Follow
Share

We have legal guardianship of our mother. She's been diagnosed with vascular dementia and her physical health has had a steep decline in the last year, especially the last six months. In January, we had her admitted to the geriatric ward of the University of Utah hospital. The doctor there recommended she be admitted to a crisis care short term nursing home. After several weeks there, she was doing better but ONLY because in that structured setting, she was eating, drinking, and taking her meds. We pled with the doctor and social worker at that place to please recommend that she be placed in a longterm nursing home because we cannot move her in with us or move in with her and she's not capable of living on her own. They did not. Since they discharged her to rehab, which then sent her home. Since then, she's had several slip and fall incidents. The hospital keeps discharging her to home even though we beg them to please send her to a nursing home. Her own doctor has recommended this, too. My brother stops by her apartment several times daily but he cannot be there 24 hours a day. She also will not eat regularly, drink enough, or take her meds as directed by him. We are at our wits' end with this system that seems to think we can be a nursing home and won't admit our mother for her own health and well being. Even in the midst of a pandemic, we feel she'd be better off in a nursing home. How do we get someone to believe us and help us get her there? We're in Utah, if that helps.

Find Care & Housing
If you are her legal guardian YOU are the one who has the responsibility and authority to find placement for her, not the hospital or rehab social worker. Why is she still in her own apartment? It sounds like you may not understand what legal guardianship entails. You research facilities. You figure out if she can private pay or needs you to apply for Medicaid for her. Then you choose a facility based upon that. Or does she not have enough funds but still doesn't qualify for Medicaid? Even so, the responsibility is still all yours. Perhaps you need to do some research on guardianship? Laws can differ from state to state so you'd need to look specifically at Utah guardianship rules.
Helpful Answer (9)
Reply to Geaton777
Report

As Geaton777 says, if you are her legal guardian, it should be you who determines where she lives and how she is cared for. Are we talking court ordered guardianship, or just using this term informally?

If this is a court ordered guardianship, what, if any, restrictions are there? I wasn't aware until reading someone else's post that guardianships are not always 100%. If you have full guardianship, then it is up to you to start looking into places, and determining if she needs financial help, in which case you would have to file for Medicaid, if she qualifies. You could contact the court to ask for referrals for EC atty and/or SW. EC atty could assist in applying for Medicaid and giving advice. YOU were appointed guardian, not the doctors, not the staff at rehab.

If, on the other hand, you are calling yourself guardian because you help care for her and watch over her, then you really really need to seek out legal help. If she has any assets, those should be used to cover attorney and court costs. If not, you might need to find a pro bono or low cost attorney to help.

We were on the other side - POAs and all that set up before dementia kicked in, but she refused to consider moving ANYWHERE. The EC atty told me we couldn't force her to move and suggested guardianship. The facility we chose would not take committals, so we had to get "creative". Staff told me just get her there, they would take it from there! Took some fibbing along with her leg injury that required an ER trip just prior to the move, but it was enough! Madder than the old wet hen, but she went with my brothers (I stayed OUT of the actual move!)

So, if you are legal, start shopping for a facility or in-home care givers. If you aren't, start shopping for legal assistance.
Helpful Answer (7)
Reply to disgustedtoo
Report

I can relate. It's downright scary when the situation you're in comes up. Family knows elder is not "fine" but no one else seems to understand (sometimes including other family members - but not enough space for that here!) I don't know the legalities of your guardianship. But what I do know is that I wholeheartedly agree with you that many elders SEEM ok when they are in a facility, but are lost in the outside world - even if the "outside world" is actually their own home. I was willing to let my LO give it a go at home, but I was nevertheless shocked at her rapid decline and lack of effort at home - in spite of my best efforts to assist her. I knew she needed to be back at the facility but I wasn't sure how to get her there since she refused to go didn't think anything was wrong with her. A family member (who didn't assist me in any way) was telling LO that I was trying to have her "put away." That certainly didn't help either. I could go on all day about everything that was wrong. In the facility, they are sheltered and have the routine they need. They are much less likely to skip meds or meals when in a facility. At least in my elder's case, she got significantly more interpersonal interaction and physical activity in a facility than she would get at home. One day, she suffered a fall at home and was deemed unable to ever return home. Now, back in a facility, she's again seeming "fine" because she's getting the care she needs. I understand the spot you're in with this. As other posters said, make sure you're clear where you stand legally. One day the solution will become obvious and you'll be able to see it through the darkness. I never thought it my situation would ever work out - but it did.
Helpful Answer (7)
Reply to Mysteryshopper
Report
joelfmi118 Jul 13, 2020
Stay away from nursing home and assisted livings until at least 1 year after the virus is cured and the homes can prove that you loved ones is being taken care of properly. As you know over 40,000 senior citizen died because NYS Governor Cuomo sent positive patients from Hospitals in April, March, and May infecting these poor seniors in the homes. My poor wife was one of them, please let her rest in Pease. She was infected with the virus and passed away.  She will be terrible missed by me and my family. Please don't go their now.
(0)
Report
Talk to the doctor again and tell them about the falls and no one there to provide 24/7 care. The next time you can get her in hospital, be very clear with the caseworker/social worker that she cannot return home, cannot move in with any of the children and they need to start the process for nursing home or assisted living care. If rehab discharged her to home - who picked her up?

