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So the NH our mom is at for short term wants to discharge. She's under Medicaid. My place is on a second floor and isn't accessible for a walker. Also I'm not home between 7-4 and no I can't leave work as I already maxed out my family leave and am short hours to take another. The NH thinks she should not be left unsupervised, which I agree but still think it's a good idea to discharge her to my place. Yes she had been living with me. Difference is she was not physically handicapped. She could walk, use the restroom when she needed, bathe herself, dress herself, she'd walk to the park and do some yoga excercises and she could call me. She was a stroke survivor who became epileptic and thus could not drive so had to leave her job and could not afford her rent so she moved in. Now that she needs help with all this my place is no longer a safe option. The NH however won't recommend full time care because to them she only needs some assistance. Again who and how are they going to provide that some assistance. Anyone have any pointers on how to navigate this. When I told the NH SW that I can't take care of her due to time constraints she said it was my duty. Well if I don't work we're both on the street so how is that going to help matters. Also when I tell them she can come live with me when she is physically able to they tell me she might never get back to that point. When I said well if it's never what are her long term options. They said let's try two more weeks. Why try two more weeks of PT if you think she won't get better. It's very simple if she can get back to being able to walk and go up and down stairs she can live with me. If that is an absolute no go then she needs a more access friendly place.

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Thanks for clarifying. I'm glad tis is working out for your mom and you !
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No SW told me on the phone when she called to tell me they had a discharge date ready two weeks ago. She told my mom days after I gave her my reasons for not being able to bring her home. I think her plan though unprofessional was to see if she could convince my mom to go home. The ombudsman on the other hand asked her to do some tasks and then asked what she thought about going home. He didn't tell her, she could, should, or would. Which is the same as I had been doing. But it felt like the SW just assumed it was all my choice. When really the one not giving my mom a choice and voice was her.
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I'm so glad that this is working out. But I'd like to clarify something.

Did the SW tell YOU that it was your duty to care for your mom, or was that what your mom reported the SW told you?

In any event, it just goes to show that you CAN fight for what your parent needs!
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Thank you all for the support and advice. I called the ombudsman and told him it was getting near to the additional 2 weeks that insurance is allegedly only going to pay and that I wasn't getting any support in creating a safe discharge. He went and talked to my mom.
Mom told him about her fears, struggles, and limitations with going home. She also told him about how the lady (sw) had told her I needed to take care of her.
He spoke with the SW who told him she wasn't thinking about discharge. I had shown him the insurance request for 2 weeks of care. So he pressed on about what happens after those 2 weeks because patient did not feel ready to go home. She told him she would have to get the doctors notes. This was all on Monday. Come home yesterday to find an approval from insurance for full time care the request having been made on Monday.
Mom is happy that she doesn't have to worry about being alone. Or me spending out of pocket for her care. Both of which she shouldn't need to think on while she's working on recovery. But she is still a mom. She knows that if it came down to it I would quote my job and take care of her. But she said she doesn't want that for me. I'm glad they finally understood that mom and me are a team. I would not have forced her to stay had she wanted to go home, but she herself realizes she hasn't felt safer and wanted to know why she had to leave.
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No worries GardenArtist. I think the SW however really thinks such things are possible. I don't want her to stay there long term. I'll be glad to leave that place in the past. But I need them to transfer her and not discharge her. Because if I take her home it's going to be a lot harder to get her into somewhere.
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Alesndy, I'm so sorry; I misread your post. My apologies.
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Yes stick to your guns. They need to find your mother safe housing. Out of the question that she can be discharged to your place. No, no, no.

Those SW need to get it moving and find placement. That is what they do. Make yourself clear in that there is no discharging her to your 2nd floor. Absolutely not. Physically impossible for her to even try. 

I hope your mom finds a good place that she likes and it works out. Doesn't matter how long it takes, your mom isn't going anywhere until her needs are being met.

Stay strong!
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Is there another rehab facility you could move her to? This one sounds like the pits.
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It's a second floor apartment. There is no first floor.
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First, I think unfortunately that the SW and perhaps other staff at the rehab facility just aren't that interested in your mother's care; they have kind of a "not my job" attitude - just make sure their files are documented that she has a theoretically "safe" place and it's someone else's worry.

I saw that in the last place my father had rehab. They might also have taken less interest b/c I've heard they have their own AL associate company, but they couldn't convince him to consider AL placement. So they booted him out too early.

This rehab place used to be top notch, but it's gradually gone downhill. Now, it's the CYA attitude when it comes to discharges.

Few thoughts: can your mother stay on the first floor if you hire someone (like the small moving companies) to move her bed down? Equally as important, is there a bathroom on the first floor? Do you have a commode?

Get box fans for the first floor. They're quite powerful and can keep your mother cooler. Also find a good place for hand towels which can be moistened and placed across her head. Keep a hygrometer close by so you can monitor the humidity and heat levels (when you're home, of course).

I don't disagree with the others that you should put pressure on the staff, but the sad reality is that the balance of power isn't necessarily in your corner, and the anxiety must be frustrating for both you and your mother.

If her doctor will script for home care, that would help, but only partly and only for a while. In the meantime, start calling private duty companies to get extra help in while you're working. Ask the SW to give you lists of them as well as other facilities of a longer term nature which you can call and weed through to find some worthy of consideration. Then meet with them to discuss whether that would be a good facility for your mother to liv in.

