psychotic episode); I told them to take her to hospital. I'm afraid if I get involved; they'll just release her and I won't be able to move her anywhere (I'm designated POA - but she won't let me invoke any power to date and claims if I try to do anything she will remove me; I'm confident she will if I had to go to court over this). She is coherent about 50% of time -- so she could easily fool the doctors into letting her go back home and take care of herself again. I see her about every 6-8 weeks and talk to her every other day --some good days; some bad days (no coherency). I know she is not eating or drinking properly. Appears to take meds okay. Pays her bills and is bathing (decent hygiene) herself and house is in order (though she doesn't clean).

Her primary care physician is no longer allowed to give me info. He knows situ and he and his social worker (in office) say there is nothing I can do until there is a precipitating event. I'm hoping this is it -- but looking to you dear friends for sound advice.

This discussion has been closed for comment. Start a New Discussion.
24

Comments

Show:
1 2 3
I hope you get a medical power of attorney.
(0)
Report

I get a bad feeling reading this. You really do have to have the HIPAA paperwork there to show them (medical POA papers usually cover this) - without it, they would not even reivew Mom's meds with me so I could catch problems and mistakes. They seem to think you can take care of mom without any real authority or information and don't seem to care very much how it works out as long as someone comes to take her off their hands. Mom may be saying to them "don't tell my daughter, don't tell my daughter" and if she has not been deemed incompetent they have to take that as revocation of the MPOA.

When a person gives their permission for someone to aid and participate in medical care, they should be allowed to come in for the visit. HIPAA does not in any way limit that, but I have certainly seen silly overinterpretation of it, to the point of a parent being denied access to her minor child's records or refusing to give out information. Not knowing what state you are in or what the rules are there, it may be that they have (vs just THINK they have) some legal basis to insist you take Mom home with you, and it may be important to find an elder care attorney to straighten things out and help you get a guardianship if you want it, before you try to take over the care management of one very uncooperative person who has no understanding of why she needs your help!!

Now - one slightly better possibility - if the memory care facility might give her that one bed, the hospital probably WILL give information to them, as that makes them a participant in Mom's treatment plan, though you might have to present MPOA paperwork and and a release form. And, it makes no sense for them not to deem Mom incompetent, but perhaps the people at the memory care unit will be more willing to do so, versus looking at a geropsych person to do that. For some purposes, under my mom's POA provisions, I needed two physician letters stating she could not care for herself so I had a psych eval and the primary care physician do those for me and it all worked out.

Sorry you are going through all of this! It is a tough business, and you have to sort out the people who will really try to help versus those who are more concerned about keeping their tail ends covered than keeping you or yoru mom out of harm's way...
(1)
Report

My heart goes out to all of you. We must have been very lucky, because when my mother fell and cracked a bunch of bones, doctors, hospitals and social workers talked to me about her problems and prognosis and we worked together to come up with a good solution. There were times I thought they were being very bureaucratic, but in the end, they really took care of her. She's in an ALF now, has gained ten pounds and is much clearer mentally. It helped that my mother was willing to follow the advice of her doctors, and maybe, also, that she lives in a small town---she had been seeing the same primary care doctor for many years.

For others who may face this kind of problem in the future, here's something that worked for us. Over the last few years I built a relationship with my mother's primary care physician and his staff. I called from time to time to pass on information about her condition between visits that I thought they should have, and always took the opportunity to thank them for their care of my mother. I said at the outset I understood there were things they were prohibited from sharing with me, and that was OK. If she had an appointment scheduled while I was visiting, I asked her to let me go in with her, so that the doctor and staff knew me, and that I was well intentioned. Obviously this works only if your parent is willing to let you into the relationship. For those whose parents resist your help, or who have dementia---I'm so sorry. If it's hard in the best of circumstances, it must be hell for you to deal with all this.
(1)
Report

Once your Mom is declared unable to care for herself, you should be able to invoke the POA. When my spouse started having problems with his dementia, our attorney came out to the house and asked him some questions, then she invoked the POA for me. Once that is done you should be all set with all the medical staff. You might want to let the Social Worker know that you do have the POA and are waiting for their evaluation to get it invoked. When my MIL was placed in a nursing facility, it was the Social worker who looked for one with an open bed and got everything in place. They might put her in the first place that has on open bed because this would be considered and emergency situation with your mother not able to be home alone. But once she is placed you can contact a Social Worker in your area and see about finding a facility closer to you and have her transfered. Good luck.
(2)
Report

