Anyone had luck with an ER dump?

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.

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.

If you bring your mom to the ER and tell them that there's no one to take care of her at home, she can't be on her own, and that she needs a 'social admit'. They will admit her to the hospital and keep her there until they find a nursing home for her to go to. You can bring her to the ER even if she isn't injured or sick. It is the last resort, but the hospital will take her. They will send a social worker to talk with you after she's admitted. A friend of mine had to do this with her grandmother because there was no one who could care for her 24 hours a day. The hospital found nursing home placement.

We would like to get her evaluated for dementia and possible placement in a NH which was about to start before all the COVID hit but now her Dr. thinks a NH is no place for anyone. We did try the alert bands but she's not into those and refuses to wear one. She will not bath, wash her hair or change her clothing daily and since she lives with us can definetely see failure thrive and can see the decline in just a few short months. We put her meds out for her but normally find them all over the floor even though we watch her take them. Its now reached the point where we feel she needs more and better care than we can give. Her going to her a room is not a problem but it does create a problem if shes sleeping 15+ hours a day and not drinking or eating when she clearly can. It seems like lately she doesn't know she has to eat and drink.......Since most of the family is back to work we do not see what she does while we are not there.

Yes. It can be done, but its a shame we don't have a better system in place, and its a shame the Doctor's and nurses don't really help. I had the same experience with my father's Dr's. I think it's because they know there is no easy answer. I ended up in a desperate state and cried out to his Dr. asking what can I do and she said "Take him to the ER, it is YOUR decision" She said it twice and emphasized "Your decision" as if to say she is not telling me to do that. I ended up calling 911, I think it is better to have the ambulance transport rather than bringing her yourself. Once at the hospital you are going to have to stress to the case manager and social worker you are unable to provide a safe environment for her anymore. You are unable to be with her 24/7. Please follow AlvaDeer's advice. Also, when you call 911, make sure it is somewhat warranted, like after a fall, or perhaps if she seems overly delusional. The only other option (other than being able to place her in a NH or memory care if that is doable, and unfortunately for many it is not) is to contact APS or a state social worker, but I really don't know how that works or if it would work in your favor or not. I have not seen any narratives of going that route.

If she has fallen more than once, it's time for an ER visit, which will immediately provide your mother a hospital social worker employed to arrange her post-hospital location.

How is this organized? In the U.S., hospital social workers are employed to arrange hospital discharge (post-care) locations.

In a typical larger hospital each floor/wing has its OWN social worker. For example, Denver Swedish separates but connects its social workers: its ER Department has a social worker, its 7th floor Neurology unit has a social worker, and its 4th floor Acute Care unit has a social worker, etc. Each separate social worker is assigned patients on their floor/wing. As the patient is moved from the ER onto different floor(s), their social work file moves with the patient to the next department social worker.

As an example. If a patient is transported to an ER due to a CVA (stroke), after that patient is stabilized (scans, tests,etc), the patient is next moved onto the 7th floor Neurology unit. As the patient is admitted into the new department their social work file moves with the patient into the new department, etc.

Which means after your mother is transported to the ER, you'll need to contact the social worker within the ER department, to clarify that your home is not a safe place for your mother to be discharged. UNSAFE because it has stairs and [insert danger here] Which, ideally should, result in the social worker arranging for your mother's discharge into the type of facility an M.D. orders.

After contacting the social worker you will need to maintain daily contact, to ensure that facility arrangements are being made. The social worker and nursing home will arrange to have the nursing home salesman to stop-by the hospital to interview/meet with your mother.

Working with the hospital social worker(s) is the safest legal option; your mother likely will qualify for Medicaid (and Medicaid long-term care), each U.S. state has separate determination criteria. Colorado for example, excludes one home and one car, and has a set amount of "cash" $2,000 allowed.

You can’t make someone leave their home to go to a facility if they are competent. Even if they have fallen. If they have their mind, they can refuse to go anywhere. An ER dump won’t work either.

