My grandmother has been in a nursing home for about 5.5 months. She has just recently started to refuse eating or taking her medications. She has also been acting paranoid and confused. The nursing home sent her to the hospital once already, she was there for 3 days, and the hospital wanted me to voluntarily admit her to the geriatric psych unit for treatment. However, I was advised by counsel not to sign (I am her POA and Health Care Proxy). I finally spoke with the medical director of geriatric psych unit at hospital who said they could give her a neuro psych eval, but that the nursing home could do the same thing. He also told me they could involuntarily admit her. In fear of a bed hold experiation and considering the fact the nursing home could perform the same necessary testing, I reiterated by refusal to voluntarily admit her. The hospital then cleared and released her return to the nursing home (was eating, taking meds, no major medical concerns at hospital) - they did not involuntarily admit her.
Less than 24 hours after her return to the nursing home I was called by a social worker and NP at the home who advised me that again my grandmother refused food and medication and that they wanted to send her to the hospital - they even told me they spoke with the step-down hospital she was in before she got to the nursing home. I really am not sure what is going on and cannot figure out for the life of me why the nursing home isn't able to handle this situation. I want to do the absolute best thing for my grandmother and get her the help she needs, but am fearful they are trying to 'dump' her on someone else.
What can and can't/should/shouldn't the nursing home do in this type of situation? Does this happen often?
Geriatric Psych placement
I think this is a fairly common issue, and your concerns about losing the bed are understandable. Unfortunately, this is not an area of elder law that I'm well versed in. I asked a social worker I know and she suggested you set up a meeting with the nursing "team", meaning the social worker, the doctor, the nurse, and find out directly from them what their concerns are and what they hope to accomplish. In other words, as the geriatric psych hospital suggested, find out why they feel they are unable to manage the situation in- house.
From your question, I also wondered if the health care proxy has been invoked pursuant to Massachusetts law. If not, that raises a whole host of additional issues. You can follow this link for some general information about health care proxies in MA. Good luck.
nursing home problem
I am sorry for your problem. At present, based on what I read, you have a nursing home that is taking the position that a patient who in their words "is refusing treatment" needs to have the patient sent to a health facility to treat the patient effectively. Of course liability is also an issue to them and other issues we may not be privy to.
You need to meet with them alone or with an attorney to clearly identify what their issues are, what their course of action will be under different circumstances and of most importantly how to best handle the situation for your relative.
I would advise seeking help from an elder attorney with experience in how a nursing home operates and nursing background.
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