My mom is in the hospital, but insists on coming home. What do I do?

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My mom is in the hospital, but insists on coming home. What do I do?

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My mother's health has been declining since she fell and broke her ribs in February. A trip to the ER revealed a blood clot in her lungs. Not to mention she has lost so much of her body weight. She insists on coming home and I know I can't take care of her now. It has been a struggle up to now just trying to get her to eat.

I've got a couple of days to make a decision. This is hard and I just need to release this pain I am feeling. I didn't know this was coming my way. This is too much. Comments please.

Care Decisions Family Caregiver Hospital Discharge Stress

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I'm sorry for the distressing situation you are in. If I were you I'd keep her in care, she is an unsafe discharge and you already know you are not wanting to care for her at home. No one can be forced to a caregiver. Maybe it's time to consider LTC or even hospice, if she qualifies due to her significant weight loss and other health issues. You don't say how old your Mom is, what state you live in, or when she was in for the clot and the outcome of that, so more info would be helpful.

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She is 79 the blood clot was found Friday when she went to the ER she was having shortness of breath could not even get her in the car EMS was called

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Blood clot is in her lungs

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MJ, have you now decided that a facility is acceptable for mom? I don't know what can help you if you still don't want her in a facility.

Can you let us know if you are open to having her placed?

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Your mother is now in the perfect scenario to get her placed in the appropriate facility. You just let the hospital social worker that your mother can no longer come home as she is now an "unsafe discharge" and that she has NO ONE to take care of her.
If you stand your ground and make sure they understand that you CANNOT take care of her, they will have no choice but to get her placed.
And then you can get back to just being your mothers child and advocate and not her overwhelmed and burned out caregiver, and your mother will receive the care she now requires.
It will be a win win for all involved.

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You have been going thru this, since your first post in February, that she was not eating and seems haven't been for a while. One post she was down to 95 lbs. Have you talked to the Doctor on what can be causing her not eating? Seems to me Mom may have the "failure to thrive". Has Hospice been mentioned?

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She is an “unsafe discharge”— use those words.

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Prayers of support to you.

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There is no decision to be made! You already know what to do.

Of course she wants to go home, but she does not understand why it’s not the best option for either of you.

I assure you taking her home will inevitably land her right back in the hospital, and a vicious cycle will continue.

You love her enough to give her the best care, and you cannot do that yourself.

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See if she can be sent somewhere for rehab. That'll buy some time so you can start looking for AL or even SNF.

When she says she wants to go home and not to rehab, you'll be able to say "I know Mom. Sorry but the doc says you need rehab."

Sorry you're going through this.

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There is nothing you can do. No longer about what she WANTS it is about what she needs. She is an unsafe discharge, let them know that.

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It’s hard to see a parent in a situation where they are no longer safe in the only place they want to be. It’s natural your mom wants to go home, that doesn’t make it wise or safe for her though. This is the time she’s depending on you to guide the decisions to get her someplace she will get needed care and be safe. Work with the social worker and/or discharge planner on the next place. Accept what cannot be fixed and be kind to yourself. Know you’re doing your best for mom even if she doesn’t see it. I wish you peace

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MJack,
Really you have already made your decision: "I can't take care of her right now."
If you can't do that now, you won't be able to do it day in day out either.

Please think of this as you doing what's in your mum's best interests, even if she doesn't see it that way. That's the truth.

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Speak to the social worker. Refuse discharge. Your mom needs to go to rehab and then a personal care home. This is going to be a rough journey for you, but you should not bring your mom back home.

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So sorry you are dealing with this, lots of great advice herein.

Hope you can take a day or two to go see qualified Medicare and Medicaid (M/M) Skilled Nursing Facilities (SNFs) which have a M/M qualified rehab unit. That is where she needs to go next. To rebab first (Medicare will pay for some of this) and once Medicare stops, she can pay privately to "spend down" to later qualify to Medicaid.

If you do not have a licensed elder care attorney working with you/her; find one asap as they can help w/all of this. Further, they will know the best M/M qualified facilities to look at and they often have great relationships with the "business office" staff at such facilities which can help "grease the skids" to get into the best facilities.

Have the attorney review any paper work as there are trick questions, such as "if she does NOT qualify to Medicaid, YOU will personally pay or take her back." Sounds terrible, but YOU MUST NOT signed in agreement to this. It is the facilities responsibility to make a "safe discharge" if needed, NOT YOU!!!!

If you do not already have access online to all her accounts (Social Security, Medicare, banks, IRA/retirement, tax filings get that) as if she needs Medicaid long term care coverage at some point AFTER spending down; you will need access to all of her records going back FIVE YEARS! Lots of paperwork to gather, the attorney can help you.

