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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
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By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
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Since she doesn't have a PoA then this means no one can legally manage her medical and financial affairs. This means no one will be able to sign the paperwork for a facility for her, if she even agrees to go and stay. DO NOT ever sign any paperwork at a facility because it will may you personally liable since you're not her PoA.
You may need to call 911 or take her to the ER and tell them she's not behaving normal and is paranoid, that she may have a UTI. Once in the hospital make sure you tell the staff she is an unsafe discharge and that you will not be taking her back to your home, that you're not her PoA or legal guardian, that she doesn't have one. Then ask to talk to a hospital social worker and begin asking about transitioning her directly into a facility and having a court-appointed legal guardian.
If she's very anxious and paranoid, the hospital may choose to keep her in their psych wing until they can find a medication that works for her. At that point she may be willing and able to assign a PoA and then go someplace permanently -- if she has the funds to pay for it. In the meantime you will need to begin an eviction process, which takes 30 days (you file it and pay for at your county government center). This way she cannot legally go back into your house even if she shows up on her own.
I'm so sorry, this is so distressing. I wish you luck in getting her the appropriate medication and care she needs.
If that's the case, and she goes to a facility, then leave her be and don't visit her,
Come to mention it, the lady of the man who has dementia, may have been trying to do the same thing, (though in his case he fell and hit his head). The hospital was wise to her plan (the delay in picking him up, then excuses, until it was too late for him to leave), and arranged for him to leave in an Uber or Lyft.
So sorry you are dealing with this. My mom lived with us too before finally getting her placed in a high quality nursing home. She had dementia and a host of other conditions, basically could no longer walk. The 24/7 care was unsustainable. This was in the middle of COVID, no help, just me.
Thankfully we had a POA in place, but as others noted, we waited till there was a reason to call 911. She fell, again and with my husband's help (he is very tall/strong) we could not get her off the floor, EMTs took her to the hospital. From there working with the hospital social workers it was easier to discharge her to a "Rehab" facility that also was a qualified Medicare and Medicaid Skilled Nursing Home Facility (of SNF). And one I had pre-researched as a good facility for a permanent placement. While at the SNF, we worked with their folks on a permeant placement and we spent her down over about 7 months so she would qualify for Medicaid nursing home coverage. Being immobile, she did not need memory care (locked unit).
She never accepted it and raged at me anytime I called or visited. The facility had lots of activities, and she would have none of it. She had a private room which she refused to leave except when they took her for her two times a week shower. All meals in her room, isolated, lights out and windows covered or she'd scream over and over. It was an awful 3 years and I decided mid-way to go no contact for my own mental health. She passed at 87.
I would strongly recommend getting with an elder care attorney licensed in your state to help navigate this, and your State laws regarding guardianship. Every State law is different by the way. He or she can help with the proper steps.
Sounds like you have identified a few good SNF to visit, that is great. Continue on your own checking them out. See their reviews, assure that they are Medicaid and Medicare qualified. An elder care attorney will also know which are the good ones and they will have contacts in such facilities that may help with the placement.
Lacking a POA, some type of guardianship/conservatorship has to be executed so that someone -- as others have noted -- can sign the paperwork. Also her funds should be spent on this, including the lawyer fees. One can pre-pay funeral expenses too as part of a Medicaid spend down assuming a Medicaid spend down is part her situation. All to say her funds and NOT yours should be spent on this.
Given it is YOUR home, you have no duty to take her back from a hospital inpatient situation. Sounds harsh, but you may have to tell her "Mom, it is not feasible for you to return to my home." This is better than the "I won't" or "I can't"; it is just "not feasible." Repeat the same over and over, as there is no need to try to explain or convince them. Their brains are not working. Much like a 2-year old who wants candy for dinner, you just have to say NO. They will not understand or except it.
This is a lot to work through legally, financially as well as mentally. I hope you might consider therapy to work through and process all of this. I have been working with a great therapist for 4 years now and I am so glad to have someone trained to help me unpack all of this. Nothing prepares us for this. The exhaustion, the role reversal, the heart breaking decisions that need to be made, the anger at it all and this disease dementia, seeing our parents this way.
I often say this is a journey that neither we nor our LOs wanted to take, but it is the journey we are on. I hope you get the support you need and can take care of yourself through this. And I hope your LO makes it to a high qualify facility.
