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I am the DPOA for my mom. She is in end stages of Parkinson's and was in a nursing home. She made the remarks she would rather kill herself than live like this anymore and the nursing home told me she had to go to a geriatric psychiatric unit for evaluation. She has been there over a week and she is just declining and I don't see where this place is helping her. As DPOA do I have the right to take her out of there and bring her home?

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Just a change in where she is living can cause a decline in people with dementia.
Have you considered Hospice?
You could discuss discharge with the doctors but will you be able to care for her at home? Do you have the equipment needed? Although if she were on Hospice they would provide the supplies needed for you to care for her. But do you have help? If on Hospice she would have a CNA that would come 2 or 3 times a week to bathe and dress her, a Nurse at least 1 time a week to check her and order any medications necessary. And you would also have the ability to have the services of a Social Worker, Chaplain as well as other therapies and volunteers if you like.
If she truly wishes to harm herself though she is where she should be. (although personally I understand her statement and wishes)
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Frog007 Feb 2020
Only problem with Hospice is she is not allowed to call for an ambulance if she would need one for any reason; she HAS to call Hospice.
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How long has she been there? If it's only been a few days or a week, you need to give it more time. Are they adjusting her meds? If so, she needs time to either acclimate to them (or a safe place to change the drug regime if what she has now is not working for her). I think it's the law for places like nursing homes to get psych services involved when patients mention self-harm or suicidal thoughts.

I don't have an answer for the legal aspects or what rights you have. However, I'd suggest not taking her home (I assume you mean yours or her home, not the NH).. unless you are able to care for her 24/7. As in quitting your job or hiring people if you can afford it. If you take her home, she won't want to go back to the NH if it proves to be too much for you to handle. It sounds like she is tired of her body being how it is and not just hating the NH?

Also (and I'm not 100% certain on this), you're risking her stay at the unit not being covered by Medicare-- or whatever insurance she has-- if you check her out AMA, Against Medical Advice.
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She has been there for 10 days and they have done evaluations and have her on Zoloft. It is not helping. Parkinson's patients get to this point and even her PD doctor has said she may be at a point where no meds will help the hallucinations. Told us at her last appointment to cherish the next 2-3 months because she is at the end stage. We are a very close knit family and everyone will pitch in to help. We just don't want her at a place where we are only allowed to visit her from 2pm-4pm 3 days a week and weekends. I live literally right next door to the nursing home she was in and would see her almost everyday for 2-4 hours a day. She needs us close. She begs us every time to please take her home.
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AlvaDeer Feb 2020
Please consult with hospice now. So sorry. Please help your Mom by honoring her wishes now to be taken home and allowed to die.
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You do, almost certainly, if you get MD permission and can care for her. Do understand that your mother may have now had enough, may indeed wish to be released from this hell from which there is no upside coming; get palliative care and hospice consult and speak with them and your mother about her wishes. Please try to honor her wishes. I am so sorry you are going through this.
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Frog007 Feb 2020
I agree, go get mom. I also agree 24/7 help. Are you prepared for that. Hospice is iffy you can not call an ambulance you must call Hospice only.

GOOD LUCK dear.
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Go get your mama!
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rovana Feb 2020
No, first talk to doctors - mom may be too sick to be cared for at home.
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If she's having hallucinations and has made comments about not wanting to live.... and the doctors are working on mediation to help her, I'd be very careful about doing anything against medical advice. As others have mentioned, it could be very risky for many reasons. She may be too ill to be cared for outside of a medical setting. Also, it takes time for some medications to get into the system and help. Ask about hers and how long before they take to work. Some take weeks.

