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Am I bound by any laws for providing care? She is currently in the hospital being treated for a serious infection and is receiving daily wound care. She is unable to walk due to her current illness and requires around the clock care. The hospital cannot release her to skilled care until she is less combative, she is currently restrained and must be stable for more than 24 hours. The case workers are informing us that we are responsible for her care after she is released from skilled care. What are our options ? I work full time and cannot afford to quit working to care for my mother. She has no assets and is on a fixed income from social security. Any information or guidance would be greatly appreciated.

Thank you,

Laura


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You are not personally responsible from a financial standpoint. Neither are you or hubby slaves who must care for her. If she has money, you must spent it on her care. If you've transferred her money in your own names within the last five years, you must give it back. If she's gifted you any money in the last five years, back it goes.

Consult an elder law attorney immediately. Certainly, if she is on Medicare, she has nursing home days...90??? That gives you time. Use that time to get answers from an expert.
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Ask for/Demand a geriatric psychiatric evaluation while she is in the hospital. You are not, in no way responsible for her care UNLESS you are her guardian. If the hospital is telling you that you MUST care for her, tell them that you would be happy for the hospital to seek emergency guardianship.

And yes, consult an eldercare attorney. Imho, geriatric psychiatrist worth their weight in gold.
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I'm a little puzzled by your profile - where was your mother living before her admission to hospital, and who was looking after her?
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Mother-in-law, I should say - I beg your pardon.
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I am Lauras husband. My mother in law was living in an apartment on her own when she became ill. She has been in and out of the hospital several times this year and was released from skilled nursing a month ago, we were forced to take her to her apt. After her treatment for a previous wound care infection was cleared. She was admitted to the hospital within a week of being release. We had to care for her at her apt. 24 hours a day and had to take time off from work to do it.
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Why did the discharge planners at the hospital not arrange for home care or trhab? Does she have Medicare or other insurance?
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You are under no obligation to care for her. The hospital, however, is legally obligated to make sure she is released to a safe environment. You should let the social worker know that she lives alone with no one to care for her, that her funds are very limited (as your post seems to indicate), and that she needs medicaid. The social worker will have to take it from there. If she qualifies medically, and can no longer live at home, they will find a nursing home to take her, combative and all. This is common and nursing homes know how to handle it. that being said, if you allow them to do this, they will send her to the first available bed and you may not be happy with the facility. I would say that now is the time to do some research. As another posted said, the first 200 days (365 beginning in 2016) are covered by medicare, so you have some time. Wait...I just re-read your post. So here's my answer: after she is released from "rehab," the nursing home will have had a chance to evaluate her and they will probably know she can no longer live alone. If you like the facility, ask that she be transferred to long term care. Most nursing homes have short term and long term facilities under one roof. When it becomes clear that the patient cannot return home, they transfer them to long term. In NY, this evaluation is recorded on a form called a PRI. Other states might do it differently. On the PRI, the nurse will make a recommendation, either long term care, or short term rehab, or help/supervision at home. That form carries a lot of weight. Here's the other scenario, if the rehab makes the determination that she is not medically eligible for long term care at that facility, you talk to the social worker. Explain the she is indigent and has no one to care for her at home. They will arrange for in-home care and help with the medicaid application.

I'm very surprised the case workers are throwing the responsibility back at you. At the hospital, this is their job...basically their only job. You could ask to speak to a social work supervisor, or a patient advocate.
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I appreciate all the responses and information shared. My mother in law has all the appropriate medical benefits for a low income senior. Medicare and Medical along with SCAN. The case manager is working on placing her to a skilled care facility, but it appears there is a shortage of long term care facilities available. We have been told numerous times that it is our responsibility to locate a facility for her. This is what happened when she was released from the rehab center last month. We could not find a place for her so they made us take her back to her apartment. We will not let this happen again. Hoping someone can provide information that can be useful when communicating with the case manager on our inability to care for my mother in law. Again thanks for all your support and guidance in this matter.
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One bit of advice. The next time she is in the hospital, have her released to a rehab facility that is also a nursing home (assuming that that is the level of care she needs, not assisted living or memory care). The discharge planners in the hospitals my mom has been in were RNS and really knew their stuff. Tell them that she can no longer be cared for at home the minute she gets admitted.

If you go to the Elder Care bar at the top, you will find resources for finding NHS in your area.