Thanks for your insight, I'm on this journey with my mother now, so far she has qualified for hospice care at home, nurse comes 2x a week, bath aide 2x a week, otherwise it's just me, dementia, not able to walk anymore, obsessed with going to the bathroom all the time, finally has a catheter in place but still doesn't understand, I know I will eventually have to place her in a long term care facility and that breaks my heart.
You can always call 911 and tell them that you think your mother has a UTI, and is acting strangely(yes, you may have to lie about that)and that she needs to go to the ER. Once there you let the hospital social worker that she cannot come back to your house as she is an unsafe discharge and that you cannot care for her any longer. They will then try and talk you into taking her back to your home with all kinds of promises of what they'll all do to help you, so you'll have to stand your ground as all they're doing is lying to you, so they don't have to do their job of getting your mother placed. But if you stand firm, the hospital social worker will have to find the appropriate facility to have her placed in. This is called an ER dump or social admit. And it works if you don't cave in and agree to take her back home.
And in your post you say that mother "won't make a decision." I do hope that you understand by now that with your mothers broken brain that she can no longer make any decisions, yet alone what facility she now wants to move to. That ship has long sailed, so call 911 sooner than later. And don't tell them that she has dementia, but you think she may have a UTI. Once at the ER and has been checked, you can disclose that she has dementia. Best wishes in getting her placed soon.
She doesn't make a decision because she cannot. She doesn't have the cognitive ability (brain functioning to do so).
Get all legal documents in place. Why hasn't this been handled already? Go to an attorney 'yesterday' meaning ASAP.
In addition, I believe out of 1,000 people needing to move into a facility -0- would agree to it. Why would anyone want to uproot themselves and go into an unfamiliar environment ... away from the home they know and perhaps have known all their life.
Put yourself in her shoes.
What you do:
You don't dwell on what is happening. You make plans to move her in. You do not ask her nor discuss. You say - when she is there 'it is temporary' You listen to her and show compassion. You learn to understand how her brain is now working and what dementia and paranoia means; you go to Teepa Snow's website / watch her You Tubes, buy her books. You educate yourself on what dementia is so you understand how you need to take control / proceed, with sensitivity, compassion and clarity (of what you need to do - and do it).
You talk to / work with social worker(s), administrator, dept mgr.
Your mother is no longer able to make decisions for her own welfare. You have to do this for her. You take as much of her own furniture as you can into her new 'room' so it feels more like her old / current home. Bring photos, whatever she is familiar with to ease the new surroundings/room 'home'.
You never ever argue with her. You agree ... you tell her anything that will keep her as calm as possible ... all the while realizing this is ALL new for her - that she is fearful, confused, losing / lost her independence, and how she will ALWAYS want what is familiar to her, namely her home.
Since she has dementia, she may not be able to make a decision. Her brain no longer works as well as it did, and it never will.
You make the decision for her. She may think she decided. You can’t pretend everything is the same as it was, so lean into her new normal and proceed from there.
If there is no POA in place then the next of kin should seek a simple guardianship or conservatorship. Ask your doctor if a social worker can help you apply for this, or see an elder law attorney of your choice and get advice and options to move forward. Be certain there is no will extant hidden away, as they often contain a springing POA in them.
Choose the one that you liked if she gives no response. Depending on what you saw speak to the marketer if they require doctor paperwork as a form of committment to a place. I assume you are looking for MC or SNF. If you get that far with the doctor agreeing, then plan for the move and ask the marketer for suggestions on what kind or a ruse that might be needed. Once there you can do a white lie that the doctor says....you agreed bur forgot...we are moving on and cannot take you with us, etc. Those doctor papers will be very important without going through full guardianship. For POA, work with her prior with getting your name attached to all of your accounts. Again give a white lie that is not really a lie that...just in case something happens to you.
Expecting your mother who has dementia to make a logical decision is not going to get you anywhere. Dementia will impair logic, reasoning, decision making, and making such evaluations as to which facility is better.
You have to decide the best alternative, based on cost, services provided, quality, references, and proximity to where you live so that you can visit often and play the role of your mom's advocate.
