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Verytired1290 Asked January 2022

What happens if parent refuses to be in assisted living once there?

Hello, my dad passed away September 2021, and it is just myself and my mom now. I live in my own house and she still lives in hers. Our doctor has said she absolutely needs to be in assisted living because she refuses to take her medicine on her own and she has extremely high blood pressure and sugar. She also has starting dementia from minor strokes she had a few years ago. My dad was everything to me and I have not even had the time to grieve him because I've been nonstop taking care of her since he passed. I have my own family and a full time job, I do not have the time to give her the care she needs nor do I have the energy. I took her to visit the assisted living place recently just so she could see what it was like and warm her up to the idea. Tried to really reference that she will still have freedom and her own room and she's able to leave if I come get her or her friends. She was not having it at all. Her friends are all widowed and living independently. Plus we are Asian. So I know it is embarrassing and difficult for her to accept being there and she's comfortable at home. My lawyer says we will court order her to be placed in assisted living with the doctors letter of recommendation. I was just wondering what happens if she says no when they try to move her from her home? What happens if she refuses to be there once she's actually in the assisted living? The director at assisted living told me they would take her to the hospital and then geriatric psych after if she keeps saying no. But what happens after that? I am just very tired and want to get this all situated. I am tired of fighting with her explaining that I cannot just quit my job like she demands. Her moving into my own home is not an option. She'd still be alone when I'm gone to work. We have no other family to help out.


Edit; Forgot to mention. I have guardianship already, but she had the limitation put in that I cannot move her from her home without court orders and it was signed off on by the judge. Back then I just agreed to it because we were in a rush for me to have guardianship to take care of her financials. Her friends were letting her withdraw all of her money from the bank and hiding it. Her bills were not getting paid and getting shut off.


And in home health care is not an option unfortunately. Her doctor said unless the nurse can stay 24/7, AL was the only choice. He also said our town does not have 24/7 in home nurses available

AlvaDeer Jan 2022
Do you have full powers for placement with MD diagnosis?
If she continues to object or to attempt to leave ALF they would likely put her in memory care. Think a sort of difference in level of care so that it would go from approximately 5,000-7,000 a month to 10,000-20,000 a month.
Verytired1290 Feb 2022
i dont think she is at memory care level yet. and yes it is much more expensive
IneedPeace Jan 2022
VeryTired, your story sounds similar to mine. My Dad passed in May 2021. My Mom insisted everything was fine even though she was starting down the path of dementia and was poisoning him by overmedicating him because she'd forget she JUST GAVE HIM HIS MEDICINE, and gave him a second dose. I had to consult an attorney because since I had the POA I was afraid the authorities would come after me if she continued to "poison him" after the doctor alerted me to what was going on. (We lived 2 1/2 hours away at that point) She was also forgetting to eat and forgetting to feed him. Long story short, I had to kidnap them. Fortunately the doctor told me how to do it - get a copy of their drivers licenses, and send the copies to the local police department explaining what was going on. Thank God I did that because Mom called the police stating that my husband had stolen everything from them, etc etc.

You are between a rock and a hard place. You should go back to court and get the guardianship edited so that she can be placed. I would not resign guardianship (even though you want to - I wanted to resign POA but there was no one else and I had to protect their assets). If you resign guardianship the state will take over, and she will be assigned a guardian that you will have no control over and who she might even dislike more than you. And if she has any remaining assets you have no control as to how they spend them.

After a year and a half Mom has stopped hating me for moving her. I had to quit my job .We rented a house close by (because of her having toxic personality traits we will NEVER live under the same roof again - she is lucky I am doing anything for her at all) and it is rigged up with all sorts of alarms, etc and she has someone every day of the week for all meals, meds, etc.

I'm sure I will regret leaving the workforce because I'm only 60, but what I'm trying to get at is - being placed isn't the end of the world. Forget about any guilt you may have. Easier said than done. The nursing home will not "release" her even if she wants to go back to her home.

As she continues on this path, she may even forget her former house. Mom asks me if she still has her house - she does - and it's loaded with 60 years of crap that I tried to help her with (to no avail - wouldn't part with ANYTHING) before she started with the dementia.

Mom even forgets that I've spent hours with her. After 6 hours sitting by her side one day, I left to get dinner by myself, and when I came back an hour later she said "what have you been doing all day?" So please save your sanity and your own health. It's time for the professionals.

