Forcibly moving a loved one into a senior living facility

[adlgel]

I live in the US. I was legally declared my mother's guardian (both guardian of person and guardian of estate) 3 years ago. 6 years ago she had two strokes which affected her short term memory but fortunately did not affect her mobility or other aspects of her life and also has dementia. We have been able to manage her living situation to allow her to remain in her home which is what she wants until very recently. We had someone come in once a week to fill her pill box and I had groceries delivered weekly (I live over an hour away). However her situation has declined such that this arrangement is no longer workable so we are planning to move her into a memory care facility. The problem is she will physically no longer leave the house - not for a dr. appt, not for a hair appt, etc.

She seemed worse off than normal last week and we tried to get her to go to the hospital and she refused. When my husband and I tried to physically get her off the couch last week she started hitting and kicking at us. I eventually called 911. They attempted to cajole her into going for an hour to no avail and while they agreed she should be seen, her situation was not truly emergent. I, stupidly, did not have my guardianship papers with me but the EMTs said that even if I had them they could not have forced her to go as that would be considered kidnapping given they deemed her sufficiently competent (she could tell them her name, birthdate and address). I have since found out that they should have taken her upon my request so next time I will have my papers with me and tell them to call their supervisor if they refuse.

We obviously want to move her into a facility. But it's clear from this recent experience that she will outright refuse to go. Therefore, we cannot envision in any practical way how we will actually get her to leave her house. And in the off chance we can trick her into leaving, we cannot envision how we will get her to leave the car when we pull up to some strange facility. I called around to a bunch of my county resources today - Adult Protective Services told me to call my local police. Local police told me to call Sheriff's department. Sheriff's department told me to call Dept of Aging. Dept of Aging told me to call Adult Protective Services so round and round we go. Basically it seems that no one has any actual way to move an unwilling senior out of their home and into a facility even when that is what the legal guardian has decided to do.

Has anyone encountered this situation before? I know that many have parents who are unwilling and have to be cajoled. But this is beyond that. My mom will literally refuse as evidenced by her interaction with the EMTs. And due to her brain issues, she is incapable of processing thoughts rationally. Short of drugging her or waiting for a medical crisis which renders her incapacitated, we don't know how to make this move happen. Has anyone gone through this specific issue related to moving a loved into into a senior living facility?

 

[Rfisher]

I am so sorry for you. Truly.
I know this feeling and situation.
I am sorry the sheriffs dept was not more proactive.
Be careful about the Adult Protective Services, if they cannot/will not help you proactively with the current scenario - be cautious about involving them because then there’s a chance they will become the opposite of helpful, if your mother’s situation isn’t resolved very very soon and they take an interest at that point. It’s a crap shoot of who you get, there.

You can try calling in a welfare check (with you not there) if they deem her unfit to live in society safely by herself or is a danger to herself - they can commit her for involuntary observation and go from there with you then being involved.
You can also contact the sheriffs office again and ask to speak with someone else for assistance and for a peaceful transition, they are there if things go south. Coordinate it for same time as going to a drs appt? Create a dr appt for her evaluation ASAP. Her dr can also be the one to direct her hold at this time.
Have your POA paperwork with you.
Unfortunately you may need to not stop by her place for a few days so the officers can see for themselves her living condition isn’t the best place for her.
She can choose to go or fight. I hope she chooses to go willingly. Unfortunately it can be hands on and ugly. With handcuffs. I am sorry to you for this reality.
Waiting for an ‘incident’ to prompt action can backfire. On many different levels.

This is only my experience, my reality. YMMV.

Best wishes, truly.
Hopefully new memories can then be made that will drown out this current memories. Or at least help them fade.

 

[pearlsngems]

Can you hire a 24/7 live-in caregiver? We got one for my mother through Home Instead Senior Care.

BTW I found agingcare.com very helpful with information, forums for caregivers etc. Good luck!

 

[Rfisher]

I’m sorry. I was assuming her nutrition, hygiene, and meds are not being kept up (or not overdosing) by herself, and no suspect of paranoia or delerium or delusions. These still can happen and be a danger when the patient still knows the current date /address and other facts.