If you said "no, there is no one to care for her at her home" and if you didn't show up to pick her up, they would be obligated to keep her or find her placement . At least that's how it works here. You have to say "no" and mean it.
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It is NOT your responsibility to find placement. The hospital has the best chance of finding placement. The first bed that becomes available, the person in the hospital becomes first in line for it. The hospital wants her out because she is taking up a bed and it is costing them money. Just business.
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I believe that there is a difference between a hospital's responsibility and that of a rehab. In this case, the op told us that it was REHAB who told them they had to find the bed. That has been my experience as well. The trick here is to get the hospital to send her to rehab that can then keep her for long term care.
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Cameo, they are bullying you at the hospital. Simply say NO and refuse to take her home. They cannot throw her out in the street, they will find an opening in short order. Ask for the hospital Ombudsman, call the health department or file a complaint with the Joint Commission. The discharge coordinator at the hospital has to help her find safe harbor.
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OMG...are you kidding me!! why should you be responsible. Don't give up your life!!
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Timbuktu is correct. Just tell the hospital you are unable to care for her and unable to find placement. Rinse and repeat as often as necessary.
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I agree. The hospital knows where the nursing facilities are. Those facilities also contact hospitals to tell them a bed is opened. Here where I live most NH have rehab. If u can find one and if she can get into rehab have her evaluated and she can be transferred to the nursing section. Social Services job is to help you. There is no law that says you must care for a parent. Combative is not good. Its hard enough to deal with an easy one like my Mom but a combative one will drain you.
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I'm in Alabama. My elderly Aunt (90) was living with my Mother who had her own health issues (72). My Aunt fell and cracked her pelvis. 3 days in the hospital and they are telling her she is going home. Now, keep in mind she was UNABLE TO WALK...not showering, using bedpan, not potty, not getting out of bed at all! I stepped up and said NO. I had to raise my voice, I had to pitch a fit, I had to explain I wasn't married and had to work to take care of myself so couldn't take care of her. That my Mom wasn't physically able to take care of her and we were all she had. That my Aunt had no one that could take care of her. And I screamed AND SHE CAN'T WALK. I know typically you get more flies with honey, not vinegar but it seemed that was all they heard....me pitching a fit. As it happened that particular hospital had a rehab unit on their 11th floor so they transferred her up there. Because I was so vocal and assertive and said NO, she stayed there, getting the physical therapy she needed, for 3 weeks. Hope you can make everything work out. Don't let them bully you!
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No you're not responsible for taking care of your MIL.
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Good for you, Beenthere. It seems as though a lot of hospitals play the guilt card with families who don't know what the rules are. This is an amazing forum for enlightenment !
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I think it all comes down to Medicaid. They don't want anymore people on it than they have to have. You do have to be really firm. My daughter is good at it since she is an RN and knows what she is talking about. I can't understand why they want to send her home. Here, if u can't walk rehab is a given.
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HERE IS A RELATED QUESTION. Am I legally responsible to take my husband home when he is released from rehab in a local nursing home?

He had a stroke in 2009 and recently fell and broke his hip. I am 70 years old and I have health issues that make it difficult for me to care for him at home. Before the broken hip, he was living at home with me (helped by 4 hours per week from home health aides). He is wheel-chair bound and he is 74 years old.
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The NH should have a social worker. Make it VERY clear there is no one at home that can provide the care he needs and that includes you. The NH can be in legal hot water trying to send a person home to an environment that they cannot be properly cared for . DO NOT let them bully you.Stand your ground!
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unfortunately....soooo many times, you have to throw a fit...and loudly!!! it works!!
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I'm not sure how old this thread is but DON'T DO IT. I took my gma groceries and to the dr the week after my mom died. She has been my responsibility since then. I've been so desperate that I've called APS...ON MYSELF. Once you start, you will be bullied, threatened, intimidated etc. My "grandma" has been a horrible person her whole life. Everyone else ran as fast as they could away from her. My mom, an only child was stuck with her till the day she died. I've called every agency and told them I QUIT. but no. slavery apparently isn't against the law when it's the state imposes it. 3 years I've been told "she's independent. She has rights. She can live where and how she chooses. But YOU are responsible for her choices" under the threat of "charges of elder neglect and abandonment". When this is done I WILL make the proverbial federal case out of this. So stay tuned.
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CameoJRC: See below---

This situation is not uncommon: When an aging parent needs care, it's often one child out of several siblings who steps up to the plate to offer help. And with more Americans living longer -- to 75 years and beyond -- this scenario will only become more familiar.

So this tells you that the adult children who aren't the caregivers are not getting in any legal trouble.
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CameoJRC: It is the hospital's responsibility to place your loved one in the rehab unit of a Nursing Home when a rehab bed becomes available. Under no circumstances are you responsible for caring for your ill elder! Here's a big reason why: YOU ARE NOT MEDICAL PROFESSIONALS!!
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CameoJRC: However, I caution you to be careful with NH's. They could pull a fast one on you like they did to my late mother. I had moved in with mother from 400 miles away....for 6 months. My brother finally arrived for his week stay. Our mother was in an NH in a rehab bed expected (by us, because she couldn't continue to live alone like she had been doing) to be transferred to a long-term care bed when they told ALL of us "maam, you're too well to stay here." They were VERY MUCH INCORRECT because less than 48 hrs later she suffered a stroke there. She deceased later at the hospital.
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