Mom is 83.
Mom was diagnosed with lung cancer around Mothers Day, 2012 (2nd time for lung cancer)
Mom had chemotherapy and radiation (her choice of treatment)
Mom was at home, independent, walking without assistance, driving, etc. until Memorial Day weekend when she went to the hospital. She was severely dehydrated and had a minor heart attack. I was out of town that week but other family members had been in to visit. When I left town I had two cases of Ensure drinks on the kitchen counter so Mom would remember to drink them and family members would see the Ensure, too. I Iearned that one of the family members found some of the Ensure drinks put away in the pantry instead of Mom drinking them - was Mom hiding the drinks so that she didn't have to drink them? I asked everyone and noone else put those drinks in the pantry and the rest of the Ensure drinks were still on the kitchen counter when I got back in town. I am confident that the visiting family members are responsible adults and are telling the truth.
Mom has been going between the NH and the hospital since Memorial Day weekend.
Mom has had diarrhea since before she went into the hospital. Neither the hospital nor the NH has been able to fix the diarrhea. Before she went into the hospital over Memorial Day weekend she had had accidents at home because she could not get to the bathroom on time - I have had to scrub the carpets more than once.
Now, Mom is in the NH, using a walker, a wheelchair and oxygen 24/7. She still has diarrhea, still needs assistance cleaning herself. Nothing seems to fix the diarrhea.
Mom is currently walking only while the staff is with her. She cannot go from the walker to the wheelchair without assistance. She cannot go from the bed to the wheelchair without assistance. Therefore, even if we have a commode right next to her, she may not be able to get to it.
Mom does not like to take her meds in the NH. The staff must actually see her take the meds before they can leave the bedside, and I often have to remind Mom to take her meds (she says "I'll take them in a little while"). I tell her that the staff must see her take the meds and she then takes them, grudingly.
A few weeks ago I talked with the social worker at the NH and told her that Mom needed to be independent to go home - that I would not be providing nursing/caregiving/bathing/personal hygiene - Mom needed to be independent, no matter what story Mom told them.
Yesterday while sitting with my mother at the NH, the social worker came into the room and said that Mom was being released on August 2, 2012. Then she turned to me and asked me (yes, in front of my mother), if I was willing to care for her. I said that I was not a nurse and did not feel competent to provide nursing care. I said that I have my own medical issues and would not be able to lift my mother, or pick her up if she falls.
Why is the NH releasing her on August 2?
Why is the NH releasing her if she still has diarrhea?
Why is the NH releasing her if she cannot get from her chair to the commode without assistance?
Why did the Social Worker put me on the spot like that?
Next issue, caregiving.
I have been here with Mom for over two years. I have desperately wanted to return to my home. I miss my children and grandchildren. I do not want to be a full time caretaker. I do not want to bathe my mother. I do not want to clean my mother when she has diarrhea. I have already spend two years cooking for her her and helping her around the house, I want to go home. Our relationship is difficult and strained, always has been. I want to go home.
The closest family member lives 2 hours away and does not make a lot of money, so he cannot take off work to come down here. It is too far for him to commute each day.
In-home care is good, but, in my opinion, is probably not enough - 1 in-home nurses visit per week, 1 in-home physical therapist visit per week, and 3/day CNA in-home for bathing/personal cleaning.
Mom wants to go home. If I was her I would want to go home, too. Mom would rather die at home than in a NH and I would feel the same way. Should she go home, alone, and let nature (both human and biological) take its course? If she has diarrhea and soils herself, isn't that neglect?
What is the responsible thing to do?
After the social worker put me on the spot like that, I do not feel that I can trust her with this issue.

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Is it normal for a NH/"rehab facility" to send a person home with chronic diarrhea? That seems like a health risk for the patient and a lawsuit for the facility.

