What do I do? I am sick in bed. Mom's doctor wrote order yesterday to admit mom to behavioral unit for running around in the highway screaming. She's been crazy for over a year. The doctor who wrote the order said to me, "at least 5 to 7 days". She agreed to go voluntarily. They were supposed to do an MR angiogram, back out her 16 meds and reintroduce any she really needs, do therapy, etc. She went in yesterday. This morning she left message, "I hate it here." At noon she left msg, "They're letting me go. I have to come back tomorrow to pick up a prescription. The doctor will call you."
Another pill???
Friends, I am exhausted and I've been sick and crying for three days. I can't go get her. I don't want to call the psych unit because I'm afraid it will start some kind of "safe to discharge" ball rolling. I want to turn my phone off.
If she's telling the truth, why wouldn't they keep her and stick to the plan??

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Are you believing your mother that she is being discharged? Do know that you can refuse to take her home. Call the social worker and tell them that you cannot mentally or physically care for her in her current condition and she must have the full range of tests ordered by the MD. As to why they wouldn't stick to a plan, no patient can be held against their will and she is free to leave at any time if she is not on a 5150 (72 hour hold) or another hold. You may need to consider placement and this is the time. Refuse to take her home and say she must have placement, that she cannot return to your home.
Certainly none of us on Forum can suggest "why" in this matter. It is a question for the doctor.
Helpful Answer (17)

Are you and your sister willing to accept responsibility for procuring 24/7/365 help? Who will be paying for this? Please do NOT spend your own money (neither you nor your sister)!

This is your chance, as has already been noted -- GET HER INTO A FACILITY. Tell them she does not have care at home. You say it will destroy her? The way things are now, she is destroying YOU.

Is she Medicaid-eligible?
Helpful Answer (6)

If EVER I’ve read a story here that cries out for a secured (locked) Memory Care unit, this is it.

A doctor has recommended it, you have no logical reason to think she’d do well at home no matter how many aides you found, and unless you hired a rotation of SAINTS, you’d have walk out, quick quits, and lapses in her supervision beginning day one.

In a Memory Care, medications would be structured, as her time would be.

If she’s an active alcoholic, the chances of finding this kind of setting, ESPECIALLY RIGHT NOW, are even harder than typically, but the bottom line is, you and those who love her are not trained for this kind of problem behavior and cannot reasonably expected, EVER, to be personally responsible for her care.

YES, refuse to take her home to her house or yours, and see what is recommended for her by people who are trained to find placements for difficult clients.

DON’T “go get her”. Whether she’s considered “safe to discharge” or not, be water on stone- “I can’t take care of her” and say that over and over and over.

Helpful Answer (6)

Otherwise, deep breaths.

I think you need to understand that, for whatever reason, you mom is no longer a "reliable reporter" of the stuff that is going on in her life. TRUST BUT VERIFY, as they say. Call the doc, the nursing station, whomever and say "this is what my mom is reporting to me. What do the docs say?".

This serves two purposes. One is that you get the ACTUAL story from the hospital, the other is that the docs get to know that your mom is not "getting" what they are telling her.

It is SO very hard to let go of the idea/fact of your mother as a teller of fact: this is something that we grow up with, right? That our moms are oracles of truth?

And all of a sudden, they aren't. You need to work through this, process this and come to terms with it.
Helpful Answer (6)
cxmoody Mar 2021
“And all of a sudden, they aren't. You need to work through this, process this and come to terms with it.”

Wow. This is why I read almost everything posted on this forum. So much wisdom, and this little nugget is GOLD for me.
Chronic mental illnesses are often untreatable, but behavior managed through medications.

**You are NOT obligated to take her back, and you can refuse to have her back. This would force them to place them like in a group home where she can be better managed. I would absolutely talk to the social worker there and tell them that.**

Some states have residential treatment programs (SRT).