A caregiver for in home assistance is obviously a great option if it’s possible. Great ones are hard to find at any cost these days and worth their weight in gold if you can find a couple of them to fit your and her needs.

 

[adlgel]

@Rfisher Her meds, nutrition and hygiene are all problems right now. She has frequent episodes of diarrhea and as of late cannot make it to the bathroom in time. She refuses to wear Depends because due to her brain issues, she does not remember/believe that she has diarrhea issues.

I went on Tuesday to take her to her normally scheduled doctor appoint and found a literal (insert poop emoji here) show. Clogged toilet, soiled clothes/carpets/couch, etc. Note that as a further indication of how poorly functioning her brain is, she didn't call anyone to ask for assistance with the clogged toilet. She then refused to go to the doctor appointment and to go to the hospital with me. That's why we returned on Thursday and called 911 as I described above.

Fortunately she is not paranoid, having delusions or delirious. She just simply cannot remember the problems that she has and she cannot process the reality of her situation.

She would refuse admittance to an in-home caregiver.

 

[lambskin]

Is there a senior center in the area or near? It may have some resources that you may be able to contact to get information and support. Prayers to you and your family.

 

[seaurchin]

Maybe that aging.com site will be able to help.

Inexpert opinion here but if she has to be moved into care then drugging her seems kinder than strangers dragging her out of the house when she may not understand what is going on.

Would it be feasible to ask her doctor to prescribe a sedative, then try transporting her yourselves to the memory care facility once it takes effect? It seems like some of the people/agencies that should be helping are doing more harm than good so maybe better to involve as few as possible, and bring along some of her familiar items too. Good luck. So sorry you have to go through this.

 

[Rfisher]

Be very very careful with the sedative route.
Have her main dr on board with this and the reason why and explore all what if’s.
Same with the facility she’s being taken to.

I understand the thinking of it, though.
Completely.
I would choose the sheriff and an EMT administering the sedative for certain reasons. YMMV.
Calling a welfare check without you there - what I mean by saying that earlier was without cleaning up her house is a harsh reality of what it might take if you cannot accomplish 24 hour in home care. At this point anything less than 24 hour for in home care will not cut it.

 

[Cerulean]

Ugh I am so, so sorry.

My experience was much less severe, and it was still horribly stressful. I just had to coerce my father (strokes, heart failure, liver failure, hallucinations, impending blindness) to move into an aged care community. It was not walk in the park. He had to be cajoled by his sister, and eventually caved. I’m grateful for that at least

My MIL and FIL will not be so easy. Eventually we will have to force them and I expect my mother in law in particular to go kicking and screaming.

I have no sound advice except try to do your best to take care of yourself. Hope you find resolution soon

 

[oceanblue]

I am so sorry. Taking care of a aging parent is so hard, stressful and heart wrenching. Have you had a chance to call the memory facility that you picked out? They may have suggestions or ideas for you.

 

[marymm]

I echo the recommendation to inquire further with the memory care facility you wish to take her to ... they must have encountered reluctant patients before and have some suggestions for you.

If you are legally appointed by a court as your mother's guardian of person, your guardian of person papers should enumerate what your responsibilities and authorities are over your mother.

You should be able to involve your mother's regular doctor, and ask for their assistance in effectuating the transfer from home to memory care facility. Certainly they should be aware of her dementia and have suggestions for this next phase of her care.

Any chance her doctor's group or healthcare / insurance group include monthly home-visits by nurse practitioners? We just found out my mom's healthcare group does this, and the 1st visit will be next month ... if you had a medical professional visit your mom at home, it would be very clear that she needs emergency transfer somewhere safe.

If the guardianship papers do not explicitly include the authority for you to move her to a nursing home/memory care facility, you may be able to apply ex parte to the court for an emergency order to have her moved from home to memory care facility since your mother is in imminent danger of harm to herself due to her dementia and living alone.

I am so sorry your mother and you and your family are in this situation. I hope you get some real help and very soon, because clearly your mom isn't safe to live alone.

Her world is very small now, and her understanding of her world is also so limited, it is no wonder she is afraid to leave the only place she finds familiar.

Is there any chance you can take a leave of absence/vacation time so that you could spend a week with her? After 2-3 days of your company, she may be more trusting and accepting, and you may have a chance to get her in your car to go for a drive, for an ice cream soda, for a visit with a friend (i.e., to go to the memory care facility) ....

