My parent is in assisted living. She fell and is being released from the hospital today, but AL says she cannot return to her room. Any ideas?

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My parent is in assisted living. She fell and is being released from the hospital today, but AL says she cannot return to her room. Any ideas?

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Mom has been in the hospital for almost a month due to a pelvic fracture. She is doing great now and walking with a walker. Mom is excited about going back home to assisted living where she is in a building with 15 other residents; all kind, friendly people. She has been living there for over a year. Yesterday afternoon, I got a call from Assisted Living. They said she cannot go back to her room today and that she has to move into the memory unit today! This is because the hospital discharge paperwork has DEMENTIA marked on it. I asked to wait at least a few days as she will see her doctor on Monday. Her doctor will evaluate her and make a referral to a neurologist. Mom's room is full of her furniture, photos etc. It took us days to set up. The facility said no, she can't come back even for a few days due to California law because the dementia box is checked. I went to the place last night and visited the memory unit. The place is dismal. Mom has some memory loss, some forgetfulness and is a fall risk but that is all. No other problems.

Can mom basically be evicted without notice like this? Is it relevant that the assisted living section has a waiting list? Memory care has space and the cost for memory care is $1,150 higher without significant additional care? The doors are locked for "runners" but my mom is not that. The tables are bare "because residents put things in their mouth" but my mom does not do that. The hospital cannot change the paperwork. We love the assisted living section and the facility and it even has a nice therapy pool. Mom is an avid swimmer which is why we chose the place; it is a small, lovely place, but memory care is as I said dismal. The call I got was very callous. No compassion at all for not letting mom come home today. No consideration of the impact this will have when mom cannot go home today. They said she will adjust. I know she will hate the memory care building where most people do not interact. Any ideas?

Assisted Living Elder Law Hospital Discharge Memory Care

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Hi calmseas, how have things been going? What happened with your mom?

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Thank you for all of your suggestions and support. Meeting with AL director hopefully tomorrow, and appt with the doctor tomorrow too. Meanwhile, brought mom home with me from the hospital yesterday (our place is very familiar to her) and she is doing well. She is having trouble walking due to her pubic fracture, but has no confusion and is very comfortable here. She is eating a lot, walking with her walker, and catching up on sleep. The AL is only a few miles from our home. We will see how it goes. Mom will be 97 in August and apart from fall recovery has no other medical problems, and is not on any required medications. Memory care might be in her future, but not now. She truly fits with Assisted Living.

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If all else fails and she is stuck in MC, can some one take her to the pool, or to visit her friends on the AL side? When my MIL was moved this was an option,, no pool but visits to her friends there...

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calmseas, I remembered back when Dad was living at his home, he seemed quite fine. His regular caregivers were starting to tell me that Dad was showing signs of forgetting things, but I never saw that. Later I learned Dad was "show timing", thus being good old Dad when I was around.

My Dad moved into Independent Living at a senior facility, he had a large apartment. Everything was going well, but later down the road the Staff called me in saying that it was time for Dad to move over to Memory Care. Yes, it took me by surprise as I was new on this journey and was just starting to learn about Dementia.

So we moved Dad into what he called his "college-dorm-room" so we were limited on what we could move into that space. Dad adjusted, he was happy to see familiar Staff faces, and happy to be having the same meals he had at the other building [food was pretty good].

As others here have mentioned, Dementia can progress quickly. Falls can accelerate the progress.

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The AL should be sending a nurse out to the hospital to see mom and do an ASSESSMENT on her before they make such a decision. Then she should be given more than a minute to relocate to memory care!

The same thing happened to my mother after a hospitalization... she had moderate dementia and mobility problems and the ALF wouldn't take her back, but they accepted her in the Memory Care bldg instead. They are within their rights to do such things. But you can choose to move mom to a different ALF who will accept her as is, but do know she may indeed require a move to Memory Care at some point.

You may not be able to afford a 24/7 caregiver for her in this ALF and even so, they may not change their mind about their decision.

Do know that Memory Care provides A LOT more care to residents than AL, and they will deal with A LOT more issues too. My mom fell constantly in MC and was never in jeopardy of being asked to leave. She was incontinent and a big handful although she didn't start out that way. Dementia tends to turn ugly in short order.

