Mom has been in SNF for just over two weeks now.
She used to live with me - has for the past three years. Between four ER visits, a stroke in January, a host of other health problems, and now a suspected fall that has left her with limited mobility, she is receiving in-patient rehab largely at my insistence, as she originally just wanted to come back to my house despite being confined to a wheelchair. She is not keen to accept reality, and insists she is "fine" and "can take care of herself".
Fast forward to last night. We had a family caregiver meeting last week, with the social worker, nurse, physical therapist, etc., and started the "journey" towards her ultimate transition to AL. She wasn't overjoyed initially, but by the end of the meeting, seemed to be warming to the idea, albeit slowly. When my brother visited her a few days later, he reported back to me that she was "smiling and talking about the AL places she wanted to visit". Things seemed positive overall.
Last night, I "checked her out" of the facility to take her to dinner (which is permitted). Things were pleasant. We sat down, ordered dinner, and then she said she is "being kicked out in five days". She then further claims she "does not qualify for skilled nursing or assisted living", because she is "perfectly capable of taking care of herself".
I think she is confusing the end of the Medicare fully covered 21 day period. Just for medication management alone, she definitely qualifies for AL, if not more.
But ... it went south from there. By the end of my meal - which I spent mostly protecting the boundary that she cannot come back to my house because she would be unsafe - she had accused me of ruining her life, making her homeless, destroying her financial plans, etc. etc. She said a flurry of other hateful things, essentially keen to cast me as the "bad guy" enough that she would win leverage over me to take back control of the situation.
The good news is, I stood my ground. I didn't falter. I took her back to the SNF, got her back to her room, gave her a hug and left.
Now, I'm no stranger to tongue lashings from her. But, I am human still, and so, so far from perfect.
I plan to contact the social worker/case worker today - who by the way was the one person at the SNF my mom said she "cannot stand". Odd, since she is a soft spoken and very kind person, from what I observed - on top of having one of the toughest jobs there is, I believe.
Just seeking a little reassurance from my "cheering section", which is how I think of all of you. Reassurance that they are not going to "boot her out" in five days, that is not something that they would do. And, well ... that I'm not the bad guy. Intellectually I know I am not, but, my emotional side took a pretty good beating last night.
Sigh. Thank you for propping me up, again and again.
She needs SAFETY and HANDS ON CARE.
You have arranged for what she needs to get it.
We who have done what you have had to do APPLAUD and COMMEND YOU.
In fact, you are MY HERO OF THE DAY!
You did well my friend you did well! :)
If I could give you a hug I would. :)
Make sure that they test mom for a UTI.
Folks with the sort of cognitive loss that your mom has, diagnosed or not, mistunderstand what is being said to them, frequently.
The smart folks TRUST their trustworthy relatives to keep them on track. My mom was like this; she knew we had her best interests at heart.
Other folks, not so much. My mother in law played her kids against each other, trusted no one and received poor care, took no advice and died quite miserably.
I hope that your mom can learn to trust you. If not, it's not YOUR fault and not your problem to spend your life fixing.
Flash forward to their youngest daughter, who also had her own mountains to climb, and instead, mom and dad protected her, did not force her to “move on”, and she has always been with them. She is their full time caregiver for deep, intense reasons. She has given them her life, and it all seems too much to me. She says “everything’s fine”. I had NO control or say in any of their choices. Still don’t.
What does the above have to do with you? My parents would never give any living situation a chance, other than their own home, and they did not stay strong enough to stay in their home, without help. They might have been shocked at how good a different solution would have been for everyone. I hope you are happy, and can give your mom time to settle in, and adjust. If she is not happy, well heck, I had long stretches in my youth, where I was not happy, and my mom and dad told me if would be ok, and eventually it was. Good luck to you.
Every single time a young person realizes they DO NOT owe their life to their elders, that making sure their elders are taken of is not the same, as becoming their elders servant, I want to CHEER. The words I just wrote would be considered mean spirited and unloving, by many of my family members. Thank you for treating yourself as good as you treated your mom. Take care.
You now know your own boundaries more clearly. No more outings until she is settled in care. She uses these to corner you. You held your ground again and the more you do that the better, the more easy and "habitual " it will come for you to defend your own life.
Do speak with discharge planner/social worker today. Do get all of this straightened out and again make it clear Mom cannot return to you. As others here said, if Mom is rational and was living with you and wants to return there may be a struggle; she is considered a resident.
Do I remember right in that Mom is still considered rational and not in need of a POA? Or ARE you the POA and is Mom diagnosed with dementia.
