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Hospital MSW made unsubstantiated referral to APS without asking adequate questions. My Mom had delirium from UTI. My Mom's PCP asked APS to call him before the visit. APS rep stopped by the clinic. PCP was on rounds. She went to the house. She told my Dad her first name only. She did not mention her last name or leave a card. My Dad should have refused her visit, but she convinced him that PCP was in agreement. The APS rep said she would return in 3 weeks. Is it normal for APS to have follow up visits? My Dad is in the process of completing a Medical Power of Attorney for my Mom. He should then be able to refuse any visit from what I understand. My Mom has dementia, but has not been officially diagnosed.

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Just to expand upon what I said, I was visited by Child Protective Services many years ago. I knew they were coming because I was informed by the person who made the call AND the agency called to make an appointment. They rang the bell, identified themselves and showed me their State-issed IDs.

Maybe that's because I live in the inner city and no one in their right mind opens the door without knowing who is on the other side.

BUT I woukd follow up with APS if your brother is a reliable reporter of what transpired.
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I can't imagine a circumstance under which I woukd allow a stranger without proper ID into my home.
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BarbBrooklyn...we have made follow up calls to determine and have not yet received responses. Thank you. AlvaDeer, how can you interpret my mental state from reading text? I have listed information. No where in that text indicates any emotional state. I have read responses to other questions on the forum, and some of the complaints are quick to assume, rash responses like yours. How does my brother saying I am here to help my Mom imply an adversarial response? Obviously, you have not been witness to older patients responses after medical appointments. A lot do not make other appointments because the wait alone is tiring, not to mention if they are also fighting an illness. I do appreciate what you included about the MPOA. It was very informative. Thank you. I wish you well as you yourself age and hope you do not have to endure a lot of conditions mentioned in this forum.
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AlvaDeer Mar 2023
I didn't say that you HAVE an adversarial relationship with APS, nor that your brother does either. I said "IF YOU HAVE".
We do know they will be coming back, and your original question was "Is it unusual".....for them to return. Nope. Not unless things didn't go well the first time.
Or perhaps, if they are a psychopath, as you make this particular worker sound.
We all make judgements. I have, you are absolutely correct, formed certain opinions about the way your family is handling an APS visit after reports from a mandated reporter. My opinions may be right, may be wrong; we cannot know. I am, however, becoming more and more convinced of them.
And yes, I do believe you are quite angry and distraught, quite unwilling to work with APS, and it does sound to me as though your brother may be the same. (Either that or the APS gal is--again--psychotic. I tend to doubt that.)
Having been a nurse my entire career, and being now 80, I am somewhat, if not completely, experienced.
You may yet convince me that you are in fact willing to meet with APS in a spirit of cooperation, to set their concerns at rest, to convince them that they have utterly no business contacting you no matter WHAT mandated reporter reported to them. But I doubt it.
And as I said, any adversarial responses will cause you further problems, something I truly hope doesn't happen for you. You are an utter stranger, as is you entire family, as is the medical staff that reported problems, as is your APS worker. None of us have any no reason to wish you ill.
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So, was this an actual APS worker or a grifter?

I would call local APS and find out if there is a record of this visit.
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AlvaDeer Mar 2023
Yes. They should ask that their second visit (because there WILL BE A SECOND) be from another worker or a worker accompanied by a second. Because this may be a psychopath posing as an APS worker, or it may be a bit of a skewed story. We cannot know which.
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In addition, I have 3 siblings nearby. They are all very involved with my Mom's care. My Mom and Dad just got home from the PCP visit and were exhausted and communicated that to the APS worker asking if she could come another time. "There is no need to come back. I am here right now. Why are you tired? There is no reason to be tired." One of my brothers was helping my Mom at the time. The APS worker interrogated my brother with rapid fire questions. "Why are you here?" My brother said I help with my Mom. She continued "Do you have a job? Why are you not at your job? Where do you work? Did not assess home safety. Did not ask about my Mom's diet. Did not identify resources or ask what assistance they may need. Said she would be back in 3 weeks. Grifters abound who take advantage of the elderly. Other grifters have been to the house before. I am here seeking information, and instead some like to wag the finger on how dare we not openly welcome with coffee and cookies people who do not adequately identify themselves. I live 5 hours away, so all of this is third party knowledge. I assure you my family is intellectually and physically capable. I visit often enough to be confident of that. It only takes one person to say things in just the right way to rob elderly of their life savings. I do appreciate all of you who have responded. The information about the MPOA was very helpful. Thank you!
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AlvaDeer Mar 2023
An adversarial relationship with APS will be of very little help here. You already seem quite angry. If your brother is responding in a like manner with APS this case will not likely go well for anyone involved. Adversarial relationships give APS concerns and will make them investigate THOROUGHLY. As long as they find nothing to concern them they will be out of your hair quickly.