Sorry for the long post. Take care - you have my sympathy!
Verytired1290 Feb 2022
Hi, thank you for your reply back and i am so sorry to hear you are going through the same.

My update at the moment is I am going through the court to have it court ordered for her to be in assisted living. My lawyer said they cannot physically make her go so if she refuses or if assisted living sends her home because she's causing such a disruption, then there isn't much I can do. I will turn it over to the state after that and let APS handle it. I do not want to have to give up guardianship. I know my mom absolutely hates the thought of the government having her money but I just cannot be responsible for everything anymore. It is getting to be too much for me. I have also talked to the director at assisted living. They said if she is refusing to be there, they send her to the hospital and then off to geriatric psych. I am not sure what happens after that but she said there is a chance she could be sent back home. So we will just have to see.. I am just waiting on my court hearting.

My mom is the same. I spent two years cleaning up her place before my dad passed. and shes back to hoarding again and pulling everything out of the closets but never putting them back

wishing you better days also

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Isthisrealyreal Jan 2022
I would ask the facility how they deal with this issue.

I am sure it happens all the time. If they don't have a protocol, it is probably not the correct level of care.

I disagree with the doctors. Your mom doesn't need a nurse 24/7 and the only place I know that has one, is a hospital.

If your mom needs 24/7 care, AL doesn't meet that criteria. There are aids around the building 24/7 but, your mom will be in her own "apartment" with a call button.

I recommend doing some leg work on what care facilities offer in your area and get an independent needs assessment done. The place you choose, should do a needs assessment to determine level of care required. Be mindful that this could change after she moves in if they get it wrong and it will cost more money.
Isthisrealyreal Jan 2022
Verytired, I am so sorry for your loss.

May The Lord lead, guide and direct you in this journey with your mom. May He bless you with comfort, strength and grieving mercies.
AnnReid Jan 2022
You seem to have several recommendations that your mother be placed in AL, or possibly MC.

If she has cognitive loss, she will not be able to decide whether or not she should enter residential care, and therefore what she says stops being part of the decision making process.

Almost everyone who enters AL/MC refuses to go, wants to come home, says there is nothing wrong with them, says they are being treated badly (not being fed, forced into the shower, people are stealing her things…..).

For HER WELFARE as well as your peace of mind, place her in the best possible place you can find, visit her as soon as her caregivers say it’s a good idea, and leave her whenever she starts to complain.

JoAnn29 Jan 2022
I think you have answered your own question. You already have guardianship. All you need is a doctor, who seems to be willing, and a Judge to sign off she now needs 24/7 care.

I suggest though, that u have her evaluated for Memory Care which is a step up from Assisted living. Both are limited in the care they can give but Memory care is better when the person is suffering from a Dementia. Maybe her doctor is willing to put her on something that will keep her calm during the transition. I would not go the private aide thing. 24/7 care would cost as much as placing her in MC. And you have will they show up, will they steal or take advantage in some way. One member complained the aide brought her child with her.

Its no longer what she wants but what she needs. This is the way it is. She lives in a Country that people have to work. They have to plan for their futures. For one reason, the parents are using their savings to care for themselves because they are living longer than thought when they were young. So no inheritance for the kids. I graduated High School in 1967. The lifespan average back then was 70. Our parents did not think they would live to 90.
Verytired1290 Jan 2022
Yes I do have that set up. My question was more of what happens if she refuses to leave. I am just trying to be prepared for all of it.
MJ1929 Jan 2022
It seems like you have two options -- let he crash and burn at home (taking you with her), or go back to court and get the move ordered.

She can destroy her life, but she's not allowed to destroy yours. She can wither away and be cranky in AL just as easily as she can in her home. With the care she gets in AL, her general outlook may actually improve, too. Don't let the Asian angle get in the way, because that's just hogwash.
Verytired1290 Jan 2022
Well I didn't want to just leave her at home because I have guardianship. I didn't want it to look like neglect on my part that I didn't do enough
BarbBrooklyn Jan 2022
I think I might go back to court; tell the judge that unless you have the ability to move her into a safe faciity, you will need to resign this sham guardianship.

Tell her/his honor that you are happy to let the state take over her care (there will be NO limitations put on that guardianship, you can be sure).