You really need to ask the doctor why she gets sent home if his orders are that she cannot live at home. Someone is not doing what is supposed to be done.
Helpful Answer (7)
Reply to my2cents
Report

Have you had a needs assessment done?

That is the 1st step in getting her the care she needs.

Perhaps she doesn't need full time caregivers, maybe having someone come in a couple hours daily with your brother stopping in would be enough for now.

I encourage you to think of other solutions to help her get the care she needs until she is bad enough to need 24/7 care. Get that needs assessment done by calling the local counsel on aging in her area.
Helpful Answer (5)
Reply to Isthisrealyreal
Report

I am legal guardian for my father but I cannot move him without a recommendation from a physician and notifiying the court of my intentions. There was a provision written into his original guardianship that said I could not move him from his home without a physician's recommendation. Last fall, he needed to be hospitalized for dehydration while still living on his own so at time of discharge, he had to be moved directly to AL as the doctor said the dehydration would happen again if he stayed by himself. Now, 10 months later, after numerous falls, compression fractures, worsening of his dementia, and a stint in skilled nursing, we are shopping for memory care (again, another physican recommendation) and I hope to have him moved by the end of this week, although we've already been turned down by one facility and have 2 others pending. He will be moving directly from skilled nursing to the new facility. We started on self-pay at the SNF last Friday so I am pushing hard to get him approved somewhere. Even with all the power I have as guardian, I could not have moved him directly from his home to AL because he would not go on his own. It's a tough situation but luckily the doctors here have been cooperative and done the right thing.
Helpful Answer (5)
Reply to Babs75
Report
Riley2166 Jul 13, 2020
WHAT ON EARTH IS 'SNF'???????/.
(0)
Report
See 2 more replies
I was in a very similar situation with my dad. I had to set-up respite care with a facility and then have an intervention appointment with his primary care physician. I let the doctor know in advance all of the self neglect issues with meds, eating and safety prior to appointment. The doctor made it clear my dad was unsafe in his own home. Thankfully, we drove directly to the assisted living facility from the doctor’s office.
After a month of respite, he is now living there permanently until his level of care changes. No matter what some say... there are safe, quality facilities available. My dad is definitely safe, eating well, taking his medications, having social interaction and is being monitored by many.

If you have legal “guardianship” over your mother, a court judge has ordered you completely responsible for your mother’s care and eligible make all decisions. I think there is often confusion with this term.
Helpful Answer (4)
Reply to Sunnydayze
Report

I think in your case having guardianship hurts you rather than helps you. The responsibility falls on you to place her in a SNF. You need to research and apply to places you'd like her to go. You also are going to have to work out how the NH is paid, whether private pay or Medicaid. If you didn't have guardianship perhaps the hospital wouldn't send her home if it was unsafe or if no one was able to look after her. But since you have guardianship, you are entrusted to look after her needs.
Helpful Answer (4)
Reply to mstrbill
Report

The fact that the courts adjudicated her means that she is not able to make sound healthcare decisions for herself that why you were awarded guardianship. You don't need anyone's "blessing/permission" to place her in a long-term care facility, your guardianship gives you the right to place her.

I would find an appropriate place and then place her. The fact that she has declined since being out to the crisis short care community shows you that she need more consistent care.
Helpful Answer (4)
Reply to cjwilson
Report

Where I live rehab and LTC are in the same building. So when a person is in rehab, thats when you tell someone you need your LO evaluated for LTC. When rehab is over, and its found they need 24/7care then the transferring is easy. This just happened to a friend of mine and it wasn't her decision. She needed 24/7 care and there was no one who could take care of her. Since it would have been an unsafe discharge, she now is in LTC on Medicaid.

Your Mom would qualify for LTC just because of her Dementia. Have her PCP put in writing that she needs 24/7 care and start looking for a nice facility.
Helpful Answer (3)
Reply to JoAnn29
Report

See All Answers
Ask a Question
Subscribe to
Our Newsletter