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Spouse’s 86 yo aunt residing in Florida was declared incompetent after being hospitalized. Her spouse now has guardianship and is successor to her trust with full POA. She is a risk to herself and others. Her home has been sold and she has 90 days to vacate. She is combative, refuses medication and to visit any doctor. Her old primary care retired. She absolutely needs to go into a care facility and we’re frantically researching which one, has Medicare and VA benefits as we need to utilize those if possible. Once we choose a home how do we get her admitted? She is not a pleasant individual, is lean, a former runner so physically she’s well, but as stated is a risk to self (leaving stove burners on, walking down the middle of the road, confused, fixated, forgetful, prior to my spouse getting involved she brought a gun into a bank, crashed her car etc.). My spouse is beyond stressed trying to get her to a safe place. We actually feel she’ll need to be medicated but again, she won’t see a Dr. Can care facilities be involved in “taking her away?” It sounds awful but is likely what needs to happen.

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Hello, i read what you wrote, and is a stressed and sad time for you and your husband. I had to get a POA for my wife that got MS, with memory problems due to the brain lesions that MS causes. I also learned that if a loved one already is having issues of confusion and or memory loss that even if she signed a POA now having Dementia the POA in any State would not be considered Valid due to the Dementia and could be challenged by via Court.
Having said that, you may want to look at your situation your aunt's situation as "what can I do to improve my aunt's Quality of Life". It sounds like she needs medical attention. Once she is at the Hospital take the nurse aside and explain that she is not able to take care of herself at home. Now, you look at the situation telling yourself "You are actually protecting her" and in placing her in a Nursing Facility where they are trained how to best care for your aunt, and by the way most Nursing Facilities have a Dementia/Alzheimer ward specially set up for Dementia Patients.
Without saying so, your aunt would thank you if it were not for the Dementia. Actually, it sounds like your aunt does things and forgets that is endangering her life at risk. Now, you have to tell yourself that what you are doing will actually save her life. So, now you know and need to think what you are doing for her is what is best for her, that it is not cruel at all.
I have been my wife's caregiver full time since 2005 and trust me when I say that not everyone can be a Caregiver to a loved one, so don't feel guilty, don't feel like it is cruel, your aunt's "Quality of Life" surrounded by medical staff may just be what is best.
If you have her taken to the Hospital, they will recommend a Nursing Facility through the Hospital Social worker. Or you can consult with an Attorney to file a Guardianship in the Court. Remember if your aunt is placed in a Nursing Facility from the Hospital then Medicare will pay for the first 100 days per year. After that the Nursing Facility will file with your State and then the State will pay the tab for your aunt to be there. I hope this helps you and your husband.
And, by all means you and your husband go and do something for you.
Again, I hope this helps
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Reply to Caregivingguy
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What are the ethical/legal ramifications of putting her to sleep with Ambien or somesuch, then having her wake up already in a facility?
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Reply to ZippyZee
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That's what I'm trying to do but they must prove that my mom has dementia first
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Reply to Mikurotoro92
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Echlin: She is an unsafe discharge to home. She should have been retained by law enforcement for carrying a firearm into a financial institution!
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Reply to Llamalover47
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I am surprised that the hospital discharged her if she is not safe at home.
If there is a reason, any reason at all to call 911 once at the hospital talk to a Social Worker and tell them that she can not be discharged to home as it is unsafe.
All the VA and ask to talk to a Social Worker and see what can be done. A call to the Veterans Assistance Commission might also be of help.
The Guardian is able to place someone in a Memory Care facility and the "patient/Ward/resident" has no say in the placement.
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Reply to Grandma1954
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If her spouse has legal guardianship, he can make that decision and arrangement. Guardianship is only awarded when a person is declared unable to make his or her own decisions, so the aunt's resistance would not matter.
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Reply to RedVanAnnie
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Lizhappens Sep 8, 2022
Yes, there is no mention of what her spouse is doing. Since there’s no mention, does it mean he didn’t care?

And I’m surprised too that if she was considered unsafe why didn’t a social worker stop her from being allowed to go home? My Mrs. was not allowed to go home after trying to walk in her house without assistance and fell and made a small small fracture in her hip. We were required to sign that we would get 24/7 care at home immediately or they would put her in a facility (this was the rehab social worker).

So is the puzzle piece we’re missing the question of how to make the spouse take care of business or go around him to take care of business themselves? Sounds like lawyer time.
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When she is highly agitated, take pictures and call 911 so that the hospital social worker can assist in appropriate placement. Under no circumstances do you volunteer financial or physical responsibility.

If you want more clarity, please contact an Elder Law Attorney who knows the laws.
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Reply to ConnieCaretaker
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This may be a little more difficult since your husband doesn’t have any real legal standing here. Is her husband living with her and did he sell the house or were they renting and the landlord sold it? Is he on board that she needs to be in a facility where she is safe and care for or is he in denial thinking he can care for her or just as bad giving in to her because he can’t hold firm when she’s digging her heals in? Does she know the house has been sold and if so what does she say about that, where does she want to go or think she is going?

