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Hello everyone. I’m in a bit of a situation. So for the past couple of months my grandmother, who has lived with me and my parents for the past 10 years, had some serious mental decline. We had to make her food, bathe her, basically take care of every single problem she had. She is not a nice woman and has a history of abuse with my dad. Frankly, all of us resent her for now having a cushy lifestyle on our dime even though she hurt my dad in such a profound way, she admitted that when my dad was a child she tried to kill him by strangling him on the couch. There is no redemption for someone like that. One day it escalated and we had to call an ambulance. My grandmother is agoraphobic and hasn’t seen a doctor in 20 years. So she was fighting and super combative but the first responders were able to see how bad it was and were able to take her. She’s been in the hospital for a week and a half now. She refused almost every single test while she was in there, calling the nurses racial slurs, and just generally being awful. In the latter half of her stay she seemed to calm down when they stop trying to administer tests and were just giving her food. We have talked to the hospital and have decided to put her in an assisted lives home with hospice care because she is certainly near the end of her life. Our greatest fear however is that she will be so angry and combative that the assisted living facility will kick her out. Forcing her to move back in with us and causing us so much mental stress. I just want to know if it’s possible for a facility to force someone to move back in with someone they abused.

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The problem is that she is determined to act out until she gets her way to come home. Who owns this home, Mom and Dad? Her?
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It sounds like she needs in-patient psychiatric care. Is she getting that?

Who is her POA for health and finance?
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It's not possible for an Assisted Living Facility to force a resident to move back in with you, but, it IS within their rights to ask her to leave. Where she goes from there is not their concern. It would be you or your grandmother's problem as to where she goes next, not the AL.

That said, the AL may not accept her to begin with because they have an intake coordinator who makes those decisions as to who they accept & who they decline as residents. If grandma is acting ugly and disruptive, they'd likely turn her down in the first place. Look into getting her a psychiatric assessment in the hospital first and foremost; has that been done yet?

If she is actively dying and hospice ready, you may have better luck getting her into either a hospice house or into a Skilled Nursing Facility vs. Assisted Living. Speak to the social worker at the hospital who is familiar with the case and ask where THEY feel grandma would be best off. And let the SW know that coming back home is NOT an option because you are unable to properly care for the woman anymore. Period. Do not take NO for an answer if they try to persuade you to take her back home and offer you 'help' at home as an option.

Best of luck!
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If no one is her PoA then allow the county to pursue guardianship of her. SHe is currently in the hospital, then make sure the discharge staff understands that she is an "unsafe discharge" (as the EMTs can testify) and that she should go directly into LTC or hospice from the hospital. The hospital discharge staff will put the screws to you very intensely to come get her but no one should go to get her. If you do, you'll lose the one golden opportunity to transition her with the least amount of struggle.

I would ask her doctor if she can be given a cognitive exam while she's in the hospital. Her history of mental illness should be made clear. This will support your argument that she is beyond any care that can be provided at home.

FYI she is beyond assisted living, based on the info you provided. If she doesn't have the funds for a facility, no PoA and is mentally incapable of self governance then allow social services to take over so she'll get the care and protection she needs through Medicaid and the system.

FYI your family should NOT be paying for her care. It is unsustainable.
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The only problem I see with everyone saying do not take her back is if it's HER house. If it is her house and they kick her out of it while staying there, then it's just a free house to them, which is abusive to the elder, even one like this. If it is her property, the three of you should move out.
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In short, a home owner (landlord or tennents) can decide who lives there. If pressure arrives to take Grandma in, the 9ccupants can say no.

But PeggySue asked the important question: Or does Grandma OWN the house?

Do you mean pressure to take her in due to guilt? (she-is-family-gulit)? Or pressure from the AL?

If guilt.. well.. Grandma's life is her own - to own.

What I mean is: she is allowed to make bad decisions. She is also allowed to face the consequences of her actions & behaviour. (Or maybe her decline has caused unintentional problem behaviours - I don't know).

Whatever the cause, if her needs don't meet those served in her current AL, they can ask her to leave. (is kick her out). Whether the AL has a legal duty of care to find an alternative may need some legal knowledge (I have next to nada) but I very much doubt it.

If Grandma has legal capacity she must obey an eviction notice. If she does not she will face the consequences.

If however, due to her recent decline she does NOT have legal capacity, her legal POA or Guardian must act on her behalf.

Who, if anyone is her legal POA or Guardian?

If no place is found it's possible an AL could do a version of *Granny Dump* to an ER. This would be called something like 'transfer for failure to thrive' or 'end of life care' or 'psych eval'. Then the duty of care moves to the hospital. Most are very experienced with *granny dumps* & their social workers will find the legal way to place them into a care facility in a swift manner.
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PeggySue2020 Dec 2021
Thanks Beatty.

OP states that G'ma is being transitioned to assisted living with hospice, with the family making that decision. OK, What is being used to pay the AL?

I could be totally wrong here, but if it's her house and everyone's been there 10 years, I could see fronting some money to put her somewhere else. But then again, if it's her house, she should have the primary right to come home to it. It's of course the family's prerogative to leave, but it would also be a reasonable expectation for her to demand the 24/7 that she got for the last decade as they say.
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She can be successfully managed with medication, so if she hasn’t had a psychiatric evaluation, get that done while she’s hospitalized.

She doesn’t have to “cooperate”. A skilled examiner will be able to get enough to determine the initial steps needed to manager her.

You will do yourselves a favor by staying in the present. What awful (or wonderful) things she did et or more years ago really don’t mean much now. It’s also a waste of your energy to attempt to figure out her “redemption”. Her brain is now damaged with no hope of improvement. Her decision making abilities are gone.

Nurses are not qualified to provide the kind of assessment this woman needs. She needs a geriatric psychiatric expert. She doesn’t have the capacity to realize that you are doing something for her benefit.

No agency can force you to care for her, but they CAN decide that her behavior is not compatible with their resources. That’s why you need the psychiatric evaluation done ASAP. A facility will often cooperate with family who will provide information about ways (including medication) that can help their loved one adjust.

Good Luck.
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There is no law that will force your family to take her back. She certainly can become a Ward of the State.
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This is the time to get her placed. ALs are private pay. If she has no money, have her placed in NH with Medicaid pending. Do not have your parents use their own money.

Have Gma evaluated for 24/7 care. Your parents should be firm that they will not be taking her home.
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