You do not even have to be her POA...the court system can appoint her one (visiting justice go to psychiatric wards).
Helpful Answer (5)

I’m afraid you’re setting yourself up for another world of trouble by trying to provide 24/7 care in your mom’s house. What will you do when a caregiver doesn’t show up? Quits? Has Covid? My parents had 24/7 care and it was still a small nightmare. Put Mom in a facility. If you don’t have POA, get her to sign a paper. Maybe lots of papers so she’s confused about what she’s signing, sell her house and use the money for the facility until mom can qualify for Medicaid. (Maybe she can qualify now?) I’m saying a prayer for you. Stay home. Stay in bed. Research facilities for mom. Be safe.
Helpful Answer (5)
barbarali Mar 2021
if mom is mentally incompetant she cannot sign legal papers. you will have to have poa appointed.
Rovana, no family members will not be charged with elder abuse or neglect. The doctors are sending her home. If the doctors didn’t think she was competent they wouldn’t have sent her home.

Just because someone has severe mental illness does not = incompetence.

I was told this over and over with my mother. Mentally ill people have RIGHTS. Good luck trying to strip them of their RIGHTS!

The only way you can send someone to a mental facility is if they are a danger to themselves or others. That’s it. No other way.

The DOCTORS are letting her go home, EVEN though she was screaming on a 60mph Highway.

Doesnt anyone else besides me think the mental health system is broken and failing the mentally ill and their families?
Helpful Answer (5)

Alva is right. If mom went voluntarily, then she can leave. But you can tell the hospital bluntly that it would be an unsafe discharge since you cannot care for her. Refuse to take her to your home. ( presume that she lives with you?) Be persistent in your "unsafe discharge - no one to care for her. They will try to guilt you but keep refusing and they will have to find placement for her.
Helpful Answer (4)
Otherwise Mar 2021
She lives in a house that she owns. We are trying to find 24/7 helpers for when the hospital launches her back out. I'm afraid if we were to say, "I can't pick her up or watch her", it would destroy her. She already begs and sobs on every phone call. She understands what's happening. It's gut wrenching.
If she's crazy then you should talk to her Dr and leave her there.

Tell both your mom,, Dr and them you are sick and she doesn't have a safe place to go to and they will have to keep her a few more days
Helpful Answer (4)

"She's been crazy for over a year."

Okay, you've been aware of this for a year. What has been done about it during that year?

"This morning she left message, "I hate it here." At noon she left msg, "They're letting me go. I have to come back tomorrow to pick up a prescription. The doctor will call you."
Another pill???
If she's telling the truth, why wouldn't they keep her and stick to the plan??"

Whatever she says regarding being let out, it could be fabricated. The crying and hysterics is just to get you to do her bidding. Don't rely on anything she tells you.

"We are trying to find 24/7 helpers for when the hospital launches her back out. I'm afraid if we were to say, "I can't pick her up or watch her", it would destroy her. She already begs and sobs on every phone call. She understands what's happening."

Does she really understand? Begging and sobbing is just to get sympathy, mostly. If she's been "crazy" for a year, she doesn't understand. In a later comment, you report the doctor mentioned dementia. If that's the case, she doesn't know, she doesn't understand and won't stop begging and crying. Neither will she be "destroyed" if you say you can't pick her up or watch her. Better to NOT say that. If you do, she will fixate on YOU as being the problem. Leave it at the doctors' decisions. Doc says you need to get well. Doc says you need time to heal. Doc says >whatever<. 

"She lives in a house that she owns."

Tagging this along with looking for 24/7 help - can she afford that? Facility care is expensive, however it is MORE expensive to keep someone in a home and hire 24/7 care. The amount of time and energy needed to keep that scenario rolling smoothly is going to be a challenge for you. Care givers call in sick, no-show with no warning, bring in virus, etc. Also, if she has dementia, simple AL is NOT the answer. She would require memory care, which is locked down so she can't wander, ending up screaming on the highway. AL does NOT monitor residents 24/7, so she could just walk out.

"If the system doesn't improve, we are going to have an avalanche of demented people in a few years."

We already HAVE an avalanche of dementia going on. They anticipate it is just going to get worse.

"She wasn't released from the behavioral unit on day 2 after all. I think this is day 5 and she is scheduled to talk to another doc in 2 days."

Good. Keep it that way. She should NOT be released to her own home nor should she be released to your home. She and you do NOT have the qualifications needed to address the concerns!