I think this is a time to lawyer up and play hardball, before you die or lose your job.
Verytired1290 Jan 2022
Hi Barb, yes you're right I do need to play hardball more. I tried to give up my guardianship before because I was just so exhausted, but this was before I was able to get the letter from the doctor. So my lawyer back then told me while i can do it, it looks bad on me to give up guardianship so he told me to take some time to think it over.
Geaton777 Jan 2022
BurntCaregiver...sigh... a private hire is who committed financial abuse and drained ALL my relative's assets (and literally even took his dog). I don't personally have anything against private hires except that it is much more work and responsibility and the OP has already stated that she has a FT job and family. An agency - in her case - would make far more sense. Does she want to be an employer for all the private aids that come in? Find subs when they call in sick at the last minute or quit? And have to do the tax reporting and submit 1099s etc?
Verytired1290 Jan 2022
Yes, you are correct, I wish to not be responsible for any of that. I'm sure everyone can relate here, but even taking a phone call for her is draining me.
BurntCaregiver Jan 2022
My condolences on the loss of your father. Here's what happens when it's time to move your mother.
She has to be declared incompetent and an at-risk adult by the court and a conservator/guardian will have to be appointed to make her decisions. This will very likely be you. You're already on the right path if her doctor has already determined that she cannot live alone anymore. He will have to fill out paperwork for the probate court to have them appoint a conservator/guardian over her. If you already have POA, then none of this will have to be done.
What you will have to do is show the documenation from her doctor to the assisted living facility along with yoru POA. Then tell them that she will be a hostile transfer. They will get her to the AL.
Is there any possibility that your mother could stay in her home with a live-in caregiver? She might be more open to that idea if she likes her home and wants to stay in it.
Verytired1290 Jan 2022
Hello and thank you, yes I failed to mention in my post all of that. I already have guardianship but she had the limitation put in that I cannot move her from her home without court orders and the judge approved. I do already have her neurologist letter declaring she has dementia and should not be taking care of financial/legal matters.

In home health care wasn't really an option. I did try to look into it though, and her doctor also said unless the nurse is staying 24/7, AL was more recommended.

Thank you for the information on the hostile transfer. I will be sure to mention that
Geaton777 Jan 2022
I'm sorry for the loss of your father. I'm also sorry for your current exhaustion at trying to help your mother.

When you say "court ordered" are you saying you are pursuing legal guardianship? I'm assuming this is what you mean, which also means she has lost much of her cognitive capacity to make decisions in her own best interests.

Your mother has barely had time to grieve the loss of her husband and to adjust to what is happening to her so quickly. As such, as an alternative, does your mother have the financial means to pay for agency care at home? This might be a step to transitioning her into AL. If you are her legal guardian she can't really "fire" anyone who shows up plus she gets to stay in her home for a while longer. Agency care would be less management/oversight for you rather than private hires (who would be cheaper but come with its own complexities).

In-home agency help is more "flexible" and less permanent (and less effort for now) than going straight into AL. Just a thought.

If it turns out that AL is the only real option, it might make things "go better" if you can tell her a "therapeutic fib" about moving into AL: her house has a gas leak, infestation, broken furnace/ac... whatever it would take to get her to move. BUT, once she's there and if she isn't adjusting and tries to leave...if she's a "wander" risk the facility may insist on moving her into MC.

Many on this forum have been in your shoes and will provide helpful insights. May you gain peace in your heart through this journey!
Verytired1290 Jan 2022
Hi, thank you, and I should've explained in my post. I have guardianship already, but she had the limitation put in that I cannot move her from her home without court orders and it was signed off on by the judge. Back then I just agreed to it because we were in a rush for me to have guardianship to take care of her financials. Her friends were letting her withdraw all of her money from the bank and hiding it. Her bills were not getting paid and getting shut off.

She has been set up for all her benefits which should cover the cost of AL. She also has a little bit of a nest to fall on from my dad leaving his life insurance to her. I did try to look for in home care. I went through here on aging agency actually but they told me they did not see any available in home health care at the moment in my area. And also, her doctor said unless a nurse can stay 24/7, in home health was not really the way to go and that AL would be better.

I do wish I would've tried something like that first, telling her she just needed to leave her house for a little bit while things got fixed. I had told her this more like apartment living for older people, but with nurses around in case she needs medicine or gets sick. She just really hates the idea, and I feel so bad I wish she had other options but we just don't unfortunately

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