My mom is getting out of rehab soon from a recent hospital visit from getting sick. Prior to that hospital visit, she was falling all the time which prompted a 24/7 care service which we had for several months. She has Alzheimer's diagnosis about 1 1/2 year ago and denies her illness, rather won't accept it, and any of the physical alignments (Parkinson, drop foot, inability to walk, spinal stensois, degenerate disc's, PAD and coronary artery, chronic UTI's) .
She is a very stubborn woman and it's either her way or the highway. However, she does not know the care services are private pay, had to tell her the government was paying for it (it was the only way she would accept caregivers).
Met with an Nation Wide 24/7 care agency regarding the care services and I mentioned all the troubles we had with previously with caretakers, at the home. The person (owner & director of nation wide agency franchase) met my mom in rehab and my mom was extremely angry cause she just wanted to be discharged immediately.
Today I contacted the agency for my mom's assessment and hire for 24/7 care, but was told our agency isn't a fit your mom. Further explanation from agency stated that my mom and I are not on the same "page" for caregiving.
My mom thinks she can do for herself, but in reality she can't and hasn't really accepted any of her limitations or aging.
My mom doesn't think she requires 24/7 care but I do for her own safety and health. What's your feedback on an care taking agency who tells you your not a "good fit" for their services.. What a joke... now scrambling to find another agency.
I think I might have mentioned too much about other caretakers in a negative way.
I was a visiting nurse (different from the in-home 8 hour shift care you need). I had a few occasions when I would not return to a patient's home.....severe verbal abuse from patient or family, physical abuse from patient, abject filth and dangerous working conditions in the patients home.
Nurses or caregivers working for these agencies make much less pay than in a hospital. Many work on a per diem basis-not getting any benefits but they get to dictate the hours and days they work. The company you contract with is at the nurses mercy for when the nurses or caregivers want to work and for whom.
You probably will go through a few agencies until you get one that will "fit". If your mom has a bad attitude, you will have a hard time retaining caregivers. They can choose not to be with her and move on to a more cooperative patient. Sad, but true.
If the situation is severe, you may have to place your mom in a facility. I'm sorry.
My inlaws had been evacuated due to a hurricane.
They both wound up in an ALF and then a hospital. About six weeks later they were to be transferred back to their home town. I had things arranged for them both to go to a NH for rehab. I had covered with the admissions folks all they had been through and stressed that I didn’t want FIL left in a wheelchair all day, that he was a fall risk etc. All the papers had been faxed and approved.
I get a call at 5 pm, letting me know the facility would not take them after all. They were coming by ambulance 7 hours away. It had taken a lot of work with FEMA to get this arranged. They were to leave the next morning.
I called another home that had actually been my first choice. I had asked a family member to check for availability for me and was told that it was full. I decided to call them anyway. They agreed to take the inlaws. Another flurry of paperwork. I was so thankful.
The next morning I received a call from the hospital letting me know FIL had passed that morning. I was stunned.
MIL was brought by ambulance alone. I had to get FIL transported by a hearse.
MIL died one month and one day later.
But the NH was great for the time she was there. I turned her over to SIL who I heard later was upset at my choice of rehabs. I was so tired, I didn’t even let it faze me.
I was traumatized by the whole ordeal. I lived two hours from their home and 6 from where they were in the hospital. I had spent everyday on the phone with the medical team trying to handle surgeries, a fall, rehab, MRSA, crazy relatives. I could write a book.
I will never forget that NH employee telling me she “ felt they would fail to meet my expectations,”. As hard as it was to hear those words at that time, I’m sure they were right.
I was like you, foolishly thinking that as the customer they would want my inlaws business. I look back on that (10 yrs ago) and realize how lucky I was to have people cooperating with me at all. I was so frantic with the enoromity (to me) of what I was trying to accomplish.
I felt so bad for the inlaws. They too were difficult to deal with in previous years. Their children were easily intimidated by the father.
The SIL had not shared the obvious diagnosis of dementia of FIL. He had been calling the shots. She was protecting his dignity. Sigh
We had just learned MIL had cancer.
All that resistance went away when the natural disaster struck. They were not pushing back at this point. All the fight was gone from them and the dementia had really escalated. They were frail old people ready to go. Lost in unfamiliar territory. What a shock it is to enter the care taking world for the elders and the family. Yes. Reality is tough.
On Friday, my sister and I met with an "elder advocate" who has agreed to be the "bad guy" in telling Mom she can no longer make decisions for herself. This advocate told us that if a State Protective Services agent found her in the state she's in, with the wreck her house is, that she would be found to be self-negligent and would become a ward of the state (Fla.). We are paying this advocate about $1,500 from Mom's estate to walk us through the process of a visit to the doc this coming Friday, which will result in a declaration of incompetence, hospitalization for a min of 3 days which will trigger Medicare-paid rehab, and eventually a move to a memory care facility. Through the advocate, we are working with a senior housing specialist who has been in our local market for 30+ years doing this job. We have complete faith they will walk us through this horrifying process. We are lucky in that Mom's estate can afford to pay the higher fee it will take to get someone to accept her - as difficult as she is. Though oddly Mom thinks the govt should pay for "old people" when they have to go to nursing homes.
