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My mother lives alone in a rental. She’ll be 90 in two weeks. She’s declined significantly in the last month and during this period I’ve been assisting daily at her apt. with meals and logistics. She has no assets and spends most of her meager SS on overhead. On Sunday she had an episode and was taken by ambulance to the hospital. I’ve been told she’s had strokes, seizures and has complications with her heart and liver. She is now mentally impaired, incontinent and cannot walk. Does anyone have experience with “what’s next”? When she is released from the hospital there’s absolutely no way she can live alone. She has no financial resources for in home nursing or assisted living. Including me, there are no family members whom she can live with. Could anyone give me some advice or insight regarding what’s next, will a social worker intervene at the hospital level? I’m in an absolute panic.

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From your profile: "Married man. Six siblings, none are involved with parents care or supportive.
Parent (mother) is angry, nasty, hateful and ungrateful. It’s affecting my desire to do anything nice for her. It’s affecting my overall mental and physical health. I’m in search of any support and guidance I can obtain."

When she is released from the hospital, it needs to be to a LTC facility of some kind. There should be NO going home to her apartment, to your home, or anywhere else other than a LTC facility. When discharge is discussed, you must be very firm in stating that she is an unsafe discharge to her home. You must also state emphatically that you are unable to be her caregiver. The social worker/discharge person might try and tell you that they will "help" you find a solution if you allow her to be released to her home. If this hospital discharge is to happen within days, they will probably tell you how difficult it is to arrange for her transfer to a facility during this holiday week.

DO NOT FALL FOR ANY OF THIS.

They will have to find a place for her -- this is their job. And do NOT cave into any pressure by any family members or friends. You have been the only one of your many siblings who has done anything for your mother, and you can bet that you will be expected to continue to sacrifice your life in service to your mother.

Keep us updated. Everyone here will be cheering you on!
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Reply to CTTN55
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EEMFLA Nov 24, 2020
Thank you SO MUCH for your swift, supportive and affirmative reply. It gives me strength at a time when I’m feeling desperation. I appreciate it so very much. ❣️
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Your mother must be assessed before she can be discharged. Find out from the hospital who will be doing the assessment, and link up with that person both for guidance/advice and to make sure the discharge team is getting accurate information about your mother's living conditions.

I.e. so that your mother doesn't say "oh, my daughter visits me every day, and my son brings the groceries" and they take her word for it, for example.

The thing is, normally I'd say oh don't worry they won't just send her home. But over the last three or four weeks we've seen quite a number of people sent home who... don't seem... to be... anything like fit for it. We are living through strange and disturbing times.
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Reply to Countrymouse
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Please follow CTTN55'S advice. Her next location must be a SNF. Do not under any circumstances let the hospital discharge her to anywhere else. You are unable to provide proper care for her. She will go to the NH and transition to LTC Medicaid. The SW at the hospital will likely get together with you and help prepare the application.
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I don't have any advice for you as I am facing a similar situation myself . I can only say I understand what you are going through. I have been having some pretty severe panic attacks myself. I decided these last couple of days to take a little step back ; have cut back to only calling the hospital 1 - 2 x a day rather than the 3-4 times I was calling. Stopped making and taking a dozen calls a day from my family. Only calling them now when I have something to report. It's helped me tremendously . I suffer from anxiety, depression and am diabetic and my blood sugars have dropped by at least 30 percent compared to what they were. I'm sleeping better and I feel better overall. My mom is stable and doing well, there is nothing i can do and I had to learn to accept that. She is in the best possible place she could be. I know I have to take care of myself so I can take care of her.
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EEMFLA Nov 27, 2020
Thanks for your reply. Stark similarities to my situation. My family hasn’t done anything to assist me in decades, now they’re expecting routine, comprehensive updates. I informed them in the beginning but not I’ve realized it’s not my responsibility to ease their conscience.
How long has you mom been in the hospital? Mine has been there five days, I’ve only heard from her PC Dr twice. One time I had to call her. She seems to be failing, but it’s very difficult to tell from the sound of her voice. Today I’m going to try to see if I can get info from an attending nurse. It’s so difficult not being able to go to the hospital, and I know it’s VERY difficult on the patient and their ability for self-healing.
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I’m sorry you are in this situation as it is heartbreaking for you to make these difficult decisions. I know as I’ve been there. It helped me to look at things objectively and helped not to let my emotions take over.

To help me decide I set #1 priority as my mother’s safety. She did not live alone but with my brother (who was over 60 y/o). However living with a son is different than living with a daughter as there were many things he was not comfortable doing.

She was admitted due to a fecal impaction (not moving her bowels for about 2 weeks). She fell and broke her hip about 1 year prior. That was the beginning of the end for her. She was 87.

