Can I refuse care?

Absolutely! You are not under any legal obligation to care for anyone! If she goes in the hospital tell the social worker/discharge planner that she can NOT come to your home. They can not send her to your home if you cannot care for her. It is their job to find a home to place her in NOT YOURS!

If this woman lives with you and absolutely refuses to do what she should be doing and is impacting your life and making you miserable, then it is time to remove her from the home immediately. If that means placing her somewhere, then you must do it. She cannot stay in your home - it is pure disaster. Stand your ground and do not continue caring for her.

Having worked in an environment and talked with others in this situation, if the situation arises and she is hospitalised, you need to tell the hospital that you are unable to take care of her at home anymore, therefore she will need to be placed in a facility where she can be taken care of. The hospital can organise an ACAT assessment and will then do what is necessary to place her in a facility. You will be told, no doubt, that this will take some time and asked could you take her home. Just keep saying NO. I know where you're coming from as I live in a similar situation (however, not as bad as yours) with my partner's mother. She lives in our house for nothing, and doesn't want to be here but no one else will have her. If the situation arises where she is hospitalised, we are going to tell the hospital that we cannot take her home and we will remain adamant about that. You need to too, otherwise you will never get her out of the house.

Of Course!!! If you have NOT signed on that Line to be POA or any Sort of Living Will Person of Interest...They will need to Find her a Home. However, Medicaid will snatch Everything if she is Not Eligible and in order to Make her So, Her Monies Must GO!

Now I have Moms age and I read CMs post I can now answer ur question better.

My MIL did the same thing ur Mom is doing, but she was in a rehab. She had a very bad UTI. Was in rehab to get her strength back. I don't actually know what she was told by my BIL but I think they gave her more info than needed. But the jist of the conversion was, she was going to have to transfer from Fla to a rehab in GA. After that, she would need to figure out which son she was going to live with. Because, none of her sons lived close enough for her to remain in her house. One in Miss and us in NJ. My Mil was a passive-agressive stubborn woman and if she was not going to go back to her home, she was not going anywhere. The woman literally willed herself to die. Doctor agreed. So she was put on hospice.

Your Mom is 89. She is probably tired and just wants to go. I think an honest sit down with her and her doctor would be a good idea. Even just you and her. Ask her what she wants. Why are you not taking your Meds Mom. Where do you want to go? Call a Hospice agency ask if they have someone qualified to ask Mom what SHE wants. You may find she is ready to pass on. My Mom had Dementia, but in the end, she wanted to be left alone. She didn't want to be touched or be forced to do anything. Nurses couldn't even get her out of bed.

Have you ever spoken with a hospice facility? They can help you with an evaluation and are a wonderful asset. I'm not sure if you're saying your mom doesn't want to be alive, or to live with you but that would be my first question. We did a lot of research and hospice is a lot different from what it was years ago. They ended up coming to help with both my MIL and FIL. My FIL has advanced Parkinsons and my MIL had a multitude of problems but mostly suffered from chronic heart failure and had had several procedures to replace stents My husband has been at their house for, we figured it up yesterday, almost 300 days straight. They didn't want any outside help which of course no one ever does, and they could easily afford it. Once the hospice nurse started coming in they really seemed to appreciate having someone there with real training and the nurse can get them to do things that we their kids can't. They can help in so many ways, including how to prepare us for the end that no one wants to talk about.

Yes, you can. There is no law to say you have to care for your Mom. If this is your intention, when she enters hospital, get Social Workers involved to tell them that you will not be taking her home again, and that you cannot do so either physically or mentally. This will give them the heads up to seek placement for her. She will not want to be where she is placed, either, and of course her verbalization to you likely comes of dementia, not of reality, but it does sound as though you cannot do this anymore. So sorry.Accept that you will feel guilty about it. When people enter care their families always do. But there comes a time when you cannot do it. The nursing home she is placed in, and you yourself can be involved in seeking palliative care for your Mom, or even hospice care. The refusing to eat is not at all unusual in the end stage of life. You will need to be firm and unwavering in this choice when you speak with Social Workers and Doctors, because they will do what they can sometimes to get you to continue your caretaking in the home. This is something to consider before you go--whether you could go on with hospice and or palliative care in place, or not. It does sound as though the decision is made already in your head.

My father was in a nursing home at the time but decided enough was enough. If they state that, the facility has to accept it. It’s basically a DNR , He was kept clean and comfortable but no food or meds. Died 2 days later peacefully.

If your our mom isn’t eating she may have already started the dying process. It can last a few years from start to finish but looking back I can see when my stepfather started it. He slept a lot, rarely ate unless badgered, didn’t communicate. Reality is they aren’t going to get better.

If these are recent behavioral changes, you have to rule out medical conditions such as infection (particularly urinary); if you feel she is a danger to herself which refusing medication is part of, I would call 911 and have her hospitalized to rule out physical causes, then evaluation through psychiatric unit. Social workers at the hospital can organize transfer to an assisted living or nursing home and you are not obligated to care for her.

IF the issue is behavioral, and not physical such as infection, perhaps she suffers depression and that can be treated with medication, which may make her more amenable to accept care. Sometimes the right antidepressant or whatever can make a big difference.

But if you drop her in a nursing home chances are she will decline because it is institutionalized

I would think that yes, you have the right to not have to deal with someone who is unco-operative. Put it this way, the nursing homes can kick them out if they are difficult. They can send them to a special facility for mentally ill elderly. If nursing homes can refuse to care, so can you. It's her choice, really - not yours.

bert, you’re getting some great responses. Yes you can refuse, make clear at her next hospital stay that you are not able to provide proper care in your home after discharge. Look for the/a reason to admit her to the hospital and then when time for discharge she should get priority admittance to NH as ‘rehab’ while you wait for long-term admittance.