Good luck.

 

[Lookinagain]

So sorry to hear this, as I know it is extremely stressful for all. You may need to go to court and get her declared legally incompetent. That won't be fun, but it may be a way for you to be able to force the move to a facility. My advice would be to contact an attorney.

 

[adlgel]

I am so sorry. Taking care of a aging parent is so hard, stressful and heart wrenching. Have you had a chance to call the memory facility that you picked out? They may have suggestions or ideas for you.

We haven’t picked one out yet. My brother and I are visiting facilities next week. This will certainly be on our list of things to discuss with them.

 

[adlgel]

So sorry to hear this, as I know it is extremely stressful for all. You may need to go to court and get her declared legally incompetent. That won't be fun, but it may be a way for you to be able to force the move to a facility. My advice would be to contact an attorney.

We’ve already done that - that is how I was granted guardianship of her. So I have the power to legally move her into a facility. I’m specifically trying to figure out the playbook for how to actually get her from her current house to the new facility when she physically refuses to leave.

 

[adlgel]

I echo the recommendation to inquire further with the memory care facility you wish to take her to ... they must have encountered reluctant patients before and have some suggestions for you.

If you are legally appointed by a court as your mother's guardian of person, your guardian of person papers should enumerate what your responsibilities and authorities are over your mother.

You should be able to involve your mother's regular doctor, and ask for their assistance in effectuating the transfer from home to memory care facility. Certainly they should be aware of her dementia and have suggestions for this next phase of her care.

Any chance her doctor's group or healthcare / insurance group include monthly home-visits by nurse practitioners? We just found out my mom's healthcare group does this, and the 1st visit will be next month ... if you had a medical professional visit your mom at home, it would be very clear that she needs emergency transfer somewhere safe.

If the guardianship papers do not explicitly include the authority for you to move her to a nursing home/memory care facility, you may be able to apply ex parte to the court for an emergency order to have her moved from home to memory care facility since your mother is in imminent danger of harm to herself due to her dementia and living alone.

I am so sorry your mother and you and your family are in this situation. I hope you get some real help and very soon, because clearly your mom isn't safe to live alone.

Her world is very small now, and her understanding of her world is also so limited, it is no wonder she is afraid to leave the only place she finds familiar.

Is there any chance you can take a leave of absence/vacation time so that you could spend a week with her? After 2-3 days of your company, she may be more trusting and accepting, and you may have a chance to get her in your car to go for a drive, for an ice cream soda, for a visit with a friend (i.e., to go to the memory care facility) ....

Good luck.

When we’ve picked the place and scheduled the move my out of state brother will come up and stay at her house to assist with moving her. But even if we can “trick” her into getting into the car, our experience leads us to believe she will not willingly get out of the car at the new facility.

 

[PreRaphaelite]

I'm sorry that this is worrying you and I appreciate how difficult it can be. This is the podcast/YouTube video series from the oddly-named-but-very-well-regarded Teepa Snow. Her web series has helped me personally in dealing with several of my elders whether relative or not. This is the closest match I could find with a cursory search but you can contact her if you like, to get more specific discussion. Best wishes! I hope you find lots of support, both online and in person.

 

[adlgel]

I'm sorry that this is worrying you and I appreciate how difficult it can be. This is the podcast/YouTube video series from the oddly-named-but-very-well-regarded Teepa Snow. Her web series has helped me personally in dealing with several of my elders whether relative or not. This is the closest match I could find with a cursory search but you can contact her if you like, to get more specific discussion. Best wishes! I hope you find lots of support, both online and in person.

Thanks - I will check it out.

 

[Mreader]

This happened with a family member. They tricked her into going to a hospital to “visit” someone there, but once there was admitted under observation. It was then determined she had dementia and was then transferred to a memory care. BUT they had the place picked out already, and they had given her some daily med to make her more calm beforehand. It sucked but it was necessary. I am so sorry . I would advise to pick a place first (it was hard to find a good place with space!).