Thank you all so much for responding.
Mom will not talk about things with me. Why? Our best guess is because I am a girl and she believes important things should be handled by a man.
Moms medical power of attorney is my eldest brother who lives in New England. Eldest brother tells me to do whatever I think is right........ Early on, the Social Worker at the hospital was very kind and explained, very clearly, how the medical power of attorney works and I literally cannot do anything or make any decisions. Eldest brother is legally in charge and frankly, he is just not really into this caretaker stuff.......
Mom has medicare, her medicare supplemental and long term insurance. So far, everything has been covered, but I suspect everyone is right - her coverage is coming to an end and the NH wants her out.
Mom owns her own home, just in her name, and a small amount of money. I will try to find out about property ownership/medicare/medicaid tomorrow.
I want to be helpful. I want to cooperate with Mom and Eldest brother. I want to be the good daughter. But I do not want to provide 24/7 at home care, I am not trained, qualified, and I just plain do not want to do that. I want to go home to my family.
Tomorrow I will contact the Director of Nursing and explain the at-home situation and make it clear that I am not going to be providing at home nursing care for Mom. Every person wants to live at home. Every person wants to sit in their own chair and sleep in their own bed. I understand that...... If proper in-home care is not covered/provided by her insurances, she will either have to go to Assisted Living/NH or she and Eldest brother are going to have to come up with their own solution. Thank you so much for responding to me and giving me advice. You have all been most helpful.

It feels bad. Financila issue is the common problem. However, if you feel that you need to take care your family, you might consider talking to a social worker back or go to near medicare/medic aid agency make some inquiries. I been working in an acute and long term setting which is most of our client/s does not have any insurance at all. You might consider to call them and explain your situation. Hint, before you get approved or interview as far I remember your mom should not own any property or money at the bank not more than $2,000 because her application for goverment benefits will be denied othwerwise the goverment might took her property in exchange of help she is getting ( this information base on what I heard, find it yourself ). Good Luck....

It is likley that your Mom may be being discharged because her Medicare days of NH benefits have been reached (usually 100 days per benefit period), or she no longer requires facility "skilled nursing care" as defined by Medicare. Does your mother have or has she applied for Medicaid or does she have a Long-Term Care insurance policy? Most LTC policies cover facility & home care. Medicaid will also pay for facility care - but the facility has to accept Medicaid and not all of them do. Some are private pay only. Does she have the resources for 24/7 daily care? If she wants to be at home, maybe an option would be 24/7 care at her home with aides that your family is comfortable with caring for your mother.

I would think that based on her condition as you described, it would be unsafe for her to be at home alone and if Social Services found her home alone and unable to care for herself, perform hygiene etc she would be taken out of her home. It is also possible if that happened and no family member was willing and deemed appropriate to manage her care, a court-appointed guardian could be named and would take total control over her care & her finances. At that point, the family likely would not be able to have any input whatsoever in regard to your Mom. I have also heard that it can be hard to get the guardianship moved back to a family member depending upon the circumstances. I know of a co-worker that went through this and it was horrible. I hope things work out for your Mom and for you.

Who has financial and medical POA for Mom? What do they think should happen when Mom is discharged? Do they fully understand your intention to go home?

Thank you for responding.
Yes, Mom is in private-pay nursing. Well, she has Medicare plus all the supplementals and long term care coverage. Hhhmmmm....... I will have to look into that. I am here, but I am neither her medical power of attorney nor her legal power of attorney, so there are times I cannot get information.
I am very grateful for the suggestion and for having you tell me to go with my instincts. I have previously spoken to the nurse on staff when I visit, that particular social worker, and the office when Mom first checked into the facility. I will speak with the Director of Nursing tomorrow.
It is nice to know I am not mean-spirited or crazy. Thank you.

That social worker doesn't have the common sense God gave bullfrogs. She may be a well-educated professional but her bedside manner sucks. Trust your instincts and do not trust her. Talk directly to the Director of Nursing. Make sure it is clear to everyone that Mom will not be going home to in-home care. Something will need to be arranged if that is necessary.

I'm taking a wild stab in the dark here ... but could Aug 2 be the latest Medicare will pay for the rehab stay?

Could your mother be private-pay in a skilled nursing facility? If not, is she currently on Medicaid?

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