I have been taking care of my 82-year-old neighbor since she came home from a skilled nursing facility 2 weeks ago. We have been friends and neighbors for 16 years. Her son lives locally and has medical power of attorney over her but refuses to take care of her.
She had surgery in the beginning of September for an abdominal aortic aneurysm. A week after coming home she fell due to a blood clot near the stent. She was hospitalized and had surgery to correct it. They discovered that she had broken her hip when she fell a month after the second surgery. After a month at the facility, she was released to go home while still unable to walk on her own. I have been caring for her ever since because her son won't do it. If I didn't care for her every day she would be left on her own constantly. I set up a camera to keep an eye on her when I can't be there. I have noticed that she is very confused and paranoid since coming home. She seems to be struggling with some form of dementia.
I told her son yesterday that I am physically unable to continue caring for her. I have physical limitations of my own that are starting to make it difficult to care for her. I have limited mobility in my arms and a pinched nerve in my neck. She can not take more than 10 to 15 steps with a walker. I have to get her in a wheelchair to get her to the bathroom and then support her body weight to get her on the toilet. I don't know what to do. I can't continue doing this and I'm afraid he will just let her rot in her apartment if I stop. Her own best friend told me I'm going to have to stop doing it for my own well-being. How do I get her care if he has power of attorney over her? I love that woman like she is family and it hurts me to see what she's going through. Any advice would be greatly appreciated.
Sometimes people just don't know what's going on and opening up communications is the first step. I'm so glad you were able to help your friend. What a blessing that you're her neighbor!
Her memory issues aren't related to an undiagnosed infection or other health issues. The dr determined it is caused by undergoing anesthesia 3 times in 6 weeks. It may get better but he said it's going to take time. Yesterday they had her admitted to the hospital to force the insurance company to cover additional rehab. It also gave the dr the ability to run more tests. After doing an ultrasound on her legs they discovered a small blood clot behind her left knee. They said it wasn't very large but this gives them a chance to treat it while she's there. They are going to start the transfer process for rehab once they get the clot treated. The plan is to rehab for 2 weeks and see where she's at mentally and physically. During those 2 weeks, her son will be looking for an assisted living facility just in case she does not improve enough to return home.
This has been a very draining time both mentally and physically. My goal this whole time was to get this adorable little powerhouse of a woman the care she deserves and the advice I got here helped me do that. I can't thank you enough for the advice that was given. I will update further when I can. Thank you again for all your help!
That's the first step to getting her in home therapy. If her son has PoA, that's who needs to call the doctor.
You can get private pay aides through an agency as well.
If the doctor orders a booster seat for the toilet, it can probably be paid for by Medicare as Durable Medical Equipment (DME).
If she refused therapy in rehab, that was the reason for discharge. Medicare will not pay for someone to just stay in bed.
It sounds like a psychiatric assessment could be a useful thing to get.
I can see that you really want to make sure she gets the help to see what she can regain and how regaining more mobility is number one. I’m glad to hear her son was there and maybe that does give you a way to guide him so that you can make sure she gets additional therapy.
You need to ask her son if home health has called yet (they usually call within 24 hrs - the rehab would have set it up at discharge and Medicare pays for it) and if you feel that you want to be an advocate for her - then to ask him to speak with home health about you being able to speak with them - when they are coming to the house so that you can be a part of it? I only say this as it seems like you want to be an advocate for her.
If the rehab discharged her - it probably was because she was no longer meeting the “goals” Medicare sets in place but she can do in home rehab.
She can qualify for home health - including PT - OT (who can assess her home and help make suggestions like grab bars or things to make her daily ADLs easier) and she can even qualify for speech which can work on the cognitive issues and see if they can strengthen them (I say this because my mom is a stroke survivor and after or during infections/hospitalizations etc - she sometimes needs speech again just to refresh her cognitive issues) it does help. where you say that you can often convince her to do things then you may be present for her therapies to tell them where she needs the most help.
