I have been caring for mom for 14 years now, however, it is becoming dangerous for her and my family. She is denied Medicaid. Makes too much money. The immediate issue is that the hospital is releasing her and when I told them she cannot come back here, they said either I pick her up or they will deliver her by sheriff. Can they do that?

No. They cannot. You can stay at the door and tell the sheriff that the hospital is doing an "unsafe discharge." Use that exact word. They are threatening you. Call the Social worker now and tell her that you are not "physically or mentally able to care for your mother at this time ." Tell her your mom will now require placement. Do not believe her when she starts with all the platitudes of "We can make this work; we will get you help. ' She cannot and will not do those things. Tell her that you will return her to the ER if they insist on leaving her with you, and that you will file for "unsafe discharge " and indangering an elder. You may need to go to court and ask for Court Appointed guardianship. Do know that once you do that you will have NO say on where she is placed and how any of her finances are spent; you will be out of the loop. Be sure to use "unsafe discharge" and for yourself "I am not mentally or physically able to care for my mother."
Helpful Answer (26)
Reply to AlvaDeer
Mysteryshopper Feb 18, 2020
Absolutely correct. People who promise to find you support often cannot or do not follow through - regardless of their sincerity. And, none of those people offering "solutions" will be there when the seriousness of the situation sets in that an unsafe person was discharged and YOU are now responsible for them! Please use extreme caution when someone (social worker, doctor, nurse, etc) suggests they know more about your situation than you do!! Two more phrases which might be useful would be these: "My schedule has changed and I am no longer available to provide ongoing care" and "Mom has nowhere to go and I am wishing to discuss realistic living arrangements."
To anyone else who joins in (currently about 92 answers), please NOTE the following if you are not going to read the other comments and replies:

1) OP's mom has advanced dementia
2) mom's been in the hospital for psych eval
3) mom's income ($1400) > Medicaid limit
4) mom's income way < MC facility ($4000)
5) mom has no house, no assets of any kind - no spend down or home sale
6) mom is dangerous to have in home with minor children (and adults!)
7) there is no Miller trust in NC
8) OP has appt with EC next week
9) OP did NOT dump mom at the ER or hospital
10) OP WANTS appropriate placement for mom

I've probably missed a few points, but the above covers most.

Rehab won't be an option, she isn't "recovering" from a treatable medical condition. Medicare is cracking down on ALL rehab, but this wouldn't qualify.

Mom can't afford LTC. Her income exceeds Medicaid limit in NC.
This is a place TOO many people are in (kind of like the donut-hole for Medicare drug coverage.) Income too high for Medicaid, not nearly enough for ANY kind of LTC care. SS is NOT going to cover the cost of LTC - it was only intended as a buffer for those with little or no retirement income. Not everyone has a great job with great benefits and ability to save large amounts of money to cover this kind of care. It's only going to get worse as more pensions go the way of the dodo bird (not everyone had one to begin with!) Sure, investments are great at the moment, as they were before 2008. We all know what happened then, eh?
Helpful Answer (18)
Reply to disgustedtoo
NeedHelpWithMom Feb 21, 2020
Nice recap of info! Thanks, disgustedtoo.
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Just a quick thought - we went through this with my grandmother about 2 months ago. Our original plan was that she would be transferred to a rehab facility after her hospital stay, and from there we would try to transition her into a nursing home. Well, Medicare denied the rehab stay because she was hospitalized for congestive heart failure, and that condition had stabilized. So we got the call on a Thursday morning that they were discharging her that afternoon. We met with the hospital social worker who explained that hospital stays and Medicare coverage deal with physical things that are treated and resolved and because my grandmother's dementia is the ongoing issue for which we were seeking a long term care solution, the route we were seeking was not available. BUT - the social worker's assessment of my grandmother was that she would likely be an appropriate candidate for a Memory Care assisted living facility. AND, the facility she had in mind offered respite care that would allow us a moment of breathing room to figure out a more permanent solution. Within a half hour, the rep from the facility was there at the hospital, explained our options, assessed Grandma, and got the ball rolling. We chose respite care with the option to transition into a regular resident. That afternoon, Gramma was transported by the facility to her new room in the memory care unit. Two weeks ago we signed the paperwork to make it her official residence.

