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Yes, I’ve gone through similar stuff with my parents in assisted living. Overall it’s a great place but they do have strict policies about what triggers an ER or hospital visit. And yes, it’s a CYA dynamic much of the time.

I had poa and now guardianship for Dad. Mom died this past April. I had a good relationship with the admin folks. Some things were a definite ER trip. Mom would have a bad fall, nurse suspected a broken bone and off we go. Other times they would call me and say it was a minor issue, I should decide. I always said no.

The bigger problem for me was all the follow up visits that all these docs insisted on. The ortho Guy, the neuro Guy.....It was ridiculous. This was an 88 year old woman with dementia and broken bones who just wanted to stay in bed a be left at peace.

I put an end to those follow ups. Like we’re gonna do neuro surgery on this poor women. The AL folks were reluctant but cooperated with me. They know the reality but they gotta watch those policies.
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Reply to Windyridge


Sorry. Lost for words.

Just blimey.

I'm stuck at the 'catheterisation to get a decent quality urine sample' stage. They want to shove a catheter up an elderly lady's how's-your-father because they don't have the time, patience or skill to get a decent mid-stream sample?


Is your MIL fantastically combative about toileting, or something?
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Reply to Countrymouse

No. Mom has a right to refuse as her POA you do too.

My Mom was taken to ER 4x in 4 months for falls. She had Dementia and would complain about pain. After the 4th time and no broken bone. I spoke with the RN and asked that the staff wait before calling the ambulance. 3 out of 4x I wasn't called until after she was sent. Yes, she probably does hurt, doesn't everyone after a fall but do you go to the hospital? Give her time to get up and walk around. If she continues to complain, call me. Besides hating to sit in ERs, each visit was confusing for Mom and she didn't like being poked and prodded. I would think they would just ask you to sign a release absolving them of any responsibility. If they do call an ambulance, your Mom can say she doesn't want to go and they can't make her. Besides, depending on the problem, you should not take her to the ER anyway. You could do more harm than good.
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Reply to JoAnn29

You need to think of it from their perspective. If they didn't send a person to the ER and there really was a problem, then people would scream bloody murder. So for liability alone they need to call an ambulance. Of course, your mom or you as her POA and can refuse at that point but then the liability is on you. For many things, like falls involving any head injury at all, you are supposed to go to the hospital to get a CT scan to check for brain hemorrhage. Which is a concern for anyone over 65 even if it's a light head bump. Whether it's AL or they are in your home, you should be going to the ER. Yes, most people don't. That doesn't change the fact that people should.

If you are set on them not sending your mom to the ER for any reason, you should look into drafting a release with the AL facility releasing them from any and all liability.
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Reply to needtowashhair

Thank you so much everyone for your responses and your understanding. My husband (her son) is POA and as such he did refuse the last time they tried to force us to take her to E.R. It was a Saturday in January and we believed sitting in a crowded ER for hours with people coughing and hacking would do her more harm than good adding to her anxiety and confusion. She is 86 years old and has Dimentia. You make a good point Countrymouse. I don't know why the staff can not provide better assistance to her in order to get a clean sample For the most part we're very pleased with care she receives. You made me laugh Countrymouse with the how's-your-father! I never heard that term before. You're right blannie - taking care of seniors is not for the faint of heart. We all are doing the best we can and we need to keep our sense of humor.
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Reply to DaisyB

It's so frustrating when they rush your parent off to an ER and don't even notify you. I had that with my mom in independent living. She had a nosebleed that the medication aid saw and they immediately called 911. Never called me (I lived and worked less than 1.5 miles away). They whisked her off to the ER and I finally found out about it after she was already there. I was SO angry. My mom had previous nosebleeds and all you had to do was have her lie flat and put some Vaseline in her nose. But they rushed her to the ER and it was 4 hours before I could get her home. She couldn't even remember why she was there.

After that, I put signs up everywhere in her room and made it very clear they were to call me before they ever took her to the ER again. SHEESH. Like Windy says, they want you to go to follow-up visits and when you do, they say, "Why are you here?" They never have any idea or seem to really care or have a plan. Taking care of seniors isn't for the faint of heart! You've gotta have nerves of steel.
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Reply to blannie

Sorry about that Countrymouse - I wasn't very clear. Yesterday the Assisted Living called me at work to say mother-in-law might have a UTI. The cultures they took came back contaminated so they wanted her to get catheterized for a good sample. I agreed. I immediately called Urologist who couldn't see her until July 10. The Assisted Living nurse told me that was not soon enough and I would have to take her to the Emergency Room immediately! Mother-in-law was not in ANY discomfort at all. She does not get physical symptoms when she has a UTI. Her behavior changes a bit in that she becomes more confused than normal. I called the Urologist back and basically begged for an appointment because I did not think spending hours in an ER was in mother-in-laws best interests. Urologist found an appointment for her yesterday at 4:00. They will get a culture and I'll have the results Thursday. However, they found no bacteria, and basically told me the Assisted Living overreacted. This is the 2nd time the Assisted Living has "strong armed" us with the threat of the E.R.! It is just so frustrating. The cynic in me wonders if the patient is secondary and the Assisted Living primary motivation is " covering their assets". Anyone else have similar experience?
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Reply to DaisyB

What about the cost of the ambulance service? My mom doesn't have medicaid so it cost $175.00 out of pocket every time she goes. 3 out of 4 times it was a fall, but nothing broken. It is darn if I don't, and darn if I do.
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Reply to Tessabella66

I think the over reaction is nuts!!! And reading some of the posts more common than I thought.
When I went on vacation and placed my Husband in the Memory Care facility where he went for Day Care I got a call about a "problem"
The facility called my Sister, I put her as a contact, I was out of the country and she could handle any problem that might have come up.....
My brother in law then contacted me that my husband had some sort of "infection" and that it needed to be treated. I gave approval. I was not too worried about cost, most of the medications were picked up by the VA or Medicare but I did wonder about cost.... I did not hear much after that ..until I get home and found out that this "infection" that "needed to be treated right away" was...Athletes Foot !!!!

Yes I would be wary of any request to transport to the hospital, wary of any facility doctor that may be padding the bottom line.
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Reply to Grandma1954

This is the reason I moved my mom from her memory care facility. Too many trips to the ER. They are required to call for an ambulance if they think she needs to go or I won't take her myself (I did once). She did need medical attention ONE time and the whole ER wait unhinged her.
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Reply to DafnaS

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