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The least problem is ensuring she takes her medication correctly. She will often take it but not at the proper time or manner. For example, she takes a medication for her thyroid, it is supposed to be taken alone and half an hour before taking anything else or eating to work correctly. She just takes it with all her other morning meds and eats her breakfast right away. She has continued to live alone although she is now 80 years old. However we have now encountered a problem. I have her durable poa as of about 5 months ago and have been her primary medical poa for the past 3 and a half years. Two weeks ago tomorrow, she was found by a neighbor, in the middle of a seizure. She was unable to speak, partial numbness on one side and droopy face on the other. She was life flighted to the nearest large hospital capable of handling that type of trauma which is about a 3 - 4 hr drive from my home. While on the drive I was called to authorize a breathing tube as she was having another seizure. My mom has a state registered DNR but nothing was displayed in her home, the ER did not know to attempt access as they did not know. I authorized the tube with the understanding that it would give the family enough time to get there to say goodbye. The entire family (children/grandchildren) was in attendance that evening. The tests did not show a stroke as we had thought, she still had substantial brain activity and her heart seemed strong although she was unresponsive we decided to give it some time. The next day she would open her eyes and respond to pain stimuli but nothing else. We gave her 5 days, then decided to let her go. The entire family again arrived at the hospital and prepared to let her go. We were amazed that a miracle had happened, she was back , she was responding to various stimuli. We decided to wait two more days to give her lungs time to get stronger. It had been discovered that she had a broken rib and punctured lung due to a couple of falls over the previous 3-4 days prior to the discovery, she did indeed have a mild stroke and a mild heart attack. So a series of events (over about a 24 hour period) along with a variety of mild infections in her body is believed to have been the cause of her current situation. She has been having episodes of confusion, hallucinations, and paranoia that come and go since I have been her caregiver. These have all been constant and ongoing since she woke up. We the family believe it is the onset of full on dementia, the doctors insist all of the other problems need to be dealt with first as they can cause these type of symptoms. They are agreeing that my mother needs to be placed temporarily in a rehab/nursing facility. We want to place her permanently, we do not believe that she will be safe to continue to live alone. While it is solely my decision due to the paperwork that has been completed, I am happy that my family supports my decision. I have been trying to for months to get my mother to go to a nursing facility as I believe it would be best. She has been reluctant, disagreeable and downright belligerently against it. She falls on average twice a week if not more, she refuses to continue physical therapy on her own to become stronger and have better mobility and will not do anything to help herself. She cannot or will not live with any of us (family members). My question is would I have to have her declared incompetent to force the issue of seeing her in a long term care facility rather than the temporary time period the doctors are agreeable to? Please advise me as I really do not know what to do, I have been discussing the situation with various professionals in the medical and social work field but am still very confused.

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Most nursing homes have a rehab area which is for short-stay patients and then the other areas which are for long-term care (medical), (dementia/memory), and (custodial which is sort of like assisted living). The hospital will have a social worker help you find placement for your mom. Even if she is still competent, and it sounds like she isn't, she is still a high risk adult and incapable of living on her own and caring for herself.
The first step is to have her admitted to a nursing/rehab facility for the amount of time the doctor sees fit. Then she will be downgraded to long-term custodial care. That is where you start. Then after she's there for a while she may change her mind about living with you or another family member.
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Reply to BurntCaregiver
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marigene Nov 26, 2020
That is exactly what I am currently doing, working with someone in the social worker's division at the hospital. So far every facility in the area we want her to be in has refused due to not having a bed or citing her current behaviors; they say they do not have the manpower to give her the care that is needed. When I asked for clarification of what behaviors they were referring to, I was told that she had a "sitter". This is someone who sits with a patient 24/7. This is what the rehab/long term care facility of choice told me, this was verified by the social work attempting to find placement. When I asked one of her doctors and a nurse taking care of my mom, I was told she did not have a sitter and they could not find reference in her chart to her having had a sitter at any time. I did find out that she had a sitter for a few hours only, one evening she had woken up, was attempting to pull on iv's and other various tubes. This one episode lasting only a few hours for some reason was not noted in her chart or they were overlooking it. I attempted to contact the social worker yesterday to advise her to unravel this confusion and update the facility of choice. I had to leave a message and did not receive a callback. Will be attempting to contact her again tomorrow. By the way, when I left the message I found out my mom had been handed off to a different social worker than I had previously talked to. I feel like they are starting to ... I don't know what the right word is nothing seems to fit. It's just that over the last few days I'm getting conflicting stories when up until now they have been very open and honest attempting to give me the clear picture of what's going on as I have asked for.
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If you can get her placed in rehab, you can try going the refusal route when it’s time for her to go home. Refuse to pick her up and tell the facility it’s an unsafe discharge. I can’t imagine them sending her home in a cab in her condition. And in the meantime, try to get her dr to declare her incompetent. That will activate your POA if it’s not already and make the transition from rehab to long to term care either.
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Reply to worriedinCali
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marigene Nov 26, 2020
I have been experiencing concern that she would attempt to sign herself out of the hospital and they have assured me that there is no way she could do that. They have assured me that she will not be released until placement is found for her. A cab is not even a concern, she is more than 1 and a half hours away from anyone in the family that she could go to, she has no funds and no way to get any funds . I have her purse and all methods of financial support with me. (I'm 3-4 hours away) The doctor will only declare her temporarily incapacitated at this point. I was told that a time frame would be given on that diagnosis when she is released and at the end of that time period she would be re-evaluated. I simply do not know if the existence of both medical and durable poa's would give me the right to keep her in the facility possibly against her will if the doctors do not declare permanently incapacitated/incompetent. I think we have enough (can get statements from family members, friends and neighbors) personal observations, etc. to be able to do so and get guardianship over her but I really do not want to do that . As I said in my intro, I have been trying to allow my mom to retain her dignity, her self confidence, and above all to show her the respect she deserves. As I said I am very confused, I don't know what to do at this point although the entire family agrees that she cannot and will not be allowed to continue to live alone.
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If mom is considered competent she makes her own decisions. Nothing you will be able to do, unless mom determines a nursing facility is what she wants.
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Reply to gladimhere
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You have really had an emotional roller coaster. The doctor is correct in addressing all the other reasons for her behavior. There are over 70 different causes for dementia like symptoms, some treatable and reversible. A full blood workup, cognitive screening and possibly scans can lead to a more definite diagnosis. If she is diagnosed with disease related symptoms (AD, LBD, FTD, MS, etc.) the facility will require some paper work and a report from the diagnosing doctor verifying the need for MC. Competency test aren't necessary.
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