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96 year old aunt is in assisted living. I visited two days ago and found a bruise on her forehead, legs...every piece of clothing, bedding was urine soaked as she hasn't been diapered properly. She is itching and miserable. They charge her $75 a month on top of everything else to do two loads of laundry. HAd to pay $30 to do emergency load ...I found a urine soaked diaper in her hamper, it had to weigh 3 lbs. she has plenty of diapers. I don't know what to do. She fights her caregivers on everything from meds to showers....she is almost out of money...about 4 more months worth. Won't allow her to apply for medicaid so she can enter nursing home until she is down to $2000....then it is a 6 month wait to GET on Medicaid...where does she go for that 6 months??? I am at my wits end.....

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Gayle sometimes you have to think outside the box. Find a reason to get her to the ER preferably one with a N/H attached. She has to have a qualifying stay in the hospital before she can be placed. I believe it is three days. Once she is admitted REFUSE to take her home and make sure she can not go back to AL, they probably will be glad to co operate with that. review all her health problems and make some up if necessary. Use any idiocyncrosys She keeps shaking her head as though she is in pain. she keeps holding her chest has she had a heart attack. She's weak on her left side, keeps falling has she had a stroke. She stares straight ahead sometimes is she having a seizure. and the old perennial a UTI so don't clean her up ,the worse she smells the better, they will want to get her into the N/H as fast as possible. If she is an old smoker she probably has a productive cough so you are worried about pneumonia. Any swelling of her legs is she in heart failure. If you don't have medical knowledge research these ailments so you can dish up the symptoms. Do it one ailment at a time they will be afraid not to investigate. At her age and with that level of neglect something will be out of wack even if it is only dehydration.
Now what is your level of tolerance can you stand up to being bullied? The hospital may be sweetly co operative or fight you every step of the way. Can you stand your ground and look them in the eye and quietly but firmly say NO. Do you have a husband or adult child to assist. start off alone but call for re enforcements if needed. probably the best time to start this would be Sunday morning when all the heavy weights at the hospital are enjoying Sunday brunch and nothing will get done till Monday morning. You can sign permission for treatment but be very careful not to take financial responsibility. read the fine print even when they are standing there with a pen and directing you to sign where the X is.
As someone suggested buy aunty some new clothes for the N/H but don't provide them till she is actually admitted. Actually go to a thrift store because the N/h will loose them
I am sorry Gayle this is going to be very rough on you standing up to a whole brigade of white coats so pull up your big girl panties and go into battle. I really hate that expression it sounds so condescending. but as long as you behave reasonably there is nothing they can do to you. While I am not advocating using these methods I have seen them used by others and they did work. We are all behind you ready to hand you the ammunition
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When an elder is so mentally and emotionally out of it as your Aunt is, you might want to contact the doctor to make her meds a standing order, NOT "as needed" or "PRN". She certainly can't decide when they are needed, the nurses do. Not giving them to her on a regular basis probably increases her agitation and non-compliance - what a convenient way for them to shirk their duties with the excuse "Oh, she won't cooperate". If she had the Ativan on a set schedule, she might become more compliant.
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Dear Gayle, This is a terrible situation for you and your Aunt to be in. My Mom went straight from rehab to NH, with Medicaid pending, so I don't know how the AL route goes. However, it would seem that due to substantial assets, your Aunt has been paying AL out of pocket and will continue to do so until she is down to $2000? I wonder which is cheaper on a monthly basis - an AL or a NH facility? Regardless, wouldn't it be logical to spend down her money in a NH now where she would get a higher level of personal care and supervision? Then when she gets down to the $2000 mark, start the Medicaid application and she would remain in the NH as "Medicaid pending". It does take 6-8 months for approval, but she stays in the facility anyway, and they continue to get her SS and Pension checks if any. Then I believe the approval is retroactive and the NH gets whatever you owe at that point from Medicaid. If I am wrong on any of this, I know more astute caregivers than I will set the record straight. I would suggest you use some of the money she has left for extra clothing/shoes/slippers before she goes to the NH. I would also start doing the laundry myself - they ruin everything. As far as her fighting everyone, perhaps the doctor can prescribe something to calm her anxiety and agitation. I wish you all the best - especially patience and fortitude!
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My Mother left assisted living, because she was no longer able to perform basic tasks like toileting. I second the suggestion that she be moved to a NH. I am guessing that you are her POA and are able to make those decisions. Start now, by meeting with the director of the facility that she is in now. She needs 24 hour nursing care.
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Veronica....that was the most honest, to the point suggestion I have had....I think it is just what I needed to read. Actually, I was thinking that all along but not sure how I was going to accomplish it. I am going to talk to facility and her Dr. today. Hopefully her Dr. will have my back and that will help. Wish us luck!!!
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Dear Gayle, now that you have mentioned you are not her Financial POA, you may want to start proceedings to be her Conservator (for finances). You have to be careful with signing documents for her as you don't want to be personally liable for her debts. I would suggest you consult with an Elder Law attorney. In the meantime, I hope you have been signing all her paperwork as POA anyway (i.e. Medical). On another post elswhere on this site, somebody had suggested that without any POA at all, a caregiver should sign as Their Name FOR Patient's Name. You really have a daunting job on your hands - it cannot be easy working full-time and also taking care of your Mom & Aunt. Blessings to you.
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Hi Gayle - I'm so sorry you are having to go through this. Clearly the AL facility isn't caring for your aunt very well. Who wouldn't be agitated if they're lying in urine-soaked pull-ups - and itching, etc. When you do finally get her to a nursing home, please be her advocate. It's so hard to find Medicaid-pending NHs that take decent care of the elderly, especially those with dementia - but they're out there. Once you are given a list of NHs from the social worker at the hospital that are Medicaid-pending, please go visit them and pick the one you think is best. Trust me, they are all different and the care will be all over the board - and most social workers haven't personally visited the NHs so can't give you good advice. I know this takes time - and that is something you don't have a lot of with working full-time and helping to care for your Mom, but please try. Maybe another family member or a friend can assist. God Bless You in your efforts to ensure your aunt is well cared for.
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Thanks...also 6 month waiting list for NH.....I was doing her laundry, but now am very short on time...I also work full time and care for my mother (her sister) on a part time basis...ugh...
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and she is also on Ativan as needed....horrid situation
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Why isn't your aunt allowed to apply for Medicaid?