You might want to consult with an attorney about it. If you're not HCPOA, you may not have the authority. Was she held pursuant to being a danger to herself or others? Was she taken before a Judge? I'd inquire about the details, but, her pleas to leave may not be based on sound judgment. For that reason, I'd pursue options with the doctor. If she's hospice eligible, inquire about the details, under the circumstances.
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Frog007 Feb 2020
HOSPICE IS a group of one nurse and some aids who come into the consumers home to EVALUATE YOUR LOVED ONE'S condition. Make their assumptions, CALL A DOCTOR (may not even be yours) give them the symptoms and TREATS ACCORDING to that. You will never see this DOCTOR. BIGGEST THING TO BE WORRIED ABOUT IS YOU CAN NOT CALL AN AMBULANCE OR TAKE LOVED ONE TO HOSPITAL YOURSELF YOU MUST MUST CALL HOSPICE FIRST ONLY. I've seen it enough times. I don't like what I see but it's not my business. On this at least you get the option of answers that you can sit down write down your replies and go over them. Good Luck I wish you all the best.
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Thank you everyone for your advice. We are going to be talking with the hospital today and see if we can get some answers. In the 10 days she has been there. We have not once gotten to talk to the doctors or the psychiatrist. Only the nurses who keep telling us they don't know and would have to talk to doctors. Then tell us that we have to set up an appointment with her team of doctors and it can only be on Tuesdays and Thursdays but not this week. Has to have more notice....
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Beekee Feb 2020
This sounds really bad! Is this a real hospital or a nursing home?
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The best place for your Mom is at home. Please take her to your home. If need be hire nursing care. Best wishes.
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NeedHelpWithMom Feb 2020
At this stage of Parkinson’s it would be impossible for her to do this alone.

Have you ever cared for a Parkinson’s patient? It’s extremely difficult, not to mention exhausting. They lose all motor skills. Falls become more frequent.

Please don’t suggest taking her mom home. It isn’t visible for everyone to do this.
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I certainly empathize. My mom has Parkinson’s disease. It’s a horrendous disease even without dementia or hallucinations. My mom doesn’t have the dementia or hallucinations that some Parkinson’s patients get.

I am so very sorry that you are experiencing this. I feel awful for your mom as well. I sincerely hope that you are able to find a suitable resolution.

My concern is that you will not be able to care for her in your home. She needs extensive care that individuals on their own simply can’t provide.

The only choice that seems feasible is to continue to work with her doctors on this extremely challenging matter. Is she seeing a neurological psychiatrist? Meds for Parkinson’s can be a challenge. You really need specialized care.
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Why are so many pushing hospice? I would keep them far away.

Make sure that the nurses have not been given your Mom Haldol or another antipsychotic. Sometimes, doctors and nurses will lie. They give medications like this that lead to further brain damage.

Once, you have your Mom home, make sure to get her on MCT oil, Vitamins B1, B3, B12, D, and C. This will help her brain health.
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NeedHelpWithMom Feb 2020
Hospice can be a wonderful service! Why wouldn’t a person want palliative care at the end of their life? They are dying!

Why are you talking about supplements? Supplements are for people that are not dying! Dying people deserve to die with dignity and to be as comfortable as they can be. That means without pain! Whatever it takes to accomplish that, morphine or anything else, give it to them.
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The NH was uncomfortable when your mother talked about wanting to die, and wanted to have her evaluated by the Geriatric Unit. Fine, that’s now happened, and you and mother would like her to go back to the NH. Go and talk about it with the NH, and suggest that she comes back and gets Hospice in the NH. She is end-stage, not happy, and of course she is getting worse rather than better. Hospice where you are all comfortable is more appropriate than ‘suicide watch’ in a psych ward.
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NeedHelpWithMom Feb 2020
Yes! Hospice can help here.
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Thank you everyone for your advice and compassion for my mom and I! We spoke to the Social Worker last night and they are in agreement with us that she should be released back to the nursing home as quickly as possible. Trying to get her released today if they can get the doctors to get the paperwork in order. If not will be Monday. I pray it is today, she can't take another day in there. We explained to them how much she has declined and how we believe it is not only the PD, but the fact that she has gone into complete depression because she has been isolated from us. I live literally right next door to the NH she was in and would see her almost everyday for 2-4 hours at a time. I think they finally see what we have been trying to tell them. They had never seen my mom before and didn't know what her norm was. She is far from her normal self at this point. They sent her there because she said she would rather kill herself than live like this anymore. She has thought that for a long time, but never in a million years would she take her own life. She is a christian and has prayed every night for a while now for God to take her. I can only hope when we get her back to the NH and are able to be with her it will give her comfort. She has always asked that we please don't let her die alone. I couldn't sleep much last night from worry . I just kept praying they can get her released today.
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Kittybee Feb 2020
Good luck! Let us know what happens.
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From what you've said, this place she's in doesn't even sound like a real hospital. Find a geriatric care manager in your area. They are generally self-pay, but they can help you navigate the medical and care systems. Good luck!
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I am so sorry that you all are enduring this now. I believe that the NH jumped the gun on sending her to the psych ward. How long had she been there? Last month, my mother made comments about wanting to die or kill herself. She got mad about something (neither she nor I can remember what). Their protocol is to have a nurse talk to the resident and find out if they have tried to set up any means of committing suicide. If not, they refer her to the facility psychiatrist and report this to the family. They determined that my mother was just frustrated and blowing off steam, and grieving over my father’s death. Many reasons for expressing this.