If she is you are in charge of where she goes to live and what's safe for her if you are her POA. If you aren't MOM remains in charge of her own life. Just do all you can to keep her out of your home, because once there I certainly will throw my own hands up in the air in surrender, because I fear at that point--for you--this would be all over.
You are in a very dicey position until Mom has placement. You may end with needing to move out of your own home and rent someplace simply to escape your own mother.
I hope this is an eternal warning to those considering having their parents move in with them. As one commenter here said "she gets mail there? that's her residence".
Insofar as them "booting" her out...remember, people hear often what they want to hear, and tune out anything else. If she had a contentious conversation with the "hated" social worker about her having to stay there, to the tune of "well, what happens if a person CAN live independently?" and the SW answered (tongue-in-cheek) "well, sweetie, then we boot them out!" knowing that it has nothing to do with mom, because mom can't take care of herself. But mom hears the part of the answer she wants to ("we boot them out") and, because SHE thinks she can live independently, this applies to her.
My FIL did this before a cancer surgery. He asked the doctor "how long will I be in the hospital, post-surgery?" The doctor said "2-10 days, depending on if there are any complications." Well, of course there were complications, and of course my dear, stubborn-headed FIL only heard the "2" part of the "2-10 days". Needless to say, he was in for the entire 10 days, he was unhappy with it, and then we moved on.
As far as not being the bad guy - you're ensuring that your mom is safe and being taken care of. That your choices aren't between "good" and "bad" doesn't make you the "bad guy". It makes you a reasonable person who is playing the hand you were dealt, so to speak. If the entirety of time on this Earth, our choices were nothing but between "good" and "bad", life would be much simpler. You are doing the BEST that you can, and that's all anyone can ask - or expect - of you.
"Good morning, thank you for reaching out. I visited with your mom yesterday and went over the discharge plan. I explained to her that Medicare will no longer cover as of 5/23. I explained assisted living, and also how unsafe it is for her to be by herself. She mentioned she would like to be in Fullerton area.
I expressed my concern to her about finding a safe discharge. I asked if she would like me to talk to you about it, but she declined, and asked me to come back to her on Friday. I do think it is very important we connect and address her discharge plan. I will be free today from 12-1 and 2-3pm
Speech Therapist did an evaluation and found not appropriate for ST."
I mean ... what the what?!? How will Medicare stop on Monday? I know they stop covering 100%, but, what she is alluding to sounds different. I thought she had 100 days per condition - just a co-pay after the 21 day period was over. Am I missing something?
What did the PT and OT have to say?
Is she no longer appropriate for those therapies?
So! I spoke to the Discharge Planner, who advised that Medicare is in fact cutting her off as of Monday. While the therapy has obviously proven helpful, they do not deem it medically necessary for her to continue in skilled nursing past Monday (ugh). So - the options she has are as follows:
(1) Stay in the SNF as a self-pay, during which time a longer-term AL arrangement can be secured - cost of $450/day
(2) Move to the AL side of the facility she is in; this requires approval by the Director of Assisted Living. Ironically, the DP felt that my mother's problematic blood pressure issue might prove a hurdle to that. Ironic that she doesn't qualify for SN, but may not qualify for AL either? Cost of $227/day
(3) Find a suitable SNF by Monday that is to her liking; cost unsure, likelihood low due to lack of available time
(4) Put her on a 180-day cruise around the world and hope for the best - cost $278/day (kidding, but, it's fun to dream, right?)
All this while being reminded that the DP is not "technically" allowed to talk to me about any of this. So ... it's all hush-hush between she and I.
I asked her to start the necessary process to explore Option 2 - so at least we know if she is approved/that's an option. And if not, I'm considering Option 1 as the "In Case of Emergency" last resort. Either Option 1 or 2 will expedite the urgency to find a longer term plan - but, at least it won't be a panic between now and Monday.
I am reminding myself that she has lived these past 3 years with no overhead whatsoever, other than her occasional grocery expense and any medical bills. So, I'm not allowing myself to harbor guilt - particularly over the expense she will need to incur with these decisions/options.
Trying to take deep breaths, and stay calm.
Pay him if you must.
When your parent is going through the mill, it is natural to feel sad and to feel responsible for making things better. But that does NOT make you responsible for the circumstances which are beyond your or anybody else's control. Even if your mother appears to think, or chooses to allege, that you are.
Consider an appeal based on what they are saying about her BP needs.
