She had colitis so was in the hospital. She's elderly and is fighting memory loss. It was being managed at home fine until colitis was misdiagnosed as deadly C. Dif. and we went to the ER.
She recovered fine but they couldn't get her to eat. She was afraid of them because they fought to force feed her. They weren't skilled with memory patients. I went in and got her eating and drinking all her three meals, and she began to recover. Then someone started a case on me for cleaning her up and so they banned me. While they banned me, she lost so much weight. She kept asking for me daily as she calls for me now. It's tragic.
They gave her 11 days to live and sent her to die at the nursing home where I was allowed to be with her. I began feeding her immediately although they argued with me that nobody at the hospital could get her to eat. Even my private sitter fell in with them to exclaim she won't eat for you. I defied them all and immediately she began drinking 2 1/2 8oz glasses of a mixture of Ensure & Pedialyte. I've been caregiving for her for 23 years. That's a total of 201,480 hours, or 100 years of 40 hours a week times 50 weeks a year. I hold multiple degrees in Psychology and work at the stock market by her beside in her very large bedroom. Normally.
They lied and gave her morphine 40 mg in two hours about midnight April 12-13 while she was recovering from kidney failure. She got pinpoint eyes, asphyxiated during the night almost dying, then giant pupils, kept turning her head to the right, and she went outward crosseyed with her eyes moving independently from each other. No appetite either. No meals till 4pm and only 16oz liquid diet. Began eating the next day after. sleeping through the night again.
I reported it to the police. APS dropped its case that day as well. Then someone called in anonymously on me saying I was nude next to her nude in the middle of the night. Right; and nobody screamed or surrounded me or called the police or tossed me out. I slept in the room every night I was there all night. Totally bogus claim that made no sense. Would not happen in the real world.
Even so, they dropped the last case after investigating it from April 15 to August 1, 2019. I was banned from seeing mom. August 1st I went to see her and was denied. They claimed the case was still active. I pulled my iPhone out where I recorded APS saying it's over and they can call me at this number to verify it. Then the same guy said, Well, yes, that's right. They were closed. But you still can't see her because … we are the ones who initiated the case. I said, no, APS also told me it was an anonymous call and facilities don't make those. Two lies to my face! Then he said, Well, you still can't see her because you caused trouble in the room. (I had commented that the hospital couldn't feed her, as she arrived so dehydrated she looked like Clint Eastwood when he came out of the desert in that movie. I said Nobody can feed her there. I'm the only one who can feed her the whole time there. They came and said, You can't stop us from feeding your mom. That I said only I can do that. They claimed I said only RNs can tend my mom. I said, No, an LVN argued with me about the brain and the research is being done by Ph.D.'s and M.D.'s, so I'll take their word since she's not even an RN and this is their specialty as well. The brain. So there was no demands but what they imagined wildly.
So I called the police to see what happens if I try to discharge her. I have the Authorization of/for Representation of mom's medical care. I am her only caregiver. We live in the same house 60 years, wonderful home. I'm a trained psychologist. We are both songwriters. She wrote country hits. Dad toured with Elvis, J Cash, J Reeves, H Snow. 50 records. She joins in with me singing. She wants to live. She wants to come home. No other conditions.
I have a paid sitter(s), home health/hospice and the PCP waiting. How do I discharge her. My first time. They lie so!
im in California so I’m not positive about Texas however the Sheriffs Dept is open 24/7. With paperwork in hand and your mom able to make competent decisions, have you considered a civil standby? Just an officer to come to the facility with you, review the facts, and standby while you collect your mom and her belongings! Now in my state you should be aware that when a patient leaves against medical advice, she will get blacklisted from other facilities so if the time came that she needed to go to a facility she will be declined occupancy (yep it’s a real thing). So you’re signing up for this till the end. You seem to be quite capable and aware of this.
Youre going to need to step down from the podium and approach these people differently, you already know you’re smarter so quit reminding them, I won’t harp on you anymore on that. With your psychology background you know you’re trying to outsmart them and you’re being met with their futile attempts to discredit you.
I see a couple plans of action possible.
