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This seems like the only option left at this point and I feel bad about even considering it, but Mom can no longer be left alone for any length of time. She's fallen a few times, but not enough to warrant a hospital visit. We tried again having a caregiver come to the house when we would be away, but she refuses to answer the door even though we have tried to explain what is going on. We also tried having the caregiver come while we are home, however she will just go in her room until she leaves. Her Dr. has been of no help since her last visit and actually suggested she be seen by the nurse practitioner next time she comes. COVID doesn't help the situation, as it just makes things so much more difficult which we get but cannot continue on like this. TIA

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I had a similar situation with my 90 year old mother with Dementia. She is fiercely independent and needed help but would lock the caregiver out of the house and refused to cooperate. I told her very sternly that it was either the caregiver staying with her or I would place her in a nursing home and the choice was hers. I made it clear that was her only options and I told her that daily. I had to be very tough. She did allow the caregiver to stay but was not not very happy about it but did cooperate. You have to take control - Do you really want an ER to place her in a Facility ?
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This is a last measure to be taken ONLY when everything else has been tried. There is nothing good about it. BUT....................
As a nurse I of course saw it over and over again, and often of course legitimately done. You cannot know the results of a fall without ER transport into hospital and xrays.
Yes, it does make it more difficult in Covid times, but the important thing is to ask for a social worker at once and to say "I will not accept my mother back in my home; she is not physically or mentally safe there or am I physically nor mentally able to care for her. She will need placement".
THEN you must NOT buy into the "We will make this work together; we will get you help". They will not. Simply say she will not be accepted home and to discharge her would amount to an unsafe discharge. They can arrange guardianship (temporary emergency) much more easily than you ever could (call to the judge) and can find placement. NOT placement approved by you but placement THEY choose. Be clear in your own mind that once you do not take her back she may be moved to State Guardianship and they then have control of her monies and her placements.
This is the devil's own bargain. Nothing good about it. It is a last ditch emergency effort to find placement for an elder you can no longer care for.
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BurntCaregiver Oct 4, 2020
They won't have to sign over guardianship of the mother on a social admit. My friend's family who had to do this with her grandmother did no give over POA or conservatorship to the nursing home. They will try to get it of course, but don't ever give in. Just because a person is unable to babysit an elder 24 hours a day, does not mean they are incapable of still looking after their interests and making their financial and health decisions.
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First, think through what you're looking to accomplish with an "ER Dump."

If mom has the finances for AL, give yourself a pep talk and begin the process of moving her. Your quality of life matters just as much as hers. And keeping her reasonably safe matters most of all.

If she doesn't have the money, and you think that she'll qualify for Medicaid for long term care, call 911 for that next fall (I hope you're not lifting her from the ground yourself - how old are you? Protect your back). There could be conditions underlying the falling.
Once you get her into an ER, it's still a process. The ER doc has to admit her. You must hold the line about there being no one at home to care for her. Hopefully, if she is admitted, she'll be discharged to rehab, where real attention will be focused on whether or not she can live safely on her own.

It can work, but proceed deliberately and don't waiver; with your mom or the healthcare folks.
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No. I have not had to do an ER dump. I can’t imagine it but I realize sometimes people feel they are that desperate. Are you wanting your mom to be evaluated or placed in ALF or NH?
Help us figure this out.
What is it that you want the caregiver to do? Is it to call an ambulance if she should fall? You can get cameras and check on her from your phone. You can get a medical alert system. A pendant or wrist band if she will wear it.
If I felt she couldn’t be alone, I would just have the caregiver stay while I ran my errands. Actually I would probably have a housekeeper instead with the understanding that they would call me should anything happen. Your mom would get used to the person being there. If she goes to her room, is there a problem with that? Does your mom have dementia? Is she shy? I had a housekeeper come and help me at my mom’s home. The housekeeper would take her a snack or comment on a program my mom was watching. After awhile my mom relaxed and the housekeeper could come and go with no problem.
Give us some feedback on the situation and perhaps someone will offer information that is helpful.
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Surprised that some suggested memory care to solve the poster’s problem. Right off the bat, MCs are expensive and are private pay. Also, the cost depends on needs. More needs = more money. Not everyone can afford several thousand $$ a month. And then not every MC has availability. Those that have availability might be far away or have poor service. I have visited MCs that I would not even let my pig to live in, much less my parents or spouse.

