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Under no circumstances, no matter what is threatened, should anyone go near her and certainly not pick her up. She is totally gone and dangerous. Do NOT give in no matter what. Take the keys away so he is not forced to get her and YOU do not have the legal authorization. I would file a report with the police as she is a danger, call the Office on Aging and if need be your senators and assemblymen and doctors. She cannot come home - period. They must find someplace to put her. Call Adult Protective Services. She will/can kill your father who does NOT deserve this. She is gone - keep her gone. And perhaps talk with an eldercare attorney. You must take charge to forbid her returning.
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graygrammie Jun 2020
Mom is lined up for a nursing home after she completes her psych evaluation at a behavioral health facility and stay in the hospital to address medical needs. From there she is going to a nursing home.
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Saw your recent post of where she is currently. A note on UTI: I'm not sure why, but often they are reluctant to culture urine. My mother had UTI that initially was 'clear', but after 7 days cultured Ecoli and required antibiotics. Maybe that was a mild infection compared to what they are looking for, but still, little things make a difference. Hope you and dad are able to get some answers, and that dad is able to get some rest. So sorry it's been such a battle for you!
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graygrammie Jun 2020
Thank you. Dad has sounded so much better on the phone for the last two evenings. Dad was a chemist / microbiologist in his younger years and knew that the "straight cath" test for UTI would not provide the final answer.
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I'm glad she is in a place where she is safe, dad is safe and she can get the care she needs/deserves. Deciding to place a loved one in a care facility is never an easy choice, but especially in this case, it appears to be the only safe choice for everyone involved.
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Grammie, there are fates worse than dying in a nursing home. What if your mom kills your father? She is then jailed for homicide (happened a few years back; elderly mom shot her 70 year old son/caregiver).

Because he was going to arrange for her to go to assisted living.

She died in jail.

Old age and death isnt what Hollywood depicts...saintly, calm elderly folks gazing upward at the light and being held by their adoring children.

The best depiction of an actual death that I've ever seen dramatized is that of the Mother Superiour in Poulenc's opera the Dialogues of the Carmelites. It depicts a woman of great faith, dying, in pain, agitated and violent, a doctor who will not increase her medication because it might tip over the line and kill her. She dies, gasping, losing her faith and thrashing. Hard to watch and terribly accurate.

I think that dying in a nursing home, with professional care and hospice at your side with morphine to ease pain is EXACTLY what I want.

I would not want to burden my husband or my children with caring for me if I became violent.
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greeneracres Jun 2020
After having witnessed terminal agitation, I wonder how often people are lying when they say that someone passed peacefully at home, peacefully in their sleep, etc.
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Tare her to the Hospital and get her admitted for whatever.

When they want to discharge her tell them you can't snd aren't able to take care of her and do not design her out.

They will find a place for her somewhere.
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I see they live in southern Delaware — “slower lower” also means less medical care access and also not the best providers-/ my primary care still only takes cash and gives a hand written receipt - can only Snail mail records - it is like I’m back in the60s!
I saw your issue is now being handled and I would stay on top of it since you can not trust providers to do right by your mother. Definitely hospice was finally helpful with your advice but they should have sooner told you to exit hospice and have her taken to an ER even if in Maryland
Good Luck
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This may sound overly simple, but sometimes simple is the answer. The UTI is causing the behaviors. Once that is treated she will be herself once again. Focus on how to get her to take the meds. I see now she is back in hospital and they will do that..... this is so traumatic for all involved, but believe this will pass. It happened to my grandmother in law.... screaming, hitting, taking all of her clothes off...since then I always ask to check for UTI when I see strange behavior in any elderly person. Keep breathing.

