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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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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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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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BurntCaregiver Sep 2022
Right now she needs to be anywhere that is locked and away from her guns and the car keys.
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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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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 2022
Thank you very much for responding to this question.
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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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BioMom41 Sep 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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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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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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Lizhappens Sep 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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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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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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