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She was recently hospitalized for fainting due to dehydration, malnutrition and not taking meds properly. We thought possibly adding more aide time each day would work but the amount of in-home care she requires and med mgt is just not cost effective to keep her safe and healthy. I fear that she is going to get seriously hurt or wander off if she doesn't go into assisted living with memory care. She is refusing to go. I don't know what else to do. Thank you for any thoughts you have.

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She has Alzheimer's... You just need to pick her up and take her to whatever facility you choose for her. If you let a demented person dictate to you what to do, you're in big trouble! Believe me as my 88 year old mom has Alzheimer's as well. I learned real fast that I need to make the decisions or we don't get off the roller coaster. Good luck and stay strong.
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Everyone refuses to go.

You are receiving overwhelming evidence that she is not safe, even with significant time provided by the care of aides, in her home.

Removing a vulnerable human being from a dangerous situation is not to be regretted. If done because of loving concern, it is an enormous kindness.

Often, especially when one assumes responsibility for a dearly loved adult, the caregiver searches for “a good solution”, when in reality, no “good”solutions emerge.

Choosing the best solution from among some very painful solutions is one of the hardest situations in caregiving.

If you are making decisions on your mom’s behalf with loving concern and as much information about options for her as you can acquire, be at peace that you are doing the best for her that anyone can do.
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Derwin1000 Sep 2020
AnnReid - Thank you for the very supportive words and points to think through while going through this horribly painful time with my Mom. Much appreciated.
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I missed something; if her mom has been diagnosed with ALZ, and she has POA, why is guardianship necessary? Seems to me only the attorney will benefit....
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Derwin, you say that your Mom has Alzheimer's. Do you live very close to her and see her daily, or does someone else in the family? Is there a way you can speak with her Aides about what they are seeing daily, and whether they believe she could be a danger to herself? I do think with age we kind of lose the drive to eat over time, require less and less food, but is she losing weight now? As to the dehydration, this old nurse can assure you that almost all elders enter the hospital with blood work indicating dehydration. We lose our drive to take in fluid we need. You say that she has a diagnosis of Alzheimers. Does she have a POA for health care and are you that person? Have you discussed with her doctor whether it is time to consider placement? Was this your Mom's first hospitalization?
You may just be entering that stage where you have to take control for Mom and that is a difficult one. Eventually things will come to a head and it almost always happens with hospitalization. The problem with the new hospital "experience " is that patients are no longer followed into care by doctors who know them, but are treated by hospitalists and quickly shoved out the door to SNF or Rehab or home, with almost no case management for what home care is.
I think I would start perhaps with speaking with aides. Show up for the shift of more than one of them, take them aside for a cuppa and ask what their opinion is.
And much depends upon whether you have any POA to act for your Mom. I am wishing you good luck. This is a hard time when decisions will soon have to be made. Hope you will update us.
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Derwin1000 Sep 2020
Thanks for your response AlvaDeer. I unfortunately do not live close. My husband did drive there to assess the situation and she is definitely not safe and the aides have also mentioned she is much more confused within the last 6 months.
It is my mom's 2nd hospitalization and 4th trip to ER in a year due to syncope.
I have reached out to Dr and also nuerologist. They do agree it is time for her to be in assisted living. She is just refusing. I have found a very nice facility and she is going to be assessed by the nurse tomorrow.
I just don't know how to get her to go and don't legally think I can force her. I am going to keep trying as she really is not safe in her home anymore.
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If you hold the POA you can place her if she has been diagnosed with ALZ. A doctor's note saying she needs 24/7 maybe a good thing to get. None of them want to leave there home. But it becomes what they need not what they want. I was lucky, my Mom was pretty good about adjusting to the AL and later LTC. We just told her she was going to her new apartment and making new friends.
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Derwin1000 Sep 2020
Thanks JoAnn29. I do have POA and she does have an official diagnosis of ALZ. I spoke to a lawyer and he advised that the only way to be able to make her go is to legally be awarded guardianship.
I have been working with her doctor too and I do think he would provide a drs note. He has ordered an in home screening.
She is refusing but I still will keep at getting her to go.
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Thanks for the support. This is all very good advice. I do need to take the reigns as she can not make sound and healthy choices anymore. Such a hard time. Trying to stay strong. Some days are harder than others.
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I would say my Mom was in stage 5 or 6 of her Dementia when I placed her in an AL. No one questioned my POA. She was incompetent to make decisions concerning her care. If Mom is still in the hospital and the offer rehab, then take it. You can have her evaluated there for 24/7 care. If found she needs it then you can transfer her to LTC if attached to the rehab or take her directly to an AL. Letting her go to rehab will buy you some time.

Guardianship is time consuming and expensive. More money for the lawyer. You can use Moms money but then thats less for her care. I feel as long as you have something from the Dr. that she is incompetent to handle her finances and health and she needs 24/7 care that should be enough.
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Good points here
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This is the time for white lies.

Tell her that her place had a plumbing leak or needs to be tented for termites, and she has to stay at another place for a week while it gets fixed. A good memory care place will help her get acclimated and in that week's time she'll be pretty well settled.

This was advice from my mother's own MC place. The director said "I can't tell you how many homes we've had 'tented' for our residents. Just give them another reason to get them out of the house in the first place, then it's easier to make the change once they're already here. The change has been made for them."
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