I do agree to keep her at the facility as long as you can while you try to make other arrangements, but don't count on much help from the staff.
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My mom is fortunately on board with care. She herself has said she does not feel safe going home to my place. She has had some crying spells but those have been linked to feeling ignored by the staff or when staff was trying to force her to drink milk and she kept saying she can't, but it's for your own good, and then hovering over her until she did. Then dealing the rest of the day with the aftermath. Or when they put strangers clothes on her when she has a drawer worth of hers and act like she doesn't know her own clothes. She tells me many times I think they believe I'm stupid or something. So I ask if this makes her want to come home and she says it does but that she also knows being at my place would make her want to do all the things she used to do and that she'd feel miserable. I have told her they want me to quit my job to take care of her. She says she doesn't want me to do that. She wants me to be able to take her places. That lady has her priorities.
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It seems like most of these places would prefer to take the easy way out.
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Staaar; I completely agree with you. Sometimes you have to pretend not to care in order to get them to do the right thing.
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staaarrr, BRILLIANTLY played! You got 'em!
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Just because your mother WAS living with you prior to, does not mean that she has to live with you now. Tell the social worker that you will NOT be taking your mother home to live with you and that arrangements must be made for her safe discharge. The safe discharge plan is the nursing home's responsibility. It sure sounds like she cannot be at your home, regardless of if she can walk 100 ft once a day. The assertion that she just walked 100ft and had PT and is fine to go home with stairs, but is too tired to show you, raises some major red flags. If she is not in a supported environment, she will need to walk 100 ft more than once a day.

You need to dig your heels in on this one. Tell the NH that it is not a safe discharge and that your mother can no longer stay with you. Call the ombudsman and explain to them what is going on. Also ask to see the PRI. That will tell you all you need to know.

Right before my mom went into the hospital and then went to rehab and stayed in the nursing home, I had been to many doctor's visits with her. They told me she could not safely live alone. I had tried to get her in home care, but she wouldn't accept it. Her primary doctor told me all I could do was wait for the next crisis and then when she went to the hospital I would have to dig my heels in and keep saying unsafe discharge. I didn't realize until it happened what he really meant by that. The hospital just wanted me to take her home and take responsibility for her. Despite multiple compression fractures from falling, they said she wasn't a candidate for rehab because she could walk 50 ft with her rollator. They said she wanted to go home and they couldn't keep her. I had to tell them okay, if you want to discharge her, go ahead. I guess call her a cab because I cannot take her home. The social worker told me, no, you have to arrange for her care. I said, what if she had no children? They said they would have to call APS and that they might put her in a nursing home. Was I okay with that? I said, it doesn't matter what I am okay with as you have just said. It only matters what my mom is okay with according to you. Good luck! I left. Two hours later I received a call that miraculously my mother WAS a candidate for rehab. Amazing.

DIG YOUR HEELS IN!!!
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She needs a Medicaid bed in a nursing home, it sounds like. Ask for her to be assessed to see if she is medically at need for skilled Nursing care.

If she is not, then you need to contact Medicaid about waiver programs that can provide her care in another setting, such an an adult foster care setting or AL.
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Good for you for countering the Tales from the Rehab. Stay strong! Keep us updated.
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62. She was 60 when she had her first stroke in hospital for 3 days and no motor function loss. This one at 62 much different
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She can't safely leave your second floor. It's really unknown if she will be even able to get up there without some adverse physical symptoms say, of fatigue. She'll need to rest for a long time to recover & she'll be pooped when. Absolutely 
Agree with all above in that she needs senior accessible housing and I would make the SW aware of this unsafe and not well thought out 
How old is she?
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Also just got reminded of another reason. It's hot where I live. We have ACs in each room the ones with tubes that go out the windows and you have to empty out the collected moisture and its still hot. She's diabetic and very prone to heat exhaustion She used to go to the park sit in the shade or put her feet in the community pool, walk to a local cafe with AC, sit at the library. Not really on option if home bound. We've tried ICE vests and those just melted after 2 hours.
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Nope,, I cannot do that.. rinse and repeat.. over and over. Because you really can't.. trust me.. or you will lose your job and another worse problem will appear. I agree with the above posters.. and if they can't / wont show you she can.. there is a big red flag! and a diaper and in bed.. I think not!
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Had a discharge meeting with the SW and OT present. The SW just asks me what are your plans. In a not my problem tone. The OT says she's physically ready can go up and down 14 steps, can walk 100 feet at a time. When I ask if I can see my mom do this. Oh she just had PT she'll be tired. When is PT. Mornings. What time? It varies. If I'm going to have to take hours off work then I need to know when I can see my mom do all these things cause when I go she is either in a diaper in bed or she gets wheeled to the restroom, the one time I saw her take some steps was with two people one holding the walker stable and another with a harness on her back. So how that translates to 100ft by herself is beyond me. They tell me she only asks to be in her room. That they try to involve her in social activities. That they think she's getting depressed there. My mom however tells me she doesn't like the common room because if she needs a change she doesn't get help fast enough but in her room she can use the call button. They also tell me she isn't eating. I told them if i had to eat that stuff I'd starve too. So I said can I have meals delivered to her. No. So you want her to eat. But you won't let me get her meals she will eat. Our nutritionist monitors the meals. Okay but you want me to take her home where I would be feeding her but your already implying I won't be feeding her what the nutritionist wants. Shouldn't this be the time we figure this out. But no it's take her home then figure it out.
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She is not a safe discharge. She needs more care than can be provided in her living situation. I will not sign for discharge. Shall we involve APS?
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Stick by your guns. Get her primary involved. If she is not physically able, then she needs more care than you are able to give her. And...it is not your duty. Your duty is to make sure she is in a safe place, fed, clean and cared for. Have you talked to the Social Worker or just to the rehab team. Call your state Ombudsman and see if they can help. You have very good reasons why you cannot have your Mom with you now.
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