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Often times, hospital Social Workers can be a great help. They helped me find placement for my dad many years ago. Case workers have offices in hospitals and they are helpful. Talk to your local senior center in your town. They usually have resources and phone numbers that can help.
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Install an electronic lock on your door. Give the caretaker a specific entry code which you can delete later. That way the caregiver can at least enter if you mom doesn't open the door. As for the rest - good luck!
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Imho, use the services of her town's elder care dedicated person and social worker that they should have on staff. Prayers sent.
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Not sure if this was mentioned, but a discerning Dr. Should evaluate your mom. If she's deemed unable to care for herself, eat properly, make good choices about being medically safe, etc. The right doctor could diagnose her as ' "medically incompetent" on a signed written statement. This piece of paper may allow you to place her (in lieu of a POA or guardianship). TMy mom's Dr and I had to do this for my mom. Also, try looking into Adult Residential Care Homes if available in your state, they usually only have 5 or less patients and are sometimes less expensive than MC, AL, or NH.
Best of luck, don't give up. Take Care.
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If mom's mind is good, then have a discussion with her. There WILL be someone with her when you are out. There may be a caregiver in the home to help you out with things and this caregiver will be entering her room to take care of tasks as instructed. You might discuss how rude she is being when she shuts herself in a bedroom while you are trying to get yourself a little help. Assuming she understands what you're telling her, you might even give her the 'it's either going to be this way with your cooperation or it's going to be in a facility where she has no privacy at all.

Remind her of previous falls and how she could end up permanently in bed if she injured herself and no one was there in the home when it happened.

If she handles this conversation with agreement, then test it out. Tell her caregiver is coming and you will be out of the house. Drive around the corner and wait. Caregiver can call you to let you know if mom opened the door or not. You can return immediately and open the door to have another conversation with mom.

You can also test out her willingness to meet the caretaker who comes while you're there. Or enter her room and introduce her to the caretaker. Perhaps do it around lunch time and force her hand a little by making her come out to each lunch with you and the caretaker. Actually even if she stays in her room, who cares. Tell caretaker to go on in and do what needs to be done (and to wear her thick hide in case mom says anything rude!)

Do you have a neighbor to leave a key with? Otherwise check into one of those key lock boxes like real estate agents use, changing the code as needed.

To do an ER dump, she needs a reason to be at the ER. If you're serious about it, then if she gets sick or falls again, take her. It would need to be something that would get her admitted so you could have the 'time for a facility' conversation with her doctor and/or the social worker at the hospital. If she's not sick enough to stay at hospital, they could even call a cab to send her back to your house.
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Davenport Oct 2020
Good suggestions. I found out my mom's spoiled and selfish, though I understand it was the era she was born and grew up in (fka 'stubborn' ha-ha/not). It's hard for me to not be angry with her as a person for her ridiculous and imperious sense of entitlement and absurd and misplaced idea of pride, and the great burden she is to her children and everyone else. I feel sorry for her, and don't feel guilty about being angry. She's supposed to be the adult! I'm grateful I won't 'go out' likewise. Meanwhile, I/we keep trudging forward, a step at a time.
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My wife refused to have help when I was in the hospital. She had dementia and could not be left alone. The caretaker came in with flowers that she said I had ordered for her. A few minutes of talking about the flowers and then all was well. The care person had found me passed out on a freeway shoulder the day before due to loss of blood after a botched surgery. My wife was with me when she stopped, ordered an ambulance, and brought my wife to the hospital. Family members stayed with my wife that night but arranged for the caretaker to enter our garage the next morning and left a key for her so she gained access. The rest is history.
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Not really an answer here, but: One of the greatest gifts I've gotten from being my mom's caregiver is to understand the self-defeating futility of ego and pride, and unwillingness to accept our own aging and fear. Being a caregiver, I now understand that silly ego and pride could and will make my own future caregiver's life a boatload more difficult for them, which I, as a caregiver, now experience as selfishness, albeit unknowingly. I'm beyond grateful for this lesson.
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An ER dump can be bad.
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I think you have to face the fact that she is a stubborn mule. If you do get a caretaker and she goes into her room, then have the caretaker follow her into her room and stay with here. She might give in when she is cornered in a tight space. And if she keeps it up, tell her she will be removed and put somewhere is she does not cooperate. YOU must take the bull by the horns and impress on her that she must follow the new rules - or else.
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If your mom is still mentally competent then they won't do a social admit in an ER. They will not hold her there against her will. You could call APS and ask them if a social worker will meet with you and her to explain why she has to let services come in to help her. I work for a woman now whose daughter was at the end of her rope because her mother was refusing to let any caregivers in to help her and she did not know what to do. I advised her to tell her mom that either she accepts workers coming in to help, or she's going in a nursing home. This worked. The other problem was that the mother did not mix well with the other caregivers who were sent to her place. She even called the cops on one. Her and I get along well enough and it works. I had to meet her several times with her daughter present before I started going there though. Your mom might be receptive to a caregiver if she's able to meet with them and you several times before she starts working for her. Try for private help though. No, insurance will not pay for it but you always get better quality people who are consistent. Good luck.
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I knew my dad needed help after my mom died. I told him that I was getting him a “cook”. Actually a caretaker.
She started out at 4 hours a day. Now years later she is up to 9 hr. Same lady. It needs to be someone that will interact and be kind and personal. And respectful. As my dad’s dementia has increased I had to tell him that the caretakers were my friends and that they were there so he would not be alone. If possible you may want to let your mom meet one or two of the caretakers and let her pick who she wants. Hopefully someone that has something in common with her that they can talk about. Some just want to play on their phones.
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If people would do their jobs, there would be no such thing as an ER dump.

