My 77 narcissistic bipolar mother has been A self medicating RX addict all her adult life. Was very easy to get in the 80’s and 90’s. Now addicted to oxycodone for cellulitis pain which she was given in rehab for 3 mos.

She was discharged from rehab since Medicare coverage ended with RX for oxy. She was deemed unsafe to live alone. (Some dementia)

I moved her across country to a beautiful clean AL with kind and compassionate staff!! It’s true!

She typically self isolated in her apt even (before Covid lockdown) she does not get dressed. She is hoarding leftover meals. She has had a hoarding disorder for approximately 30 yrs. She throws the meds across the room when aides come in to administer them. She was prescribed Depakote for a previous “episode” in June.

Director called me today to say she needs to be placed somewhere else where they can “manage” her medication rather than “remind” her of her medications.

She takes Oxycodone (pain), Trazodone (sleep) at 10 pm, Seroquel (Bipolar) and Depakote.(mood stabilizer)

Does this mean NH?

She will have to give up her SS and pension and go to Medicaid NH bed since she has no assets.

So sad to me she had an opportunity to thrive and socialize and make friends in the AL and enjoy living. But her untreated depression (she says she is not depressed) and personality results in her bad behaviors.

She has abused my siblings and I as children and our entire lives. I am totally burned out. My sister is estranged from her for past 10 yrs.

My 2 younger brothers have both passed much too young.

I am going try to turn her over to a SW and pay my attention to my own family who deserves it. This is easier said than done. But there is no reasoning with her.

I guess the AL apt will go to someone next in line who deserves it.

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This woman is "gone" in every way and based on her behavior and her treatment of others, you OWE HER NOTHING. Tend to yourself and your family and get her put into a nursing home away from you. Don't wait.
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Reply to Riley2166

Wise move to turn her over to social worker. At this point in time, she’s not changing.

Best wishes to you.
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Reply to NeedHelpWithMom

In my state(Massachusetts) nursing assistant cannot administer medication, but in AL can " remind" resident to take prepackaged medications! That is , the CNA can open the med pack and put in med cup and tells resident "here are your 9 O'Clock pills". Technically this is not administering meds as assistant did not fill the med pack. In a nursing home ,all meds are dispensed by a licensed nurse following a doctor's order(RX) In AL the pharmacy can prepack meds ( bubble pack) or family can fill weekly med box. But in either case, no one can force a resident to take medication! If a person is very resistant to taking medication neither a nurse nor a CNA will have much luck! MC runs about the same as regular AL as far as meds, Very complicated as to what is legal.
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Reply to drooney

agingmother4343: SW is best choice. Prayers sent.
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Reply to Llamalover47

Memory care
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Reply to GAinPA

I have not heard of AL not being the ones to manage And dispense the medications so I don’t know why they would let your mother. Seems odd. What are you paying for? Also, most will not let you have all your meals in the room. Perhaps a move to memory care?. But first scope out what the policies are regarding this. Sounds like a care conference is in order.
i agree with Isthisreally real that she doesn’t seem to meet criteria for NH placement. Also no one can force a patient to take medication against their will..anywhere they are placed.
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Reply to Harpcat

AL will remind clients to take their medications but do not necessarily follow a schedule. NH will follow a schedule and have a nurse administer her medications. If your mom is having that much difficulty with behavioral problems, a NH seems like a better place for her.
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Reply to Taarna
Isthisrealyreal Sep 24, 2020
Taarna, some AL facilities sell care packages that do med management, which means they do it per doctor's orders. No place, not even a nursing home can force anyone to take meds.

Nursing homes have care requirements for admission and being difficult does not create a need for a NH. Nothing said leads me to believe that she would qualify for a NH.
It REALLY sounds like AL is not an appropriate facility for her, that MC is going to be necessary, not even sooner rather than later, but now, immediately, ASAP !!!

You moved her across country to what state- - and it is it the same state in which you reside ???

Do you have Durable Power of Attorney, Healthcare POA and all the necessary HIPAA releases ???

