Mom is in hospital after a fall. She has early onset dementia and a large mass on her kidney among others. I'm in a panic. Where do I start?

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Mom is in hospital after a fall. She has early onset dementia and a large mass on her kidney among others. I'm in a panic. Where do I start?

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My Mom fell and now I'm in a panic. I've tried and tried to get her to start making plans but she always made the excuse that she was too tired etc. Now I don't want her to go back to her apartment because even before the fall I knew she needed more care than I could give. There are no plans made....No POA no funeral arrangements nothing. I don't know where to start. I know I sound like a complete idiot but I am disabled also and work I can't sort my brain out right now. I'm worried about her savings for funeral costs and her bills.

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I don’t know what state you live in, but here it South Carolina, it is my understanding, that once a person is diagnosed with dementia they cannot sign a POA. If your mother does not have an official diagnosis then she may very well be capable of executing a POA. Please check with an elder care attorney.

As for her end of life stages and subsequent final arrangements, it is important you do all you can to get her to give you the power to act on her behalf. If she will not, you have no choice but to let her eat the fruit of her own way.

My mother is 89. She us more stubborn than a mule. Evidence of age related dementia is showing. Yet, in all my efforts, she refuses to give me any authority to act on her behalf. She claims I’m just going to lock her up and throw away the key. Therefore, I am unable to make any decisions once she gets beyond a place where she is not cognitive enough to care for herself. The state where she lives (Colorado) will end up making all her arrangements for care and she’s not going to like it. As for her passing, I will simply tell the state to cremate her and ship her cre-mains to me.

I want to help, but her stubbornness won’t allow me to do as such.

Give your mom the facts and move on. Tell her you love her and move on. While as a child you have the desire to help her, you are not responsible for her bad choices.

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My parents refused to consider a reverse mortgage years ago for the same reason. For no reason. Now, my mom is burning through their savings (Dad died 18 months ago. COVID. Before there was a vax.) She's at home now, but we won't be able to afford 24/7 care much longer...

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What you need to do now is meet with the hospital social worker. Make sure you are clear with the SW that you are unable to safely take care of her in your home, that she cannot be released to you. It should be clear to the SW that she cannot be released home to her apartment either, that would be an unsafe discharge. She likely will be discharged to a SNF for rehab and if is determined that she is no longer able to live on her own, than plan to have her stay there. You can help apply her for LTC Medicaid, but remember you do not have to take her home with you and they cannot release her to an unsafe environment.

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The good news about no POA is that it means you are not responsible for any of this. Tell anyone who will listen that you are not and cannot be your mother's caregiver and that any choices your mother makes must be manageable by her on her own. And then stay out of it.

About her possible return to her apartment: that's up to her. Just because you can't provide the care or support she needs doesn't mean that nobody can. (She doesn't have "early onset" dementia, by the way, seeing as she's 91; you mean she is in the early stages of dementia, and that shouldn't incapacitate her too much to discuss her arrangements with social workers and discharge planners.)

Pay attention to whatever discussions are taking place but only to make sure that any proposed plans do NOT rely on your participation; beyond that, if your mother can sort things out to suit herself, good luck to her.

You're also not responsible for paying for her funeral: her estate is, and if there is no estate then your local municipal authorities must manage it. So sit easy and find something more cheerful to talk to her about.

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Local municipalities are not responsible for covering someones burial in the US. The State government usually does that.

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One more thing.....don't worry about the money and care. As you said, you cannot care for her well now.....trust me it won't get any better. It is easier to place someone direct from the hospital than it is to change you mind later and place from home. A lot more leg work from you. If she is on small money and can't pay....you will likely be on a waiting list. A hospital can get it done.

All you can do is all you can do.

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Discuss with her doctor and the hospital Social Worker that it is unsafe for her to be discharged to her home.
If she has been diagnosed with dementia she can not assign POA since she is not cognizant. If it is not an "official" diagnosis you can try to get her to sign papers appointing you or someone else as POA.
You may have to discuss with an Elder Care Attorney the best course of action. Could be application for Medicaid. If she is a Veteran the VA may be of help if that is the case contact your local Veterans Assistance Commission to determine how much help you/she can get.
The important thing now is to make it very clear that to discharge her to her home is unsafe and that you can not care for her.

