How far does duty go?

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This journey started Jan 2015 when our moms partner passed away. She was diabetic prior to this date but was a happy go lucky woman. She was living on her own and running her own business. For a few months after her partners passing she appeared fine. My sister and I would visit her on weekends. In April of that year she went to visit her family. Then in June I got a call from her with slurred speech at 2am. I called someone that I knew was nearer and asked them to kick down the door if they had to while I got there. That scare was averted with insulin and my sister and I set up a meal plan and had someone come over to check her sugar levels for months we continued seeing her and all was being complied with. Then around October work got more hectic and our visits were even less frequent. Then Dec 8th I get a call from a neighbor that she is refusing to eat, soiling the bed and just in tears. I rush to see her and without hesitation bring her to our place. We went to 6 different doctors and they all said she was depressed, which I'm sure she was but on dec 21st we took her to the emergency room after she woke up at 2am fell on our bathroom floor and then wanted to sleep on the bathroom floor. We were met with a nurse that said "well her vitals are fine and she is answering all questions" we had to fight for further testing. Which showed signs of an old stroke. She went to the hospital and was discharged within 3 days . She was back to her old self. But we weren't letting her live alone. She fought us, but finally agreed to stay with us. Then June 2016 comes around and she has a seizure. Her cognitive level declines after this episode. I burn through my savings for an in home care taker while at work. After 3 months she is back to being able to be slightly independent. The dec 16 she has another seizure. This one scares her so much she's scared to be home alone and I can't afford to pay for care out of pocket. So I take 2 months off. She's fine again and I go back to work. End of march 2017 another seizure this time a grand mal. She gets suicidal after this one. We get her help and she is put on mood stabilizers again within months she is okay again and even started going out with her girlfriends and being a bit more independent. Then June 12th, 2017 she had another stroke this time her left side became imobile. I have no more savings to pay for care. I can't take anymore time off work and I can't quit my job. I still have to afford my rent and our living expenses. At the hospital they took my concerns and decided nursing care would be the best option for rehab. She has made progress and is able to use a walker once helped up. The nursing facility wants to discharge. The social worker told me it's my duty to care for my mom and basically told me I don't care about her when I said I could not care for her at home. She is cognitively well and she even doesn't want to come to my place not to mention the fact that I live on a second story apartment and she can't even go up one step. I'm told thier MIGhT be in home care but that it will take time to set up and that I have to take her home in the meantime. This doesn't sound right to me. Anyone else get pressured to take a loved one out of a care facility before they were ready.

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Since your mom has not been declared incompetent, you need to get a medical power of attorney from her.
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Frankly, it sounds as though your mom might need to be transferred to a psychiatric facility.

If she hasn't been declared incompetent, then she is entitled to hear information from the doctor. My mom was put on a very powerful antibiotic via IV during her last bout of pneumonia and we were all informed that there was a possibility of kidney failure. Fortunately, mom was too out of it to hear that.

Is there a psychiatrist at the facility who is managing her psych meds? There may be some benefit to adjustment of those meds, and the BEST place to do that is when she is in a facility and her reactions can be monitored.

Having had the experience of my mom's psych meds being changed without my being told, I completely get what you're saying. But I would NEVER think of it in terms of "winning".

We had a care meeting with staff and they agreed that the change, while mandated by state regulations, should have been reported to us, and that there should have been closer monitoring of mom's mental state after the change was effected.

Going forward, they have been more responsive about letting us know about changes.

A, this is a marathon, not a sprint.

No, you can't pick a facility from a catalog. But if her current facility doesn't take Medicaid (Medi-cal in California) then you must ask them to find you a facility that does.
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I've asked to be notified of when her appointments with the doctor are so I might take time off to be there. Also honestly I don't trust that doctor and have had to get her regular doctors to jump in. 1. He decided to take her off her psych meds. Because he felt she was on too many medications. I filed a complaint with a letter from her psych and won. Then second she had a minor infection and the doctor decided to tell my mom that her kidneys were not doing well and told her if the antibiotics didn't work she might need to be evaluated for dialysis. This freaked my mom out and she was inconsolable for days. Which I only found out from her roommate because I never got a call letting me know and at this time can only visit 3 sometime 4 days a week on the evenings. They love to play the I'm the responsible party or I'm not because twice when I asked for medical records they denied me saying I needed a medical power of attorney. I wish I could pick a nursing facility from a catalog. But sadly I have to go with what's available at this time. If she was just at the level before the hospital where I was her support and not destined to be a full time caretaker. I'd have no problem with her living with me. What does is she was at a facility for a week post march seizure and when she came home and couldn't handle more then walking around my apartment and felt unsafe to go down the steps and started to be suicidal and me having to struggle every meal to get her to eat. That's what I want to prevent. She has made progress and I don't want that to stop and neither does my mom. She looks forward to her pt sessions.
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One more question, when mom was living with you, she had Medi-cal, yes? We're they paying for caregiver services? Did mom have a case manager? That might be someone you could contact for advice.