If those documents were in place before her dementia, and you can also have a doctor's determination to back you up, you can usually deal with placement on your own. NEVER "bring her home" !!!

The exception to that would be if your mom put up a substantial fuss, as mandated reporters, the AL would likely feel required to report the problem to Adult Protective Services. APS could actually force a court hearing on behalf of your mom, where the judge would assign a court-appointed lawyer to represent your mom's interests.

It's true that a public Guardian can take charge, but then you don't have to be allowed any input of any kind - - so you have to decide ahead of time how that may or may not bother you. Picture this: you may feel it's a simple matter to walk away, but it IS your mom. If a guardian is involved and you don't like where she's placed or what you see about her treatment (not even talking about what she tells you or complains about, but what you SEE yourself), you won't be able to do much, and if you complain too often, the guardian can even cut off your contact with your mom. Most of them are overloaded and have a low tolerance for people who interfere with what they're trying to do by law.

I was responsible for my aunt, my mother's younger sister, for 6-1/2 years. Because she had alcohol dementia, she was mean and cantankerous, but she had no children and I was her favorite niece. I would sit her down for heart-to-heart talks and implore her to listen to the logic of what I was saying: that if she continued her behavior, "they" would put her under a state guardianship and I would no longer be able to speak for her or help her out - - that "they" would take that power away from me.

We had many talks such as that, and it reached a point where all I had to say was, "Remember how we talked about your behavior. If you want me to keep helping you, you can't do that." There was a difference in our cases however, when I brought her down from Northern California to Southern, she went directly into MC. Over time, she actually became more cooperative, and I was able to take her out to her medical appointments, to dinner and to the movies. Since she liked doing those two things, it gave me more to remind her of what we wouldn't be able to do if she kept up negative behaviors.
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Reply to CarolLynn

Unfortunately, yes. PLEASE visit all unannounced, & ask to see every part, floor, wing, and/or ward they have (whether you can access it with ease, or needs a keypad to enter what I call he’ll on earth). U won’t believe what still exist in the U.S.
U describing your mom’s personality, there are “special” wards for difficult patients who are deemed residents in NH’s. I don’t care if the NH has a 5 or 1 star rating, the stars mean nothing when it comes to the residents well-being. Look at State Laws re: Medicaid & getting help for your loved one. I recently found out the Supreme Court in FL has made this official...
any lawyer who goes up against a facility where the person is receiving Medicaid, they aren’t practicing real law. This is their way of saying to all lawyers, “You WILL NOT win, & it will be annotated in their legal jacket.” It’s the same folder that follows children & stereotypes them as early as 1st grade thru unfortunately HS, & will impact college. U hear the slate is wiped clean after High School, that’s not the case if your trying to get into a Ivy League or any reputable University. In Court, U are only as good as your attorney’s reputation, period.
U don’t have a clue what is going to happen to your mom. I know you don’t want to hear this, but someone has to start speaking up. Plz. don’t think what you see during the day/night is peaches & cream, as it’s not. Actually, your mom will be so over medicated & false diagnosis to cover their rear ends for these meds, she won’t know what’s happening to her during the time she’s medicated, but will recall what did, in between the Med times that aren’t dispensed on a regular bases. Isolation is a given.
I’m embarrassed & ashamed to admit, I heard horrible things re: NH’s & let it go in one ear & out the other, or thought the incredible inhumane things I heard were exaggerated. I’m begging you, don’t be naive as I was. Open your ears & eyes, Document everything with pics/videos/notes. Pick a facility that allows cameras in ur moms room that can see every space except restroom, but can see entrance to it. This isn’t a dignity issue; they’re safety, severe injuries, premature death issues. Don’t ever speak to another person in front of a staff member, don’t b fooled. U won’t get the truth, & U don’t get what will take place to this defenseless person. FYI...a Medicaid bed, is no different than a private paying persons bed. Facilities have allocated a certain # of beds in their facility for Medicaid/Medicare residents.
I can’t stand using the terms nursing homes or residents. “Home” & “residents” are not words that should be used. Here’s the substitute words/phrase: “Putting a real live human being out to pasture, If family doesn’t care, they don’t. The person is now free game. U will hear or not, everything chalked up to her dementia or whatever diagnosis they’ve falsely encouraged the 70+ year old physician to diagnose.”
Don’t go to Administrator, that job doesn’t need to exist. The DON runs the facilities. Don’t go to DON or Ombudsmen, they have a job to do & it’s not protecting your loved one.
These are FACTS, not bad experiences. FACT: If the Federal & State laws-mandated, were adhered to, nobody would know what to do with the human beings in these facilities. The word human being stops at the front door of the facilities. I could write a book, sell a movie to Steven Spielberg (sp?), & he couldn’t dream up this horror. When I say be afraid, I mean b very afraid!!!! This is not just my personal opinion, it’s many others who are afraid to come forward. The individuals at State Level who are to ensure residents are cared for & advocate for them, will do everything, to lift the rug & brush it under.
DON’T UNDERESTIMATE MY REPLY!! Watch next tv show-License To Kill-not aired, U will see what employees will do.
When a neighbor-RN-quits at a NH & has to work to support her family, but couldn’t take what she saw happening & knew she couldn’t report it. BIG PROBLEM, BIG!!!
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Reply to Tghetti
OldernWiser Sep 24, 2020
So I see a lot of frustration in your comments, and advice about what NOT to do.