I'm sure you're gobsmacked and upset with this news rather than "in denial and seeing what you want to see" which is rude and uncalled for rhetoric.

Best of luck with a very difficult situation. I hope everything works out for your mom

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I like Alva's suggestion. Offer 24/7 care for now. Tell them you feel Mom is not ready for MC and after looking at it, she will not adjust. In the meantime, look into other ALs as Alva suggested. Moms AL combined both Denentia and cognitive people.

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Very early stages of dementia might be difficult to diagnose and a neuropsychological evaluation might be necessary. Once the symptoms begin to appear, it becomes rather easy to identify it by observation alone. A hospital diagnosis of dementia is unlikely to be in error. Of course, the family disagree because they are in denial and only see what they want to see. The dementia symptoms aren't full blown yet, but they will come in due time. I understand that it's difficult to accept the diagnosis of dementia. But actually, is good to know it during the first stages, so that you can prepare ahead of time for what will be coming. A full blown neurological work up it's not always necessary. Most likely the hospital already did a brain scan to rule out a stroke. After almost a month in the hospital, she already received plenty of medical care and diagnosis. She is not in dire need to see more doctors at this time.

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As a nurse whose career was more than 40 years in hospital I feel the hospitals are OFTEN wrong about diagnosis of dementia. Fragile elders with injuries and hospitalization often get what seems to be dementia, that clears very quickly once back in their normal environment. So to my mind it is LIKELY that this is an incorrect diagnosis, something just to add onto the list in order to get more days off the medicare payment codes. My opinion only. This senior deserves I would think a trial back at home. 24/7 care or sitter for two or three days is costly, but if that burden can be handled the senior if much more likely to come back to where she was PRIOR to hospitalization. My concern is that there were already issues that the facility didn't fully discuss with family. If that is so this isn't a matter of "denial" which is in itself a kind of "diagnosis " we have no right to make, but a matter more of not being informed. Only time will tell in this case. Many at my brother's Assisted Living were dealing with deficits in competency, but still were able to function well in a well staffed and well run ALF. I hope the same for CalmSea's Mom.

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Were you told why the hospital marked Dementia on her paperwork? Were you aware she has it or is this an error? My folk's assisted living facility has a memory care unit too. It's 4,000 more per month so 1150 seems more reasonable.

I hope you can get some help from her doctor. Sad that they won't take your mom back in AL.

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You are correct in that you need the intervention of your MD at once and Mom needs an evaluation. I hope you are MPOA. This evaluation will include a check list from your facility or provided by MD as to what kind of care Mom requires. Meanwhile, and until these EMERGENT NOW tests are done, your Mom should go to ALF with 24/7 sitter if required.
This facility is following their rules as they are written, one of which is apparently that someone with the diagnosis of dementia cannot be alone without memory care. I would start TODAY examining other facilities. You can explain why you are there and explain your Mom. My bro's place was full of people with a diagnosis and he himself had Lewy's (probable early Lewy's ) and was assessed by the rehab MD as able to be on his own, take his own meds, with balance problems but safe on his own, and etc.
Call your MD and let them know this is an emergency. Get the referral and the testing. Start visiting other ALF. Speak with your own and plead for allowing for the testing and reassure them that Mom is as good as when she went in to care (altho be ready to hear she was failing more than you knew BEFORE admission and they won't accept her in anything but MC).
This may be a follow the money issue and it may be a real issue. We don't know your Mom and couldn't make a guess. You need MD help AT ONCE.
I sure wish you the best.

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Thank you so much for your thoughtful and detailed responses, Alva! I will update you when I know more. I am delighted my mom is doing well and is not confused after 30 days in the hospital for her pubic raymus fracture and 2 different UTI'S. She also fell 11/21/2020 and was hospitalized for 42 days. I took her home 01/01/2021, brought her back to health, and then we both agreed she should try AL for a minimum of 2 months before deciding to stay or go. She moved to AL 05/01/2021 and was there until she fell again 05/12/2022. So more than a year in AL, and she is in much better shape than most of the residents there.

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My parent is in assisted living. She fell and is being released from the hospital today, but AL says she cannot return to her room. Any ideas?

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