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My mom will be returning home from skilled nursing today. She fuss and threw a fit until she was able to leave. The facility is recommending 24 hour care with PT and OT and medicine management but she says she can do it on her own. She can't do it on her on and she is pushing her family away. My mother is in a wheel chair and not sure how she became unable to walk, but my mom has been paranoid, delusional, she has bad behavior and it causes her to stay up with no sleep to stay on the look out for I'm not sure what. She fell asleep in a chair trying to stay up because she thinks someone is making her go to sleep, so she fell out of the chair. She could not get up. She thinks some light is beaming on her knees and other areas, or something is trying to get her. To me that's a red flag for mental impairment. So this is going to be challenging but just not sure as to how to care for her and make sure she goes to the doctor, take her medication, not unplug the phone, open her door for home health and family members. I'm worried that she is going to barricade herself in her home. It's hard to get her to sign anything to gain guardianship over her.

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Good idea, Pwberg. While it's like there is more going on, this is certainly something that could contribute to her issues. She shouldn't be discharged from the nursing facility in this shape. I hope that you have a lot of support, realfayth. This is going to be an awful transition and you'll need all of the help that you can get.
Take care,
Carol
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Has anyone checked her for a UTI?
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This is a case where guardianship sounds like it is in order. You do not have to have her sign anything to get guardianship. You petition the probate court. You will have to have doctors submit something saying she is incompetent. It is generally expensive to get guardianship and can be paid from your mother's money. You can get guardianship without legal counsel, but you may find it easier if you do it through an attorney. Good luck with all this. You sound like a caring person, so I'm sorry you are having to go through this. Huge hugs.
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I agree about getting guardianship, but, why would the NH send her home to a place where she does not have adequate care, when she can't walk? Hmmm......

I'd consult with an attorney about your options. Are you the only family available? I'd ask about what your duties will be as a Guardian. It's a lot of work and she'll likely resist care. It's tough and stressful. You can ask the court to have someone else take over as Guardian, such as the county or another person.
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I suggest you get a mental health evaluation immediately. For some reason, healthcare workers never consider mental health. They always go for "memory issues" and alzheimers. Try to find someone who specializes in geriatric psychiatry. Who knows, if you get your mother's mental health stabilized, she may make a complete turn around. Being paranoid and seeing and hearing things is a red flag. Best wishes!
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If she returns home without sufficient outside care, then it will be an accident/crisis waiting to happen, the high probability of a disasterous outcome.
It is often hard for adult children to confront the situation that their parent can no longer care for themselves. In this situation, you will not be able to act in her best interest by yourself. You need an evaluation of her mental status and elder law attorney. A guardianship is a painful and expensive process, but you may not have a choice.
However, I agree with others that you need to have her physical health evaluated: UTI, medication interactions--only a physician can pinpoint if there is an underlying physical condition. On the chance there might be an underlying condition, you need to find that out before you engage (pay for) an elder law attorney. If you look for an attorney make sure the person has experience in obtaining guardianships and is familiar with the court procedures in your jurisdiction. An attorney will speed up the processes required to ensure that your mother is cared for appropriately. Good luck.
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Have her examined before she leaves. Contact an elder law attorney (www.naela.org) to ask whether she should be discharged home (her behavior may have influenced the nursing home's decision), whether a guardianship would be appropriate and how to get one in your state.
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I wonder what happened. It's been 9 days since the original post. I hope things are going well.
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The advice to check for a UTI is great. I asked to have my mother checked for UTI at the nursing home frequently. However, from what you wrote, I think her delusions go beyond a bladder infection. I could go on and on about my mom's delusions. As time went on and her dementia worsened, I didn't even try to rationalize them. She was receiving excellent care so I knew her claims of everything from spy cameras in the heating ducts to a young man who could walk through an invisible door in her wall to have sex with her were based nowhere in reality. And having said that, and from reading your post, there is no way your mother should be released from the facility. I no of no facilities, nursing homes or rehabilitation hospitals who don't have some sort of liaison or social worker who can counsel and advise family. Ask your mother's therapists or nurses. I never had to get guardianship status for my mom. I dealt solely with the NH staff and they always called me with any issues. If she is discharged back to her home, her facility is no longer responsible for her, YOU are. I fear that, should something happen to her, Adult Protective Services could be called on you.
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Sounds like your mom has alzheimers and is heading into a later stage. I would recommend trying your best to get her to a doctor/ neurologist first to have her evaluated. The neurologist can test her ability to comprehend without her even knowing. Then file for guardianship through the county clerk. They will send over a guardian at litem to determin if she is incompetent. Then tackle getting her into a facility. Take it one step at a time and make sure siblings are on the same page. If your siblings are not on the same page you need to act alone and quick for your mom's safety.
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