The moral of the story is that you need to stay calm, and enlist the experts that are available to help you discover options. Sort through them and ask every question you can think of. I don't know why the OP's hospital wasn't more helpful, and I don't know why these options aren't part of the initial conversation as a general rule. It would certainly make things easier.

It would be lovely if we didn't have to become so aggressive just to get the answers we need to make good decisions. But, that's not the reality. Advocacy for your loved ones - and yourself - is not an easy road, and it's essential to be tenacious while traveling it.
Helpful Answer (15)
Reply to gmadorisylove
catlady20737 Feb 20, 2020
Hi my mom was in the hospital for two days for a painful tailbone fracture. She came home last night. My brother and I pleaded the hospitalist doctor to trans her to skilled nursing facility to rehab her broken tailbone. Doctor said no she is going home because Medicare now has a new law that if you are stable they will not allow for skilled nursing care. Physical therapy will be done at home. He said i need your mom's bed. How cold! A couple of years ago when mom had emergency hernia surgery she was sent to nursing rehab for two months and sent her home. Medicare has become more and more stingy
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You mentioned that you have an Elder Law Attoney consultation scheduled for 2/27. Contact them and let them know an urgent situation has occurred. In my experience, they may try to work out something sooner.

Unfortunately, these types of situations are becoming increasingly common. There was a story this week that a N.C. NH discharged an elderly man with only 25 mins notice to his daughter due to nonpayment by insurance. They called her and told her to pick him up in 25 minutes. She was at work and unable to leave and explained that it was not possible. So, the NH arranged for wheelchair transport which left the disabled senior in front of her house. She found him crying and screaming and soaking wet from a passing storm upon her return home. They never notified her that they were transporting him. The medical system hasn’t been about people or caring for a long time. The best way to protect yourself is to have a lawyer because finding someone to help or intervene on your behalf is nearly impossible.

In the eyes of the law, your home is her home. She has had legal tenancy for over a decade. Worst case scenario, she returns...any time she is violent or displays a threat to herself or you and your family, call 911. Get video of each episode. It is possible to have her removed from the home for an involuntary psych admission. At that point you may have more leverage in refusing her return.

In my case, I had a very similar experience with my aunt with dementia. She lived in my home with my children and I but became increasingly angry and violent. One day she struck my daughter. I contacted every NH within 30 miles and was fortunate enough to find one that would take her. She was out of my house within 24 hrs. I packed some things and delivered her myself. The attorney was able to get her on Medicaid through legal spend down of assets, etc. It was awful so I appreciate what you’re experiencing. No one else in the family would step up and they in fact, made it more difficult.

Sending you strength and courage to get through this. Keep us updated.
Helpful Answer (13)
Reply to anonymous1010889
Tiredmomma Feb 19, 2020
Thank you so much for your response. What is going on with the elderly in this country is shameful and horrifying. I appreciate all your advice. I have contacted adult protection services and explained everything. A social worker is supposed to be calling me back. They said I may need to go through the whole process of giving a guardianship to the state. Again, thank you,
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We ran into the same thing with both of my parents last year. We were advised by the social worker at the hospital to tell them upon discharge that he/she is not safe. Tell everyone that talks to you about her discharge that she is not safe. We were told to say it 100 times if we had to and then the hospital would not be able to release her. At that point the social worker will contact nursing homes or other places qualified to give her the care she needs. It worked for us for both of my parents. Good luck to you!!
Helpful Answer (13)
Reply to jdlenzner

Tiredmomma, Who is the person who is telling you your mother will be taken back to your house by the sheriff? This doesn't sound right to me. Since when does law enforcement provide transportation from the hospital?

I would call that person, and tell them you are recording the call (and do so). State the date, your name, your mother's name, the name of the hospital and ask that person to state their name. Inform that a copy of the recording will be going to your lawyers office.

Then proceed to tell them your mother can not be safely discharged to your home and that she has been violent in your home. Any push back and just state again- this is not a safe discharge to my residence at (say your address) for (mother's name).