Im not sure what her last hospitalization was for but it sounds like she was exhibiting this behavior for them to deem her incompetent and while it’s too bad she was allowed to go home then it sounds like something similar needs to happen again. Ideally she would be transported into the hospital for an evaluation in the psyc ward and since her husband already has guardianship he can make that happen with the coordination of a geriatric psychiatrist or social worker who will make sure she is seen with her age in mind and kept there until the right balance of meds, if that exists for her, is found. Then it has to be made clear to the discharge coordinator and everyone at the hospital that her husband isn’t able to care for her at home and she needs to go to a facility when released. They should be able to help you find the proper facility or choices so your husband can help his aunts husband chose the rite one. Where is her husband planning to live? It sounds to me that supporting him is going to be the most important thing your husband can do over the next 90-120 days.
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Reply to Lymie61
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Soooo many people have this exact same problem. I am in the same situation with my father. He isn’t ready for placement yet as he is still too “there”, but when the time comes he will fight it like a rabid dog. He was difficult before his ALZ dx. I get it, nobody wants to go into a facility. It’s an awful thing. I live 3000 miles away and unfortunately my strategy is waiting for some event that triggers placement. Most likely with his car that he won’t stop driving. As he lives alone there won’t be anyone to release him to so I can tell them he is unsafe to go home. At that point I will fly home and deal with his house. It’s terrible, but there really are no good choices with situations like this. It’s all choosing between the less bad of two bad options.
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Reply to Caregiverstress
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BioMom41 Sep 7, 2022
Thank you so much, I could have written this myself. The key is to say “ they are not safe at home” , it is a terrible waiting game
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Baker Act her in Florida
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Reply to Retired50
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This is basically an ambulance transfer with the service having the information, along with documents, that you just gave us. More importantly is a facility that will accept her knowing the above. She is going to need a medications cocktail and that's no easy feat when the the person is in a care facility. The trick to to get the proper mix of medications to come with a calm that isn't a paralysis in most ways, or a calm that isn't a knockout. Again, that requires time and a willing MD and a willing facility. I am so sorry.
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Echlin Sep 2, 2022
Thank you very much for responding to this question.
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Echlin, so many of us here on AgingCare have run into the situation where a love one refuses caregivers or even the thought of moving to a more user friendly environment [no stairs].

I had that issue with my Mom. After a very serious fall where 911 was called, Mom went into the hospital for treatment.... from there she went into Rehab for the required number of day.... and since she now needed a village to help her, the Rehab had a nursing home where she spent her final months.

My Dad would have preferred Mom being back at their house, but Dad understood that Mom's brain, due to the fall, was now in final stage of Dementia. Dad knew it would be too emotional for him to have her back at the house. With Mom in a nursing home, Dad could now bring in caregivers to help him. My parents were in their late 90's.
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Reply to freqflyer
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The hospital should not have released her if she is an unsafe discharge with no care at home and has been declared legally incompetent. Your husband has to have her brought back to the hospital. They will have to re-admit her to the hospital as a 'Social Admit' and will keep her there until they find a facility for her. Or your husband can.
Your husband has to get all of his paperwork together along with the declaration of incompetence from his aunt's doctor and get it to the police right away. I truly hope for the sake of any people within in a bullet's distance of this demented, old fool that your husband removed any guns from her house. Your husband as her guardian will be held responsible if a gun tragedy happens, as he should be. The hospital will be too for unsafely discharging an 86-year-old incompetent elder with dementia facing homelessness in 90 days. Hospitals have their a$$es well covered but your husband will get in serious trouble. The police will come with paramedics and take her back to the hospital by ambulance until her permanent care arrangements have been made. Make sure they know she isn't leaving with you.
Transportation of the aunt is not going to be a problem. Hospitals and care facilities know how to handle a hostile transfer. They see this kind of thing every day. They will arrange getting her to whatever facility she's going to.
Please, if she has any guns in the house remove them today. If she has access to a car, take the keys away now. Let her call the cops on you and your husband. That would be the best thing that can happen because the cops will get her to the hospital.
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Reply to BurntCaregiver
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Is she currently still in the hospital?

Mare sure that the hospital discharge staff understands that there is NO POSSIBLE WAY that this person will be discharged to your home. It would be unsafe.

She may need an involuntary hold in a psychiatric facility to get her on the appropriate meds.


She will need a secure memory care facility, as opposed to a Nursing home, since her health is good.

You should be looking into Medicaid as well as VA benefits. MediCARE will only pay for short term rehab, and it doesn't sound like she is eligible for that.

The discharge planners should be telling what LEVEL of care she needs. They can suggest facilities, but you need to check them out.
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Reply to BarbBrooklyn
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BurntCaregiver Sep 1, 2022
Right now she needs to be anywhere that is locked and away from her guns and the car keys.
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Good article from Aging Care:

https://www.google.com/amp/s/www.agingcare.com/articles/amp/155888
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Reply to BarbBrooklyn
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One tactic is to tell her a "therapeutic fib" that the home has a dangerous gas leak or black mold or infestation and needs to be cleared out and fumigated. Tell her she needs to go to a temporary apartment. Facilities are familiar with this problem and as long as you're working with the admin prior, they will be in on it as much as possible. Not sure about the VA.

Or, have her evicted by the new home owners (and you will need to pay the fee). This means 30 days after the agreed date she needed to vacate. At the end of the eviction "grace" period she can be accompanied off the property by the police, especially if combative. They can at least apply pressure to get her into your car to take her to the facility.

Or, if you show up to help her move (with no eviction) and she becomes combative, call 911 and tell them she's delusional and threatening and they will take her to the ER. From there she can be transferred directly to the chosen facility. Make sure you go with her to the ER with your legal documents so that her discharge is properly managed by you.

I wish you success in getting her into Memory Care (which she will definitely need since she'd be a flight risk).
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