I am going to follow up later today with the Discharge Planner. Today is when she has to deliver the 72 Hour Notice of Discharge to my mother, then my mother can confirm her plans. The Discharge Planner is going to strongly encourage her move to AL there, for the time being - but, she can't force her, which I understand.
So, my mom will either (a) go willingly to AL and accept that it will take a few weeks to find the right AL for longer term, (b) she will stay on the SN side and go self-pay (which would make zero sense, as it's twice the cost of AL), or (c) refuse everything and accept an "unsafe discharge", and do who knows what - go to a motel, who knows.
My mother is certainly stubborn enough that Option C is a very real possibility, just for the fact that she could better amplify her anger and manipulation that way.
Today is going to be a long day.
Mare sure that discharge reports mom as an unsafe discharge to Adult Protective Services if she goes to a motel.
AND if she calls you from there with am "emergency ", you call 911.
Some of these "stubborn elder" dramas have several acts.
Think of us as a silent cheering section for you today!
Option C seems to be the winner. She has refused all options that involve transfer to assisted living or self-pay for short term stay. She claims she is going to accept the "unsafe discharge" option on Monday, hail an Uber, and somehow cart herself and her various bits of paraphernalia to some yet undetermined motel in the Fullerton area. She is as of this moment refusing to talk to me, and asked the Discharge Planner not to talk to me, either.
And so it goes.
I'm sticking to my position, and not wavering. I think the worst thing I could do at this point would be to welcome her back here, as I'd be setting a clear precedent that she owns the manipulation game, and control of me is within her grasp.
Oh, and the cherry on the cake of today? A friend of mine, I just found out that she lost her mother suddenly a few weeks ago. How, you ask? A sudden fall that, due to trauma to the head/neck, proved fatal.
I hope you all have some fun plans this weekend that involve self-care, blessing-counting, and lots of sunshine-raying.
The thing to remember is that when she fails/falls/calls, YOU call 911.
You don't rush in to rescue or prop her up.
She's chosen a path that guarantees the need for further public intervention. And that means that strangers, not you, will determine where she ends up.
This is a convo that some folks here have had successfully with their stubborn relatives (you trust the state of California to do better than I can? or They're going to go through your underwear).
It might or might not work. But these conversations have to be in a tone that is cold and serious, not pleading. Quite literally the hardest thing I've ever done is tell my mom, quite coldly, that I would no longer show up for her if she didn't cooperate with us. And that my brothers were on the same page.
Not pretty and not pleasant. But it was what we needed to do to keep her safe and keep our sanity and our livelihoods.
YES! You will be doing exactly the right thing in sticking to your position and not wavering!
If she actually does get an Uber and go to a hotel, you might consider blocking her phone. She'll be closer to your brother, after all, right? Does he know her plan? If not, he'll probably find out soon enough, because HE'S the one who will be called from the motel.
One more thing -- this has probably already been written in one of your threads, but if by chance the discharge planner does talk to you again, remember not to believe anything she might say about taking your mother "temporarily" into your home while she works to get help. Once she's out and in your home, she's your responsibility, and they don't do another thing to "help."
You're doing everything right. You cannot be your mother's 24/7 caregiver and your house is not equipped for a handicapped wheelchair bound person to live in. Your mother believes her stubbornness and refusal to accept help will force you to take her back and force you to renovate your home to accommodate her needs.
She will adjust to AL because she will have no choice but to adjust.
Things will probably get worse for your before they get better. The vilifying of you by your mother will likely continue. Try not to let it get you down because you're doing right by your mother and what is best for her. Your brother will probably become the "hero" of the situation for her. Until he refuses to take her in which I'm sure he will do.
Your mother is not going to hail an uber then go to a hotel. She's wheelchair bound and cannot walk. This is an empty threat and is likely the reason why the Discharge Planner did not bother to call you. I would call them though and tell them about this threat she's making, if they don't know already.
All you can do is stand your ground and wait it out. Good luck and I wish you and your mother all the best.
I chatted with Maria, the Discharge Planner, yesterday afternoon. She actually hasn't once suggested I take mom back; I speculate that she's seen enough from her side of the equation to have a clearer picture of things. She's been kind and relatively forthcoming, particularly considering my mother's demands for her not to connect with/speak to me. So, she's sticking her neck out to keep me in the loop - for which I have told her over and over I am immensely grateful.
Maria confirmed that she gave my mother the official 72-Hour Discharge paperwork yesterday, and my mother is refusing all options that involve "respite care" (which is the term they use for a temporary/no contract stay in their AL), and instead opting to check herself into a Quality Inn in Fullerton. Maria said she has no choice but to arrange the obligatory home care visits to be conducted at that motel.
