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My mother is chronically depressed, has generalized anxiety, migraines 5 days a week, is supposed to be on an oxygen machine but instead chain smokes, drinks heavily, falls on the ice outside and has to wait until someone comes by to help her up, barely eats, cannot ale care of her dog etc. do I have any power to get her into a hospital when she refuses????

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Denchen, thanks for the update; I'm glad you were able to get mom to the doctor. Glad also that the doctor laid out in graphic terms what will happen (death, paralysis or brain injury) and that you and mom BOTH heard that.

I think the best move might be to contact APS and encourage her neighbors to do the same if they are concerned. No, they won't take action right away, but you want to get her on their radar as a vulnerable adult; she needs a social worker assigned to her to provide ongoing mental health support.

When she falls, visit the discharge planning office as soon as she is admitted and inform them that she is unsafe living at home. Do NOTHING to enable her returning home; do not sign the discharge papers and do not provide transportation.
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Have you accepted that you are waiting for a fall?

At some point her neighbors are probably going to stop wanting to do things for her. Right now they are prolonging the charade of independence.

You said that your H and you help, also. What kind of help do you provide and how often? How far away do you live? Has there been "mission creep" for you? Are you also enabling her charade of independence?

What is the plan for when she can no longer live alone (if not to that point already, she is rapidly approaching it)? What is her financial situation?
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Denchen Jan 2023
Yes, I have accepted we are waiting for a fall. Her doctor tried to make that crystal clear to her 2 days ago.
for years my husband and I have helped by at times successfully convincing her to go therapy, a neurologist , and other medical help, bring her food etc. I’ve put up boundaries in therapy with her saying I will not take care of these needs, that she needs to help herself. She was a therapist for 30 years and puts on a “healthy game face” and seems to lie to me and therapists and says she doesn’t need anything from me but weeks later will say she’s too sick to get herself food. When I refuse to get it to her, we don’t talk for a period of time. She can’t understand why I get angry at her for wanting me to constantly help her. She also seems to get more depressed when I don’t help her, somewhat blaming me for her mental issues. It’s a mess!!!
Her friends recently texted her and said they would not continue to enable the situation by “taking care of her.”
She knows that I will not take her into my home and I assume resents me for it, but doesn't my accept she will need to be in a nursing home any time soon.
I don’t know how much money she has, but she has quite a bit. A couple of million or more.
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Could you begin with getting Animal Control Services to deal with the dog? Not that your mother isn't in need of so much but maybe this is how she goes out but the poor dog needn't suffer due to all her bad choices and they are bad choices. She just hasn't bottomed out yet.

I don't mean to seem cruel but she is making these choices. She is still young but she needs to want or accept help.
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Denchen Jan 2023
I hired her a dog walker yesterday, but she said she found someone in her building to do it.
yes, the doctor told her she is making terrible choices. You are right
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No, you have no power to get your Mom to do anything from hospital to home care to rehab. You can only suggest it. We have a right to make our own decisions until we are adjudged by medical and courts incompetent to make our own choices. That will NEVER happen due to substance abuse, and is unlike to occur due to mental issues.
Recommending a book, a memoir by Liz Scheier called Never Simple, about her lifelong journey attempting to get care for her mother who had mental issues and substance abuse. Ms Scheier and the entire social services community of the city and state of New York wasted their efforts until her Mom finally died. The book is a wakeup call on what can and cannot be done. Consider Al-Anon where you will get great guidance, ideas, support and information.
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Denchen Jan 2023
Thank you 🙏🏼 I just ordered the book.
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A POA is a nice tool to have but it does not put you in control of someone who is competent to make their own decisions even if Immediate. If Springing, you usually need a Doctor or two to say she is incompetent to make informed decisions.

"and have have the hospital refer in-home assistance to come daily" In home assistance is usually after a Hospital stay and the person needs some Physically Therapy. You do get an aide but only about 3x a week to help bathe you. Once the PT is done so is the in home assistance. If you want an aide for Mom on a daily basis, Mom or you will have to pay for it. At $15 an hr thats $120 a day for an 8 hr shift. $840 a week if 7 days and I am being conservative. If Mom is low income, she may be able to get Medicaid but rarely is that 8 hrs a day. Office of Aging may be able to help.

