How do I force an extremely stubborn elderly parent out of their home to get a mental evaluation?

Call the Office of Aging back and ask to talk to a social worker, and ask what the trigger is . When I called them about my mother , they asked me a bunch of questions which were red flags to them and the social worker went the next day to my mothers home to see for herself what was going on and my mother was determined not safe to live alone.

The social worker asked my mother questions about various scenarios
“ What would you do if ……….”
The social worker reported to me that my mother could not “ come up with a plan , or execute a plan “. This was the trigger in my mother’s case . My Mom sounded like your mother , she was living on cookies and water , in the same pajamas , refusing to go to the doctor , or tour assisted livings .

I ended up finally getting Mom’s dementia diagnosed in the hospital , and Mom was placed in an assisted living that I had already picked out . Then Mom challenged that along with some of my siblings who wanted another opinion . So Mom was seen at a gerontologists office who confirmed the dementia and that she could not live alone . Mom was very angry . She thought she was going to talk this doctor into letting her go back to her house and that her “ rotten daughter had no right to do this .”

You call 911 and tell the EMS that you think your mom has a UTI as she's acting strange lately and you INSIST she be taken to the ER. You don't mention any dementia until after she's been seen at the ER.
Then you let the social worker at the hospital know that your mom can no longer return home because there is no one to take care of her there and that she is an "unsafe discharge."
The social worker will then have to find the appropriate facility to place your mom in.
Now of course they will try and talk you all into taking her back home with all kind of empty promises being made, so you'll have to stand your ground that NO she cannot return home.
That is better than just trying to get her out of her house for an evaluation as all that will do is verify what you all already know.

If I was dealing with you I would be pissed. The key word is forced. And HOPEFULLY get diagnosed and trick. Sounds like you have an agenda. Right now she is comfortable in her home. I think the plan should be to get her involved in activities. Maybe get some in home care a few days a week. There are even meal services. Just so many things you can do than to force her into a jail

You can get a home health doctor, which medicare pays for and they will come to the house and make a determination. They also know of lots of alternatives to help keep mom at home if she determines she is safe. We have home health care and never leave the house. I am caregiver to my MIL who has dementia and uses a walker. We don't take her anywhere because we cannot get her in and out of car. Home health care has all kinds of supports.

I would just pump up the drama when calling the Sheriff. The things to stress are your fear that you parent is a very real danger to herself and in serious danger living alone. Things to fabricate would include fires being left on the stove, falls, wandering and etc. You are so far handling it well in reaching out to proper authorities. I do think APS needs to be involved and they are likely the ones to be sending social workers out.

The other suggestion is calling EMS and then, when you get your mom strapped onto the guerney and into the ER ask for Social Services at once, and don't allow discharge until you speak to them about the need for thorough evaluation.

As I said, you are going to need to pump up the drama and perhaps even fabricate some dire circumstances in order to get this done. A competent seeming senior won't be taken to an ER against her will.

Thank you for asking and for doing what you've done so far.

Lots depends on your legal authority. Do you have all the legal documents in order - POA, banking, (co-signers required and/or you get copies of all the statements, blocks on spending (credit card and checking account) limits? Who pays her bills now?

* I do not understand the specifics of getting her to an MD for evaluation.
Are you asking her to go by herself? Of course she won't do that.
Is there a family member or someone who can accompany her, which is a necessity. Is there someone that can be in the exam room with her during questioning?

* My experience (with a client) is very similar: She would not go to MD. She happened to fall and someone walking by her (large) home heard her screaming and called 911. Once hospitalized, she was evaluated and then family could make arrangements (in her case, placed in a memory care unit). It was a difficult transition due to trying out different medications in the hospital; I was there through some/most of this transition).

* Is your brother or some family member close by or could be for a transport ? MD visit?

YOU NEVER ASK OR TELL HER YOU WANT HER TO BE MEDICALLY EVALUATED.
You tell her your taking her out:
- to lunch
- a special event (a movie, play, go to the museum
- whatever will get her in the car.