YES, once you know the best 1 or 2 facilities: tell the social worker at the hospital 1) "it is NOT a safe discharge" (key legal words) for her to be sent home, 2) that no one including YOU can care for her at her home, and 3) here are the first and second choice of a M/M qualified facility she needs to be discharged to their "Medicare qualified rehab unit." Again, an elder care attorney can help with this.

Hope you have a POA, are named as her "health agent" and have other legal documents in order to take over. To get access to her accounts, you'll need a non-springing POA (lawyer can explain).

Good luck with this. But YES she needs to be in a facility moving forward.

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Try to get a financial and medical POA in place ASAP. If dementia or confusion starts she will no longer be competent to make that decision. Just be prepared that she may say that you are doing this so that you can legally "put her away" or something simliar.

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You will be better able to work this out with hospital social workers than with strangers on this forum. They are responsible for discharge planning. Time to tell them you cannot accept care of her back in the home and she would be an "unsafe discharge" if sent home. Time for setting them out on seeking placement for her.

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I think that MJack2025 knows this and is asking for support in making a difficult decision. If the hospital is giving her a hard time about her mother's situation, then perhaps MJack2025 is asking if any of us have been in this situation and has any tips or ideas on how to handle this. That is what this forum is for. We all know that the answers we get to our questions are coming from people who are not experts in medicine or law, but are people who may have been in our situation and would like their input or support.

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My mother was 88 years old and passed away at home in March with Hospice. In 2020 she fell and broke her neck and was severely disabled and had a 24/7 caregivers. She went through a lot during the four years at home, Falls hospitalizations, etc. I agree with everything that said here the keyword is an unsafe discharge, and by law they cannot discharge her to home. I would also agree with having a hospice evaluation as that was the best thing for my mother in the end of her life. We did not tell my mother she had Hospice. We just said it was a service to help with her care.
You did not cause the aging process and you will not stop the aging process. You’re doing your best be kind to yourself and do what’s best for your mother..

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That would be my concern too, in this situation. If the elderly mother is already falling, with life-threatening consequences (a clot in the lung), then no amount of being willing to care for her outside a professionally staffed nursing facility will ever be remotely safe. Breaking her neck is a vivid example of what it means to be profoundly unsafe.

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" life style change for the ones you love "

my wife is in her late stages of dementia, i have been caring for her since day one. I'm retired navy with good health/medicine coverage, so i can afford this life style. just don't have any fun money. i have set my house up just for her to be safe. a lot of changes to the house though. all very in-expensive. with all this and an abundance of required patience and love, it works for us. I'm able to keep a smile on her face every day. yes its a lot of work but i love her that much. besides, i can not afford the in home care or any other paying care.
so the question is how much do you love your parents.

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fullsailale, while I can appreciate all you've done for your wife and that you've been able to afford all the changes you needed to keep her safe at home, not everyone is in the position to do all that you've done for your wife and it has absolutely NOTHING to do with how much we love our family member who's requiring care, but rather if we can afford to do it financially, physically, mentally and spiritually, as yes it takes it's toll on all of that.
Because as you are well aware, caregiving for someone with any of the dementias is the hardest job we will ever do, and it's not for everyone.
Plus caregiving for a spouse is WAY different than caring for a parent. To our spouse most of us vowed to be with them in the good times and bad, in sickness and health until death do us part.
That is not the case with parents. We as adults owe them nothing. And most children have their own children that they're still raising or at least are still working(and needing to work)and are not able to give all that up to care for their parent.
And for those that can...good for them, but again it has NOTHING to do with how much one loves or doesn't love their parents, but if the caregiving situation works for ALL involved. And yes, that means the caregiver too.
I too cared for my late husband with vascular dementia at home until his death in 2020, and I would never try and make anyone feel bad if they couldn't do all that caregiving entails because it is a lot, and it is NOT for everyone.
So yes, I took offense to your last sentence, as we on this forum are here to encourage other caregivers whether they keep their loved ones at home or have no choice but to place them in a facility. And the last thing a caregiver still in the throes of caregiving needs is to be made to feel guilty over the choices they make in their individual situation.
We all just do the very best we can, and that just has to be good enough.
So I'll say it one last time...it has nothing to do with how much we love the person needing care.

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“ When the doctor says it’s safe” make sure you speak with them and the discharge coordinator and tell them you just aren’t able to handle it safely on your own anymore and need their help figuring out what to do.

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Everyone wants to go home from the hospital.
Home is our familiar place.
Unfortunately, for your mother, if she does not have someone to provide the care she needs, she can not go home. You have to make this clear to her doctor, the one who will give the discharge orders.
She should be transferred to a skilled nursing facility/rehab. That is considered a short-term stay, pending the progress made by the patient. If the patient is no longer making progress - that is, getting better and able to go home, then she will need to be transferred to a long term care facility.