1. You tell them if she’s “dying” you want her home which is her final wish, yes you know she’ll get better under your care but use their “11 days to live” to your advantage. I don’t care if you have to conjure tears and beg, do it. She’s your mom and if downplaying your smartness is required then do it.
2. Inform them (not threaten) your moms attorney is coming in to review their care or lack there of, and that may get someone in a higher up position to get involved because I believe what they consider “caring for her” is elder abuse and false imprisonment. Mentioned once ONCE, to the correct person and don’t throw it around. Otherwise it seems an ingenuine threat.
3. Call sheriffs Dept and ask for a civil standby to accompany you to get her the hell out of there.
You are wise, now quit throwing it around and use that wisdom to your benefit.
Finally, don’t use the word hospice unless she’s dying, they’re for comfort care and end of life assistance. Personally I didn’t know the difference between hospice and In Home Care/In Home HEALTH care. If she’s not dying she just needs home care and her loving son, but that word can imply your intentions are to put her out to pasture... unless that’s the card you’re playing to bring her home.
Go onto avvo.com and type in a few keywords and your state or even review questions similar to yours. It’s like an attorney forum where they’re giving small amounts of advice and of course hoping to solicit you to retain them. It can be invaluable reading answers to others questions or just ask your own.
Ok, head on straight, keep it short and simple with facts and get your mom home by whatever means necessary. Remember you’re intelligence level is intimidating to them, you need to soften that and approach this swiftly and matter of factually but if you have to “pretend you are scared she won’t get her final wish” or you are “confused why she’ll only eat under your supervision so you’ve retained an attorney on her behalf because you are met with resistance “ play the cards. You got this... you need to separate your emotions and anger long enough so you can get the prize... getting mom home and fed and live happily through her days.
You should also be aware that the AMA forms that they give you do not necessarily have to be signed in order for you to take your mother home. It is enough for the Nursing Home or Rehab to"present them" and chart that they did in my own State; at least that was the case more than a decade ago when I was nursing.
A Nursing facility or hospital is not a prison and people may leave unless they are adjudged unsafe to leave, a danger to self or others, in which cases laws such as 5150 (72 hour hold) are implemented by the court.
I am a bit unclear if your Mom is in Nursing Home, Hospice, or Rehab. Each is a different mode of care intended to accomplish different things.
You are her POA? Did you sign her admission papers?
Hope you keep us updated.
There are many things for you to consider here. Occassionally insurance will not cover (supplemental, etc) when a patient leaves Against Medical Advise. Sometimes facilities that have had contentious altercations with family in which they have come to feel in some way "threatened" will file for wellness checks. If the State becomes involved you can occasionally be looking at a filing for guardianship of the state. I know a fiduciary who makes a living doing little other than this.
So take care, try to keep your emotions in check. And honestly, you have the funds to do it, and should consider letting an Attorney take over; it sidesteps all the emotional stuff on all sides.
Hope you keep us updated on how you and your Mom are doing.
Unless they have guardianship they can't stop you. As far as being congenial with these people, hell no, they declared war and I wouldn't give them the courtesy.
Make sure that you have everything she needs to be well cared for at home with all of her medications and special equipment before you bring her home, then let them call APS or the police. You have the authority with POAs and this facility has obviously overstepped itself.
I had my dad in a skilled nursing facility that acted like a bunch of idiots and did everything in their power to make him sick enough to need to stay indefinitely, until the insurance company said that they wouldn't pay, oh boy, look he is well enough to go home. WTH? Yesterday he was to sick and now he's ready to go home? I transferred him to a different facility that actually cared about making him as well as possible. I would have just rolled him out if they tried to stop me. I have DPOA and MPOA, and I would have told them to call the cops, but if you try to stop me I will sue you for false imprisonment. You can't stop someone from leaving without legal consequences to yourself.
Rich, YOU mentioned hospice.
As I said, get a lawyer. I don't understand your reluctance, given your resources.
Sofia and GA are pretty much saying what I wrote and I am a layman.
I did say that Mom is not a prisoner. If you you can establish that you have set everything up for her care in her home, I don't see why she can't be discharged. APS, as part of their investigation, should have checked this out, that you have people waiting in the wings to give Mom care, probably better than they can give. I also suggested your state Ombudsman. They can evaluate the situation. You may want to consider Hospice in ur home saying thats where Mom wants to be. If she improves, and that has happened, then you can have her discharged. You will have people to take up the slack that Hospice leaves. They aren't there 24/7. You have the right to have Mom transferred to another facility. Easily done if private pay.