Anyway brother & I decided to place her at a SNF. Not an easy decision at all. One that he and I wrestled with during that time, as well as during the 14 months she stayed there (after the impaction), and then for years after she passed in 2013.

I knew my brother couldn’t take care of her properly (he had been a perfect CG prior to her physical decline). I lived in another state and tried to move both of them here for years but time ran out.

So we worked with the SW to get her on Medicaid (she had no assets) which was done quickly and she was moved to a nursing home very near my brother.

It’s one of the hardest decisions you’ll most likely make but your goal should now be to get mom a bed in a nursing home. She needs care you cannot provide (which most of us would pay to keep them at home if we could afford it). Not many people I know have that option of unlimited $ for care at home. While nothing is guaranteed to be safe, our decision was based on where she would most likely be monitored 24/7 - BM checks, hygiene, etc.

Her medical issues will most likely get worse. She may progress to needing Hospice as well.

My thoughts are with you in this difficult time. Just do the best you can but at times viewing it objectively helps to keep the heartache at bay.

My best to you! Hang in there.
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Reply to Shane1124
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I am so sorry that your mom is going through such a sudden decline.

Ask to speak with a social worker at the hospital. 1st thing, make sure that the hospital has admitted her and not just have her under observation. This will help get her into a facility upon release. She needs to be hospitalized for 3 midnight's for insurance to cover rehab.

You need to tell the hospital that she needs a Medicaid facility because she has no one to care for her at home, they should be able to provide you a list of rehabilitation to long term care facilities that accept her insurance for rehabilitation and accept Medicaid pending patients.

You will need to do the research and decide what facility you want her to go to. Have at least 3 that you are happy with, they may not have a bed when she transfers. Be open and honest with them about needing to apply for Medicaid right away, the facility can help you get the ball rolling on that. They will also tell you if they have any Medicaid beds available.

That is what is next after she is released from the hospital.

May God touch your mom and heal her body.
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Reply to Isthisrealyreal
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EEMFLA Nov 24, 2020
Thank you for your kind words and information. You and so many others on this site have given me the strength to face the day ahead when I’ve been exhausted, not thinking clearly, without direction and have little to no support.
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Ask your doctor who your social worker is if he or she doesn't contact you before you read these responses. S/he will give you a list of skilled nursing facilities (SNF) and will handle getting your mother into one. My mother was in one for about a week following a trip to the emergency room. From there you can transfer her to a more longterm nursing home.
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Reply to SFdaughter
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First.... talk to your mom's doctor or nurse & ask them to do an assessment on her while she's in the hospital & explain the situation briefly & they should help you figure everything out.... you'll need to call social services in your area....I had an amazing social worker help me through the process......
When I went through this with my mother I was told it speeds up the process having the assessment done in the hospital.... I had to fill out paperwork for a different kind of medicaid... may have been called lifelong medicaid which should pay for Nursing home but if you don't want to put her in a nursing home then there's this program called PPL which is what I done.... PPL will either pay you or someone else to take care of your mom at her home....
I'm surprised that nobody at the hospital informed you of anything..... it's not easy in a situation like that especially when you don't know what to expect.....I really feel for you cause I know exactly what you're going through....my mother was a diabetic with heart failure, kidney failure, she had dialysis 3 times a week & could barely walk, fell 2-3 a week at times, I could NOT go anywhere except the grocery store once a month & I practically ran around getting my shopping done as fast as I could scared that she'd fall....
If you decide to put her in a nursing home don't feel guilty....I did & I had to put my life on hold for a little over 3 years & the stress of taking care of her & being cooped up for so long has really taken a toll on me....I wish you & your mom all the best....
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Reply to April81
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Let them know at the Hospital that you need to speak to someone about finding a Nursing Home for her because she can't live in her Apartment any longer by herself and you're not able to have her live with you.
They will keep her in the Hospital until she is well enough to go to a Nursing Home.
Please make sure you Do Not let the Hospital Release your mom to you and they will have to keep her until they find a Nursing Home to take her.

She should have Medicare now and If she has no assets then Medicaide will take over.

Just inform the Hospital now that you need to speak to someone to make arrangements for your mom for when she is discharged because she has no place to go.
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Reply to bevthegreat
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First I want to say that I am sorry that you and your family are going through this.  For those of us who have dealt with this, we know it's not easy.

Definitely pull in the hospital's social worker.  Tell them she can't leave until they help her find a long term care facility to go to.  Be explicit and firm about the fact that she has no where to go.  If they try and talk you into taking her home and just giving you a suggested list of places, tell them you can't take her home. Not an option. Once she leaves the hospital, you lose your "edge" for placement.  I know this sounds harsh, but the hospitals have more connections and more weight than you do.

Stay calm and be firm.  You'll have plenty to do once they find a facility for her...all of the required paperwork, providing documents, cleaning out her rental, etc...

Good luck and take care.
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