Where is the help?
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mstrbill Oct 2020
The Dr's and the nurses don't want to get involved, they don't feel it is part of their job and/or know there is no easy solution. They are good at handing out pamphlets. Then their default is to call APS. The job falls on the shoulders of a good social worker to find workable solutions for everyone. If the family can afford it, that means hiring in home help. If the family can't afford it or getting in home help is difficult for other reasons such as what appears to be the case here, there seems to be no other solution than getting help from the local hospital. Its terrible, but often its the best route to take. The hospital care coordinator has connections and the ability to get placement while the family member is too overwhelmed or runs into brick walls.
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mstrbill

Yes, I hear and agree with you. What I am saying is, someone has a job to do.

There is a system out there that is suppose to provide help placing our loved into a facility. If the system was put into work the way it is designed to, there would be no need for a "ER Dump."

Hence, I know all about this dumping. "The system" dumped my family member on Christmas Eve and again last week to the ER.

Our help is not helping us.
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mstrbill Oct 2020
Hailey, what is that system? Or where is it? I didn't experience it nor did I have anyone help me through it. I think the lack of a system is something that needs to be addressed by our society.
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mstrbill

I hear you.

How about APS, Social Workers, Ombudsmans, Guardians, etc.?

My grandmother's son lived with her and APS was so fast to come into her home and tell my dad she could not live there any longer. My dad took her into our home for as long as he could.

However, where was APS when my dad contacted them when he could no longer care for her and the nursing facility was refusing to accept her?

Where were the professionals when my BIL got kicked out of a Memory Care Unit on Christmas Eve and dumped to a hospital? He was only there 30 days? When I contacted the Ombudsman, I was told what the facility was doing was "illegal." However, the Ombudsman changed his story to fit the Administrator so there would be no work for him.

My BIL spent 8 months in the hospital before he was placed into another facility. The doctors did an amazing job with him.

What was the APS, SW, Ombudsman, Guardian doing when they sent my BIL to a 1 star Memory Care Unit just a month ago to only get dumped to a hospital again? To tell me he "He was not aggressive" but to be dishonest when discharging him to the hospital and state "he was aggressive."

So, we do have a system for this but it is not being enforced. Most of them are lazy and don't care.
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mstrbill Oct 2020
Agreed, it seems they are there to work for the best interests of the facilities, not necessarily the patient.
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An ER dump will not work. Especially if that person is competent. The hospital will just send the person home.

On a side note, APS will NOT help at all if the person is COMPETENT. Been there, done that.
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mstrbill Oct 2020
Obviously it won't work if person is competent, but competent means that person can care for themselves. If mom (the mom in original post) can no longer be left alone, than person is not competent. If caregivers are unable to provide care anymore or provide proper care, hospital cannot just send person home. unsafe discharge.
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