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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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Calm yourself. An early night (9pm) will renew the energy & the spirits.
All problems have numbers of solutions. Including yours.
Pray to be shown the way to chose that is for the highest good of all. And be willing to see/hear the answers from heaven.
You might consider having a calm rational discussion with your mother. If speech is limited she can indicate yes or no with the nod of the head or blink of eyes.
Inside that old infirm body is a keen spirit.
She lived alone until 90, so she's an exceptional lady to begin with
You don't have to control everything..you can work with her. Im sure she will be understanding
Moringa Powder (available on Amazon) has the highest nutritional profile of any of the plants. It would be very helpful for your Mothers health to give her
1/2tspn of the powder x 2 times daily (or caps x 2 times daily)
If the 'whole..nothing added) powder or caps are taken daily this will help her recover in many regards
Keep your head up
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Just a comment on hospital/facility social workers. My experience is that there is very high turnover in this type of social work. Of course, who among us has not been new at a job? Of course we should extend the same grace and understanding that WE ourselves would want as a new person. However, in these types of crisis situations, there isn't much time to undo a mistake or chase down an inexperienced and/or minimally trained person who may very well be dodging calls - only to find out they don't work there anymore! I've run into a lot of rookie mistakes at that level and it's cost me time, energy and resources that I did not have. I didn't know any better when I first went through this, but I'd highly suggest verifying what you are told by social workers with regard to placement issues, discharge instructions of any kind, home care availability/duration, Medicaid, etc. There's just too much at stake and little to no accountability on their part when you find out an error was made or poor judgment was used. I'd suggest posting issues on the forum and see what people say about it - rather than putting so much faith in one person. The forum will give you ideas of additional questions to ask and can clarify what's really going on. It's good to hear it from peers.
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Imho, a patient should never be discharged from a hospital to their home if it is evident that they no longer can live at their home. If she is transported via ambulance to an SNF, Medicare will cover I believe 20 days. If she has no funds, the patient would then apply for Medicaid. Prayers sent.
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don't know if too late in answering, but I would let them know at the hospital that there is NO one that can take care of her at home.  She would qualify for Medicaid so the hospital should be in contact with someone from office of aging or whatever it is called in her area.  Do you have POA or guardianship?  The hospital will get the case worker involved and have her placed somewhere that they accept Medicaid.  In my fathers case, my brother and I had already been visiting different places and knew where dad would be placed if something happened (which it did, he fell/went to ER/ my mother could no longer care for him).......we told the hospital where we wanted him to be placed, they worked everything up and that is where he went.  luckily they had a room.  You should also get in touch with an elder attorney to get all things worked out as far as monies/Medicaid info, etc.  I wish you luck.......and breathe.........a lot of us have went thru this.
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I am so sorry you have to go through this under these circumstances. I, too, are going through the same at this time, except my mother is suicidal. We think she tried to take her life end of October. Went to hospital, doctor said she could not live on her own. Luckily I was anticipating her needs and had an assisted living place lined up. I have to say was not easy during pandemic. They do not allow you to visit in person. But luckily, again, this place was great. Release from hospital placed her in assisted living.
About a week ago she went outside in enclosed backyard and refused to come in and she wanted to die. They called me and I told them to call an ambulance. She is now in involuntary comittment at a psych hospital. The assisted living people told me to tell the hospital that she will need to land somewhere other than my home. They told me I would have to be adamant and not accept her coming to my home.
I couldn't have her come here. I don't have the skills to take care of this type of illness, Alzhiemers and depression. I would not be able to handle it if she took her life in my home.
The social worker called and I told her what the assisted living people told me. They will be looking for respite care until we can find another placement for my mother. The assisted living place will take her back once they have another place opened. It is a little different situation from your situation. But the advice from several people here and from my mother's assisted living home is the same. Put your foot down, get them to do their jobs and do not, under any circumstances feel guilty. It is the right thing to do for your mother. Good luck to you. I am praying everything works out for you and your mother.
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First, do you have Power of Attorney, and registered as an authorized rep on her social security record? Is she Medicaid eligible? Apparently, she is nearing the end of her life. Hospitals are staffed with patient liaison representatives. They consult and assist with such matters. Best scenario would be to let them assist with hospice care in your home, or placement in a hospice facility nearby, most likely covered by Medicare and Medicaid. She deserves a compassionate, respectful transition for her passing. Don't panic, it will work out.
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Please ask to talk to somebody from social work. He/She can help guide you into helping your mom into a total care residential facility that will accept her finances.