Here is an excerpt from my recent book "Dementia Care Companion" available from Amazon related to evaluating nursing home facilities:
How to Evaluate a Nursing Home Care facilities vary in the services that they provide. The quality of care, the ratio of patients to caregivers, group and recreational activities, the types of patients and their illnesses, as well as nutrition, medical care, and cost vary from one nursing home to another. Sifting through all these variables may take a while. It is best to start the process early so you don’t have to scramble to find a care facility when the need arises. · If you believe that you’ll need the services of a nursing home in the future, do not delay your research. Some nursing homes have long waiting lists, and if you leave it to the last minute, you might not be able to get your loved one into the residence of your choice. · Research the nursing homes in your area. Evaluate the costs and the type and quality of services they provide. Learn about their care routines and staff, and whether you’ll have easy access to their management. · Before signing a contract, be sure to visit their facilities several times to see them in action and ensure that the quality of care and programs on offer are according to your expectations. · Participate in their group activities, such as painting, music, dance, and storytelling, to experience them firsthand. See if the staff makes an effort to include all the residents in the activities. · Ask the management of the care facility for references. Consult with other families who have placed loved ones at that residence. Ask them about their experience and their satisfaction with the services provided. · The best option is a care facility that offers the services you want, at the quality you desire, within your budget, and close to where you live so friends and relatives can visit your loved one easily. You might not be able to get everything you want, but you can try to optimize your selection given your specific situation.
Mom is no longer your caregiver ...you are her caregiver and need to make those decisions. I know you will make the right decision for her as she did for you years ago. She just can't do it anymore because her reasoning is just not there.I am sorry for your family.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
You may need to call 911 or take her to the ER and tell them she's not behaving normal and is paranoid, that she may have a UTI. Once in the hospital make sure you tell the staff she is an unsafe discharge and that you will not be taking her back to your home, that you're not her PoA or legal guardian, that she doesn't have one. Then ask to talk to a hospital social worker and begin asking about transitioning her directly into a facility and having a court-appointed legal guardian.
If she's very anxious and paranoid, the hospital may choose to keep her in their psych wing until they can find a medication that works for her. At that point she may be willing and able to assign a PoA and then go someplace permanently -- if she has the funds to pay for it. In the meantime you will need to begin an eviction process, which takes 30 days (you file it and pay for at your county government center). This way she cannot legally go back into your house even if she shows up on her own.
I'm so sorry, this is so distressing. I wish you luck in getting her the appropriate medication and care she needs.
If that's the case, and she goes to a facility, then leave her be and don't visit her,
Come to mention it, the lady of the man who has dementia, may have been trying to do the same thing, (though in his case he fell and hit his head). The hospital was wise to her plan (the delay in picking him up, then excuses, until it was too late for him to leave), and arranged for him to leave in an Uber or Lyft.
Thankfully we had a POA in place, but as others noted, we waited till there was a reason to call 911. She fell, again and with my husband's help (he is very tall/strong) we could not get her off the floor, EMTs took her to the hospital. From there working with the hospital social workers it was easier to discharge her to a "Rehab" facility that also was a qualified Medicare and Medicaid Skilled Nursing Home Facility (of SNF). And one I had pre-researched as a good facility for a permanent placement. While at the SNF, we worked with their folks on a permeant placement and we spent her down over about 7 months so she would qualify for Medicaid nursing home coverage. Being immobile, she did not need memory care (locked unit).
She never accepted it and raged at me anytime I called or visited. The facility had lots of activities, and she would have none of it. She had a private room which she refused to leave except when they took her for her two times a week shower. All meals in her room, isolated, lights out and windows covered or she'd scream over and over. It was an awful 3 years and I decided mid-way to go no contact for my own mental health. She passed at 87.
I would strongly recommend getting with an elder care attorney licensed in your state to help navigate this, and your State laws regarding guardianship. Every State law is different by the way. He or she can help with the proper steps.
Sounds like you have identified a few good SNF to visit, that is great. Continue on your own checking them out. See their reviews, assure that they are Medicaid and Medicare qualified. An elder care attorney will also know which are the good ones and they will have contacts in such facilities that may help with the placement.
Lacking a POA, some type of guardianship/conservatorship has to be executed so that someone -- as others have noted -- can sign the paperwork. Also her funds should be spent on this, including the lawyer fees. One can pre-pay funeral expenses too as part of a Medicaid spend down assuming a Medicaid spend down is part her situation. All to say her funds and NOT yours should be spent on this.
Given it is YOUR home, you have no duty to take her back from a hospital inpatient situation. Sounds harsh, but you may have to tell her "Mom, it is not feasible for you to return to my home." This is better than the "I won't" or "I can't"; it is just "not feasible." Repeat the same over and over, as there is no need to try to explain or convince them. Their brains are not working. Much like a 2-year old who wants candy for dinner, you just have to say NO. They will not understand or except it.
