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I've tried EVERYTHING before doing an er dump (awful term btw) but I got nothing left. The state isnt doing crap and the one remaining caregiver is about to leave. My dad who is 87 with stage 5 parkinsons is out of his mind even after being treated for uti. My 85 year old insane mom is awful. On advice from his pcp, were taking him to er tomorrow and saying "unsafe discharge " to anyone we see. But we cant get him into a car - physically. Sirens trigger my mom and dad. Can an ambulance come without lights or noise?

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I realize that this is an old post. However, as a hospital social worker/discharge planner myself, I couldn't help but respond! :) I can tell that dealing with your parents and their needs has been exhausting. Bringing them to the hospital isn't necessarily a bad idea - we are here to help! However, if they are able to admit them, I kindly ask that you (and anyone else that might be in this same position) be helpful to the hospital dc planners/social workers as well. Usually, we can also see immediately that someone is not safe to return home. However, just because they are not safe to be returned home, that does NOT mean that we can simply place them in a nursing home/AFC without their consent (if they are alert and oriented) or discharge them to a facility like an assisted living/AFC home that is a private pay expense without them agreeing to pay for it. We do everything in our power to figure out a plan that will get them to a skilled nursing home under their Medicare benefit to start, but even that will eventually come to an end unless they have Medicaid and qualify to utilize the room & board benefits through Medicaid. We cannot just keep a patient indefinitely because their family member does not want them to return home, unfortunately. (Well, we could, but the patient will probably receive a huge bill for the time they stayed in the hospital without a medical reason). So, I suppose this is all to say that discharge planners/social workers are not miracle workers who can make money appear for a patient (as much as we wish we could)! If you go into this process with that expectation, you might end up disappointed. Sit down with the dc planners/social workers as soon as they're available to discuss a plan that is within what your parents are able to afford or what they're willing to agree to (if they are able to make their own decisions). Best of luck to you - I know this can be a very difficult process.
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Reply to directioner612
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Post from October 2025 FYI
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Reply to southernwave
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It is up to the ambulance company and don't DARE to say "we want no sirens". When you call an ambulance it is for an EMERGENCY and saying this is admitting upfront there is no emergency. What you will say is this "I have no idea what is going on but can tell you that a siren will greatly agitate Mom".

Now important, if you want her transported in you are going to have to lie like a rug. You are going to have to claim things that make them question whether a stroke or some other dire thing is happening. You are going to need to go on about rapid change, garbling, word salads, weak, you have no idea what is happening. Even some lashing out and inappropriate behavior.

This will get her into a cubicle in ER in a way that just showing up and ushering her out of the car will NOT. You will then say she cannot return home without full assessment. You will refuse to have her back at the home without admission and check.
Immediately on Monday you begin with "She cannot return home. We need to see discharge planning and social workers NOW".

And yes, you already know the magic bullets of knowing "unsafe discharge" and I will report you to JCAHO (Joint Commission on Accreditation of Hospitals).

Good luck, Peanut. Remember. A) This is an emergency. B) Leave the premises if you must; but do not allow them to transport her home C) you cannot go back on this; they won't buy it twice D) you are forced against the wall now, and lies are a sad fact at this point.

I hope you will update us.
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notgoodenough Jan 11, 2026
Is it mom or dad they're trying to get placed? I know she's talked about problems with both...
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A lot of ambulances won't use the sirens to transport back to the hospital, because they have found it creates undue stress on the patient.

Whether or not they come lights and sirens to the house depends a lot on how they receive the call.

How are you going to convince your mom and dad that dad needs to get into the ambulance and go to the hospital? Do you think it might be better if mom was "out" for the day when this happens, if that can be accomplished?

Now, as to your dad's PCP - it is all well and good for this doctor to recommend a social admit to YOU, but is he (she?) willing to put his money where his mouth is and contact the hospital - or better yet, go in person if it's a hospital in which he has privileges - and add his voice to yours, telling the staff that, in his medical opinion, your dad is no longer safe being at home? Because I would imagine that would make this process much smoother for everyone.

I would try to convince the ambulance team to take dad to the hospital to which dad's PCP is affiliated, if they would be willing and able to do so. Then dad's PCP can go in and maybe help convince the powers that be - including mom and dad - that this situation at home is not safe, and dad needs placement.

Good luck to you.
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We did a social admit for my father three years ago. We were waiting for the opportunity. He finally fell and we told EMS we thought he hit his head and needed to go to the ER. We lied about that, The ambulance did not use the siren if I remember correctly. We followed it to the ER.

When we got to the ER we told them the truth. He lived with my 94 y/o mother and she could no longer take care of him. They needed someone there 24/7 now because they both had a lot of needs and there wasn't enough money to do this. I lived in California and was not moving back to NYC and my sisters both worked. I told everyone that we encountered in the ER the same thing. This is an unsafe discharge. He cannot go back home. We met with the social worker at the ER and she fully understood what we were doing and agreed with us and made it happen.

He was admitted to the hospital for three days, they found some reason to admit him and then he went off to rehab. When a long term care bed came available at this facility he was transferred to the long term care wing. We are nearing the third anniversary of his going into this nursing facility.
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Reply to Hothouseflower
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If you prefer the more gentle "social admit" to the ER, then that term will suffice Peanut.

Sorry about the ambulance noise, but I am afraid you can no longer practice the "niceties" of what triggers others and what doesn't.
The LAST THING IN THE WORLD NOW that you will do is to tell a 911 or ambulance that this isn't an emergency. THAT IS NOT AN OPTION, In fact your are going to have to lie your bottom off that it IS an emergency and that you parent is lashing out of control and must be transported to ER.

Once your parent is there you will LEAVE and return home. If they are living in your home you will tell them that the parent cannot return, and you are physically, emotionally and mentally unable to continue care. You will call APS and tell them the same. You will demand placement.

I cannot remember all the specifics in your case, but you've been here with us a long time Peanut. It is time to call in ALL THE TROOPS now, from Social Workers to APS to elder law attorney. If you cannot go on as POA, or having parents with you or unsafe alone at home, then you need to let all entities know you are standing back.

You may be threatened with abandonment dependent on how much care you have already taken on. Let them know they can take you to court, but you ARE not going to be involved in care you cannot mentally, physically or emotionally do now.
If the state takes on care, then know you don't get to participate in any way in when, where, why or how placement occurs or in the management of your parents assets; that would go into the hands of the state should they accept guardianship.

So step #1. Call ambulance. Too bad about the sirens. So your father is lashing out and dangerous to the household. Be certain to INCLUDE that you FEAR FOR YOURSELF AND YOUR MOTHER.
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Reply to AlvaDeer
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I think the patient has to be truly actively dying and the ambulance in a rush for them to run the sirens. When my Mom had a fall and called 911 they didn't come with the sirens on. My neighbor 2 doors down was dying of a blood cancer at home and his wife called the ambulance many times and they never came with the siren on. But this may all depend upon the ambulance company, or the county. I think when you call 911 you can ask them not to have them on.
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Reply to Geaton777
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You can ask the dispatcher and say why. However sometimes there are laws or policies governing this, such as requiring them to be used in neighborhoods to alert pedestrians and drivers to their presence. But it's worth asking since jurisdictions have different rules. I wish you well with this challenging process. Let us know how it goes.
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