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I was in that situation with my sister. After her son and caregiver died suddenly, I was the last man standing. She had on her records "cognitive impairment". I was able to get a POA signed/witnessed but even to those present it was very clear that she was having problems. Eventually, after moving to AL, she was sent for mental evaluation after becoming difficult and combative. She was found to have moderate to severe dementia. With meds, she is very manageable for now in AL. I do NOT have a medical POA. But for whatever reason, no one asks about it so far. I had to give permission for her 10 day stay for that mental evaluation. But since she has no other family, I don't expect this to become an issue. Sometimes I wonder if I am doing the right thing for her. But I have managed to get her into a nice apartment in AL, got her VA benefits reinstated after they were suspended..suspended because her caregiver son, didn't work, was not only bleeding her savings down to less than 2 dollars but also spending her monthly retirement of about $3,000 a month on drugs, he never kept her VA medical appointments so they suspended her. He had dropped her Medicare prescription part and I needed the VA for at least prescription coverage which is now 7 different meds for her dementia. I wish I had contacted DHS to check on her as I was not aware that she was having memory issues. I didn't live in her city. When DHS did get involved because Regions Bank refused to accept the POA (no one is required to accept it), they found that he had been withdrawing cash rather than just writing checks and that he was paying almost $800 a month for drug treatment for his wife, among other things. He had also charged over $20,000 on her credit cards which had been cancelled and demanding payment. Utility bills unpaid. His free ride was coming to an end and I'm sure he would have simply moved back to Florida and left her. DHS said if he hadn't died at age 40 from a heart attack, he would have been charged with elder abuse and most likely gone to jail. Vaccine...she is not vaccinated and now I have made the decision for her to schedule her shots. I hope I'm doing the right thing, I have no other family to discuss with. I am thankful that her retirement is fully paying her AL expenses. I was also able to get her into the VA community care program and a local doctor can write prescriptions directly to the VA and they ship them to me. She has to go twice a year to a VA clinic for evaluation for now. I don't know how that will work as her dementia progresses. Right now I pick her up and she enjoys the drive of about 40 miles. See the VA psychiatrist, then have lunch and I let her pick where she wants to eat. Very easy to manage...for now. I was fortunate that she knew when I got involved that she couldn't live alone and AL was a good alternative to a NH since otherwise her health is pretty good. She could very well outlive me. The only thing that really bothers me is that I have no one to do for me the things I found necessary for my sister. I do have a son, but at age 42 is now homeless, living with friends, and never seemed to find his footing. Not a good situation for him or for me to depend on him.

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Deep breath....it'll all get done. Did she injure herself during the fall? Start a conversation with the hospital that she is an unsafe discharge and will not have adequate care at home. They will deal with placement. Do find an elder/estate/probate type attorney to get the POAs taken care of...
.sooner than later because she is probably still mentally able to sign the documents. Start there.

If she's going to another living arrangement, she will have to pay for that. Its not required that you sell a home (if she has one), but you have to be able to maintain it out of the available funds as well. In other words, the assisted living/nursing home gets paid first until the money is gone. She then can apply for Medicaid and I believe is still allowed to keep like $2000 for funeral costs. I'm not sure that you can pre-pay a funeral now to avoid it going to a care home.

What other sort of bills does she have other than the standard lights, heat, phone?

And again...just take a deep breath. One step at a time.

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The 2k is not for funeral costs, it is what Medicaid allows in assets. Not that it can't be used towards funeral costs when the time comes, but you can prepay for a funeral to help spend the persons assets down for Medicaid.

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dear laura,

hug!!

i hope many people on this website have great advice for you.

i just want to say, i'm sorry for your mother and for you -- her falling, kidney, etc.
i hope she pulls through!!

some elderly people have enormous strength and pull through, despite emergencies. i hope she recovers very soon!!

bundle of joy

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If she is in the early stages of dementia, where she can still make legal decisions, it is not too late to help her get all of her paperwork in order with powers of attorney for medical and financial matters, a living will, etc. If she is no longer capable of making legal decisions, you can request guardianship. If you don't do this, the State will assign someone to be her guardian, and if that happens you will no longer have any control over her financial and medical decisions. Talk to the social worker at the hospital to help explain your mother's options. Also get connected with a local social worker or organization that can advise on senior care options, who you can turn to for advice on an ongoing basis. Can your mother spend some time in a rehab facility while you make other arrangements for her? It sounds like you will not be capable of giving her the care she needs. You have 2 choices: have aides come in to help her, or she can move to an assisted living / memory care facility. What you choose will partly depend on her financial situation and what your state offers. If she does go to rehab, Medicare will pay for it for 90 days, which will give you time to find a memory care residence for her, or aides, whichever you decide to do.

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I would start with a POA. You will definitely need that. Your mom, if she does not have a will can do that at the same time. Believe me get this done fast. You should also be added as an owner/ signer to her bank accounts. Also have her doctor give her a release to sign so they can discuss her health care needs with you. This is very important. I would worry less about funeral costs and more about the cost of long term care or other assistance you may need. You should familiarize yourself with all her bills, debts, insurance, stocks, retirement account or any other assets she has. Once dementia progresses she won’t be able to tell you about any of this and it can make taking care of her estate very hard. I’m speaking from experience.

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Ask hospital social worker if they have PoA paperwork. Hospitals have notaries on staff. If they can’t provide the blank PoA docs I strongly suggest downloading it from Legalzoom or Rocketlawyer.com because it’s better than nothing & you can have mom sign it & notarized in the hospital. Much less expensive than going through a lawyer. Make sure it is “durable” so it is in effect immediately so you can start advocating for her and managing her affairs.

make sure discharge knows she is an unsafe discharge & you are disabled and WILL NOT be able to care for her. They will intensely pressure you, even make promises to “help” but do not believe this.

Work on getting HIPAA form to become your mom’s Medical Representative, and help her create her Advance Healthcare Directive.

Mom is in hospital after a fall. She has early onset dementia and a large mass on her kidney among others. I'm in a panic. Where do I start?

28 Answers

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