The cost for the AL Respite Care Option is about $220 a day. The cost for the Quality Inn - with no services, meals, etc. - is about $170 per day with taxes.
Did I mention my mother spends almost $1,000 a month on a car she has barely used? One that she should not have been driving now for some time? She chose to get a new car last year after she totaled her last one (and, her passenger passed away from injuries caused by the accident). The car payment is only about $400; the other $600 is the exorbitant cost of her insurance, as she has at least that one accident on her record. But, I digress ...
... that leads me to the one added detail I've gleaned. Maria said that it really disturbed her to hear my mother say that, instead of taking an Uber, she plans "to drive herself", and that my brother is going to swing by my house, pick up her car, and deliver it to her. So, naturally, I texted my brother to confirm, and he did say she requested this of him. Whether he chooses to comply is still up in the air.
Aghast that her own doctors would not do this themselves, I reported her to the DMV months ago. She'll be losing her driver's license, legally, any day now (she does not know I did this). Other than hiding her car - which I fear would lead her to accusing me of car theft - I am not sure what else I can do. If she is going to insist on making dumb decisions that put her and others at risk, she has to suffer those consequences.
I've changed the locks on my house, to include a keypad garage door. At least I know she won't be trying to get in here.
So much drama. I sat on my couch last night, sandwiched between my dogs, and watched "August: Osage County." And wept. My mother and Violet Weston have a whole lot in common ...
So the dead passenger's relatives never filed a lawsuit against your mother after that fatal accident?
Maria the DP sounds wonderful. IF your brother actually delivers her car to your mother, is there any way Maria the DP can stop it? Maybe not? Too bad the DMV is stalling on taking away her license.
Good move by changing your locks - you are prepared!
What do you think will happen on Monday -- will she actually take an Uber or will your brother bring her car? Since he didn't tell you outright that she'd have to take an Uber, I'm guessing he might actually bring her car? However she gets to the motel, he's the closer one and will have to (or not; his choice) deal with her.
That is the big question - what will happen Monday. She has the option to pivot and dramatically change her mind - which, if she is wont to do, will surely wait until the last minute, with the hopes that her attempts to manipulate otherwise would have succeeded by then. As far as I am concerned, my position remains firm.
Will my brother pick up her car keys, deliver her car to her? I shudder at her putting him in that position, but .... in that situation, I don't know the right course of action. Refuse to hand over the keys? I fear she'd accuse me of car theft. Hand them over? Then my brother is in the position of enabling her ... but, not sure what else I can do. What I definitely want to avoid is any chance of her, say, taking an Uber, showing up on my doorstep, and demanding her keys ... I'd rather avoid that confrontation if I could.
Ugh. Things I never imagined I'd be dealing with ...
What I know is - she was in an accident May 2021. The police did not deem either driver at fault (which also means, by the way, neither are ruled NOT at fault); the passenger went to the hospital, had bleeding on the brain ... she spent about 5 months at the hospital, had several strokes, and ultimately succumbed to her injuries. So, so sad.
I don't know for certain what legal action was taken - either by the other family, or by the hospital itself. California has some unique rules about liability pursuits that can be executed by hospitals directly, versus having to go through insurance companies.
I do know that, one day, my mother made some comment about how she "needed to hide some money", and made some intonation that she was going to "give half to your brother, and half to you" to hide for her - to which I said "HELL to the no!". I also talked to an attorney to make certain there was no liability risk for me, given she lived under my roof (this was last summer). What went on beyond that, I do not know; I never had the courage to ask. Her passenger/friend passed away in the Fall, and she hasn't brought up anything about it since.
She should not have been driving then, in my opinion; and having the stroke and a fall since, it should be out of the question entirely.
Her license will be suspended as of this coming Friday, May 27. She is not aware of that; I called to get an update. She can contest it if she wants, but, that process would be a mess. So, this Monday, she is still legally able to drive, unfortunately.
I did inform her months ago that, if she gets into an accident and the insurance company finds out she had a stroke, and didn't report it to them, that her insurance coverage will likely be null and void. But, she just flipped me off and went on about her way ...
If only the DMV had stepped up the pace a bit, right?
We'll all just hope that she will change her mind about being discharged on Monday.
And if you can't lie take the keys and throw them in the garbage. Then they are technically lost.
Its not theft if you lost the keys. Brother can call a tow truck or do whatever he wants to move moms car from your house. You job is to make it as much of a living hell for him and mom as possible to do it.