I just saw they stopped treating her for UTI?? Your sister the nurse should somehow get on this to insist they complete the treatment or have your father as her POA insist - your mother has rights- and your father - on her behalf - can say yes or no to anything. It never ceases to amaze me what they don't know at the hospital. It took an experienced nurse to realize what was happening to my grandmother in law.
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graygrammie Jun 2020
In all the confusion of what has occurred over the last few days (ER w/ two-day hospital stay, then transferred to behavioral health facility, then emergency trip to a different hospital, back to facility, another emergency trip to the hospital where she is at this time), I'm not sure anyone is dealing with the UTI. However, I was told by the nurse at the facility that in the amount of time he had with her, she was calm and pleasant.
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It sounds like she is a danger to herself and others. I would persue an involuntary mental health commitment to stabilze her mentally. Geriatric psychiatric unit. If you can hide the medications for the UTI in food that she will eat, I would try that. I would also contact the area agency ombudsmen for assistance as well. It takes about 2 days for the medication to kick in. Another thought if it could be crushed. If she is really violent, I would remove your Dad from the home for his safety and ask the hospice for an agency that will assist with home care in an emergency. You could also have her taken back to the hospital and tell them you can't take her home under these circumstances. Maybe the antibiotic can be given as an injection or an I.V. You could also contact her PCP and request that they admit her to the hospital.
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graygrammie Jun 2020
Please see my above answers. I wish I could just update the original post.
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Fact of Life: Hospitals and their "hospitalists" often discharge patients early. Often they are they don't like or don't want to handle. There is an appeal process that may extend the time a little bit. First tell them you aren't ready, can't come, it's inconvenient, whatever you can say. You must give the hospital staff four hours notice that you are appealing the discharge. I can't find the phone number but there should be one among the admission papers you were given at the admission. (My paper has been green each time.) The phone call to Medicare itself (wait till late in the day) gets you two days for appealing before they deny it. Then you appeal the appeal, giving the hospital time to find a place for combatant mom. They will find one and it may not be one you would choose in these times. Good luck.
Here is a helpful Medicare website:
https://www.medicareinteractive.org/get-answers/medicare-denials-and-appeals/original-medicare-appeals/original-medicare-appeals-if-your-care-is-ending
https://www.medicareinteractive.org/get-answers/medicare-denials-and-appeals/original-medicare-appeals/original-medicare-appeals-if-your-care-is-ending
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my2cents Jun 2020
This has gone beyond using the word inconvenience. She should tell the hospital mom cannot come home because she is a danger to her caretakers and tell about the insecticide she sprayed in dad's face. She simply cannot be cared for in the home any longer and hospital/dr should assist in the paperwork to find a place suitable for her current needs/out of control behavior. Mom can't help it and they do have facilities better equipped to handle her than for dad to take the risk again.
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It would take more than $23 an hour to get me to take care of her! She's Nuts. She will abuse Anyone who tries to care for her. Get her into a mental institution FAST and Don't feel bad about it, Her brain isn't working right. And why is she on Hospice Care? She is not dying if she is able to smear Feces all over, and torment Dad. As for killing Dad, that is a real possibility. Get her out of his home. Take her to the nearest mental institution.
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graygrammie Jun 2020
She was moved to a behavioral health facility from the hospital she was taken to Sunday.
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If there are senior services or adult protective agengies get them to help file for
Probate guardianship as she is a danger to herself and others. There can be an
immediate short term comittment for evaluation. The hospital is not likely equiped to handle her long term anyway -They should have had this done after
second incident. The UTI was a consideration -but if it did not work something else has to follow. Nursing homes generally can't handle her behavior even if they
were open to new patients. Probate ordered institution and care is the only solution I see here for the time being. I am an attorney now; previously a registered pharmacist; but mainly speaking from some personal experience in both professions.
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It does sound like she needs placement that addresses her mental and behavioral problems. The hospital can only keep her if there is a medical necessity to do so. They do not take patients just b/c they are too hard to take care of at home. Suggestions about involuntary placement in a mental health facility.
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Tell the doctor your concerns and ask for a case worker there at the hospital. Tell them you are concerned about her safety but also for the safety of your Dad because of her violent behavior. They tested my aunt for COVID-19 before they allowed her to enter the assisted living facility (nursing home, etc). She was in the hospital at the time. Here in S.C., you are also required to stay in hospital 3 nights before you are eligible by Medicare unless you are going to rehab first. Hope this helps.
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Medicate and re-examine all other meds, actions, and inactions-- get a second opinion ! Be that POA. Don't ask Dad. do what needs to be done for two parents obviously suffering from dementia in various stages. Remember how dementia behaves-- declines, then plateaus, then declines more and plateaus for who knows how long. New meds are obviously in order and a new place for combative Mom... so Dad can rest up for a while... AND he may not see her for 2 months after she is moved. Better still, tell him it is the COVID rule.
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Would concur with having her committed to a psych hosptial. They will have her turned her around within a couple of weeks.
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graygrammie Jun 2020
Was done on Tuesday. I don't know how to edit my original post with an update.
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Imho, a hospital is a business, moving patients in and out. However, your mother needs to be held in a behavioral/mental health facility. Your mother is mentally ill. I would not wait on that decision. Your father's life is in grave peril!
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graygrammie Jun 2020
Unfortunately, I don't know how to update my original post. Mom was transferred to a behavioral health facility on Tuesday. However, they have twice taken her to the hospital for choking, so she has actually spent more time in the hospital than at the behavioral health facility. A nurse at the facility told me today that she has been peaceful and calm and funny. Apparently she is speaking -- which is surprising since she's hasd expressive aphasia since a major stroke several years ago.
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Grammie, I'm so glad that mom is starting to get the care she needs!.

