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My mom lives alone in an upstairs apartment with stairs no elevator. Since August she had a caretaker for a couple hours a day four days a week. The caretaker broke her ankle a few day before Thanksgiving . My mom was able to live alone and was mostly fine except lonely and depressed. She has no serious medical problems but needed help with laundry, groceries and getting to doctors appointments. So the day after Thanksgiving she fell while getting up and landed face down on the couch and possibly hit her head on arm rest. I live an hour a way and at her doctors insistence drove down and took her to ER. After hours of running tests she was discharged, vitals good and no broken bones. I stayed with her over night . Two days later she fell again , back to urgent care, two days later fell and wasn’t found for 24 hours. I called 911 this time. Again vitals fine ,no broken bones. They discharged her but did send her to a SNF for in patient PT. Fast forward two weeks, my mom went from occasional forgetfulness to about an 8 on confusion. She also is having hallucinations, confusion and is nothing like she was a couple weeks ago. She has fallen twice since in the facility trying to get out of bed unassisted and taken to ER. CT scan etc. They now have to park her in a wheelchair near nurses station at night to keep her from climbing out of bed. Today I get a call from the doctor saying she was being discharged on Friday. I said to where and she said to her home. She said she can walk 125 feet with a walker and minimal assist. I said oh can she get up and go to the bathroom by herself and she said no she needs minimal assistance. So then she had the social worker call me, I said so how can she go home by herself, I said even if I can get her 4 hours a day caretaker, what does she do the other 20 hours? Beside the fact I don’t have a caretaker for her by Friday. My mom has Medicare and Medi-cal (for now). She is 80 years old. I asked if she could be placed in a nursing home and she says she doesn’t need that level of care. I told her my mom has $1400 a month that is it. She basically told me I needed to start calling around. I also told her if the doctor and her think she can be discharged to her home with limited in home services, fine I will get her home. But if not I will not be picking her up on Friday. So now what? If I don’t pick her up what happens, where does she go? I am sick with the thought of doing that to my mom. She is still aware enough to know what’s going on. Mostly... I am the only person my mom has. She is very difficult and last year when I took her home after a fall for a few weeks I was ready to Jump off a bridge. Everything about her is difficult including her refusing to go home. I have not brought her here since. I visit once a week, do her shopping, finances, appointments, clean apt. Etc. Talk to her daily. I had to take her home last time because it was either her or me but something had to give. She hates my husband of 20 years and the feeling is mutual. I can not take care of her 24/7 when she can’t even get up without falling . I asked social worker what are my options if they discharge her and I can not take care of her and refuse to take her, she said she could give me a number to a board and care facility that I could call. I told her my mom has no money and can not pay for that, and Medicaid doesn't cover that. She told me I need to put together a plan. We have no other family. I told her my plan was for her to stay there until she can get around, get up, and go to the bathroom by herself. And then, take her to her home with In Home Care. They are discharging her Friday . Can anyone help me? I am in California, she has Medicare and Medi-cal. If I take her I do not believe I will ever be able to get her to leave and within 2-3 days I will be looking for a bridge to jump off. Then What will they do ? Sorry for this long post. I am lost.

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Don't accept the discharge. The facility will want your mom or you to sign a paper relieving them of all liability. Refuse. Just keep saying that there is no safe home for her to be discharged to. Keep the ball in their court. They'll have to figure it out.

In general, do not sign anything even though they tell you family members sign it all the time. DON'T. If you must, always sign it "for <insert your mom's name>". You don't want to sign something accepting financial responsibility.
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Reply to needtowashhair
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I think you need to make it clear to social services that you will not be taking Mom to your home, that you cannot afford her to go to her home with 24/7 care and that anything else constitutes "unsafe discharge". Those words only. Tell them they need to explore placement options for her with her income. Supply all you can regarding her assets and income. They cannot discharge her without someone to accept her, but if they can talk YOU into that then she is off their hands, which essentially is ALL THEY CARE ABOUT.
Do not let them discharge her to YOU and tell them that if they DISCHARGE HER HOME it constitutes an "unsafe discharge".
Now they may require that she pay her own daily rate as they likely already had agreed with medicare that she is no longer coverable, cannot progress further, cannot participate and rehab is no longer appropriate level of care. I think for now your Mom is headed to SNF or placement.
So sorry. This is very awful.
Just know, Medicare will not cover her until, as you say "she can get up and around and go to the bathroom by herself". In fact that may never happen again. She likely will need placement. You need THEM to begin to work on options available to her with her assets, her income, and etc.
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Reply to AlvaDeer
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Explain to the social worker that you cannot bring your mother to your home and to discharge her to her own home will be considered an unsafe discharge. You will absolutely hold the facility responsible should she once again fall and injure herself or be compromised in any other way. The social worker must do something other than simply give you a phone number to call. She’s shirking her responsibilities to you and your mother.

