About to be a caregiver, how do I protect myself from neglect accusations?

You may be taking on more than you can or will be able to handle.
However, if this is the plan, I would highly suggest that you:
1. Google TEEPA SNOW - take her webinars, buy her books, watch her You Tubes.
2. Being accused of neglect: It likely depends on the brain functioning of the person who may be the accuser, i.e., dementia.
a. Has your mother been diagnosed by an MD to have dementia or brain issues (losing brain cells, parts of her brain not functioning) ?
b. Keep good records. You can likely find a 'check off list' form of daily care. Caregiver agencies often use these forms.
c. If you are consulting with your mother's MD about care and her dietary needs, I would presume there is no need to be concerned with being accused of neglect - in the legal sense. This doesn't mean that your mother won't blame you / hold you accountable for - any and everything. The point here is that if she is upset, angry, discouraged, depressed (for example), you are the person she may / will blame or vent her feelings toward. Whether or not she would 'accuse' you of anything depends on her psychological/emotional make up, your relationship over decades, and her current brain chemistry/changes.

If you are in a situation where you could take some classes, check out a community college or state college. You might be interested in the CNA training (Certified Nursing Assistant). You'll feel more confident with this training. You might be able to do it on-line, too.

You will need to learn and/or be able to set boundaries.
This often is not easy for a person who is not used to doing so.
You need to be aware of what you will / will not do ... can and cannot do
(be it an unreasonable request, you worked 8-10 hours and need to sleep, mother is having a tantrum and you need to leave the (a) violate situation.

In other words, you understand a person is frustrated and/or in pain and this DOESN'T mean you allow another to treat you like a 'punching bag.'
* You learn to concurrently express compassion with boundaries.
* You learn reflective listening skills (i.e., I hear you saying xxx)
- You do not argue with a person with dementia.
* You set clear 'behavior' guidelines (if they can cognitively understand)

You could say:

1. I am going to do xxx now. Do not argue. Be clear on what you want / need to do. A person depressed and/or in pain may want 'more of you' than you can reasonable give - or should give. You must take care of yourself 'first' to be available to care for another. It is a fine dance.
2. If aggressive behavior, say: "It is not okay nor acceptable for you to scream / yell at me ... You do not treat me this way. If you continue, I will leave."
- If they continue, walk out. Otherwise, it is an empty threat - and they will know it and keep repeating unacceptable behavior.

"Everything' depends on the cognitive abilities of the person (your mother).
If she has dementia, you certainly speak to her differently than if she doesn't.

The best to do: educate yourself - get a few books, watch You Tubes, etc.
* Know you deserve a life of your own (and you need this time to renew).
* You cannot work / run on empty and burnout is very easy to do if you are not aware of it.
* Address any legal document needs.
- Are you the POA?
- Do you handle your mom's finances?
- You may need to contact an attorney to find out what you need to do, depending on if your mom can legally take care of herself.

* I would NOT rely on AI. I presume this is artificial intelligence?
* If you can afford it, hire an independent (medical) social worker to help you get started. Write a list of questions ahead of time.

Gena / Touch Matters

Consider keeping high protein Ensure on hand. If mom drinks 5 bottles a day - she is getting enough nutrition.

This isn't your direct question but since you wrote, "I'm making a lot of sacrifice taking her home," before you do this, are you sure this is what you want to do? Are you sure you are able to provide adequate care? Are you sure your friend is going to want to stick this out for the long term? Are you sure this isn't going to wreck your life? Just asking because if you have qualms and are moving her into your home only because you feel like you should, regardless of whether it's appropriate, then the best time to change plans is now, while she's still in rehab and you can discuss alternatives with the discharge planning staff.

Elderly and sickly people will lose their appetites. Of course, medical people will want to hold someone else responsible for when an elder begins to show a failure to thrive. Don't hold yourself responsible for something that is out of your control. You can't force someone to eat when they don't have an appetite. Maybe, you can substitute with shakes, milkshakes or some highly calorie dessert they may like. Maybe, ask if they have a preference for a favorite food they haven't eaten in a very long time.

I did caregiving for my mother, sister, daughter and husband. I ran into the accusations by so-called well meaning social workers, and my older sister.

My daughter had major surgery in 2009, and the daycare called Child Protective Services because my grandson had a mild diaper rash with a few bumps on his backside. He was in pull-ups. He had spent the weekend with his mom who was recuperating from a total hysterectomy. My husband and I both worked full time jobs, and he was detained by the social worker. It was really annoying and unnecessary. After working all day, we had to allow this woman to walk through my apartment, look in my refrigerator and cabinets to see if this was a fit place for my grandson.

When I had full care of my younger sister, my older sister kept calling APS making false reports. Older sister was angry because she wanted the family home. Finally, I got tired of the situation and had my sister placed in a nice group home. I moved out after making sure she was safe.

Accusations are par for the course. Make sure you keep good financial records about how you are using her money. Keep records of doctors appointments and such.

Keep your money separate.

Also, make sure you are taking care of yourself by keeping up with doctor's appointments, dental visits, eye appointments and such.