And I agree with an above suggestion about getting her admitted to a hospital so she can be discharged to a NH. It's not difficult to get an elderly person admitted to the hospital. Take her to an emergency room. I don't know her ailments but use of her ailments to get her to an ER. Then you can talk to the RN or the Dr. about getting her admitted. If your aunt is confused and living in an unsanitary environment tell the RN or the Dr. that. I wanted my mom admitted to the hospital because she refused to get out of bed. I took the RN aside and explained my situation and they admitted my mom. It can be done. Then you can start working on the NH.

I don't remember if you said you had POA. If not, can you get POA? A lot of people say you have to see an elder care attorney to get POA. I got POA over my dad by downloading the paperwork from legalzoom.com. Had it notarized and we signed it and I never had a problem with it. Once you have POA get to the Medicaid office and begin that process. It's not always as daunting as some might thing. When I applied for Medicaid for my dad, who was in a NH, it was a fairly simple process. It took 3 months to get him approved and he had died by then but I was told by our Medicaid caseworker that it's rare for someone to be denied "vendor Medicaid" which is what NH Medicaid is called here in MO.

I stress out easily. I get my britches in a knot and freak out over everything. But even I was able to get my dad to the ER, to the NH, and get him Medicaid. And if I can do it anyone can. You can start the Medicaid process as soon as you have a NH for your aunt to go to. And my one suggestion would be to keep in touch with your Medicaid caseworker. I practically befriended the gal who took my dad's application and called her weekly. It didn't get the stupid thing done quicker but I don't think I was just a case number to her either. And when I went to the Medicaid office I had all this paperwork with me. The NH had given me a booklet telling me what I'd need to apply and most of it was bogus. I was terrified because I didn't have my dad's birth certificate but they didn't even ask about it. I knew his social but didn't have his social security card, again no problem. It was a lot less of a mess than I thought it was going to be.

Good luck!
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