 

[MollyMalone]

I eventually called 911. They attempted to cajole her into going for an hour to no avail and while they agreed she should be seen, her situation was not truly emergent. I, stupidly, did not have my guardianship papers with me but the EMTs said that even if I had them they could not have forced her to go as that would be considered kidnapping given they deemed her sufficiently competent (she could tell them her name, birthdate and address). I have since found out that they should have taken her upon my request so next time I will have my papers with me and tell them to call their supervisor if they refuse.

Your state may be different, but here in New York, the kind of forcible removal by law enforcement authorized by statute means they have reason to believe that the person is suffering from a mental illness which is likely to result in serious harm to self or others and for which immediate observation, care and treatment in a psychiatric center is appropriate; the person is then taken to a psychiatric facility or psychiatric unit in a hospital for an emergency 48-hour "hold," during which a psychiatrist must conduct an evaluation that determines what happens next. My concern is that confinement to a psych ward, even for a brief period of time, would be super traumatic for her. Nor will it resolve the question of her longer-term care.

So I concur with @marymm's recommendation that you scrutinize the order appointing you as guardian of her person. If it does not expressly authorize you to change her residence against her will, I can see why the police and sheriff's personnel declined to restrain and transport her.

Did you have a lawyer assist you during the guardian applications process; if so, s/he would seem to be the first person to contact for aid in seeking a revised ASAP order.

We haven’t picked one out yet. My brother and I are visiting facilities next week. This will certainly be on our list of things to discuss with them.

I'm not sure if you've been able to do any preliminary legwork, but be prepared -- much as I hate to say this -- for the fact that any memory care facility that's decent may very well have a waiting list. If you used an elder law attorney for the guardian appointment process, ask him/her -- and your mother's MD -- for recommendations, or at least places to avoid (some will be reluctant to make a positive recommendation but will feel comfortable steering you away from a place).

How I wish I had a magic wand for you all. This is a gut-wrenching, heart-wrenching experience.

 

[TooPatient]

A good care facility should be able to help. I volunteered at one for awhile and people not wanting to be there and wanting to go home is normal. While I wasn't there to see anyone new brought in, I am sure what you are going through is more common than those happy to move in. Good luck finding a great place with room quickly. It sounds like she will be much safer with round the clock care.

 

[Made in London]

I am in the UK so I don't know if this might help in your situation. My husbands Mother had dementia & the time came for her to be forcefully moved from her home due to similar situation that you have found with your own Mother. She would kick, scream & hit if anyone tried to touch her. Her GP was called on the scheduled moving day & together with the aid of an ambulance crew they injected her with a sedative. She was told that she would be coming home again & she went peacefully

 

[Daisys and Diamonds]

I live in the US. I was legally declared my mother's guardian (both guardian of person and guardian of estate) 3 years ago. 6 years ago she had two strokes which affected her short term memory but fortunately did not affect her mobility or other aspects of her life and also has dementia. We have been able to manage her living situation to allow her to remain in her home which is what she wants until very recently. We had someone come in once a week to fill her pill box and I had groceries delivered weekly (I live over an hour away). However her situation has declined such that this arrangement is no longer workable so we are planning to move her into a memory care facility. The problem is she will physically no longer leave the house - not for a dr. appt, not for a hair appt, etc.

She seemed worse off than normal last week and we tried to get her to go to the hospital and she refused. When my husband and I tried to physically get her off the couch last week she started hitting and kicking at us. I eventually called 911. They attempted to cajole her into going for an hour to no avail and while they agreed she should be seen, her situation was not truly emergent. I, stupidly, did not have my guardianship papers with me but the EMTs said that even if I had them they could not have forced her to go as that would be considered kidnapping given they deemed her sufficiently competent (she could tell them her name, birthdate and address). I have since found out that they should have taken her upon my request so next time I will have my papers with me and tell them to call their supervisor if they refuse.

We obviously want to move her into a facility. But it's clear from this recent experience that she will outright refuse to go. Therefore, we cannot envision in any practical way how we will actually get her to leave her house. And in the off chance we can trick her into leaving, we cannot envision how we will get her to leave the car when we pull up to some strange facility. I called around to a bunch of my county resources today - Adult Protective Services told me to call my local police. Local police told me to call Sheriff's department. Sheriff's department told me to call Dept of Aging. Dept of Aging told me to call Adult Protective Services so round and round we go. Basically it seems that no one has any actual way to move an unwilling senior out of their home and into a facility even when that is what the legal guardian has decided to do.