She also qualifies for DME equipment - if she needs a hospital bed - wheelchair - commode (while she gets stronger) - walker - etc. Home health could also request a social worker to just come over and they can tell you of additional resources in your area that can help her while you see how much more recovery she can get to. Meals delivered - sometimes even home health aide hours if there are local programs with such. Etc. Some areas have better local resources than others but she could qualify for things that really could help her and you and a social worker could help you get her signed up for these. Home health nurses can get orders from her dr to check for UTIs Etc. You need to ask her son if anyone has called him from a home health agency and if not then he needs to call the rehab case manager and ask what company was assigned her case at discharge. Wishing you better help and answers this week for your neighbor.
The way rehab works is that Medicare will pay while you are making progress. If she "plateaued" or was refusing therapy, they discharge. She may have been able to walk 15 feet and transfer while being assessed, but at least with my mom, she was frequently able to put on a good show. Didn't mean she could do the same thing when the therapist wasn't there.
I disagree that she needs to go back to rehab. If she can't toilet herself, she needs either full time in home care or a placement in Assisted Living.
What has the son's response been to your "resignation"?
Years ago, I had a dear sweet neighbor with dementia who was also blind. Her kids were convinced that if I could simply " be on call" for her, she'd be fine. I refused. I had three school aged children and it was clear to me that she needed full time care. Because I said "no" my neighbor got what she needed.
My Cricket, that's what we call her, is extremely stubborn. I'm usually the only one who can get her to cooperate. I make her talk to me all the time. She has told me that she's scared and frustrated. She trusts me so I can usually set her mind at ease.
I have not gone full resignation yet but I have told her son that I can't be there constantly. I made him take care of her yesterday and was surprised that he did it. Normally he sits there on his phone for about an hour then leaves. He spent about 6 hours with her and actually made her get up and walk. He's coming back this morning after he does her grocery shopping. I have a camera set up so I can watch her when I'm not there. I've been trying to leave her alone for longer periods but I watch for signs that she needs me.
I don't know if she will ever return to normal mentally. She was always a nervous type of personality. Stressful situations were always difficult for her. She hasn't been the same since her cat died 3 years ago. She had a mild stroke 2 weeks after he passed away. Part of me thinks that his death took her reason for living away. She stopped having something to look forward to every day so now she's just going through the motions. I have made a list of places to call tomorrow to see if I can get her the help she needs. I won't stop trying until I get her what she needs. She's too important to me for me to just give up on her.
I would call APS and tell them the situation. Tell them that you physically cannot take care of her. You are seeing signs of confusion, etc and don't feel she should be alone.
This lady has been thru a lot. Breaking a hip is very serious in the elderly. Her meds or lack of could cause problems. It is her sons responsibility to see she sees a Dr. or hires someone to see she sees a doctor.
I would try first to tell your friend that you believe she has an infection and “that is why maybe she doesn’t feel like herself” or have as much strength - just keep her calm and say “you will feel so much better once you get the proper antibiotic” and suggest “let’s call 911” and that way they can transport you easily.
If you don’t think she will agree to call 911 or you are hesitant to do so - Maybe even just going to the local fire department and telling them your concerns ask if they can put in a welfare check and that you would rather keep it private so you can continue to watch over her without the son blaming you. 🙏🏼
You are a dear and rare person to take care of her with such dedication BUT even if she assigned you as her PoA you will not be able to carry on being her primary caregiver due to your physical limitations (and probably your age, sorry). She now -- and permanently into the future -- needs more daily help than you can provide. Now it's time to hand off the baton and rest in the fact that you did yeoman's work and should go to bed at night with peace in your mind and heart!
Also call Adult Protective Services. Report her as a vulnerable elder who has no one to care for her.
If you know the name of the last facility she was in, you might consider calling their social worker/discharge planner and telling them that she is at home with no assistance. That will trigger THEM calling APS as well.
It seems likely that someone (either the lady herself or the son) misrepresented the situation at home which enabled her to be discharged. Or possibly home health services WERE set up and she dismissed them.