So, after a year of searching we finally found an assisted living facility for my mother-in-law that she could afford. We moved her from California to Washington State at the end of June. There are several factors in play here: she suffers from paranoid delusions, there was mismanaged care when she was in California (she was in a residential care facility), an extended hospital stays upon arriving at her new assisted living facility in WA, and tonight was supposed to be her first night in her new home at the assisted living facility.
We got a phone call from the facility about an hour ago, apparently, she (my mother-in-law) says she was in pain, called 911, and was demanding to be taken to the ER. The EMT tonight says her vitals are fine and they can't find anything wrong with her. When she was in the hospital earlier, she complained of back pain, but they found no explanation for it.
She refused to take her meds tonight, says the assisted living facility is refusing to help her and wants to go to the ER, talk to a social worker and find somewhere else to live or come live with us. We told her we can't help her, we can't care for her, and that since we do not have power of attorney (she did not want to give any of her children that), we can't make any decisions on her behalf. She hung up on us.
We were in the process of applying her to Medicaid (she needed to be in WA before she could apply, and it would help cover what her own insurance doesn't) and we were beginning to make headway on getting her to give us medical power of attorney so we could at least help with some of these decisions. She needs physical therapy and that was going to start next week at the assisted living facility, she was going to have her first appointment with her new primary care physician next week ... now that is all up in the air because we're not even sure if she is going to go back to the assisted living facility (because she says she absolutely refuses to stay there a second longer).
We're beginning to think she needs a nursing home, but there's no money for that. We don't have the financial resources for that, and she doesn’t (part of the reason we were applying her to Medicaid was that it was going to help alleviate the cost of the assisted living facility). Part of the problem with the Medicaid is because we don't have POA, we can't help her enroll because we aren't able to verify her income or expenses, and she can't remember any of it.
What happens in a case like this? There is nothing else we can do because she is saying she is not going back to the assisted living facility and that was our touchstone for her care.
What does one do in a case like this?
The OP was a one time poster and never came back.
I doubt the MIL is still in the hospital since they couldn't find anything wrong with her on day one.
If she is mentally competent, then she will need to work with the case manager or social worker to secure placement in a residential facility that she can afford.
Then came the T8 fracture in 2017, and that one put my mother on her back and in extreme pain. After another ER visit and an x-ray and an MRI, we finally made it to an orthopedic doctor who performed a Kyphoplasty and immediately the pain was gone. My mother came out of the sedation singing hymns she was so happy.
Since then, my mother has had a couple of other small compression fractures but they didn't put her on her back and again they healed and life has gone on.
The Kyphyplasty is an outpatient procedure that has very low risk and high results typically.
Please don't ignore your mother's complaints about her back pain. The hospitals are notoriously incompetent at finding the source of many ailments.
(My mother had a wreck 20 years ago and was complaining that it hurt to walk and the nurses told her to walk anyway - come to find out she had a broken calcaneous (heel bone) for crying out loud.
Your mother should have an x-ray or MRI or Dexa scan in order to determine whether or not her back pain is from compression fractures.
Peace.
When my Mom and I started down this road, she complained of pain even though the doctors said that she was healed from her surgeries. On the 4th trip to the ER, the doctor told me, “You know she has arthritis, right? “. I said yes, I was aware she had arthritis. Then he went on to tell me that the arthritis was amongst the worst he’d ever seen. So I asked my Mom if she knew she had arthritis and she said no, no one had ever told her. It turns out that she was popping prescription pain killers and had gotten addicted them, which was prescribed for the surgery pain which really was pain from the arthritis. (I later found out that my mom’s eye doctor had recommended cataract surgery and she didn’t know about that either).
Anyway, I got my mom on a different regime (non addicting) for arthritic pain and was able to stabilize her mood and health.
The diagnosis of arthritis was with X-rays and even though she had X-rays and mris done the previous 3 times to ER, they had not done xrays on this part of her back because they thought the pain was due to her surgeries.
It was a huge ah ha moment for me.