Telling APS "I'm too tired to speak with you" is going to arouse suspicions. I think it would for MOST people. While it may be true, it sounds like an excuse.

APS is NOT there to rob your elder.
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Maybe SW was concerned about dad's abilities to manage all this...

I'm playing devil's advocate here. I am going to assume that hospital SW found something concerning enough to call APS.

Are you getting your info about what hospital refused to do, about what APS worker did, from dad?
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TheMoreYouKnow Mar 2023
Confirmed by siblings who were present.
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My Dad had contacted Home Health while my Mom was hospitalized. Hospital refused to send orders to Home Health and said all further care of my Mom needed to be coordinated through her PCP. My Dad informed the MSW at the hospital of my Mom's appointment with her PCP. Home Health would begin as soon as they received PCP orders. My Mom received Home Health previously, so we are familiar with what their services involve. Home Health Nursing, PT, and OT among other responsibilities survey home safety. Home Health MSW is responsible for long term planning as well as determining eligibility for Meals on Wheels and other assistance. Home Health MSW may contact APS if they are concerned about Patient's well being. Why would this not be the logical order of follow up care?
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Yes, too late for DPOA. Mom not competent to assign it.

I would put in a complaint about this APS worker. When Dad answered the door, she should have announced she was from APS, her full name and her ID/badge. Then ask if she could enter the home. He could have refused saying that he wanted someone with him when she talked to him. Also, she lied. His primary did not give permission.

No, you allow APS to come. They can also be helpful. There is a reason the SW felt she/he needed to call APS but it would have been nice if she/he had talked to family members first about their concerns. Nice to know PCP was willing to be involved.
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No, I would not "refuse" an APS visit. That is the beginning of serious problems.

To start at beginning, you say your Mom was in hospital with UTI at the point that the social worker and PCP became concerned.
Does you Mom and Dad live alone? Is he attempting to care for your mom alone?

Secondly, if your mom has dementia she cannot confer POA upon your dad. Too late for that. POA is GIVEN by a competent principal to another person willingly and with a clear mind. HOWEVER, as her next of kin APS and a social worker can assist your dad in getting a diagnosis and guardianship of Mom, so WELCOME APS. They can HELP.

Thirdly, do know that even a POA/guardian/conservator can be investigated AT ANY TIME BY APS as easily as anyone else. This is for the protection of those in care who may be being abused.

APS should be welcomed. Every worker in the hospital/medical setting is a mandated reporter. When a patient tells any one of them something that triggers concern they MUST report it and see that it is followed up. That is whether the patient is hallucinating or not.

When APS shows up they should provide their ID and say where they are from. You have the right to say you are indisposed at that moment, but you had better set up an appointment ASAP for them to return.
Be ready to answer all and all questions. Be ready to see your loved one interviewed PRIVATELY and without YOU present. Be ready to allow your home to be inspected for safety if this is where the principal lives.

Again, these people are there to prevent and investigate allegations of abuse. I trust you when you say that your mom is not in an abusive situation. So welcome in those trying to protect her, offer a cup of coffee, tell them you appreciate their concern and their mandate to protect elders. Allow them to do their job and they will trust you more, and will be gone soon.

Do know, also, that APS can assist you in getting Mom diagnosed. And that is something that should be done.
Again, too late for POA. Guardianship is what is required now, and that after diagnosis.
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IMO if your Dad is as old as your Mom, he is not the best person to be her PoA... someone a generation younger should be in this role. Cognitive impairment and memory loss creeps up on elders and it could creep up on your Dad and then who would be managing your Mom's affairs then? It is possible your Dad didn't get the memory of the APS visit correct. Why would he refuse a follow-up visit? Wouldn't he want to prove that things are going well? If they are working on getting a MPoA at an attorey's office then he should make sure to ask the questions about the APS visits.
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What questions did the social worker not ask?

Who was she asking them of? Your delusional mom? Dad? You?

APS needs to follow-up until they are satisfied that your mom (and possibly dad) have adequate support in their home.

Why do you want to keep them out?
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Yes, APS will make follow up visits.

I am confused about the rest of your post.
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