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ruthna Asked November 2017

Can a nursing home not allow a resident to go out to church?

My aunt lives to go to church every week and has someone that picks her up. When she gets there, they get her out and she immediately is put in a wheelchair where they push her around the whole time. The nursing home told me that she is getting weaker and they do not think that she should be going out. After a few days of thinking it over, I decided that her quality of life is more important then her quantity of life. A fall can happen anytime - even at the nursing home and I feel that the people that pick her up are able to help her. She also does not go if she is not feeling well that week. When I told the nursing home how I felt, they immediately told me that they are now using a lift to transfer so they will not allow her to go out. Are they allowed to do that? As her POA, I am trying to do everything in her best interest but I feel that they are overriding her/ my wishes. Can someone please let me know if they are able to do this? If not, what can I do?

gladimhere Nov 2017
Ruth, are you in the area that aunt is? When did you last see her and her condition? Could it be that aunt is too weak to go? Maybe people taking her to church have decided it has become too difficult. Nursing home may have stepped in to help transporters so they are the bad guy. There does come a point where it is too hard for everyone involved to take the elderly out.

jeannegibbs Nov 2017
I wonder if Aunt is difficult to deal with once she has been out?

A fellow-member of my local caregiving group took her late-stage dementia husband to church frequently. She hired special transportation to take him in his geri-chair and to return him to the facility. He had a special jacket/lap robe for wheelchair users. The facility did not object because all of his needs were being met and the risks were being mitigated. And she could be the Caregiver From Hell when she needed to be. :P She also arranged for communion to be brought to him in the NH between his church visits.

Having kind volunteers to pick Aunt up may no longer meet her increasing weakness.

Once my mother was a two-person transfer with a sit-to-stand device, she seldom left the facility. Once a month they transported residents to Walmart. She did not get out of her wheelchair for that ride. My sister met her there and wheeled her around shopping. She rode back in the special van. The challenge was, what if she had to go to the bathroom? Well, that could not have happened. She'd simply have to wait to be changed when she got back. Other residents were in the same situation, and the trips were kept short. The only other trip she made was to her sister's 100th birthday celebration. We hired a van so she didn't have to get out of her wheelchair, and limited her visit to about an hour (which was enough for her energy level anyway).

If Aunt really wants to go to church, ask the facility what would make that possible. Could you hire a medi-van and take her in a wheelchair? What would make this safe, in their view? Could you sign a waiver, taking full responsibility for the period she was gone?

I agree that quality of life is way more important than quantity at this point. But if Aunt falls or is dropped or bumps into something, the quality of her remaining life could be miserable. Getting her from the wheelchair to the car and back again is an increased risk period.

My mom's nursing home had several church services per week, of different denominations. Residents could attend easily, without getting dressed for outdoors and without leaving their wheelchairs if they used them. Aides came and got them and brought them to the chapel. There were also a couple of Bible study sessions, and rosary sessions, and hymn sings each week. My mother was not religious at all, but she sometimes went to the religious music events.

I wonder if participating in what is available at the nursing home might be a good practice now for Aunt. It would be another way to connect with the residents she sees often. And maybe those kind people who pick her up for church could instead occasionally visit her where she is, perhaps even going to a church event with her there. Ask her pastor if there is a visiting committee who could come and see her occasionally so she doesn't completely lose touch with her church buddies.

I give you gold stars for advocating for your dear Aunt! She is lucky to have you. What is best for Aunt may change over time. Stay flexible, while continuing to work in her best interests.

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cwillie Nov 2017
I wonder about the way this was presented by the nursing home. Your mother "can't" go to church anymore - she physically can't because she can no longer transfer from wheelchair to car. Perhaps the message really was We can't allow her to go to church unless you find suitable transportation that doesn't involve transfers. In my opinion they have a duty to bring this to your attention and insist on a safe solution , and sometimes friends and family do need to be told bluntly when something isn't working anymore.

SueC1957 Nov 2017
I can't imagine the facility would have the "right" to deny her, especially if she doesn't have dementia. They are not her POA. They would bear no responsibility for her once she left the facility. If she fell at church, they would not be liable.

A not so nice thought; Maybe they want to keep her there as a patient, receiving the income from her. If she falls, she would go to the hospital, then to a rehab facility for a long while. If she's not there, they don't make money. You don't want to think that way but I can't figure out why they are laying down the law. Contact an elder law attorney to get this set straight.

GranJan Nov 2017
I would go with your Aunt one time and witness the whole process from start to finish. Several things to consider; how competent is the church's pickup service? How are they transporting her? If left in her wheelchair, is it being anchored in place for the trip? If transferred from the wheelchair to the vehicle, do they have someone who can transfer dead weight? Once she is there how do they deal with it when she needs to go to the bathroom? I am a church goer myself and I understand her wanting to attend but sometimes it just becomes too difficult. It is obvious you love your Aunt and care about her wishes. Keep us posted on how this progresses.

DianaP Nov 2017
I would call an attorney about that. Both the places my mom has been allowed it as long as she wasn't going by herself. Sometimes the churches will help with transportation.

Veronica91 Nov 2017
If Auntie is a true two person assist and needs to use a lift then unless she is transported in her wheelchair in a spcially adapted vehicle then she could not be allowed to go out sad as that might be. Can you be there when she needs to be transferred to see exactly how that is managed and decide if they are blowing smoke for some reason as yet not known to you.
Many church goers tend to be elderly to and it may be that the nursing home feels those who transport her are not now up to the job. Would they allow you to transport her? There seem to be a lot of unknowns here. it might just be a case of "Mother knows best"when you challenged it.

Sendhelp Nov 2017
Get a doctor's order.

Thisishard Nov 2017
I too had the question of who it is picking up your Aunt. Is it an aide, church member, etc.? I'm not passing any judgement, but there does come a point when friends, family, workers simply don't want to be responsible for someone with mobility issues. Sometimes, it's for legal reasons and sometimes when the resident returns back to the facility/own home, the outing has left them even more debilitated. In the case of the woman I take care of, she is so weak after an outing, she can barely move and the trip induces unbelievable sundowning. Unfortunately, the NH employees may be less interested in her ability to worship, and more interested in the extra work and stress of getting her there and her condition when she returns. If possible, I probably would watch the process, beginning to end, including the church service and return to NH.

freqflyer Nov 2017
One thing we all must understand is that an Assisted Living or a Nursing Home has been on hundreds, if not thousands of rodeos so they know what is safe for a resident, and what is not. For us, the relative, this is usually our first rodeo and we are learning as we go along.

There are legal aspects of allowing a resident to leave the building when it has become not feasible. Even if a waiver is signed, the family can still try to sue, if something happens, saying that the Assisted Living or Nursing Home knew about this but still allowed the resident to leave the complex.

It is not unusual for the resident to return back to the complex and become a hand full for the Staff, not cooperating, wanting to leave again, etc. That takes time away from other residents who need hand-on care. Since the relative isn't there to see this happening they think their Mom, Dad, or other love one had a good outing.

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