Somebody needs to go to the medical hearing. Any reason for drawing this particular line in the sand?
(0)
Report

I'm sure you have your reasons, but why would you want to have to move her twice, once to the facility the hospital chose and then again to one close to you? is it lack of time?
(0)
Report

2much2cover - thank you for your insights; you are right I need to get a diagnosis first and prognosis in order to arrange for proper care. This wked was a nightmare. When I talk to mom; she sounds very coherent (but I'm certain it is because she's had full time care, supervision, nutrition, group interaction, etc.proper med management) -- all of these definitely point to "full time care in nurturing environment" helping her thrive. Going back doesn't seem like a good idea with the hopes she'll follow thru. I HATE taking away her independence; but I feel if I don't, I'm just postponing the inevitable and this will drag on.

They are sharing limited info with me -- LPN calls me and nursing asst and they tell me how she is and "she is doing fine"; wants to go home, etc. but no one will give me a diagnosis (I guess I haven't communicated what I want). They just keep saying to me "...and you'll be here Tues for the medical hearing" and I keep saying, "I will be; provided the Doctor calls me and speaks to me Monday morning and tells me she cannot live on her own and isn't capable to live at home anymore" I beg them for help in working with her to make her understand that she can't go home.

HIPPA, I agree with. But if they are going to call "next of kin" to get her released and discharge her from the system; then they should be more cooperative and provide info.

THIS SYSTEM (for this facility, her hometown, her physicians, etc.) HAS FAILED HER. I believe there are plenty out there with good outcomes and desires to do right by the patient. They haven't done this for her.
(2)
Report

sharirose, Our culture VERY highly values personal independence. HIPPA laws were passed to protect individual privacy (aimed at practices like hospitals selling the names of new parents to baby product marketers) and established rules about what medical staff could do with patient data. The patient, consistent with our value of personal independence, must consent to sharing information. I own my medical data I get to say who sees it. This sometimes backfires, but the intention is to protect privacy.

We assume that adults are capable of independent living, unless proven otherwise. We have laws and agencies that try to protect adults that are considered vulnerable, but unless an adult is declared unable to mange their own affairs (incompetent) then the law allows them to make their own decisions -- even bad or unsafe decisions.

(None of this has anything whatsoever to do with so-called Obama Care, and none of it is new.)

I think we'd all hate to have our own independence interfered with, but the laws that protect us from that also make it very difficult for children to care for parents who don't want to receive care (even if they clearly need it). I would not want someone to easily be able to take over my affairs and tell me where I have to live. I would want them to have to prove I can't do it myself. I sincerely wish that this were easier for sunflo, but I do understand and respect the laws behind this situation.
(3)
Report

If you want info about HIPPA (which was enacted into law in 1996, (LIKE I THINK ABOUT 12 YEARS BEFORE OBAMA WAS ELECTED)

copy and paste this link
hhs.gov/ocr/privacy/hipaa/understanding/consumers/familyfriends.html
which will lead you to this document
When Health Care Providers May Communicate About You with Your Family, Friends, or Others Involved In Your Care

sunflo2: are you saying your mother is refusing to give permission for medical professionals to discuss her situation with you? If not, then maybe review of the HIPPA laws with them might straighten things out. If she is refusing (but they called you from the emergency room?) , you can alway provide them with any information you think they need to know to make a proper decision on her behalf. You might want to get in touch with the social services staff at the hospital or whereever she is b/c they are the ones who are going to be involved in actual placement. If they are calling you to pick her up, it seems they have acknowledged you as an allowed contact or wouldn't they be in violation of hippa rules? Tell them you need her diagnosis in order to assist in determining safe and proper placement when they call you to "pick her up". I don't know what insurance she has but if you are not proactive in getting some information you might have bigger problems if they put her in a taxi and send her home. Let them know you are very concerned about her safety should they release her to her home. put it in writing if you have to in order to get them to listen.
(3)
Report

Is this what HIPPA and the Obama care are doing for the patients? It sounds very cruel and inhumane. If someone does not approve of a party being in the exam room with them they can verabalize it. If they cannot , I guess we need to prove they want us there. Who wants to die alone with your spouse or child outside the door wanting to comfort you. A dog or cat would not be treated that way. People need to write their Congressmen (most are worthless) and Senators (same goes for them). What a blooming mess Thanks for the heads Up! That is why I love this site.
(1)
Report

1 2 3
This discussion has been closed for comment. Start a New Discussion.
Related
Questions