Has anyone encountered this situation before? I know that many have parents who are unwilling and have to be cajoled. But this is beyond that. My mom will literally refuse as evidenced by her interaction with the EMTs. And due to her brain issues, she is incapable of processing thoughts rationally. Short of drugging her or waiting for a medical crisis which renders her incapacitated, we don't know how to make this move happen. Has anyone gone through this specific issue related to moving a loved into into a senior living facility?

oh you poor thing
i know just what your going through
im sorry im not in the US so i cant offer advice
we had a lot of trouble with both my mum and my father in law
eventuality my mum was hit by a car - because she impulsively rushed out
- that got her in the system, by being admitted and assessed
my FIL was found in a state of litterly poop and my poor sister in law didnt know what to do
she rang her boss (SIL managed a cafe at retirement village) who advised ringimg 111 for an ambulances - he was also admitted and assessed at hospital in a geriatric ward then transferred to a secure demeture care facility
its unfortunate the paramedics did mot take your mum but hospitals are so busy right now with the pandemic

i know its frustrating and unbelievably hard but try to remenber its not your mum's fault, mine also turned violent with altzimers
they can't help it
that's not who they really are

Im so sorry you have to go through this
be prepaired for your mum to go down hill mentally quite fast once she goes into care

 

[Buttercookies]

@Rfisher Her meds, nutrition and hygiene are all problems right now. She has frequent episodes of diarrhea and as of late cannot make it to the bathroom in time. She refuses to wear Depends because due to her brain issues, she does not remember/believe that she has diarrhea issues.

I went on Tuesday to take her to her normally scheduled doctor appoint and found a literal (insert poop emoji here) show. Clogged toilet, soiled clothes/carpets/couch, etc. Note that as a further indication of how poorly functioning her brain is, she didn't call anyone to ask for assistance with the clogged toilet. She then refused to go to the doctor appointment and to go to the hospital with me. That's why we returned on Thursday and called 911 as I described above.

Fortunately she is not paranoid, having delusions or delirious. She just simply cannot remember the problems that she has and she cannot process the reality of her situation.

She would refuse admittance to an in-home caregiver.

The best situation here is to call 911 on Tuesday when you found her soiled and unable to be coherent. EMT will ship her off under the chief complaint of delerium. If you clean her and call 911, it makes no sense then because they simply do not see the problem.

 

[Rfisher]

@adlgel
I think having her tested for a UTI as soon as possible would be a good idea as well. UTI’s can present very strangely and have atypical side effects in the elderly, including altered behavior.
The diarrhea hopefully (I say that in truth, even though it sounds horrible) can be attributed to something she unfortunately ate or due to poor hand washing, not due to her dementia. Hopefully it’s something that’s temporary incontinence that can be addressed - not a new symptom of her disease that’s here to stay .
It’s very unfortunate, but a real consideration that some/many memory care units are not set up to care for someone who cannot take care of their own basic hygiene needs. If she requires more than a reminder and a small amount of guidance - it wouldn’t be surprising if they will quickly shuttle her to a nursing home. Or refuse admittance. At least the top amenity ‘preferred’ ones in our area turned out to be this way.

Best wishes.

 

[pearlsngems]

True that UTIs in the elderly can cause great confusion. My mother experienced this several times. Finally I loaded her Med Ready (automated medication dispensing carousel) with D-Mannose capsules. These worked like a charm to prevent UTIs.

Re: diarrhea: One evening when I took groceries to Mom's Independent Living apartment (after short term memory loss began, but before she deteriorated to the point that she needed a 24/7 caregiver) I found her in the bathroom struggling to remove clothes covered in diarrhea. It was all over the bathroom floor and the carpet leading to the bathroom, too. I had to shower her, wash her clothes and clean the rug. But this was not a regular occurrence. She was lactose intolerant and may just have forgotten to take her Lactaid tablets when eating dairy.

