Can she discharge herself without a "medical advice" form? - AgingCare.com

Can she discharge herself without a "medical advice" form?

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Mom was told by her youngest of three daughters that she was being admitted to rehab for therapy (for walking, hip problems). Mom expected to return home. Sister #2 (who resided at MOM'S house with her) is now refusing her return because she doesn't want to assist/care for Mom . The nursing home states that Mom needs 24/7 care and that she can't take care of herself to the extent that she believes she can. Mom's limited mobility is at the heart of the issue (no actual "illnesses"). Mom is securing an ombudsman to facilitate her leaving the nursing home without a recommendation from the nursing home. Then what?

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Why won't he agree to assign his SS to a nursing home? At this point it seems as though that's his best option to get care as he can't return to a place w/o plumbing or bathroom facilities. I'm surprised that place hasn't been condemned.

Can you contact the VA and ask to speak with a social worker? I would also try to get the NH social workers going by helping you with solutions. This is a complex situation, and you're right to refuse to care for him, but it may require intervention by APS to find a place that will take him, if he agrees to assign his SS payments.
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Brother in NH..competent for all intent and purposes...does have "good decision" Making abilities...He is VA but in reg NH..from accident...His medicare days up..He has no caregiver..no place to go...he needs NH care..He will not assign NH as his payee...I will not take this on..I am elderly and cannot care for him...Can he be discharged without caregiver, or home without plumbing and bathroom facilities? He cannot walk or propel himself with a W/C or walker...needs assistance...He had the NH Social Worker to call me and ask me to come pick him up..I have refused and will continue to do so because I am not able to care for him...Can someone help me help him...
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Oops ... I can not form intelligent opinions WITHOUT "real" information. Sorry about the typing mistake!
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First, I want to thank all of you who have taken the time to share your input! My research into issues regarding Mom continue to lead me to yet more and more research. The more I learn the more questions I come up with. It is getting quite complex. Countless calls to agencies, etc. This is becoming a second full time job and especially difficult because I'm not available to do so until after regular business hours! I will not give up but I have to take a day or two break. I am mentally exhausted. I need to refresh my mind! The information resources are plentiful but tiring. In spite of the situation, I try to put myself in the shoes of every person involved to see their point even if I feel I don't agree. It's only fair to everyone. I can not form intelligent opinions with "real" information. Unfortunately, as of today, I have learned one must be really, really careful who you trust, especially for your Health Care Proxy, and to be extremely clear IN WRITING what your wishes are. It frightens me to think about is THIS what we all have to someday look forward to if we live long enough? What a debacle! I will add more information soon. Thanks again . . . everyone.
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I should have written "if you think your mother can live at home" instead of alone.
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sar, as you are talking I hear two sides of the story in my mind. Often people who do not live with a care receiver don't realize what was required from a caregiver when Mother was living at home. Sometimes when a parent is adamant about not leaving their home, the caregivers have to use trickery to get parents into a place where they can receive better care. Have you talked to your sisters to see if this is indeed the case? If you think your mother can live alone, maybe you can step in as her caregiver. From what you write, it sounds like she is going to need someone there around the clock, but it sounds like you are up to the task. I hope you are able to work out something with the NH so they will release her to your care.
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Sounds like your sisters have been very sneaky and secretive about this. Is it mainly sister #2? Unfortunately, it sounds like the other sister with the POA has the legal authority on her side in this matter. What has your mother's actual doctor before she went to rehab say about how safe it is for her to live at home. I guess that discharge without medical advice is the same as what my mother's NH calls a unsafe discharge. One consequence will be that the doctor related to the NH will no longer be her doctor. There is a possible consequence of her not being able to go back there when she really needs to. I believe your sisters are setting themselves up to be held liable if anything bad were to happen to your mother upon being sent home without medical advice. I wonder how the rest of the medical community would respond to someone who was sent home without medical advice? You might want to inquire about these things. I don't think you could override your sister with the POA by going to court for guardianship because it does not sound like your mother is incompetent to handle her own business.
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In answer to "aging consultant" and "cmagnum": Unfortunately, Mom has no social or financial resources aside from owning her home. To my knowledge, my sisters have not looked into outside resources as their intention to admit her to the nursing home as a permanent resident was evident from the beginning. They have avoided me and also did not allow me to be on the NH "contact" list making it impossible for me to get first-hand, professional medical information about my mother. It will be three months this Thursday that Mom was brought there from a short hospital stay (due to pain-hips). Only Friday, after many calls to advocate agencies, was I able to get the consent of the NH social worker to talk to me. They (NH) decided that being my mother is "alert" that they would honor her written request to add me, her oldest daughter, to the contact list. It is now apparent that my sisters did not want me to be a part of any decision making as I have an aversion to lying and deceit - their m.o. the whole time. Sister #2 (lives in Mom's house) simply doesn't want any inconvenience and Proxy/POA sister doesn't want to make waves with her nor assist as she lives minutes away. I live approximately an hour away. My sisters AND the social worker say nothing more to Mom other than "you can't take care of yourself" ... how indirect! Now, Mom has been told by the social worker, quite matter-of-factly, that she is there as a permanent resident when she was "led" to believe she would go home after her PT and OT were complete. That was over three weeks ago! Mom is shocked, angry, hurt and feeling betrayed and desperate. She can not believe "her daughters" would do this. She is not "sickly" but just needs some assistance. She can walk about 40' with her walker. Her home is small. Her shock and desperation have led her to an ombudsman. She is putting a plan in action which is to pursue the "discharge without medical advice". I am concerned of the consequences of this action. Hearing her cry and cry every night over having to live in the NH the rest of her life is really doing me in. While I'm sure this is never an easy transition, this was absolute trickery and deceit. My sisters rarely call or visit her because they don't want to hear her beg to go home. The whole situation is just pitiful. Her worst nightmare has come true. I'm not even sure what questions to ask of all of you at this point. Any information you can add would be so much appreciated. Thank you for your responses and I look forward from learning from you!
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sar2456, who has medical and durable POA? My mother went to a NH after hip surgery, but never regained the ability to walk as her dementia took over. It was already not safe for her to live at home and the nursing home has told me that they will only make a safe discharge. Has the doctor connected to the rehab place or say a social worker met with your mom and explained to her why she can't go home?
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The hospital/rehab facility is not allowed to release her without a plan in place assuring that she will be safe. The sister with whom she lives needs to escalate this to the head of the nursing home to assure that she is not released without a proper plan in place. Once she is out, you end up int he situation that Marylee described, which is much more difficult.
Does your mother have the resources to get assistance at home? Have you looked into what resources beyond your family are available?

As a practical matter, it sounds like you and your sisters need to work together to take care of your mom, since it sounds like #2 needs help. There are people who can help you facilitate a conversation if you can't work it out among yourselves.
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