A lawyer maybe able to move things along. Because, APS can petition the court to have a guardian assigned to Mom. Your Medical proxy would be null and void. This u don't want to happen so tread lightly.
Good Luck and please update. We all learn from others experiences. 😊
They're going to "fight" you every step of the way, probably and most likely using phrases as "doctors concerned she may not be well and/or strong enough" It's a business to them, They want to make as much money as they can and not be held liable.
As some other members have mentioned, they'll probably check to be sure where she would go would be safe. They don't want any issues to fall back on them.
If it all looks good and proper, once she is officially discharged and if not money is owed, you'll never hear from the facility again.
Nobody has told me this before. You are the first. I'm extremely grateful to you. I do not know how well they will respond to my friendliness or cordiality. They are prone to hard looks and stares.
Do you happen to know what rule or policy or law of the state backs us up. There must be a section in the law or state policy, rules, regulations that refers to what they must do. They have lied so many times.
I want to go then and do it. I didn't know if I could go today to do it, right now. It's the weekend. It's going on 5pm now. "Nobody's here. Come back Monday." Anyway, if I do it on Monday and they try to resist me, what do I tell them. They may simply say, The doctor has to write it up against medical advice. Come back tomorrow. To me you should be able to discharge someone on any day but certainly any weekday not a holiday. Maybe holidays too, I don't know. People need to travel sometimes. Leaving town.
I do intend to have all things necessary for mother's benefit here at home. She has handrails throughout the home. She has a large hospital type adjustable bed. I bought her a really nice made at the auto factory wheelchair van. BraunAbility with a foldout ramp and it kneels if needed with captain's chairs that go up and down and turn around.
I am not sure why you mention home health with hospice and palliative care. She is not dying. She IS in her 90s but she was up walking around until the hospital visit. So I wouldn't say palliative waiting for her to die. I just got a report from my private sitter for her that mom just sat up in bed by herself and put her feet, both of them, on the floor. She wanted to go PP. She wants to live. She wants to get up and go PP. That's my mama. Wow.
Any other thoughts you have to further my success at this, I AM ALL EARS.
I am so thankful to meet your acquaintance.
This is a "normal" process of entering and being discharged from a "nursing home" which typically is a rehab facility and not necessarily one which provides hospice services. You probably know this, but please follow and listen, b/c this is a "normal" process, while what you're attempting is not.
An individual goes from hospital to rehab for a specific purpose, with specific goals, arising from conditions identified in the hospital. The individual is assessed, care plan developed, PT and OT prescribed, if appropriate, and when the person meets the standards set by the rehab therapists, he or she is discharged, to home, often with follow-up home care.
Typically, the same individual who signed the admission papers signs the discharge papers prepared by the rehab facility.
There is an applicable psychological effort often required on the part of the patient's family. Whether you like it or not, the med pros are in a position of power, and although you don't have to "kiss up" to them, you do need to treat them respectfully, regardless of how stupid or incompetent they might seem.
I don't care how many degrees you have; you MUST be able to learn how to work with med people in order to accomplish your goal, which now is to get your mother discharged.
I realize you're frustrated, but there's a significant element of superiority in your posts that comes through "loud and clear." That's probably offending the med pros. They are in the fact trained to do what they're doing. You're not.
This is just as much of a challenge as other aspects of care. And this is perhaps where your missteps are occurring.
Your screen name says it all: RichCapableSon. That reveals a lot about your self image, and attitude. And your interactions with medical staff support that. Look at how you've characterized them, and examine your attitude. I think this is very insightful:
"You can't stop us from feeding your mom. That I said only I can do that. "
Only you - and that seems to be your attitude, that you can do it better. Believe me, I am NOT writing this to be cruel, but rather to address the demeanor you present. And that alone would I think make med pros less cooperative. It's a demeanor that comes through "loud and clear" in your post.