Have the doctors given you any clue as to why she keeps falling?
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Reply to Ahmijoy
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JulesNeedsHelp Dec 17, 2019
They have not found anything wrong. They had her in PT to get strength and work on balance.
I have yet to see her get up and get the walker and go to the bathroom, They get her out of bed into a wheelchair then take her to PT, get her standing and watch her walk down the hall with them behind her in case she falls. The minute she tries to get up unassisted whether she came here or to her home she would fall within the day. I have no doubt.
With her new state of confusion I don’t think she would be capable of living alone.
What type of care does she need or what qualifies for Medi-cal care?
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No No No! That's what you tell the hospital. Do not pick her up. Like Ahmijoy said, it would be unsafe for them to discharge her to her home. The social worker and case manager must find a bed for Mom. And Mom pays for whatever help she can afford, it is not your responsibility for you to pay nor is it your responsibility to stay with her more than you are able to. She needs a nursing home. Be firm!
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Reply to mstrbill
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shad250 Dec 17, 2019
Sad thing is, the bed found may be in a crummy NH
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Do not pick her up. Let them know about her stairs and no elevator and that this is an unsafe discharge - they will have to find options for her to live. Do not get in the middle as her caregiver - you will be sucked in to a whirlpool going down and will drown.
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Reply to Kimber166
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JulesNeedsHelp Dec 18, 2019
When no one shows up for her, how is she going to feel? Now that she has such confusion she will be really lost going into another strange place. I'm drowning, I can't take her if I do, I will drown.
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If you don't have POA and she is still competent in the eyes of the law, you can say that the discharge planner and your mom will have to make those decisions and you will not take her into your home or pick her up and take your mom back to her apartment. Tell this social worker to discuss options with your mother and set things up because you won't be involved in any of this. It's the social worker's job to make arrangements. Of course they will say they can make this work but they won't. Why? Because they are lazy pieces of crap.
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Reply to Evermore99
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Jules, I'm so sorry you're in this situation. I read below that you buckled. You didn't need to. If APS was called they would have found placement for Mom, the only negative consequence for you would be that they would have obtained complete control (guardianship) and you wouldn't have any say in the matter. Which means they would have found a place or situation where Mom would have been cared for but it could have been 100 miles away and you wouldn't have a say. But that's it. You are not obligated if you are not able to care for her financially, physically or otherwise. You wouldn't be "charged" with anything, its not your legal responsibility like it is if you abandoned a child. There will be a next time. I wish you the best and hope you are able to manage.
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Reply to mstrbill
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Worried, you're quite right; only your points then raise the question: who is the authoritative decision-maker here, mother or the OP?

If it's still mother, even only in theory, then the discharge planner should be supporting mother in making the decision, and if mother's decision is to return home that needs to be done safely and it's down to them to help her put the required care in place. If it can't be done and she needs LTC, then mother will have to understand and agree to that.

If it's the OP, then that's different; but the OP hasn't said so. Responsibility without authority must always be firmly refused!
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Beatty Dec 18, 2019
Absolutely.
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I want you to remember that this crisis is in part fueled by your mother's difficult personality. She can't get along with your husband, doesnt cooperate when you try to figure out how to best get her needs met.

This pickle is not of YOUR making.
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Reply to BarbBrooklyn
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Manage best you can over Christmas and then find an elder law attorney who specializes in Medicaid planning
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JulesNeedsHelp Dec 24, 2019
Thank you!

Merry Christmas and Happy Holidays.
Thanks for all of your responses.
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