Arrange care when you want to get out and do things to keep you sane. Caretaking is very confining, and you will get resentful when you are unable to get a break. Keep up with hobbies, church and social groups. Don't allow yourself to become isolated. Caretaking is an extremely isolating and thankless job.

You may want to be concerned about allegations of abuse. I am the sole caregiver of my husband, who is blind, diabetic and VERY urinary incontinent. Two years ago he fell in a hotel room we were using while we were out of our home due to water damage. I was not in the room when this occurred and found him like that when I got home from seeing about our home one evening. The paramedics were great and understanding about the limited information I could provide. However, the hospital was much different. One of the doctors started questioning my husband after he regained consciousness and apparently hinted that he suspected abuse because I could not be in two places at once. I think anything you can do to protect yourself is helpful because you never know from what direction potential "abuse" allegations may come.

NewCarer77: Make sure that you can take on this task.

Clearly something happened during that surgery that complicated things--I say that because of the trach. And clearly Mom isn't now thriving. She lived alone before, and was? She's my age. Sounds as though there is now some problems ongoing. What has her doctor told you about:
A) diagnosis
B) prognosis
And how does your MOTHER feel about this drastic change to her life.
Is your mother competent? Does she feel exhausted with life? Would she like palliative care or Hospice care? The later would be a help to you.
Your intention to take care of your mother in home now should include a visit with an elder law attorney. There should be a POA, there should be a care contract for shared living expenses (not rental which is taxable). You should understand clearly--both yourself and your mom--that this is going to mean a downward trajectory and that when it isn't working for one of you then she should consider placement.

I can't know your goal here.
Is it to support mom hoping she can be independent again?
Is it to support mom until she dies.

You are taking yourself from being a DD as say here (darling daughter) into the realm of being a caregiver. Those are two different things and no one likes caregivers. They manage, they direct, they suggest, they insist, they make appts. you don't want to keep, they manage you diet, and etc.
Your relationship with mom is about to change and drastically and if you've been around on this Forum you have seen this first hand described over and over again.

Worry about accusations of abuse? I cannot imagine where that even comes from. It is now legal for patients to refuse to eat at all and to arrange their final exit via VSED (voluntarily stopping eating and drinking) attended by family. Abuse is not addressing after finding decubiti, leaving an elder who cannot be alone all by him/herself, thus endangering him, stealing his/her funds.

I think I can just recommend you google "What is Elder Abuse" to get some ideas of what you DON'T want to miss, but I simply cannot imagine how or why you might suspect yourself capable of abusing your mother.
Discuss this with the doctor, please. Discuss also palliative care, and what prognosis you can expect.
Forcing a person to eat or drink is not required of any caregiver. When you are overly worried about weight loss you will ZOOM or call or visit the doctor.
I wish you the best of luck.
Please know going in that you are TRYING this. Not that you are DOING this. You need to give yourself room to maneuver.

Has the rehab doctor said anything about failure to thrive?

This is what it is called when someone is not eating enough, drinking enough or getting any stronger or having any improvement.

I would want to know if that is what is happening, because, she will likely go downhill if that is the case and you should prepare for that.

My step dad died with bedsores and malnutrition, my mom was not questioned about anything, he was being taken care of best as could be expected with his medical diagnosis. That's why I ask, if the doctors aren't seeing this I would get a second opinion just to ensure the trajectory of her care needs and physical limitations.

May The Lord give you strength, wisdom and courage for this new season of life and your caregiving journey.

Highly doubtful anyone would ever accuse you of neglect over mom’s eating habits or waning appetite. Has mom had a swallow study to ensure food is safely going to right place and she’s not at risk of aspiration? That might be a good idea to mention if it’s not been done already. Otherwise you can follow her lead, offering her food but not insisting she eat what she doesn’t want. A home health nurse will only take vital signs and briefly check in. Big signs of neglect would be more like bedsores. Know the falls will continue as they’re sadly inevitable, hopefully they won’t always result in breaks or damage. I wish you well as you take on this challenge, mom is blessed to have you

I’m a little confused by this question. I haven’t read as much on here as many people. Who do you think is going to be accusing you of neglect?

Just my experience, I’ve been my mom’s advocate and point person for years and 24/7 care for 18 mos. Anyone with elder experience understands the eating issues, including flat out lack of hunger. The worst anyone has ever said to me was “Try to get her to eat more” and that was years ago. I asked that dr exactly how I should do that, what exactly I could do that I was not already. That shut her down.

My mom is on home hospice, has been for over a year and is down to 75 lbs, No one has ever even hinted I might be neglecting her. If your overall level of care is good I think there should not be issues and it sounds as if you’ll be very good at it and have people already in your corner.

Sometimes sites like this are good places for advice but can overwhelm you with all the bad. I try to remember the old retail adage “A happy customer will tell one person, an unhappy customer will tell 10 people”. No relationship is perfect and my mom and I have had issues but with help we’ve resolved them and carried on. This is difficult, demanding work but overall I’m still happy that I’m able to do it. Yes, I have bad days but the good far outnumber those.

I wish you the very best in this journey and remember that very few people come here to tell happy stories but they are out there.