Yesterday I had the social worker meeting with the nursing home. It was not terribly productive. They feel she needs a locked unit to her wandering and belligerence. I was given a list of places with locked units to look at. They said insurance might not pay for her IV therapy since technically she could do it at home. And I again scream from the rooftops that her home is not safe and I’m not taking care of her there or any outpatient capacity ever again. So the meeting ended with just kind of let’s wait and see. PT said she has strength, but is a hands-on assist because she has terrible balance.I left the campus, not even having seen her yet for the day and went to get something to eat. Came back to the parking lot and was eating my snack when a police car and ambulance pulled up to the nursing home. And I JUST KNeW it was there for her.
I go inside and she’s having a debate with EMS. They want to take her to the hospital and she’s refusing. In that moment, she passes competent with them. And then a few minutes later, she starts talking about believing she is in that moment at her former law office where she used to work. So that triggered EMS to realize she was not competent. They ended up having to give her two injections of something to get her to relax I go on the unit and talk to the nurse and I don’t remember the specifics but she gotten physically aggressive with one of the staff members. They were worried maybe a medical issue was causing her behavior so they called the EMS. I’m also sure they were just ready to get rid of her. An admin came to me and said they had placed a referral in to a couple of places for a locked unit.She goes to local hospital ER. A doctor called me late at night and said they were going to admit her and they felt like she needed to be transferred out for psych. And five minutes later the ER doctor called me and said she can’t go to a psych facility. She’s too medically complex. Right now she has very low kidney function. Her GFR is 18 and her creatinine is high.She had some leg swelling at the nursing facility and they gave her some Lasix. I don’t know if the swelling was from sitting in a wheelchair a lot or if it was other issues. When she left the hospital, her kidney function was normal.So she’s now in the sister hospital an hour away from me getting kidneys looked at and testing on her heart. I told the doctor they must figure out her behavioral issues because we have to figure out long-term placement.I know they ask everyone this, but in the same conversation, he asked me if she had an advanced directive or a DNR, etc. I told him there’s language in her MPOA that says no extensive measures. And he said I need to come there in person in the next day or so and sign a DNR if that’s what we want. I’d also documented two conversations with mother last fall where she very specifically says no CPR no chest compressions no “being electrocuted “. So that’s where we stand a lot is up in the air. The elder Attorney had also given me the name of a care manager, and I left a message with her yesterday, but have not heard back.
If you start to get the “guiltification” type of blather from the SW, from a hospital staff, from anyone at the NH, make it clear that mom leaving wherever she is and going to live in your home is not ever feasible.
You have a 21 yr old and a 23 yr old. One in college and the other recently diagnosed with autism. Right now their health insurance can still be on yours till they turn 26. Its Federal law on this. If either is still doing FAFSA to pay for college / Uni, they are still viewed as dependents as your income factors in for how FaFSA determines need. So they are very much still under the umbrella of being “dependent”. That is where your responsibility and focus is and unfortunately there is no ability for mom to enter your household and there are no alternatives you can do to provide for a safe and secure environment for her. Make this into your own mantra. If you have to practice this all in front of a mirror, do it.
The default for any facility - hospital, NH, AL, whatever- for a difficult resident / patient is to get family to take them into their home. Whether or not it is feasible is not their problem once ya leave with them.
please pls do remember to get your rest and take a break for yourself. You are juggling a lot of different situations. It’s easy to get overwhelmed and then make bad decisions. You can deal with this, you got this!
You're doing everything right. You've made it clear that you cannot and will not care for her at home, so the hospital will now have to get her appropriately placed. It's a terrible situation for everyone including your mother, and you're doing the best you can. No one can ask more than that.
Good luck to you.
I pray that your mom gets the appropriate care and if it is her time to leave this world that she doesn't suffer.
Well done for making your boundary of no hands on care crystal clear. Her needs are beyond home care now.
May The Lord give you strength, wisdom and courage to get through this hard time.
However, I do sympathize with you over the medical merry go round , and would almost be rooting for it to be solely a psych and dementia problem so she would go to geriatric psych for meds while permanent placement in a facility is worked out .
A care manager costs money , who’s paying ? I hope not you .