If not, your County website will have a link to services for elders and the disabled. You might be able to sign on for a case manager for your mom. From what I can see, you need someone in YOUR corner!
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http://www.dhcs.ca.gov/services/medi-cal/Pages/default.aspx

The Social Worker at the facility is supposed to be helping you navigate this maze of social services programs. It's her job.

There is a difference between NURSING HOME Medicaid and community Medicaid. Also, there are Medicaid waiver programs, which are designed to help folks stay out of Nursing homes and remain in the community. Perhaps that's what mom has?

Not sure why taking mom to see her SW or PCP would be cause for the NH to deny her Re-entry? Has someone told you that you can't take your mom out at all?

So, is she in a nursing facility that will accept her as "Medicaid pending"? If she is, they should be helping you apply for NH Medicaid. If not, ask them to help you locate a facility that will accept Medicaid and arrange transfer there.

So, you have an appointment to get her cerified for Medicaid? Is that with her original doctor? Can't the nh doctor do that certification?
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I'm also trying to see if she can get anything through ssi. But again her precense is required since she hasn't been declared incompetent. Makes things more complicated but I guess in a way it makes me less responsible for her.
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Oh I wish I could get another but there is only one social worker at the facility. She has one through her primary care doctor but she would need to see my mom which would require an appointment with her and at this point I don't want to take her out and then be denied reentry after the appointment.

Really medi-cal is Medicaid. Becomes she has medi-cal but when I applied for medicaid they said pending doctors evaluation and gave me until July 7th to get a doctors status of health. Which with her second stroke and missing her appointment we weren't able to get. I reapplied and now have a date in Sept. But again now getting her to the appointment without it being seen as me taking her. Not sure why these services don't take medical records. I have copies of all PT, OT, primary, neuro, psych, appointment summaries and hospital records.
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For starts, Medi-cal IS Medicaid for the State of California.

Challenge the SW'S assessment that your mom is back to her prior level of functioning. Tell her you want an OT to come to your home and assess if discharge there is safe. You want that in writing.

Also, you want discharge to reflect that your mother can safely be left alone for the 12 hours a day that you will be gone. Or that home care must be set up PRIOR to discharge.

You are needing to call her bluff. Don't be afraid to ask to speak with her supervisor, as you are terribly afraid for your mom's safety.

If the State takes over, you are not doing hands on care, you are then mom's advocate.  I see it as a technique to show SW'S like this that you can't be pushed.
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I know you don't need one more thing to do, but can you ask to be reassigned to a different social worker? This one is a dud.
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My sister has had arthritis since age 4. Her caring for our mom isn't an option. She took on more work when I took time off. Her arthritis didn't like that.

No Medicaid just medi-cal she isn't 65 yet and the disability part requires a doctor note which we don't have yet. Medi-cal no longer contracted with her old doctor and hospital and she's had a new primary since post March hospitalization she helped us get psych services and was set to see her again in June then the stroke happened and now she's under the care of people who don't know her full history and don't seem to want to know.

The social worker tells me she is back to how she was prior to hospitalization. She could go up and down the stairs before. I'd leave her breakfast on the table and she would get up dress herself, eat the breakfast wash her dishes (never required her to do any housework but telling her not to do it was not an option), drink the meds I'd leave her, use the restroom as needed on her own, she'd take a shower when needed, she'd either go to the park on her own or she'd get invited to a girlfriends home and she'd be at the front of our apartment building waiting for them. At the nursing facility she can't get up on her own how would that be the same level.

I hate that I'm being pushed towards this all or nothing place. If she becomes a ward of the state would all medical decisions divert to the state. I can't provide the care but I am aware of all her medically related desires.
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