If they keep pushing, repeat above and then say that is all you have to say and end the call.

See if that changes anything.
Helpful Answer (12)
Reply to ExhaustedPiper

Unfortunately you are in a state that does not allow for qualified income/Miller trusts. However your state does have a medically needy pathway so your mom can spend down a portion of her monthly income on her health care & qualify for Medicaid.
Helpful Answer (11)
Reply to worriedinCali
Tiredmomma Feb 18, 2020
Hello-Thank you that sounds promising. Do you know what a "medically needy pathway is"? I have an appt. with my attorney on 2/27. Maybe he can help me with that. Thanks again!
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I have to think that the unsafe discharge COUPLED with the very aggressive, documented behavior toward a minor in YOUR home has to count for something. I would stay very calm but speak to social worker’s boss in the morning and get a call in to your attorney. Even if you don’t have one right now, maybe find one...

You keep saying...

She has dementia WITH behaviors (this is a medical term that should indicate to anyone who works in geriatrics, etc that the dementia has a danger component to it) that are escalating. Not only would she not be safe in YOUR home, you do not feel safe. As much as you love her, you cannot allow someone to come back in who has demonstrated such aggression to your child. And then go up the hospital food chain... say you have put a call in to an attorney as this staff member appears to be trying to strong arm you. Tell the next level up that you have told this person repeatedly that you will not accept responsibility for someone who needs far more care than you can provide because it would be unsafe for your mother, that you have made it clear that you can no longer continue to have the patient stay with you because of the DANGER they present to your MINOR children. That no one will be allowed to force their way into your home... you have been kindly allowing her to stay there, but between her increased needs and aggression to you and your minor children, it is no longer an option.

I might throw in that you are concerned that this facility may not realize it has employees that are possibly not trained well enough for their positions to be able to engage and assist their patients without resorting to threats. That could leave the hospital very vulnerable to lawsuits.

You would much prefer to work with the hospital (they through their contacts) to help get your mother settled into an APPROPRIATE environment. This should not be something they are unequipped to help with.

After you have been firm, reiterate that you both have the same goal, that mother is discharged to an appropriate environment that is safe for her and those around her. How do we work toward that goal?

You want to look reasonable, logical and calm to the hospital, the sheriff and the attorney you end up using. The hospital should be in a defensive position, not you.

The eviction type thing could be an issue, but keep reinforcing unsafe discharge and danger to minors. And keep your house unavailable to anyone trying to bring her back to stay with you.

I hope someone responds with more firsthand knowledge... I just wanted to throw out some language that might get results for you BEFORE something major happens. Best wishes.
Helpful Answer (11)
Reply to 499HopeFloats

Tiredmomma, please don't bow out. I'm responding to your latest post responding to Blue. Most of us here DO understand. I certainly do, and I agree there is something wrong in our system and there is a big hole that some people who do not have financial resources fall into that nobody has a good solution to. I went through it. The Doctors don't help nor do the nurses nor do they give any guidance or advice that solves the issue. OP means original poster, I used it here as shorthand to refer to you. I hope you can take the constructive advice given here and put it to action, most of us do really care and understand and post here to help people in situations like yours.
Helpful Answer (11)
Reply to mstrbill
Mysteryshopper Feb 19, 2020
So very true. We're lucky if we get: "She's being discharged and someone will call you next week to see how she's doing." Granted some homegoing plans are a little more detailed than that, but most of the situations on this site require something very precise and comprehensive. There is no one to provide that type of information and support. People who say they will get you help often simply disappear in the chaos. There is usually no one who honestly understands the totality of the situation or who has both the time and compassion to fully process it. Families are left to sort it out and hope for the best.
This thread is degrading very quickly by trolls who have not bothered to read the previous responses. Tiredmomma, I'm sorry you're going through this, and again I hope you follow through with the constructive advice many had given yesterday. Stick to your guns, make sure you follow through with APS and the attorney and keep Mom out of your home.
Helpful Answer (11)
Reply to mstrbill
carekeeper Feb 20, 2020
The responses don't come up in the order in which they were posted so sometimes the reader is responding without all the posts being read.
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