Based on the advice of social work, you may wish to notify your mother's place that she will not be returning and needs LTC placement. Make sure to remover/secure your mother's things. Make sure to clean/repair her place so the landlord can more easily rent her apartment to another. Having powers of attorney for finances and medical will make it easier to handle your mother's affairs. If you do not have powers of attorney, ask social worker how to proceed in breaking her lease, turning off utilities, etc.

Social worker may also help you in applying for Medicaid - if your mother is not already on it - to finance living in LTC.
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In my experience, if she has no assets the social worker will intervene. If you do not have a power of attorney for your mother for any capacity, she could become a ward of the state and placed in a nursing home. This is good and bad. Some nursing home staff are wonderful and care, some are just there for their check. Good luck, and I'm very sorry about your mom.
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Hello
Your mom should not be discharged from the Hospital until the Social Worker/Discharge Planner discusses next steps with you, and sets them up. Your mom should go straight to a skilled rehabilitation center or home with Skilled Home Health set up. I can give you resources, if needed.
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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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You need to ask for mom's social worker. Great responses below but don't forget about palliative care and hospice if she is eligible.
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Either you take care of her 24/7, or nursing home. What other choices are there.
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vmetoyer Nov 2020
Home health or home care
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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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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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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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Ask the hospital to connect you with a social worker immediately! There are assisted living facilities for people on medicaid but some may have waiting lists. The social worker should be able to advise you on what facilities and services are available for her in her area. There are organizations that have senior care specialists such as this one AgingCare who can advise. Ask for help.
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You have MPOA? Any Living Will or Advanced Life Directives in place? It would be easier to follow what your Mother had wanted if the need arrises (& avoid family tension over hard decisions).

None are completed in my family. So if it falls to me, I will be guided by the values that person had: how they lived their life & their attitude to nature's way vs medical intervention.

Any improvement? If so, try rehab if you can? Next will be the big fork in the road: either Home (if able) or SNF (if not).

Thoughts to you through this time of crises.
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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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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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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 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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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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while she’s in hospital, speak to Social Worker about admitting her to Skilled Nursing facility. Take the opportunity to tour a couple of places nearby so you can check on her. The Medicaid office at the facility will help apply for Medicaid...it’s actually easier that she doesn’t have much $$$...or else you’d have to deal with a lawyer...just make sure you get your name as poa & health proxy...while she still knows who you are & can ok it. This you probably need lawyer for. ... but can be her advocate while she’s in facility. Make sure she stays at hospital the required 3 night at least Hugs 🤗
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EEMFLA Nov 2020
Thx. I did the necessary legal docs a couple years ago, power of attorney, medical power, etc.
Last night was her 3rd night in the hospital, so seems we’re over that threshold. Such invaluable support and advice from so many, the support and information is invaluable.
Definitely a time to count ones blessings. I’m grateful for all the kindness extended here. 💕
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You are getting good advice. I would not think about taking her to your home considering what care giving is doing to you. it is very stressful and 30-40% of care givers die before the other they care for. Your mother has many problems and, IMO, needs professional care. Please, in all of this take time out for yourself to relax and keep yourself in an even keel. You matter too.
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EEMFLA Nov 2020
Thank you, it really does become necessary to be reminded to take care of the caregiver. It wasn’t until mom was admitted into the hospital, and the brisk pace of tending to her needs and running back and forth to her place subsided, that I’ve realized just how exhausted I am. Due to COVID, I’m not even allowed to visit her in the hospital. My days have quickly become quite different.
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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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EEMFLA Nov 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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Talk to the Hospital's Social Worker.
You may begin the process for application for Medicaid.
Most likely your mom will be sent for rehab.
It is possible that she may transition to being a full time resident at the facility where she is sent for rehab so choose that carefully. (It is just more difficult to move someone later on)
I suppose the questions are
Is mom able to live with you? Are you willing to take that on?
Is mom a candidate for Hospice? If so Hospice will provide you with supplies and equipment that you need to care for her as well as a Nurse that would visit weekly and a CNA that will come in several times a week to bathe her and do other tasks related to her care and she/ he would order supplies.
If you can not accommodate her in your house she would get the same Hospice care in a facility.
the Social Worker will help you through this. This is what they are trained to do.
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EEMFLA Nov 2020
Your insight is invaluable at a time when I feel I’ve no experience with any of this and very few places, if any, to turn.
Thank you so much.
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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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EEMFLA Nov 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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