Re the poster’s problem with the caregiver, I had those hide-in-rooms too. It took a while for the agency to find the right match (for now), but I am glad I fired the lazy ones.
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sunshine45 Oct 8, 2020
AKA Haileybug

Not all Memory Cares are private pay.

I do agree with you that some are not a Go To place.  Sadly, in an ER dump, that may be where a dumped family member ends up at.
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We tried that. My MIL actually decided she was going to leave and "never come back". We do not have guardianship over her and we had been trying to convince her that a nursing facility or retirement home would be best. But she refused to go. We called the police who convinced her to go to the emergency room instead of going to "die under the bridge". They kept her for a full 30 days, telling us she needed to be placed in a long term care facility. But since she was refusing to go, none of the facilities would take her. After the thirty days, they said that she had "timed out" and they released her. She still refused to live with us and ended up being homeless again for a while. We took her to two different ERs after that, when we could convince her it was for her benefit. The doctors all admitted that she needed to be in a care home, but none of them would actually put her in one. She is currently living with a man unknown to us, who tries to get access to her disability and other benefits every once and a while. I have a good relationship with the ladies at the local SS office, and they have been vigilant to keep him away from her money. We are her benefit payees, and are authorized reps on all her accounts and with doctors. Thankfully, we got this all set up before her mood changed. We have been making sure her living expenses are paid, she gets groceries, sees her doctor and picks up her medication. It's been several months and she has now forgotten about all of it. She calls us happily and is excited now to visit for the holidays. Sometimes, the best you can do is the best you can, even if it's not ideal.
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Myownlife Oct 8, 2020
That sounds like just such an unbelievably hard situation for you. I am so sorry for all you have gone through and continue to go through.
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I think AlvaDeer posted wise advice and a “script” for what to exactly say to the hospital social worker in the ER. The key is to get in touch with the social worker as soon as possible... do not wait around.
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We purchased a door knob hanging lock box for the house key off Amazon so the caregivers could enter and leave as needed (updated info with local police to have notes on address with code to access in case of emergency). We also installed Arlo security cameras inside and out to monitor movements and visitors. I could check throughout the day to see if they were safe and not in trouble. This allowed our loved one to remain at home for almost 5 more years before being placed in a facility. The worry eventually consumes you. Wishing you all the best in finding a solution.
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InFamilyService Oct 8, 2020
We are using the NEST system now and its great. My aunt has three cameras installed with audio and visual.
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I ordered a life alert necklace for my mom, with it comes a lock box for your front door with a code so emergency workers can get inside. She was reluctant to wear it but I explained to her that it made me feel better about her safety when I was out. She also is a fall risk. So that could be an option for you to know she is covered when you are out or to give the code to a worker to come in as well. I realized that for my own sanity and ability to be out doing things that I want to and need to do to LIVE MY LIFE, I would have to insist on this. It gives me a sense of peace knowing she is covered while I am out. And it works, she has pushed the button by mistake in her sleep and the paramedics were at my door at 4:00 am. They also have ones that can detect a fall and the button does not need to be pushed. A lot of Medicare plans pay for this. If not, it runs about $30-$40 per month depending on your plan. I hope this helps🙏🏼 Tammy
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ExhaustedPiper Oct 8, 2020
Tammy, do you mind sharing what system you purchased? Thanks!
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Personally I don't see anything wrong with having the caregiver come while you are at home and letting you LO go into her room. So what if she doesnt want to socialize with the caregiver. Are you worried something might happen while she is in Her room? At least there is someone in the house to make sure she doesn't get out. If something did happen while she was in her room... I am sure the caregiver could listen for any noises that might indicate a fall. She may eventually come out of her room. What about Adult Day Center? They are open here although I know many of them are not open. The Housekeeper solution sounds like a good idea as long as she knows she is to keep an eye on your LO. Let us know what you have decided and Good Luck.
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Kittybee Oct 10, 2020
I had this thought too. As long as someone is in the house and monitoring the overall situation, then let her hide in her room.
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