Once when filling the prescription the pharmacist asked why she was taking it. I told him for her knee surgery. He asked how long ago. I said it was about 18 months. He said that was far far too long after surgery to be taking those drugs which raised a red flag.
Turns out she had been doctor shopping and this doctor had just been prescribing the pills for her long after she no longer needed them and she was addicted. Her new doctor took her off of all of it. She still complains about pain but the doctor says it is arthritis and she can take a much less powerful drug for that.
Getting her off those medications helped her a lot. That and quitting alcohol which she also had an issue with has made her a lot healthier. She still sometimes tries to get the hard drugs when she can but we put notes in all her files that she is an addict so that the doctors don’t prescribe them and over time asks about it less and less.
She still complains about pain and the doctors tell her it is just part of getting old and not to worry unless it is debilitating.
https://story.californiasunday.com/covid-life-care-center-kirkland-washington/
This was written during covid, but when you look beyond that, this nh had actual nurses. Elaborate activities such as the Mardi Gras party mentioned. Lots of personal staff interaction. Their gardens are very nice. Going to a place like this would be a positive outcome for all.
trust me it was not an easy thing to do and there were a lot of emotions but it was the right thing to do.
Also, your mother is not diagnosed as incompetent in her own care.
I cannot imagine what assisted living accepted a woman with a history of paranoid delusions, undiagnosed and without funds, but apparently one did. I feel they will soon be on the
phone to you telling you that they have transferred your mother to hospital (they certainly SHOULD do so). She has back pain unaddressed which could be anything from kidney infection to fracture. Do feel free to tell the ALF to call an ambulance for Mom.
So sit back and wait out this bumpy ride. When Mom does end up in the hospital let the social workers know that you have no POA and your Mom is undiagnosed. They will assist in getting diagnostic workup and either POA or conservatorship.
You say you have applied for medicaid. I don't know of any assisted livings that accept it, but all nursing homes do. And I suspect this may be the direction this is all heading. I surely do wish you good luck and am so sorry you're going through this, but currently you have zero power to do anything. Just be VERY certain you NEVER take this dear woman into your home, because once you paint yourself into THAT corner you may be beyond the help of almost ANY advice.
How does her AL bill get paid for? The AL in Washington would not have accepted her unless the mode of payment was secured.
Her being in the hospital can be a blessing in disguise because while she's there you can ask to speak to a social worker about the Medicaid application. They will help you.
Under no circumstances should you take her to live with you. Don't do that and don't let anyone (the AL, the hospital, or their social workers and nurses) talk you into it. They will promise all kinds of available "resources" that will come to your home and take care of her, but it doesn't happen like they say. Refuse to take her. Then the AL that accepted her will have to take her back and secure her Medicaid application.
1. As someone else mentioned, contact an Elder Law attorney (see www.naela.org) to discuss the situation.
2. The paranoid delusions. There can be numerous reasons for this - even stress can be the root cause. Her experience in the CA facility and the move would certainly be enough to trigger these. My mother had a psychotic break when moved from independent living to a care facility against her will (I was not involved or even aware of the decision; presumably it was the continuing care retirement community's management who pushed this - illegally and to preserve the "look" in independent living.) ** I suggest it is important to find the cause of the paranoid delusions and treat it, if possible.
3. IF you can care for her with help, check out the P.A.C.E. program in your area. If she can get in, they will provide care in your home. ** This situation doesn't sound possible, but maybe???
4. You may need to detach and let the system address your mother's situation. You will then likely need therapy to deal with the guilt and frustrations. (Okay, I am projecting - but that you posted on this forum suggests you do care at some level.)
IMO: Our society has failed vulnerable, dependent elders and continues to do so. Instead of getting cared for, they are effectively neglected in warehouses for the elderly. Me: I'd rather be dead.
Please call an elder law attorney to understand your options. I'm concerned that her acting out is going to get her booted out of this AL.
My mother recently went into a nursing home (Massachusetts) and my father has been working with an elder law attorney to apply for Medicaid. $15K legal fee. Sounds crazy, right? Well, not really. These people know EXACTLY what to do to collect all the right financial information and make sure they get approved. This attorney has spent so many hours, it will be worth it as my mother's placement will now not impoverish my father.
