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Hi All, My 84 year old grandmother had a recent hospital stay (4 days) because she severely burned her legs on space heaters, she did not feel her legs being burned. She has dementia and is now in a rehab facility which is also a nursing home. She has periods of being confused and her short term memory is gone, but she has always been aware of what she is and isn't going to do. She has stated to everyone that she is not staying at the nursing home and she is not going to stay with my aunt, but she is going home. I live 4 hours away and have two flight of stairs in my home, so safety is an issue at my house. I have her medical POA, is there a way that I can prevent her from going home if she has hurt herself? She is adamant about going home, but there are some safety concerns. Do I need to petition for guardianship and have two Drs exam her cognitive skills in order to have her declared incompetent in order to get her out of her house?

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You need to talk to the discharge planning folks at the rehab. Clearly, she needs to be in long term care. They should be able to advise you on whether your POA, in your state is enough to force a placement or if you need guardianship.a
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Is it possible for her to hire in-home help? People with dementia generally cannot safely live alone beyond the very earliest stages. But they can stay in their own homes IF there is adequate supervision.

With no short term memory she needs help remembering her pills, remembering that she can't sit close to the space heater, remembering to drink fluids, and even to eat! She would get all this help and more in long-term care. The people providing it would be fresh each shift, and have immediate access to backup help in an emergency. Long term care makes the most sense in every respect EXCEPT that she doesn't want it. It is practical, efficient, safest, and totally unacceptable to the person it applies to.

That is why I ask if there is any chance care could be provided in her home? I'm not thinking you should be able to do miracles, just hoping all options are objectively considered.

This is so difficult for all concerned! It is wonderful that you are looking out for Grandma even from a distance!

If she does have to be placed in long-term care (which seems likely) would it be better to do it in another location, perhaps close to you or another family member who could visit often and advocate for her?
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lizsdaughter207, usually whenever someone has dementia and they say that they want to go home, "home" usually means their childhood home, back when life was so much simpler and more fun.

Sounds like your Grandmother needs 24 hour care, which can be very costly if done at her home. For my Dad, we used a professional caregiving agency, 3 shifts per day, and it cost him $20k per month. Dad did move into senior living, had his own apartment, and it cost him around $5k per month, then it cost him $6k per month for Memory Care. He really enjoyed living in the community being around people his own age, and all the good food :)

If Grandmother cannot budget for self-pay, then it is time for her to apply for Medicaid [which is different from Medicare] which will help pay her way in a nursing home.
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Hi all,

Thank you for your responses. I spoke with an Elder Law attorney and she informed me that because my Granny isn't incompacitated or disabled she can't be forced to leave her home, so the medical POA that I hold with her cant force placement in a nursing home or with my aunt. She said that if I want to force her out, I need to petition the court for guardianship. So as it stands, it looks like my only option is to let her go home, but have care givers come to help her everyday.

I feel that a nursing home will be safer for her, but she insists that she is not going to stay at the nursing home, she's going home ( as she balls up her little fist to show me, she means business) lol

She is a firecracker and will not be denied!
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What is it about our mothers that they become a cross between Cruella Deville and the Wicked Witch of the West when they get old and need to go into some sort of assisted care? "She is a firecracker and will not be denied" is the exact phrase i'd use to describe my mother. It's like they've called the shots all their life and can't deal with losing control, even when they've already lost it.
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Is it possible that your mother doesn't understand the POA, and could be persuaded based on what she's told? With Dad, I told him that I could end up in jail if anything happened to him, and that it surely would if I left him there. That's all it took.
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So, she can demand to go home, but the NH is not allowed to make an unsafe discharge , i.e., can't send her home alone. I would fib and say the doctors say she has to stay until she gets stronger.

If she wants to go home, then she needs to arrange (and pay for) care. Does she have the funds to pay for income care?
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I feel quite faint at the thought of what happened to your poor Granny. Oh dear Lord.

It does make you shake your head and wonder what the heck constitutes a risk if this doesn't. Snakes alive, what if her clothes had caught fire - ?!

But I agree with your respect for her wishes. Okay, she is determined to go home and you quite rightly want to make that possible. So I second BB's question - can she afford the necessary care for it to be done safely?
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I was my moms POA and thought that would keep her at Resthome long term as she was threatening to leave...resthome said I had to obtain guardianship which I did...she had evans done by doc, social workers, and physicalist who all determined she needed long term care, including her family practitioner who gave s letter of all moms physical/mental issues and why she needed long term care...she clearly needs long term care as she doesn’t even realize her flesh is burning..thankfully her clothes didn’t catch fire or things would b much worse..my mom thinks she can live on her own despite everything wrong with her...I think it’s human nature to always want to b home my mom says she’s getting an apartment and she doesn’t need me to take care of her.. despite dementia, Sundowners, urinary/fecal incontince and being so weak she broke her arm, fractured her back and her tailbone 2x, heart attack, strokes and a multitude of other health problems..I would get a letter from her doctor stating why she is no longer to care for herself and needs long term care...OBTAIN GUARDIANSHIP...being POAwill not stop her from walking out the door..it’s a process but worth it because you no longer have to worry about her being on her own and getting harmed
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