My mom was found unconscious yesterday and brought by ambulance to hospital. What can I do?

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They think she had a seizure but can find no issues. She has dementia and is part paralyzed on left side. The hospital wants to send her home with pt only. There's no one there to care for her during the day. I want to refuse to take her home but the hospital said that it was abandonment. I don't no what to do from here. She is declining fast and needs more care than I can provide. What can I do?

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Do not let the hospital bully you. Unless you are your mothers legal guardian, you can not be legally held responsible. Tell the hospital you have to work - that your mother would be left alone all day if in your home. Ask them to put you in touch with their social worker who deals with elder care issues and ask them to help you find a placement for your mother where she will receive the appropriate level of care - that you can not provide. The pressure that hospitals and rehabs put on family to take the sick, elderly into their homes is really starting to chap my hide!
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Be professional, sweet, and turn the tables on them. One thing you can do is ask if their recommendations meet with the standard of care for someone who is partially paralyzed. I.e., do they routinely recommend that someone in that condition return home with no one to care for her?

Be prepared for a change of attitude, preceded by some quickly changing facial expressions. Standard of care is a legal standard considered in medical malpractice cases. Just the hint might cause them to be more realistic about the situation.

And don't let them bully you. Like RM, I'm really getting fed up with the manipulative tactics of hospital discharge planners and rehab social workers to shove off all the care planning on the family, and engage in a CYA move themselves.

I don't know the specific legal qualifications for abandonment, but I think your best option at this point is to state that you can't care for her, you need advice on how to get that care professionally, and ask for their recommendations. I.e., what can and will they do to help get 24/7 care, recognizing the fact that you cannot provide it. Turn the tables on them.

If they insist you take her home, ask if they'll pay you to stay home as you can't afford to quit work! (Sometimes you really have to be adamant in dealing with these people.)

And DON'T sign anything in the Discharge Instructions that commits you to provide care. I discovered that someone at the last rehab facility snuck in an "acknowledgment" in the discharge instructions that I agreed to provide 24/7 care for my father. That was never even discussed! And I read them before leaving - I'm still not sure how that into the instructions.

Of course I didn't sign them so it's not a valid assumption or commitment. But still, it really irked me, and it's on the list of issues to raise if we ever need care again.

Fortunately or unfortunately, the rehab facility is great except for the somewhat manipulative social workers. In the past I've been able to raise these issues prior to admission when the staff wants the patient and the Medicare dollars, so they've been worked out.


On the issue of having been unconscious, has anyone mentioned a syncopatic episode? She could have passed out, there might not have been any obvious cause, and that could be their assessment. Syncope was the cause of my father's falls. Despite cardiac and other post fall assessment, no determination was ever made what caused the blackouts.
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It's a long story for another time but one of the worst 24 hours of my life was when an ER pulled that crap on me six years ago. Left me and my brother frantically looking for an appropriate place for my sick dad. H3ll - we were so clueless at that time we didn't even know what appropriate was! If I'd only known then what I know now! And not in terms of appropriate but in terms of the BS hospital discharge people try to pull.
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We had a similar experience with my mom. She became incoherent while on the phone with me and fell. The hospital wanted to discharge her to AL, which wasn't able to handle the 24/7 care she needed. My sister (nurse in NH) kept using the words "unsafe discharge" to the discharge planner. We steadfastly refused to take her home, as we couldn't provide the needed care. She was a pretty snippy, unhelpful woman about it and thought we should be taking care of her personally. Ultimately, she gave us a list of NH, a friend in healthcare crossed off places she didn't think would work. We took two days and visited facilities. She went directly from the hospital to the NH, where they did rehab, then transitioned her to long term care.

You have to put on your body armor and say "that's not possible" a lot. GA is right - the doctors and therapists were terrific, but the discharge planner was a piece of work. Network with friends and family for feedback on NH - that helped us speed the selection process.
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I see from your profile that your mother is living at your home. So does that mean that your home is also her home? So that, if the hospital were to discharge her home, they would be able to demonstrate that they are discharging her to a home environment where she lives with other adults, yes?

I don't know, and I don't want to depress you, but I wonder if that complicates things for you. You can certainly still refuse to collect her. But can you prevent their sending her home, I wonder?

Who found her unconscious, by the way, and what was that person doing in your house?

How long has she been living with you? Does she have another home of her own, or is this a permanent arrangement?

If it were me, I think I would:

take a brief leave of absence from work
take mother to see her GP
get an assessment of care needs done
find out what the options are
pick one.

Your mother has dementia, she is declining rapidly, you work (quite right too, no reason why you should have to give that up) and there is no one around during the day... Something's going to have to change anyway. Might as well make it sooner rather than later, don't you think?

And meanwhile, hospital is not a good place for a frail elderly lady with dementia. All things being equal you'd want her out of there as soon as possible in any case.
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To clarify Rainmom's post, that's a court appointed Guardian, not to be confused with POA. And they are trying to do the same things here in Canada too even though they know full well it isn't right, it is all about preserving the hospital's bottom line.
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Sometimes I think hospital staff work at opposite purposes. Nurses, aids and doctors try to provide good, quality and concerned care, but the discharge planners seem anxious to just boot the patient out the door and move on to the next football...or rather patient.
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I know it's tough but it's perfectly fine to say no, you can't take care of her. Make the hospital find alternate arrangments for her. You have the right to say no, it's not happening and not doable for you to do. Don't put you long term financial well being at risk nor, if you have one, family's at risk.
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GA's comment reminded me of something else. The first time my mom was in the hospital, she was admitted "under observation", not "in-patient". We learned later that we/she didn't have the same rights to fight the discharge as we would've had she been "in patient". Also, the lack of diagnosis made things sticky. She was discharged that time, only to end up back there two days later. That time, her doc made sure that she was designated as "in patient" and had a diagnosis. These were important for Medicare reasons. It gave us more to work with with the discharge planner.
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I had an experience where a hospital did it's best to send me for rehab and I was refusing. After 2 months in the hospital I was far too ill for rehab They were refusing to let me go home and I was refusing rehab. In the end when I demonstrated that I could walk to the bathroom and manage a couple of steps they reluctantly agreed. Three days later I was admitted to another hospital for another month.
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