I’m trying to see what you advise TO DO.:
1 visit -investigate thoroughly
2 be skeptical.
3 learn your states laws

is that a good summary?
It is going to depend on the state. Some states, guardian and conservator (management of finances) are seperate appointments. Definitely have a guardian appointed for her for some peace of mind.
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Reply to jodiannie

I’m totally with Grandma1954 to have it so that she has a state appointed guardian. She would essentially become a “ward of the state” and the court appointed guardian should deal with her finances and placement for care. You’d help the guardian by supplying whatever financials, etc. needed that you have access to.

The issue would be imho just how easily this can be done.
And this may be complicated. If where she is has an actual Social Worker, that’s where I’d start. Often ALs if they are mainly about residents who are pretty good on their ADLs so it’s minimalistic care by staff, won’t have a SW staff. If that’s what your up against, I’d suggest you contact your Area (Council) on Aging office (there will be one as all states have them, it’s part of your regional governmental planning system) to see how to do a court appointed state guardian for her. She’s going to need to be shown to be incapable of doing for herself. Her drug dependency can actually come in handy to prove this. Where she is now would imho likely need to be willing to do some sort of statement as to her being drug dependent and presenting an issue / threat for the residents , staff at the facility due to her dependency...... if your her dpoa and ok in this, they hopefully will do it.

If they have just recently told you that she needs to move, it will have to be dealt with. I imagine that they will give you a bit of time but if things don’t move quick enough, what is likely to happen is a “30 Day Notice”.
If that’s done, then if zero happens within 30, the AL can get creative. The usual is to call EMS as she has seemed to have had something of concern..... perhaps a TIA as TIAs can be ahem!.... very very subjective in presentation. So EMS called, mom whisked off to ER via EMS and then maybe a observation or hospitalization done but whichever one happens, the AL will not take her back. The reasoning will be is that she needs a higher level of care than they (the AL) can provide. So moms essentially stuck in the ER/hospital and the discharge planner at the hospital will need to find placement for her UNLESS YOU COME & TAKE HER. Discharge planner will try to get you or other family or even a family friend to come and take her.
If you cannot seem to get traction in getting guardianship, you might have this as the backup plan. It’s loads more stressful, but it’s stress no matter whichever path is taken. Good luck & let us know how it goes, ok.
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Reply to igloo572

Memory Care might be an option. There they manage medication not just remind. And if she had been diagnosed with dementia this would be the next step that she would take anyway.
If you are POA and do not wish to be responsible for her any more you could talk to the Social Worker about the process of having a Court Appointed Guardian take over. This would mean that you no longer have any say about where she is or what is happening to her.
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Reply to Grandma1954

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