Any options if a senior is “unable to make medical decisions” and has mobility and home environment concerns? Does the hospital have to present viable options?

Hospital is required to make a "safe discharge". Have the discharge planners (Not family member) make it clear to the patient that going home alone is not an option

It sounds like Guardianship would/should be put in place.
If you explain that to Mom (I am guessing from "helpingson" this is your Mom) that she has 2 options at this point.
1. Reside with a family member where she will be safe and cared for.
2. Be placed in a Memory Care facility where she will be safe and cared for.

If she is not safe staying in her home the Hospital can not discharge her to go home.
If you do not think that you can care for her long term it might be be better to discharge her to rehab then have that become a permanent residence. Always saying .."when you are stronger we can discuss going home"..

You might want to discuss this with the Hospital Social Worker they may have better ways to present the options.
Also before you begin the thought process of bringing her into your home consider the work involved caring for someone with dementia. Also the mobility issues will only get worse. Is your house set up for that? And are you married? Children at home? What does your spouse think of this plan?
Is your Mom Hospice eligible? They can help greatly with supplies and equipment that will make some things a lot easier.

He was for 2 Days this time, 7 Days three weeks ago. Both times discharged to a rehab. The rehab discharged him to his apartment where he lives alone.
He was in the hospital last summer and discharged to rehab then home. He was admitted to the ER 3 or 4 times in the past 6 months for falls in public, but he was not admitted to the hospital because he was not injured. The falls were from
Standing up too fast after walking for a few miles.
So now he is in rehab again, and we are recycling this drama once again. This is very very difficult-there are six of us siblings and all six are totally burned out. He will not allow anything-not home health, not a cleaning service, none of his kids are allowed to clean or throw away food.
We could not have him live with any of us, everyone works, and more than one hour with him will suck all the energy out of you.
I feel deeply sympathetic for every person posting on here. It is so difficult.

I feel your pain and frustration.
My Dad has been in the hospital and rehab several times in the past year. He has memory problems, doesn’t take meds as prescribed, hoards food and anything else. I am the durable medical power of attorney. I cannot make medical decisions for him unless he is unable to make them for himself.
In all of his evaluations he is able to answer the questions. Last time we had them administer a competency test. It is what they use in his state to determine if a person is competent. He passed with flying colors.
That means that no matter how dysfunctional he is, how much he can’t figure out any of his phones, how much he will not get on a bath chair, how much spoiled food he keeps in the frig, how many payday loans he takes out, that he is his own person and has the right to live how he wants and where he wants. He is 90, and if he wants to die at home, we cannot do anything about it.
He was just discharged Monday from a rehab, went home and got on the couch, laid there until Thursday and was readmitted to the hospital with a urinary tract infection.
We did call adult protection more than once but they won’t even investigate.
People have the right to live the end of their life as they desire, unless they are so impaired you can prove they are a danger to themselves or others.
I understand how frustrating it is, but people have basic constitutional rights and doctors and hospitals are very aware of what they can and cannot do.

So sad, Helping. (((((((Hugs)))))))

I know it's not much consolation but imagine I'm patting you gently on the back. You made the best of an impossible situation. Well done.

The Hospitalist will not discharge the patient to the home. That is not  the protocol-safety of the patient is. It is usually the rehab unit of the NH once a Medicare bed is deemed available.

Llamalover47, unless, possibly with home health, like with my dad

BarbBrooklyn

You replied to my original post within minutes. I remembered your comment "Hospital is required to make a "safe discharge". Safe discharge became my theme when talking to her physicians.

Thank you very much for your prompt response when I needed timely advice.

helpingson

(Blushing). Helpingson, thank you for your kind words!

I learned EVERYTHING I know about eldercare HERE. "Safe dischare,"" I can't possibly do that", and "won't there be a Medicare penalty on the hospital if she's readmitted within 30 days for the same dx?"

Stick with us! I'm sure there will be a round two.