I expect your mother is in a NH because you were unable to take care of her at home. How fortunate you are to live close by to be able to see her so often! I would call in Hospice to evaluate her. This would give her an extra layer of care in her end stage of Parkinson's. I would also set up a care plan to address the suicide talk, so they don’t try to send her back to the psych ward. The facility doctor could prescribe something for the hallucinations also.

Several people have told you to bring her home. I may have missed something, but I understood your mother’s talk of “not wanting to live like this anymore” as referring to her Parkinson’s disease, not specifically the nursing home. It sounds to me that you have an ideal situation with you living so close. I remember a poster who had been caring for his wife for sometime. She had Parkinson’s or Alzheimers and was end stage. He was exhausted and burnt out prior to the placement but described how he would come to be with her every day and was able to go home and sleep uninterrupted. This enabled him to be that more present for her at the end of her life.

Please let us know how your mother and you and your family are doing. I am praying for you.
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Yes!! you have Durable POA that decision is up to you!!
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Absolutely!! My mom has made similar remarks and so far so good, but if they tried to do something like that, she would come home with me. A psych unit will worsen her condition. All they do is keep the patients drugged... very drugged!!
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I’m glad you’re getting this worked out. If every elder with dementia who said they’d rather die or kill themselves than live like this was sent to a Geri-psych hospital, there would never be any beds! I can’t believe they used that as a reason to send her. I agree with getting hospice to help her end stages.
my dad is always wanting to die and I don’t blame him one bit. As for me, I will be stockpiling pills if I end up like that.
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Why do people immediately jump to the conclusion that an elderly person with a condition that will never get better is a psych case for wanting to die instead of riding it to the end?

even those deep in Parkinson’s often have times of complete clarity. Imagine realizing you predicament in one of those moments....wouldn’t you prefer to find another way?

so many places acknowledge the right to die with dignity on their own time table.

so, this NH had her moved to psych care....

imagine this was you. Wouldn’t you see that there is no one going to help you and the situation is actually hopeless. The only thing left to do is just give up and see if you can will yourself to die.

if, under these circumstances, my Mom had told me she wanted to die.....I would have figured out how and where she could legally be allowed to do this....and taken her there.
my father in law did exactly that....only back then... the place you had to go was the Netherlands.
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jacobsonbob Feb 2020
I wonder if the reason for sending her to a psych ward is basically a "CYA" issue--if the patient manages to kill herself, they're afraid they'll be accused of not having done everything they could to prevent is, leaving them open to some kind of legal issues. They may really know that in either place there is nothing that can be done to improve her condition, but feel they have to jump through all the hoops to prove they've tried.

At least in the US, it might be that the fortunate person is the one who can get through life without being sued.
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Check on what they are actually doing to help her. Maybe they are only evaluating. Is she being neglected?

If you find the facility defective, try another one.

Does the facility have a social worker who may have options to present to you?

Also, can she actually be helped? Maybe discuss sedatives with her doctor? Look into at home Hospice? Medicare pays for that.