You can still place her in memory care now. What will bringing her to hospital accomplish? You want them to place her? Does she need to be seen by doctors or are you just trying to get her out of the house. They are not going to search for a good place for her; they will put her in a place with an available bed? They cannot keep her at the hospital for long if nothing is really wrong they can treat.
i don’t think you said how a facility would be paid for. Medicare does not pay for nursing homes.
I suggest you look around and find memory care facilities near you and contact them. Yes, she is at risk due to Covid but she is also at risk not taking her meds and not eating.

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.

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 ?

Place her in Memory Care.
Suggest you start looking and if mom needs application for Medicaid begin that process now.
An "ER" dump is not fair to your mom, the hospital staff

" 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."


Does your mom's doctor not think she needs to be placed in a facility?

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.

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.

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

Get a key box like realtors use and caregiver can get in at anytime

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.

Having help come is probably best. Second best is respite in a residential facility.

You could check local assisted living facilities to see if they have respite care. COVID may be preventing respite care but it’s worth a try. I used respite care once for my mother and hospice paid for 5 days but your mother would have to have a qualifying condition for hospice. Good Luck.

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.

I would leave a key in a lockbox for the caregiver so she can go in; they are insured and work through agencies so will be safe. It is tough for the person to accept they need help so you have to frame it as if the government requires that she is safe at all times so it is necessary that someone is there when you are not. We find making up stories to satisfy our mother works (not always but just keep trying) and she has no choice but to eventually accept. Even if she sits in her room, at least you know she is safe. Let the caregiver do their job and she will give in. They always do. Good Luck tia. These are very hard times for us in this situation.

Sadly I have had to do this twice since the hospital sent him home saying he was doing amazing. He does belong to the veterans hospital currently he is getting more testing done and the clinicians there have been super helpful And admitted him to their hospital room I am currently waiting to hear back from some other long-term care homes which I’m praying will work out this time

one more thing. We put in the RING camera in her kitchen and front door, it has helped us so much - we see and understand everything that happens when we are not there - you can put it in the kitchen and living room (not in bedroom or washroom or private area ie where she would change). I love this camera, it changed our lives (and no i don't work for them) You can feel safe with caregiver too because you see and hear everything. It puts all the pieces of the puzzle together for you. I promise you will love it. I put one in for my mother-in-law too and she is so happy because she sees her husband with dementia when she is shopping and feels so comfortable that he is safe.

I can't imagine leaving my mom (dumping her off somewhere). I don't even like the term ER DUMP. If your Mom is not abusive to caregivers, but just isolates herself, that is better as she will have someone nearby. I can't imagine she'd be happier in a foreign environment (hospital) after being left with strangers by her family. It sounds like you are at a desperation point, and a social service agency for the aging might be a resource that can help you. Good luck!

Is there a government social agency -- something named "adult protective services" which could help. If you explain to them that you can't care for her and she can't care for herself, maybe they know how to move her to a nursing home.

Medicaid will pay if she qualifies financially. If not, contact an elder law attorney to figure how how to get her qualified.

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.

Yikes! A nightmare..... scary, too, since my mom absolutely refuses to go to a facility, though she can do almost nothing for herself. "the best you can do is the best you can" - you said it.

If you could have a caregiver come while you are there for short visits and get her comfortable with a particular caregiver she may get used to them and actually enjoy them. Sometimes a gradual change rather than a sudden change will work out better. Change is difficult for for all adults but is even more difficult and scary for elderly adults. Good luck!

Let the caregiver come and get a baby monitor that she can watch your Mom while she's in her room and the caregiver can be in another room.

Do you really think an "ER dump" in the present pandemic is going to help anyone? Hospitals are overwhelmed with sick and dying people from COVID and the majority of their energy and resources are going to treat those patients. Taking your Mom into that situation is just plain cruel--expose her to COVID, take resources, especially time, away from dying patients. Do you really have no other alternative? I think a lot of the ones sited below are great. Contacting Adult or Geriatric Protective Services in your county/state is a great place to start. Also try senior services for your county or town. It will take a lot of your time on the phone, but these people deal with these issues regularly and know what is available and how to go about getting help. Hoping for a reasonable outcome for you and your family.