You could call Office of Aging or Adult Protection services and ask if they could evaluate Mom. They may help with resources.
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You need to admit your mother is an addict to cigarettes and alcohol. Her depression and migraines will not improve until she seeks treatment for her addictions. You need to go to Al-Anon to better understand her addictive behavior.

A hospital is probably not going to offer or order home assistance for her.
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So at this stage your Mother has refused a 30-day program & also local hopsital treatment for her migraines.
She has not yet hit her rock bottom. Not ready to make any changes.

Indeed you are awaiting the next crises.

There is much here you cannot control. Work on what is within your control.
Be ready for that next crises. Be ready to inform her care team of her recent choices. It's up to Mother to change her mind.
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Denchen Jan 2023
Thank you 🙏🏼
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I am 66 and I don’t walk on ice, …. You mom doesn’t belong walking on ice at age 70, regardless of her health..
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If you (or no one) are her PoA, then you will either need to pursue guardianship through the courts and prove she is unable (not unwilling) to care for herself, or you keep reporting her to APS until the county acquires guardianship of her if she is unable (not unwilling) to care for herself. Even if she has a medical emergency and goes to the ER, you can tell the staff she is an "unsafe discharge" but if she seems to have capacity, they will let her go.

I agree you need to go to Al-Anon for yourself to find reality and boundaries. Yes, alcohol is a symptom but it is the main thing in preventing her from dealing with her deeper issues. If she's also mentally ill, she won't be able to take any meds safely and effectively until she's off the booze. So, it is the first thing that needs to be dealt with.

You seem to keep wanting your Mom to be someone she is not, and probably never was. Please know that you aren't responsible for her happiness. You can't have her recovery for her. These are hard truths, so I wish you much clarity and wisdom, and peace in your heart whatever the outcome.
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Start by going to Al-Anon.

You are waiting for a fall, as mentioned above.
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What do you hope will be the outcome if Mom is admitted to hospital for treatment?
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Denchen Jan 2023
I hope that the if she is admitted to a 30-day treatment program, which I asked her to do yesterday, she will be on deeper path to healing emotionally, physically, and mentally. Since she refused that option, I would like her to just go to a local hospital to attempt migraine management, check her vitals, and have have the hospital refer in-home assistance to come daily.
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If she has a doctor, let him or her know about mom’s condition and situation. HIPPA laws prevent the doctor from talking to you, but you can still write an email or letter stating your concerns. Then make an appointment for mom to have an updated medical evaluation, lying to her if necessary to get her there. See if she will agree to preparing documents such as POA and an advanced directive. If none of this pays off in getting any help or progress, not your fault, know that you’ve joined a common club here, waiting on an event that will force change. The event will come, it’s no fun waiting for it, and providing an illusion of independence for her will only delay the event. I’m sorry you’re in this position and wish you the best in coping with it
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Denchen Jan 2023
Thank you. I was able to bring her to the doctor yesterday and explained her condition to him right in front of her. He didn’t feel she was an alcoholic; he believed that the core issue after evaluating her body was that she needed to go senior rehabilitation with physical therapy twice a day to increase strength and mobility to navigate walking on ice, to have regular nutritious meals, and some mental health support. He reevaluated her migraine meds, and blood thinner dosage. He said that if she wouldn’t go to senior rehabilitation at our local nursing home for an extended period, we were waiting for a huge fall that would result in death, brain damage, or paralysis if she hits her head. She refused rebuilding the strength in her legs with rehab. He said she was making poor choices but we couldn’t force her.
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If you don't have PoA for mom, all you can really do is play the waiting game.

She's going to fall and wind up in the hospital (chances are)...and then she'll probably want you there...IDK how your relationship is with her.

If/when she winds up in the ED you can report her as an unsafe discharge and hopefully get someone to check on her living conditions, etc. She may 'lose' the right to choose for herself.

In the meantime, let her know you're there for her, but sounds like she just does what she wants.

Curious-how old is she?
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Denchen Jan 2023
Thank you for the information. That is helpful. She is 70
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Sorry your mom is such a mess! Do you have POA for your mom? If she falls, call 911 to get her up and get her evaluated. She's a train wreck looking to happen so I can't imagine it will be long before there is an emergency. Who takes care of her dog if she can't? Is anyone caring for her or is she just muddling through on her own?
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Denchen Jan 2023
She lives in a condo and a couple of neighbors have been helping her with groceries, her dog; she seems to be able to make it to the store for her own smokes though. My husband and I help also.
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