Does she still drive?
If so, you could tell her appt is to renew her DL - if that might help (although I think she'll see through that ... if not know she wouldn't pass a test and not go.)

If this doesn't work (getting her in a car and going to MD): Yes, can call Adult Protective Services (APS) or the sheriff, although I feel strongly that a family member needs to be with her at that time.

* In terms of her having 'no where to go,' if she is admitted to the hospital, which she may not be, even with a dementia diagnosis (I am not sure, ask sherrif or APS), I do not know if / how they are required to handle a person needing to be placed in a nursing home.

- Do you know if a nursing home will take her?
- Have you re-searched / called any?
- Ask APS / Sheriff Dept the procedures.
- A family member must (should be) with her during this transition.

- Who would be signing her in - to a hospital ?
That person may be the responsible party when she is 'ready' to be picked up to return 'home' (whereever that is). In essence, find out the procedures - and legal responsibilities of a hospital / or any medical institution.

Who is going to deal with her house / apt if / when not returning home?
Your brother?
Does he/another have keys?
Make sure all appliances and lights turned off, garbage pick up cancelled.

Someone / family member LIKELY/may need legal authority to turn off PG+E, stop billing, get rid of car (DMV) - I went through this w a friend-companion and had all legal documents in order. Many businesses ask for this (required) information to close out accounts or change anything, i.e., have her mailed delivered to you/r address.

Whenever she is placed in a facility, be sure to include as much of her own furniture and furnishings in her (new) room to make it look as much like her home - what is familiar to her - as possible.

Also consider her quality of life and her wishes. While it may be too soon to think about these things, consider if you were in her shoes and how would you want to live the rest of your life - with dementia?

Gena / Touch Matters

I understand your frustration. The advice of being patient and waiting for something terrible to happen makes sense but feels so neglectful and wrong.. Plus it is so stressful. There is no reasoning with dementia. My MIL has canceled 3 folllow-up appointments with a gerontologist because I think she knows she’d be deemed incompetent to live alone at home as at her last appointment she was diagnosed with mild CI. . I legally can’t do a thing and I am her POA. None of her regular doctors will have her assessed- they refer me to the gerontologist who she now won’t see. I won’t lie to her or trick her- I don’t have the legal right to do that. . So be patient if you can and she will fall or have a heart attack. It is absolutely crazy. But I believe you can call the police for a “wellness check”. They would at least make her be assessed. Good luck to you and hang in there.

I don’t have recent experience, but my guess is that out of the problems listed, her inability to take her own medication and refusal to see a doctor for more would be the triggers. Say that the medication running out is ‘imminent’. Living in a mess is a ‘right to rot’ issue, which could explain the 'vague and confusing'.

Questions the Doctor asked me regarding my LO's living condition;

Is the home tidy?
A little messy? Very untidy but 'goat tracks' to the exits?

Clean? Not too clean? Spoiled food, overfill rubbish bins?

Evidence of rats, mice, cockroaches, other pests?

Person unwashed, soiled clothing?

Is the person confused to day or location?

Is the person at risk of self-harm or a threat to others?

Basically, looking for squalor, vermin, odours, self-harm & serious danger to self or others.

I saw that there was a huge gap between what I considered *living well* to *dangerous to the level an authority can step in*.

The grey zone I have come to call that space.

Here's my take: If you are not going to physically take her or be there, then she will not be seeing an doctor or medical professional any time soon,

The real issue is that unless she is really bad off or if something nasty happens to her, you are not going to get a diagnosis of dementia. And even if you do find out that she is going to go into a Memory Care ward, there are things that need to be done, that are overwhelming to seniors, in preparation to stay at a MC. She will have to decide where to go, what to take with her, and what to do with her apartment (rent, sell, leave empty) and all the decisions that need to be made (financing, etc.). If she really truly has dementia, she cannot do all of these things by herself, and she knows it.

The psychiatry section of the hospital, is not fit for dementia patients. It is there for people who are aiming to hurt themselves or hurt others.

You and your brother need to step up and help prepare her for a change in her lifestyle. It is not going to be easy for her or for you.