Hopefully this suggestion doesn't get lost in the shuffle: have them also do a urine culture and complete blood work. UTIs and other infections can cause dementia-like symptoms OR they can make the existing dementia WORSE!

"Detoxing from alcohol."

Does this mean she is detoxing now, while in the behavioral unit? If so, all the more reason to keep her there. That could take some time. It's also a good reason NOT to allow her to return to her home or yours. There will always be ways that she can get her hands on something, even if it's rubbing alcohol! Dementia and alcohol are a bad mix!

"I would guess vascular because of the CT, but her symptoms seem like alz, so probably both?"

Many people have mixed dementias, but the symptoms between vascular and alz are not really that much different. It really doesn't matter which, if it's between these two. The care and treatment are very much the same. Other forms of dementia are very different and the symptoms/treatments are different as well. If no conclusive evidence between vascular and alz, no worries really.

"She says she is taking fewer meds."

This can be a good thing. Often people are over-medicated. She should only be taking the ones that will stabilize her health, such as BP meds or diabetic meds (no idea what she was taking.)

To be continued in a reply to this post...
Helpful Answer (4)
disgustedtoo Mar 2021
"She still cries constantly, fears for her life, has mad delusions, nightmares, hallucinations, and seething anger."

That could be just the dementia talking/acting, or the detox, or both. Let them keep her until she is relatively stabilized. As difficult as it may be, don't let her crying, sobbing, begging make you feel guilty. She NEEDS care and you can't provide that. If possible, don't take her calls - talk with the docs only.

"She can't remember how she got in the hospital."

Again, could be either the dementia, detox or both. Short term memory loss is often one of the first signs of dementia (VD and Alz), so this isn't surprising.

"So I guess this is as good as it's going to get."

She might have SOME improvement. Depends on how much alcohol is/was impacting her. Testing for UTI or blood imbalances and correcting the issues might help as well. Some medications can also impact people and their behaviors.

"They don't tell you to get ready for this."

No one has a working crystal ball. There's no way to know what's in store for any of us in the future. Cancer. Heart failure. Accidents. So many things that can impact our lives that we can't prepare for. All we can do is have someone diagnose the issue(s) and learn all that we can about how to deal with it. I knew nothing about dementia when I realized my mother had something going on. Some research online led to dementia. From there I read information on various legit sites about the condition and what to expect. Other conditions might be more manageable and/or treatable, but this one is pure nightmare in many cases! Informing yourself is about the best you can do for yourself, to understand the condition and what to do in various situations to alleviate her fears or concerns.

"My sister and I are trying to figure out 24/7 in-home assistance. (Mom's house, NOT our houses.)"

Lottery tickets aren't the answer. The odds are NOT in your favor.

Again, I would recommend against in-home care. The expense can be prohibitive (remember, you have to figure in ALL the costs of keeping the home, utils, taxes, food, cleaning, repairs, etc in WITH the cost of care givers.) The logistics, if your mother doesn't just outright refuse to let them in or work with them, can be a huge undertaking. We tried just 1 hr/day to get her used to it, with plans to increase care and duties later - this didn't last 2 months! They didn't even really DO anything, just sanity check and med check. She refused to let them in. Plan B = MC!

IF she can qualify for Medicaid, work on finding out if there are MC facilities in your area that accept it. Not all states have provisions for this. Most cover NH only, but then someone would have to qualify for needing NH care as well. Dementia is NOT enough in most cases. IF there are facilities and IF she qualifies, selling her home isn't a huge priority. There will be a lien on it, to be paid back when the place is sold, whether that happens before or after she passes. A consult with EC atty would be advised, to understand what options there are available for her care.

IF she doesn't qualify for Medicaid, any assets she has plus her income would be needed to cover the cost of a facility. More than likely the house will need to be sold to cover the cost if she has no other assets. Again, consult with EC atty would help with this. You need to be aware of what income she has, what assets she has, the value of the house - any repairs/maintenance needed, etc.

Even if they stabilize her, do NOT let them bully you into allowing her back into her home. If she hasn't got 24/7 care, who will monitor her, ensure she takes any medication they RX, keep her from wandering AND keep her away from alcohol?
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