Agree with others - do not let her in your home for a visit or a night, NOTHING. Do not do it!
Unfortunately, that's the way it is. She doesn't get it yet, but maybe she will eventually. I mostly think she won't. She's already shot herself in the foot, and she intends to follow that path to the bloody end.
Very sorry, OP, you don't deserve this.
Looks like Washington State pays for AL. You are so lucky because most states don't. In my State u have to pay privately for at least two years to apply for Medicaid help in an AL
By the way, I will be 74 next month, my DH is 76. Yes we have our aches and pains but we aren't elderly. MIL seems to have a mental problem that needs to be addressed. An AL assists, it is not equipped to care for someone who has mental problems. If she disrupts the residents, she will probably be asked to leave. I would allow her to go to the ER and be there when the doctor talks to her. I agree with MD, she could have a UTI. My MIL complained of back pain with hers. Because she had back problems the doctor thought nothing of it. Kidney infections produce back pains too.
Let her talk to a social worker. Keep making it clear to her and the Social worker that your home is not an option. Do not give in. I don't know ur MIL but I knew mine and she was passive aggressive. This is exactly what she would do to get her own way if she wanted to live with us. Tell her if she leaves the AL, she is on her own. That any help she needs should be thru a SW. Because, by not having POA, you can't help her. Again, 75 is not old. If she can manipulate a situation, she can figure things out for herself. Again, don't play into this. The SW may end up telling her the AL is her best option.
I would continue filing for Medicaid. It takes a while for the application to go thru anyway. In my State about 90 days,
Back off do not get involved, your mother-in-law has some serious mental health issues that you cannot solve by stepping in, time and time again.
If she refuses to go back to AL then she will have to figure something else out with a social worker, you have no power, no authority.
Whatever you do...do not bring her into your home to stay overnight even for a day.
To my knowledge Medicaid does not help with AL, although that may not be the case where you live.
Your MIL has not been deemed incompetent, and no one has a DPOA, so let her figure it out, she may determine that it is best to behave and stay where she is.
My mother refused to go into AL, she had a slight stroke, was afraid to stay alone at night, she kept calling the EMT's, well finally they started to charge her $600 per visit, that ended that. She now lives in AL near my brother and I.
My mother is 98, your MIL could live a very long time, don't lock yourself into something you have no control over, believe me continuing to deal with MIL's issues will have a very negative impact on your family life.
Sending support your way!
You're spot on right about eveything else though, MeDolly.
In my state a care facility cannot do an unsafe discharge even if insurance is refusing to pay.
But, if someone takes that person out of the facility, even if it's just to drive them to a doctor's appointment the facility does not have to let them back in. They are assuming responsibility.
I worked for a few ambulance callers over the years. That nonsense always stops when they start getting charged.
Is your wife going to want to bring her to your home? If so, then you must remain strong and insist that the SW find somewhere for her. You and your wife are NOT responsible for her.
Do not listen to any promises of "help" if you bring her to your home temporarily. Once she's out of their facility, she is off their caseload. There will be no help for you. Do not fall for that ploy.
Keep us updated!
Do NOT pick her up.
She stays at the hospital, talks to the Social Worker in the AM.
She is (technically) competent and can direct her own care.
YOUR HOME IS NOT ON OFFER. Make d@mn sure the SW understands that.
She might have a UTI, might be dehydrated.
Let the hospital admit her and figure out what's going on; might need a psych admission to get medications sorted out.
I'm curious, what was her extended stay in the Washington hospital for? Did she go to rehab after?
If she is medically in need of a NH, Medicaid will be her source of funding. Without POA, the NH she gets admitted to will need to manage the Medical application themselves. They will apply for guardianship.
The worse case scenario is that she gets declared incompetent and is made
a ward of the state.
That, unfortunately, is often what happens to stubborn elders who don't trust their kids to hold POA.
Requests for ER a cry for help.
Emotional pain/anxiety +++.
Geriatric Psychologist? A Social Worker? Is she someone of faith? Someone for her to discuss this very hard transition to a new living arrangment?