What I would recommend are consideration of these issues:
1. If I understand correctly, you stated that your mother was sent to a "nursing home" to die. You mentioned having admission papers. Did you sign them? Did anyone approach you and ask for written concurrence that she would be given hospice care (if she was in fact in a terminal state)? Who certified that she was in fact in a terminal state?
2. Alternately, did you ask for a care plan from the "nursing home"? Or was that foregone if she was considered terminal? Did you ask to sit down with either the DON, social worker, or someone else to address the care/hospice plan? Did you ever express an intent to work WITH them for your mother's benefit?
3. If in fact she is terminal, did you offer a home care plan until she passes?
My point is that you seem to be making the determinations of what you think is best as well as conveying that you're the person who needs to provide care, and that you can do it better.
How do you think med pros will react to this? Do you think they're going to respect you, and work with you for a solution?
Seriously, back off. Analyze the situation, your behavior, your attitude, apologize to everyone you insulted, and start over.
Again, it's not my intent to offend or insult you, but your manner suggests that you're fighting/arguing with literally anyone who doesn't agree with you. You're not going to get your mother discharged until that attitude is changed.
I hope you take this as constructive criticism. That's my point of being so frank.
NH, please. They were most concerned about not having a break in payment then her care. Every visit was to be sure she was signed up so she could apply for NH Medicaid, both Social Workers. Care plan? Please. One social worker even took lightly when she said she wanted to commit suicide mentioning they had her on the 1st floor by the nurses station.
Never had a meeting with social worker, DON, or anyone else about her care
One thing you did not mention, if her PCP is different from NH doctor, PCP won't get involved. I contacted my mom's "PCP" raising concerns about her going back and forth to the hospital, never heard back from her.
End result, she is gone, and so are all of them.
If they stop getting paid, they will probably petition the state for emergency guardianship. You want to make sure that doesn't happen.
Another reason to retain a lawyer.
If you are told that it is not possible to take your Mother home to continue care as you have been caring for her ask them to give you written assessment of their reasoning for refusing to discharge your Mother to your care.
You will then have to seek an attorney for advice on how to proceed.
Very few people whose parents have been placed in nursing homes WANT to discharge them. Most of us, at least those of us on this forum, are folks who are grateful that our parents are safe and being looked after. Most of our parents are in decent places with good care; that being said, none of us (that I know of) have the resources that you seem to have at your disposal to care for your mom at home.
That's why I'm suggesting a lawyer. You need a go-between to negotiate mom's release; the lawyer will be the NH's assurance that your promises are on the up and up and that the NH will not be held liable for making an unsafe discharge.
People don't check into NH's the way they do hotels; you have to be in need of 24/7 skilled nursing care. For a NH to discharge a patient with your mother's medical needs and history to a family member would probably be viewed as unsafe, unwise and illegal in most states.
Go find yourself a certified ElderCare attorney who can assist you in doing this discharge in the safest and most calm way possible, for your mother's sake.
If you are determined NOT to use a lawyer, make an appointment with the Social Worker at the facility and ask her/him what you need to take your mom home. The NH has the right to send out someone, usually an Occupational Therapist, to assure that the place where the person will be going is safe and prepared. It would probably help to have an official letter or other communication from mom's doctor saying that mom will be under her/his care as soon as she gets home. Also from the home health care agency that aides will be present when mom is home.
What I am asking is, for those who either work at nursing homes or who have gone through the process of discharging someone, to tell me what the process is?
Do I just go up there with my paperwork, the AOR and other documents, with the admission papers for there, with the law quotes, with the video recordings of official statements from law enforcement to counter any lies or bluffs, do I go straight to the doctor, is the doctor ever in?, I've never seen a doctor, do I talk to the admissions, can I do it on a weekend?
Because frankly, everybody that does a discharge of their parents does not need to contact a lawyer. They go there and discharge them. HOW do they do that?
Officially I have heard they must comply with the law if you say you want to discharge even against medical advice. Even if they say they'll report you for it. Even if the doctor doesn't agree, that's against medical advice, and that's some kind of deal because they aren't the only doctors in town and they hardly have enough people to give attention to any one person unlike at home with 24/7 just on my parent by sitters etc. So how does a discharge NORMALLY go? Thank you for a direct apply to what I am asking for.
This is in Texas, by the way. Where that may matter.