My mother is fully ambulatory, just requires supervision for safety concerns. I cannot provide that in her apartment, and Medicaid does not cover that level of need.
She goes downstairs to the main lobby through the fire exit staircase, then sometimes proceeds to walk right out the front door. I understand that having someone watch her every move is not possible, but even still something should be able to be done.
I understand the safety concerns and when I ask them what can be done, they offer no suggestions. We have tried medication but being behavioral issues spurred by the desire to go home, be with family, go shopping, socialize so to speak. I will admit the activities they do are slightly juvenile, and my mother is not at that point. On the other hand, she cannot be left alone since she can harm herself or someone else.
Medications have not altered the behavior. I suggested giving her a benzo or heavy sedatives if that is what is necessary. They cannot do that for many reasons, which I understand.
She is fine with a one-to-one and they have asked me to provide a one-to-one, but I refuse to spend $29-$35/hour for a private aide. They have also suggested specialized dementia communities for those with more social desires and behaviors, but once again those are private pay, my mother has no assets, and I refuse to flip the bill.
So what exactly can be done with such a patient? I am being told I am stuck and the facility is stuck. I refuse to have her live with me, my family will not take her. They have offered help if I take her out but refuse to take any responsibility, and I do not trust them to do as they say they will. If I take her out and they do not follow through, I am back at square one. It was already a pain to get her placed in the first place.
The part that gets me is my mom cannot be the first person that has left through a fire exit. Yet they are making it seem like they have never seen this before.
When I asked what will making my mother a ward of the state accomplish, if you guys are unable to place her what exactly could the state do. They did not give me a straight answer, so I assume that means they will dump her off wherever? Why exactly can they not do that now?
Was also told placement is going to be hard because my mother requires a one-to-one sit due to being a flight risk. Overall I have just been told every reason why it is hard, but have not been offered viable solutions that do not revolve me giving up my time and money.
I just want to add DO NOT CAVE IN or let the hospital coerce you to bring her home. You do not have to and you will regret it if you do.
As it stands the SNF is able to remove my mother by sending her to the ER and refusing to take her in. Which us unfortunate but it appears unless I am willing to take her in or pay for proper placement with more social and skilled care regarding dementia behaviors she is SOL.
So rip guess my mother will be playing SNF, ER roulette until something gives. It is ridiculous that places that specialize in PWD that are younger and need more one-on-one attention coat upwards of 11k.
As the Ombudsman pointed out off the record. Dementia does not discriminate but the care most certainly does. That is life.
Yes I do wish I could end my mother's life, that does not mean I want to see her needlessly suffer. Playing this roulette she is going to suffer. We have tried medication but facts are unless someone watches her like a hawk she is still extremely fit for her age she will get into things she is not meant to. That said I am also not willing to throw my own life into chaos taking on a role I know I am not equipped to handle. I would snap and could hurt my mom if I took on a more hands on level of care.
If she is sent to the ER, it becomes the ER's problem to find her placement. Hope you hear from the Ombudsman soon.
Every name he gave me only two had MC with Medicaid beds without private pay needed for a min of two years rest were private care. He advised me to take her home and try to set up home care verse leaving her in SNF with a MC floor. Since, what will happen is that the SNF can create an emergency situation and refuse to take her back from the ER leaving me at square one.
Has anyone ran into this.
Looking for new placement is not exactly an easy task. Getting her current placement was an uphill battle.
I was told directly by the NH manger during a rehab stint that in our LO's state, if they can GET OUT of the locked facility, they can stay out. Then they can only be returned under court order. Not even a POA allows the return. It is state law and not policy that mandates this. So the facilities options are very limited too.
I agree to start with the state ombudsman.
You may want to check with your State Ombudsman about the facility being able to kick Mom out. By law they cannot discharge anyone if its not a "safe discharge". If Mom is deemed 24/7 care and there is no one to care for her at her home, they can't force her out. And that 3 second door thing. At Moms AL it was 15 seconds. Just enough longer to help deter someone.
IMO, the facility needs to do what is needed to protect Mom. What if she had no family? How would they handle it then.
Many SNFs have locked down neighborhoods for people who are at risk for elopement - it sounds like your mother is not in one like this? Maybe a different SNF would be a better fit?
I asked why not put a guard or someone at the door. They do not have the staff to do that. My mother is very quick, and is determined.
At my local NH residents who wandered wore a bracelet that locked the doors when they were close to them (a bit of a pain when they hovered near the door and you wanted to enter/exit). But that would require a financial outlay from the NH and they might not be willing to invest in that.
Which is creating the problems, also the fully MC facilities that have better staff to patient ratios are all private pay, or they have Medicaid cover the medical side but not room and board which she cannot afford.
I have brought many if these suggestions up and the facility keeps telling me it cannot be done, or expect me to do all the leg work to fix the problem. Either by finding better suited placement or finding a solution.
I understand that not every solution has a good answer, that is why I said I am okay if they are forced to heavily sedate her to keep her safe and contained.
In my area there is a SNF with a locked down floor that is fully covered by Medicaid. The residents cannot get off that floor. Have you searched (or the NH) for a similar facility near you? If not, you need to stick to your guns, it is their responsibility to keep her safe. You do not need to pay for a sitter. They will work out a way. You may want to call the ombudsman for support and guidance.
My concern is they are going to send her to the ER.