You say you can't take care of her now. Does she have the means to hire full-time care in her home? There are live-in care providers, or she could hire caregivers to come in shifts as needed.

You need to tell her, without hesitation, that you are not able to provide the care she will need at home. She may want to pressure you, only because that is the easiest path for her. She needs to understand that it is beyond your capability, and you can help guide her toward a more feasible option.

I'm so sorry you are going through this pain. You have watched your mother decline, and I'm sure you instinctively know that she will only continue to decline.
She could make a remarkable recovery, but that is not likely.

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The O.P.'s mother has been living with her, The mother does not have another home.

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It is too much and very difficult emotionally and psychological to handle.
NO NO and NO. Do not bring her home.

Get her into rehab or a nursing home.
She will insist anyway - no matter what you do as she is scared and wants what she is familiar with - you and being home. However, what she needs is very different from (her fears driving her) what she needs.

You HAVE to take care of yourself. Otherwise, you won't be able to care for her as you crumble / potentially have a breakdown. You are grieving. Get into therapy or find a grief therapist to help you sort out your feelings. It is a very difficult time and you need at the support you can get.

Gena / Touch Matters

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One does not know how much one is able to handle until one is placed in a situation that requires such skill that is beyond one's means or is perhaps humanly impossible. If your mother was living with you before she was hospitalized and is ready to be discharged, bring her home. During her hospital discharge meeting provide the staff with all the information you believe will prevent your mother from adjusting to your homelife. Get any and all in-home assistance available. Get all the information that you can from the staff that you will need to request expedited assistance to move your mother to a more appropriate place if needed. You may want to contact the resources they provide you to familiarize yourself with them and they with you.

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I disagree, since MJack2025 has already stated that the situation is beyond her/his capabilities. I am 76 years old and my mother is 96, with dementia, blind, and profoundly deaf. We struggled with her living with us, and she did, too, and lifting her off the floor when she fell numerous times, the scares she would give us with the inability to remember or just plain refused to follow sensible adaptations to her disabilities, was wearing on our health - physically and mentally. I know our health has declined - and the fact that my husband has suffered has left me feeling even more guilt along with feeling that no matter what I do, it will never be enough for my mother. When she had to go to the hospital, then rehab, we were finally faced with finding a place for mother who could tend to her needs much better than we were. This should be a lesson to all of us. Many of us caregivers are senior citizens, in old bodies. Why do you think it costs so much to live in Assisted Living or Skilled Nursing Homes? Because it is hard work, it is SKILLED work, and it is constant vigilance. We love our parents, but we know when it is time to give our parents a better chance of living out their remaining days in a place that knows what to do and has the people with the knowledge and strength to do it. I am a parent and grandparent, and in no way to I want to burden my children with what I have been going through for the past several years. When parents say that they would give up their lives for their children, I intend that to mean that I do NOT want my children to give up theirs for me - ever. We have done our best to plan for our future, even though our parents refused to do so ("God will take care of us" was their main solution). There should never be any guilt for a caregiver in saying, "Enough. I cannot no longer do this, and I know it." There should be no caregiver that puts a negative onus on another caregiver for choosing an Assisted Living or Skilled Nursing Home for the parent. I hope that MJack2025 knows that most of us realize the difficult decisions that we all have to make for the sake of the parent and the sakes of the families that must live with the decisions they have been forced to make for their parents are decisions made with love and honest appreciation of the care that they require.

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MJack2025: Utilize the hospital social worker.

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It is too much and you already know that you can’t take care of her. Do not bring her home.

If you haven’t already done so, sit down with the hospital team, and look at what the other options are in your area.

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A couple of days to make the decision? Days? Has her insurance reached maximum stay or the hospital decided she no longer needs hospitalization? You've only got two days, and that's not enough time to get her into an AL facility. If she's being released in two days, and not being sent to Sub Acute rehab first, you may have no choice. Take funkygrandma's advice and make sure the know she can't come home with you.

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Tell the hospital social worker that you can absolutely not take her.

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Sadly 2 sisters did this, now their mom is deceased.

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Strength and prayers to you.

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You need to assess the care she needs perhaps in-home care few days a week is good if not, maybe Hospice is in order. Hospitals will not allow them to stay, but that’s what extended care facilities are for true. They cost a lot, but that is something you have to decide. I do know that once all the funds are depleted that Medicaid will kick in and pay those costs, but the facilities that Medicaid will pay for are not the best, but that’s your decision to make

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Ask for rehab placement that can segue into skilled nursing care. Tell her when she is strong enough she can come home. Ask case manager to help you find her placement.

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My mom is in the hospital, but insists on coming home. What do I do?

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