 

[MamaBee]

I‘m so sorry you are going through this. My mom made me promise when I was in my twenties to not place her in a nursing home. I since then had my son who has Autism..I had my hands full when the time came when she decided she wanted to come live with me. I had her live with me for twelve years. Last February she fell in her bedroom breaking her pelvis. She went to the hospital..then to rehab…She wasn’t ready to come home because she needed a lot of care not being mobile. My mom kept begging me to pick her up and take her home. It was awful…My blood pressure was so high I had to be put on extra meds so I wouldn’t have a stroke or something. My heart goes out to you because I understand the stress you’re having. She also had major diarrhea accidents which the specialist said was due to aging. She wore a diaper then..even before the fall. It was pretty bad because I had to clean her up and pretty much the whole bathroom. I think your mom..depending on your mom’s age and condition may just be having the same problem…The specialist explained It’s age related and very common with the elderly. My doctor, who was also her doctor, told me that there was no way I could take care of her at home. This relieved the guilt over my having to place her in a nursing home.….I was able to explain to my mom that I couldn’t take care of all that she needed now. Her legs were leaking lymph fluid…Her blood pressure would drop…etc. I took her to our doctor before the move to the nursing home. She filled out a form that said my mom needed to be in a skilled nursing facility and could not be cared for at home...even with visiting nursing. Could you make an appointment with her family doctor to discuss how to proceed? She/He may be able to make the process easier. Maybe this could be presented in court with an attorney to amend your guardianship so you can then place her? I have dual guardianship, with my husband, of my son with Autism…We can make all his decisions for him..I would have a lawyer that has done many guardianships to explain what your options are. My mom is now content in her nursing home. She would rather be with me..but she’s settled in and comfortable. I think my first step would be to talk to her doctor and ask for help in how to proceed. Then I would get a lawyer..It’s an awful situation. It will work out eventually. Big hugs..

 

[HollyJane]

When you say you have legal guardianship, do you mean Power of Attorney, or do you mean a court has declared her Incompetent Major and has fully interdicted her and appointment you her Curatrix? I ask, because those are two VERY different levels of legal control. If she is fully interdicted...by the court and you are appointed by the court as her Curatrix (actual legal guardianship), then yes you have legal control over where she lives.

POA only covers so far as to where your mother can't answer for herself, basically is a lot more limited and does NOT mean she can't make decisions for herself when she is able.

Me? I'd rather rot away at home over time and die alone on my floor then end up in a "memory care facility." I hope I'm given that right to do so when the time comes.

Edit to add: I've actually been in this situation with my mother. The difference is many times and over the course of years while my mom was of sound mind and body, she told me that if she became incapacitated, she DID WANT to go into a nursing home. She was clear about her wishes. We had many discussions together. So, years later when she had dementia, my dad and I cared for her at home for as long as possible and as long as she wanted and then made the transition to a nursing home. We continued to visit often and stayed very involved in her care. She was as happy there, I believe as she could have been. However, it solidified for me that's what I don't want and what my wishes are for myself.

 

[HollyJane]

Oh, one more thing about the diarrhea. Sometimes polypharmacy issues come into play. Her meds should be reviewed and adjusted if possible to lessen side effects. My mom had issues with diarrhea, and her meds were adjusted by her doctor.

 

[canuk-gal]

HI:

I would start with the GP --they are gatekeepers. The Dr. may not be aware of your mothers current state of fitness/health--but since you "represent" her, you can be part of that conversation. Perhaps the GP can contact a transition team member from a hospital or through home care in the community (Geriatrician, social worker, NP) to do a home assessment with you present.

While an assessment may not get her "forcibly" removed, at least there would documentation that she needs assistance and of what magnitude. And that you are participating in her well being. In addition, you'll have more of a network to assist you.

I feel for you. I've lived this experience and it is very very stressful.

kind regards, Sharon

 

[adlgel]

To be clear, she was declared incompetent by the courts and I was appointed as her legal guardian. Therefore I have legal authority to make medical decisions on her behalf as well as decide where she lives. The issue is how to actually physically move her from point A to point B when she won’t go willingly.

I was able to get her to her regular doctor appt today and he agreed she needed to be in the hospital. He called 911 from his office and fortunately this time she went without too much of a fight, although I had my guardianship papers at the ready to force the issue if needed. Hopefully we can get her in a better state physically while we plan for what to do next. Thanks for all of your comments and thoughts.