I am a live in caregiver. My patient was confused for a couple days, had some pain in back and started having nose bleeds. Yesterday she took safety chair out of tub at 12:00 am, fell in bathtub and 5 hours later when I woke up I found her wedged in tub. Had to get an assist from 911 and taken to hospital. She normally takes spit baths and only showers 1 time a month, dresses by herself. I’m wondering if confusion will continue, should I put her nursing home now? Her family has POA. I need help if I should wait or send her now to a home. Please!

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Midkid is correct that you can't do anything more than inform the family of the incidents and let them decide if you are not the PoA. If you feel the family isn't really understanding then you should keep a daily log of everything odd or dangerous she is doing, even take video with your phone.

It may be helpful to suggest to the family that she get tested for a UTI, which can create dementia-like symptoms and no other physical ones. Can be cleared up with antibiotics. I would really encourage them to discount this. The family needs to tell her doc about the back pain and nose bleeds as this may be significant. If she doesn't have a UTI and since she'll already be at the doctor's office, suggest to the family that she be given a cognitive test.

You must record everything so that the family an make the most informed decision possible.
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Firstly, I am assuming that the family knows about the fall. What do they feel? Are they reluctant about placement? If so, why? I realize it’s unfortunately more challenging because of COVID-19. Still, it may be the best choice.

Secondly, are you having second thoughts about being her caregiver?

You are with her more than her family. Do you feel that it is time for placement? The family deserves to know the truth.

You should not stay in a job that you are not committed to if you do not feel it is best suited for the patient.

If you feel that this is not working out for you, I would give notice and they will have to make future arrangements for their loved one.

You can find a client that is more suitable for home care.

Best wishes to you.
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THIS was the exact dynamic that put my sweet Grandma out of her home and into a NH.

She decided she wanted a hot bath, instead of a shower and left her call pendant on the vanity.

Had her hot bath--and a mini-stroke in the tub. She laid in there for 2 horrible days before mother called me and asked if I'd spoken to her (we each took a day and called or visited her) and no, I hadn't spoken to her. 911 was called, immediately and they broke in her place and found my sweet, dignified grandma crying in a tub of lukewarm water.

She did pass 2 weeks later--this was the beginning of a quick end, but it still breaks my heart to think about it. We had in place everything we could think of to help her live independently, and she had done so for many years.

IF YOU don't have POA you can't do anything. You need to inform the family of the nitty gritty and let them make the decisions. IF they decide she's still OK to live with you as CG, your job will be that much harder.

This is a family decision--you can only push so hard and then you have to step back. I'm so sorry. I hate when people age out slowly and sadly.
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