Our situations sound so much alike. And I understand the facility's saying there wasn't a "good fit." Workers at these places shouldn't have to put up with brutal treatment from residents. The indignation the needful residents experience is understandable, unfortunate, but unchangeable. They don't suddenly turn around one day and say "Oh, honey, you were right. I'm so happy here." People who think that are naive. This is a tooth-and-nail battle in which no one wins. I wish for you luck and peace. And eventually, happiness again.
No one has said anything about her being a vulnerable adult. If the hospital or rehab declares she needs 24x7 cares, and you cannot find an agency, then she should be placed in a Skilled Nursing Facility. Her going home without that level of care puts her in imminent risk and danger. You should be able to get emergency guardianship by going down that path and work with a probate attorney and the county to get it in place in just a few days.
There are many memory care facilities that can accept the more challenging clients but you have to ask.
You may also have the opportunity to work with your mom to say it is either home care and you have to be “nice” to them or we will have to move into a facility. As another writer stated, verbal abuse is hard on the CG despite alll their training, I believe she said she lasted longer than anyone prior.
Good luck and try the route of emergency guardianship as it sounds like you need to have some level of say and control.
One lady eventually moved under protest into an excellent continuing care facility whose experienced and highly trained staff were made bullet-proof by first rate management. She was thus able to slander her caregivers and family members in safety and comfort and to her heart's content until the day she died.
The other lady, happily still with us, is in the care of a reputable agency - about the fourth the family has tried - who have looked on her as a challenge. Over the last three years or so they have put together a team and are extremely selective about who they assign to her; two or three individuals rotate shifts and live in from Sunday evenings to Saturday mornings. Over weekends, the lady goes to one of her children's homes to visit. I quail to think what the service costs, but it will not be less than $1200 per week and is probably nearer $1500. Note: this lady does not need any form of personal care and is in good physical health. And on a personal note, I don't happen to agree that she's demented, either. Just... a bit of a handful, you might say.
So I sympathise with all concerned in your situation. With the agencies, whose job is not easy. With you, of course, because you must be frantic. And with your mother, because when I look through her eyes I can feel her resentment of interference and intrusion, and I know I wouldn't like it any more than she does.
So where next? You say: "My mom doesn't think she requires 24/7 care but I do for her own safety and health."
Okay. You have a diagnosis of Alzheimer's Disease from, what, 2017? - plus a range of other major issues. Until that diagnosis develops into a formal assessment that your mother lacks legal competence because of her mental incapacity, though, your mother outvotes you. So what you need is allies. Who else agrees that your mother needs 24/7 care? Who is on your side of the page?
having the police show up because mom was in the street screaming for the neighbors to help as someone’s in the house is just one of many moments I’d rather not have experienced
even now, immobile and needing to be hand fed most of the time, mom suggested the other day that her least favorite caregiver leave as she wasn’t needed
have you thought about assisted living for her?
If she won't accept 24/7 care, can she survive with 12 hrs a day? Maybe family can step in for one day a week?
"She is a very stubborn woman and it's either her way or the highway. However, she does not know the care services are private pay, had to tell her the government was paying for it (it was the only way she would accept caregivers)."
and
"My mom thinks she can do for herself, but in reality she can't and hasn't really accepted any of her limitations or aging."
Her mantra was "I'm independent." "I can cook." "I can take care of myself." We hired staff to come in once/day for an hour only, mainly to ensure she took her meds from a timed dispenser and otherwise just check on her, as she was able to do most things (cooking? no way. at this point it was frozen dinners and boxed snacks.) We also told her that someone (MediCare or VA) was paying for this. Eventually when she asked about how the facility we moved her to was paid, we just said the VA covers it. No need to tell her otherwise!
However, our mother did not have all the issues you have listed. Mainly mom developed dementia, which impaired her short-term memory, and led to problems following through (cooking/finances) correctly and kind of self-isolating. Are you talking in-home care? If she refuses to let them in, there isn't much you or they can do. Our plan was to increase help as needed, but after a few months she refused to let them in. They even brought in their "expert" at getting clients to understand - that woman was lucky mom would not have been able to toss her out the door!! Your mom certainly sounds like she needs 24/7 care and if she won't let anyone in, you will have to consider a facility,
That said, being stubborn and "independent", mom also would not consider moving to AL of any kind. In the end we had to "trick" her. She developed cellulitis just before the planned move, and one brother typed up a letter from "elder services" at the hospital where she was treated (ER/outpatient only) saying she goes to the place we selected or they will place her. Mad as a wet hen, but she reluctantly let the brothers move her. For 9+ months after she hounded that brother to take her back to her condo - never asked me thankfully. Then she stepped back in time a bit (!!) and became focused on the house they lived in previously (about 24 years ago.)
For your mom, this decision can be taken out of her and your hands. The rehab should be doing an assessment and if they feel she cannot be discharged to her home without 24/7 services, and those services are not available, they can deny discharge.
I would seriously consider finding a safe place for her and have her moved directly from rehab to the facility (assumption is you would not be taking her in, which sounds like it would be a disaster even if you wanted to do this!) Once you find a place and set it up, you can use some kind of transport system to transfer her from rehab to the facility (it'll cost, but again, then the onus is not on YOU!)
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