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Grandma is 87. I live overseas. She has no family left in California. So I'm the only person that calls and checks on her. She forgets that I'm now 36 and argues with nurse on a daily message . They call me which is around 3:30am my time and ask me to calm her down. I'm happy to help but are they meant to call me everyday when her confusion gets bad? I'm usually then on the phone with her for 45 mins to 1 hrs. She will argue and argue until she gets tired and gives up. I tried to speak to the administrator for advice on how to proceed from here. She made a comment that they need the bed anyways as she is Medi-cal patient and if she doesn’t want to stay there then the bed can be used for someone else. I'm so confused. Grandma has no family there. She can’t live on her own either. I'm constantly worried and scared that the NH will discharge her or send her to the hospital as the administrator mentioned that.
I can’t even fly there right now due to Corvid. Feeling so helpless.

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Stop accepting the calls, and stop trying to explain things to her. You cannot expect someone with dementia to accept any reasonable explanation, and it's not your job to try to calm her down every night.
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AshKiran May 6, 2020
Hi
I often tell myself that I won’t answer the call but I start feeling guilty and worry what if it’s an urgent call and she is not well or something. I know I need to be more stronger . I m just really struggling right now .
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If Grandma has no money, Memory care would not have been an option, its private pay.

They cannot discharge Grandma. Without family there they can't discharge her safely. The only thing I can see happen is to tell them you can't be the responsible party. Living overseas is making it hard. Ask if there is a way for the Court to assign a guardian.

The first time they called me at 3am, would have been the last. As said, this is the staffs job. She needs medication for her anxiety. The facility has a doctor associated with it. I would talk to the Director of Nursing and ask if there is a medication they can use. Its just a matter of the Dr. giving the order.

I would also ask that the staff be made aware of the time difference between CA and where ur. Give her the times convenient for you using CA time. You also would appreciate only emergency calls. Calming her down is not one of them. As her Dementia progresses, this may go away.
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worriedinCali May 9, 2020
Joann memory care IS NOT PRIVATE PAY! Where did you get that information from? The OPs grandma is in California. Medi-cal pays for memory care. Medicaid in most states pays for it as well. It’s not private pay.
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She needs to be seen by a geriatric psychiatrist; the facility should have one who visits other patients there.

Demand that she been seen.
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AshKiran May 6, 2020
I just spoke to the nurse in charge and she said she will have the facility doctor assess her and he won’t be in until Friday . Hopefully it happens
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Is she in a Memory Care Unit? If not, she needs to be. The facility should not be calling you every night. They should be made aware of the time difference. By calling you each night, they are expecting you to do their job for them. Then, they prove they can’t do the job by threatening to throw her out. Are they saying they’ll send her to a psychiatric hospital? Maybe she needs to go. They can adjust her medications while she’s there. Do you have Power of Attorney for her? If not, there is nothing you can do. You can’t make medical decisions for her and you don’t have any financial rights for her money. Explain this to them. Turn your phone off at night. I would pursue finding a guardian for her here in the United States.
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AshKiran May 6, 2020
Hello
She is in a skilled nursing facility. I went to visit her in September last year and she was not well . She was living with her sister at that time who was not well too and has since passed away . I took grandma to the doc and she was evaluated and the doc said she was suitable for snf. I don’t live there ofcourse didn’t know about memory care . I extended my stay until I managed to find a bed for her in snf.
The nursing home asked me to the be the responsible party which I agreed to . There is no one else that could do it . I m really confused what I can do and what I can’t do. Grandma signed the documents too and I signed as responsible party .
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Set firm boundaries for accepting calls from snh asap. They are being paid & thus responsible for managing Grandma's behavior, that's why she's there. Calling you is an excuse for them to not do their job. They have access to the doctors who can assess her & possibly prescribe some meds to help grandma settle down.
You may have to speak with a doctor or social worker and ask what THEY can do to help you (being out of the country) with grandma so she can get the proper care she needs without constant phone calls. Be persistent! I've been there too.
Best wishes.
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My sister was younger with dementia, but mood stabilizers took that mean nastiness away.
Good Luck
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When I (on the West Coast) had my mother in a nursing home (on the East Coast) ran into this, I told the administrator that they were the experts and should certainly know how to handle the situation. Since they ostensibly are trained geriatricians and are being paid to do this job, they should be able to contend with such a situation. It is unconscionable for them to lay this trip on you in the present circumstances. Unfortunately or maybe fortunately, in the past, these places just doped the patients up. I cannot speak to this.
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This is ridiculous behavior on the part of the NH. I agree, call the DON (at 3 a.m. her time..lol) and tell her you want the doctor in charge to evaluate her for medication. At the very least she should have Xanax as a prn medication. But there are many thing that can help. Tegretol wonders for my dad.
Are you her medical POA?
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You can request an evaluation by a geriatric psychiatrist. They are specialists trained in the management of mental health conditions. Once they evaluate her, they can recommend medications to help manage her behaviors associated with dementia. Most facilities have this speciality available to them. If due to the pandemic, the facility is not allowing consultants in, then ask the physician managing her care at the facility to prescribe something to ease the agitation. Good luck.
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Guilt is the worse. My own mom 91 just broke her right shoulder. She has previously broken her go, pelvic, and femur. Because of this I had to move her from CA where she was comfortable and close to my brother across the country to TN. It’s only been a week but seems like 5 months. Yesterday my brother said, just think of her as an old lady with a phone. It’s helping. But all this advise here is priceless. Yes to the facility. Yes to better medication. Yes to boundaries. It’s a sad thing for sure, but we cannot fix it alone. And what I’m learning yet again, is it’s pointless to try and fix it on the phone. I’m sorry you are
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