What would at home care do to your health and well-being? It is not good to risk becoming an extended problem to your children. Have to balance things out.
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You can take her out anytime you want. But I'm also going to tell you is that she is going down hill because they use people that are sent there as tests. They change all medications on the person and do thid in combination so 1 drug had no time to get out of the system when they are removing it and giving another. She probably just needed 1 medication adjustment, and now you will have to compare her old list with her new list of all the drugs she had while there and go to your doctor or look them over yourself get the originals back and check the medication on her old list, one might have just needed tweeked.
GOOD LUCK.
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PiperLee Feb 2020
That is very good advice you wrote....That happen to my Mother and I firmly told them you put her back on the high blood meds she had when she came in here...also a big problem some family members are not aware about meds..Meds are the first thing you need to address ask for a list of there meds look up see the side effects compare
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Why did you put her in a nursing home in the first place? Being an around-the-clock caregiver is no piece of cake and requires someone to quit their job and be there 24/7.

ANYWAY, you need to talk to her doctor, and may even consider end-of-life care if she is end-stages of Parkinson's. You need to do a plan of care. When she is no longer able to eat, would you and your family opt for a feeding tube? If your mom is still "with it" you need to discuss this with her.
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She is probably under new psychiatric medication which is making her condition worse. You need to be there. No one knows what "living like this" means. You need to be more clear in what's going on which would require being at the facility.
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PDcaregiver, do you have an appointment to see the geri-psych doctor on Tuesday? How are things now?
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Im really sorry you going this! It's hard in so many ways. From my own experience I can say Go get your loved one. They can discharge her at any time with the doctor being present and giving the order on what to do. My dad has Alz. He wanted to leave that psychological ward so bad. I was called early Sunday morning by my sister who said he was asking for me and to come get him NOW. So I did. I waited a little while for the doctor , who happened to be doing rounds and within a few hours he was dr is charged. He didn't want to be ther. They sent him home. But with referrals to a psychiatrist.

It sounds like your loved one may need hospice. Hospice is helpful. My dad s on it. But we taking him off. Like someone commented, if you need to you cant call 911. Nope you hve to call the hospice people first. Me personally don't like that.

But you know your situation and your Mom, what you can and cannot do. Find out what your options are and how the medical system can help you and her especially to have a peaceful end of life. Pray for guidance if you believe in GOD. Helps me all the time. God bless you.
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Theres so much to say. One thing I learned is the Zoloft dont work by themselves for hallucinations. It has to be with another medicine. For my dad they gave Zoloft and Risperdal. It works. But currently he s beginning to hallucinate again but not as much as it was in the beginning.
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So many people are getting worked up over this situation and making assumptions that may not be true.

The truth is that any time a patient starts making remarks about "killing themselves," a facility is obligated to obtain a psychiatric evaluation, because that patient is considered a "suicide risk." The NH was covering themselves, legally. If they ignored it and the patient did manage to kill themselves, the State could come in and shut them down.

Have you obtained a list of the medications she is on? If not, you need to do that immediately and review the meds with the nurse there. If there has been a big change in her medications, it could be contributing to her decline.

You could take her "out of there and bring her home" - but are you really equipped to deal with that? What if the hallucinations are all part of her late-stage Parkinson's and she will continue to hallucinate in your home?
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My husband has Lewy Body Dementia & is on hospice. I have taken him to ER's for UTI'S and dehydration. I have also used an ambulance when he is not able to walk due to the infection. While on hospice, if my husband is admitted to the hospital, I need to notify hospice so they can release him from hospice ( this is due to the fact that hospice can't bill Medicare since he is in the hospital, so he has to come off their service). Once the hospital is ready to release him, I just have to call hospice so they can send someone out to recertify him and he's put back on hospice.
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Absolutely you do. I would line up caregiver help first though. I just took my dad out when he said he had been mistreated to be on the safe side. They wanted me to sign a bunch of papers first, which I did, but nothing releasing our rights to sue. My mom had Bronchitis at the time so it was difficult to take care of both of them at once. I believe I did the right thing for them though.
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Please listen to her and move her out.
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I was told my friend, Beth, for whom I was her DPOA and had her in a memory care apartment for her frontal temporal dementia, had to go to a geri-psych ward for a medication that would calm her down without doping her up. It took 3 weeks there before they had the correct drug and dosage that worked for her. After that, she was cooperative with the staff and let them clean her up when she soiled herself, which she had been resisting. So, it takes some time, sometimes, for the geri/psych people to find what works. Please consider that in your decision. They should also be able to tell you what they are thinking as they try things, too, so you understand better what they are trying to do.
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