This is a lot to work through legally, financially as well as mentally. I hope you might consider therapy to work through and process all of this. I have been working with a great therapist for 4 years now and I am so glad to have someone trained to help me unpack all of this. Nothing prepares us for this. The exhaustion, the role reversal, the heart breaking decisions that need to be made, the anger at it all and this disease dementia, seeing our parents this way.
I often say this is a journey that neither we nor our LOs wanted to take, but it is the journey we are on. I hope you get the support you need and can take care of yourself through this. And I hope your LO makes it to a high qualify facility.
All the best.
Once there you let the hospital social worker that she cannot come back to your house as she is an unsafe discharge and that you cannot care for her any longer.
They will then try and talk you into taking her back to your home with all kinds of promises of what they'll all do to help you, so you'll have to stand your ground as all they're doing is lying to you, so they don't have to do their job of getting your mother placed.
But if you stand firm, the hospital social worker will have to find the appropriate facility to have her placed in.
This is called an ER dump or social admit. And it works if you don't cave in and agree to take her back home.
And in your post you say that mother "won't make a decision." I do hope that you understand by now that with your mothers broken brain that she can no longer make any decisions, yet alone what facility she now wants to move to.
That ship has long sailed, so call 911 sooner than later. And don't tell them that she has dementia, but you think she may have a UTI. Once at the ER and has been checked, you can disclose that she has dementia.
Best wishes in getting her placed soon.
Some hospitals may be wise to this, and again arrange for a ride home
She doesn't have the cognitive ability (brain functioning to do so).
Get all legal documents in place. Why hasn't this been handled already?
Go to an attorney 'yesterday' meaning ASAP.
In addition, I believe out of 1,000 people needing to move into a facility -0- would agree to it. Why would anyone want to uproot themselves and go into an unfamiliar environment ... away from the home they know and perhaps have known all their life.
Put yourself in her shoes.
What you do:
You don't dwell on what is happening.
You make plans to move her in.
You do not ask her nor discuss.
You say - when she is there 'it is temporary'
You listen to her and show compassion.
You learn to understand how her brain is now working and what dementia and paranoia means; you go to Teepa Snow's website / watch her You Tubes, buy her books. You educate yourself on what dementia is so you understand how you need to take control / proceed, with sensitivity, compassion and clarity (of what you need to do - and do it).
You talk to / work with social worker(s), administrator, dept mgr.
Your mother is no longer able to make decisions for her own welfare.
You have to do this for her.
You take as much of her own furniture as you can into her new 'room' so it feels more like her old / current home. Bring photos, whatever she is familiar with to ease the new surroundings/room 'home'.
You never ever argue with her.
You agree ... you tell her anything that will keep her as calm as possible ... all the while realizing this is ALL new for her - that she is fearful, confused, losing / lost her independence, and how she will ALWAYS want what is familiar to her, namely her home.
Gena / Touch Matters
You make the decision for her. She may think she decided. You can’t pretend everything is the same as it was, so lean into her new normal and proceed from there.
You have to decide the best alternative, based on cost, services provided, quality, references, and proximity to where you live so that you can visit often and play the role of your mom's advocate.
Here is an excerpt from my recent book "Dementia Care Companion" available from Amazon related to evaluating nursing home facilities:
How to Evaluate a Nursing Home
Care facilities vary in the services that they provide. The quality of care, the ratio of patients to caregivers, group and recreational activities, the types of patients and their illnesses, as well as nutrition, medical care, and cost vary from one nursing home to another. Sifting through all these variables may take a while. It is best to start the process early so you don’t have to scramble to find a care facility when the need arises.
· If you believe that you’ll need the services of a nursing home in the future, do not delay your research. Some nursing homes have long waiting lists, and if you leave it to the last minute, you might not be able to get your loved one into the residence of your choice.
· Research the nursing homes in your area. Evaluate the costs and the type and quality of services they provide. Learn about their care routines and staff, and whether you’ll have easy access to their management.
· Before signing a contract, be sure to visit their facilities several times to see them in action and ensure that the quality of care and programs on offer are according to your expectations.
· Participate in their group activities, such as painting, music, dance, and storytelling, to experience them firsthand. See if the staff makes an effort to include all the residents in the activities.
· Ask the management of the care facility for references. Consult with other families who have placed loved ones at that residence. Ask them about their experience and their satisfaction with the services provided.
· The best option is a care facility that offers the services you want, at the quality you desire, within your budget, and close to where you live so friends and relatives can visit your loved one easily. You might not be able to get everything you want, but you can try to optimize your selection given your specific situation.