Even though you can't edit your original post, it is probably easiest for you to simply post an update at the top here rather than replying to each in individual. ((((Hugs)))).
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graygrammie Jun 2020
Thank you! Did just that. I'm used to forums where you can post an update in your original post so people don't miss it. I'm also used to forums where you can lock a post so no one else can reply and apparently I can't do that here either. I don't like to ignore folks replies but it does get a little overwhelming.
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UPDATE: Mom was taken to ER on this past Sunday (Father's Day) after dad opened his eyes in the early morning hours to her standing next to his bed with a butcher knife. (I found out yesterday that the knife actually broke, handle came off, when he was trying to get it out of her hands.) Dad refused to pick her up and hospital kept her for 24-48 hour observation.

Hospital decided to transfer her to a "behavioral health facility" (new word for psych hospital, I guess) on Tuesday. Both Wednesday and Thursday mornings she had choking episodes (that's new, didn't have that before) that resulted in trip to the hospital. She came back to the facility after the Wednesday episode but was kept overnight after the Thursday episode and that is where she is now.

She has spent more time at the hospital since being sent to behavioral health center than at the center. No psych eval has been accomplished yet. I spoke to staff and was told she is calm and peaceful. I forgot to ask if she is being treated for UTI. I was also told she is funny. When asked where she was, she responded, "I am here." When asked where "here" is, she responded, "The nut house." I also asked if they were having trouble communicating with her since she has expressive aphasia. They said she is speaking quite well and have no problem understanding her. Hmmm . . .

When offered dinner Wednessday night, she was only given a plate of pureed food, which she refused. She asked for a cookie and they told her no, so she went to bed without dinner. I wonder if that contributed to the choking on Thursday morning? (She tried to eat too much at once, had a mouthful of small bits of sausage when she was only supposed to take one small piece at a time.) Also, Dr. Google tells me that choking can be a result of UTI. Untreated UTI leads to dehydration, dehydration leads to dry mouth, dry mouth can result in choking.

Hopefully mom will be back at the center today and they can actually accomplish the psych eval and get the process moving. And I am praying that the bed stays open at the rest home.

(Thank you, BarbBrooklyn, for your suggestion to post my update as a reply.)
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Daughterof1930 Jun 2020
So glad to read your update and see that the ball is finally rolling for your mom. My dad is currently in rehab and has had what he describes as choking episodes. He is also rushed back to hospital and it proves to be reflux. Not saying that’s what’s going on with your mom, just another possibility among many. And my dad doesn’t necessarily have any psych issues (maybe we all do?!) but he definitely puts on a better show for doctors than his normal self. Hope answers are found for your mom soon
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Your Dad is in a unsafe place. Get her on a waiting list for memory care facilities so she can be placed when covid lifted. The Hospice Dr. can give her some mild anxiety med. Request a social worker from hospice came to help your dad deal with what is going on. He has in his mind he can deal with his wife rather than pay extra help. Anxiety Med. is a first.
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graygrammie Jun 2020
Please read my update below.
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