I also have a mom who clearly states repeatedly that she doesn’t want to be here, and I understand her. We're waiting for admittance to to NH. As soon as we can, we’ll take her off maintenance meds. These folks have a right to not want these things, but also professionals should watch over them during that decline. My mom goes without food when not supervised, and a few weeks ago declared she will not brush her teeth anymore. Bathing is touch and go, I’ve bought no-rinse bathing wipes and she said she’ll use them periodically.

Nature brings such indignity at this point. Where we’re at, let’s get them moving toward their wishes as smoothly as we can. God bless her and you.

If you call an ambulance or you take her to the emergency room because you are concerned about her health status due to not eating they will keep her in and monitor her for a few days. Because she is refusing to eat you can ask that she be placed in assisted living because you are finding it too difficult to care for her. I believe they need to be in hospital for 3 days for Medicare to cover her moving to a senior health care facility. I did this with my mother in law when it became too difficult to care for her. The doctors were very understanding.

Yes, which will mean state getting involved and taking over and at extreme you not being allowed to see her. So as long as you are willing to go along with any possibility then certainly you can refuse to take her home if you feel she could be better cared for and it would be better for your health.

Get her to the hospital. Tell them she’s not eating.

She may have new medical problems. There may be something causing food to taste different, or making her otherwise nauseous. Could she have a UTI?

Usually in in the hospital they push everyone toward nursing homes at discharge. That is the American cultural norm. You don’t even have to ask or answer questions. They will tell you automatically that your mom should be in a NH.

I think Jacobsonbob has put his finger on it. By "does not want to be here" your mother means she's had enough and is ready to go, do you think?

And you don't want to feel responsible for having allowed her to waste away and die.

I deeply sympathise.

If your mother were in reasonable health but depressed about her age, then a spell in hospital and rehab might well perk her up and she could enjoy a good quality of life again. But that's not the case. She is very ill with a chronic disease, she's already blind in one eye, and the brain hypoxia can only go one way. Your mother's outlook is not a good one, wherever she is looked after.

You say you are afraid that she will get so sick that eventually the doctors will be able to do nothing for her. But... dear loving child, with hugs to you, that IS going to happen. And it won't be your or anybody else's fault.

When my mother was at a similar stage, after a lot of denial and futile struggling I eventually realised that if she was not in pain and not afraid, that was good. We know that our very sick elders are not going to get better. What we have to aim for is a soft, gentle landing.

If your mother is not already being treated for depression, it would be worth asking her doctors to consider that. Depression would fit with her other conditions, and can be alleviated.

If she is already being treated for depression, and in fact that's one of the meds she won't take; and seeing that she is still considered competent to make her own decisions; how would you feel about trying to accept the choice she's expressing? Have you discussed that possibility with her doctors and care team?

YOu may ask the doctor if it is safe for her to come home. Doc may say she needs more specialized care. Ask for evaluation. My friend was released from this decision, doc and hospital said in no way can mom go home. That was that.

Yes, if she is admitted to the hospital, you should explain that you cannot care adequately for her and will not take her back to your home.  It would not be a safe discharge.  Then the hospital social worker will have to place her. What other place does your mom want to be? Is she competent legally? If she is legally competent then you cannot force her - it would be abuse, but be careful to protect yourself by making it clear that food, medicine, etc. are NOT being withheld by you. It's her bad choice, not yours.

All the agency’s that have been to the house, are looking into placements for her, however, we are on hold until a Medicaid Wavier is approved for placement which can take up to 4 months. We considered an emergency, so from what I am told we are being pushed through.
However, placement is not my biggest concern here. It her health. I am being told be told because she is still mentally capable of make her own decisions, I can not force her to eat, wash nor take her meds.
With that all being said, she in essence is making her health decline rapidly and if she does end up in the hospital and gets healthy, I don’t want to bring her home and she decides to do this again.
Im afraid, she ultimately get so sick doctors will not be able to bring her back.
Shes 89 blind in one eye, has CHF and brain hypoxia.

First, how old is Mom. Age has a lot to do with how we will answer. Does she have Dementia?

If she doesn't want to be there, have these agencies suggested any options. Really, thats what they are there for.

Where I live, rehabs and LTC are together just different sections. So if Mom is in the hospital and is sent to rehab this is where u ask for an evaluation for LTC. If they say she meets the criteria, have her transferred to the LTC section or find a LTC facility. If Mom has no assets and income is just SS and some sm pension, then apply for medicaid. Otherwise, any assets she has needs to be spent down. Then Medicaid can be applied for.

Is it possible she actually wants to die? However, from your description it appears to be more of a "hunger strike". Does your mother say where she would rather be?

You can certainly decide at any point that her care is beyond what you are capable of providing, and since she doesn’t want to be there and is fighting your care it sure sounds like you’re at that point. You can take the route of her being hospitalized and then refusing discharge back to your home, or you can start immediately looking for a place for her to live that can meet her needs. If she can’t afford to pay for this the business office of the facility can help you through applying for Medicaid.

Many people on this forum say you can. I’m not sure how you’d go about it, but your first step would be to contact the social services department in the hospital. They may send her to a geriatric psychiatrist for evaluation.

You can also file for Medicaid for her and find a facility.