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Why do you need a doctor's permission to find your mother a place in SNF? This is something to discuss with the facility. I have been through this with my mother, getting her into AL, then rehab and SNF. None of these require red a dr's order.

I am now I n the process of finding a Memory Care place for Mom and have talked to 6 facilities this week, none has mentioned needing a dr's order for placement. Each wants to do an assessment of Mom's metal and physical status to determine the best placement for her. They will talk to the current staff and/or doctor as needed, and interview Mom.

I suggest talking with the facility director to find out what they need to place your parent. Also your state's Department on Aging. That doctor sounds like a jerk!
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haileybug Sep 2020
Where I am from, the very first thing that is requested by a Nursing Facility is an FL2 form filled out by the doctor.

This document consists of the person's level of care needed and diagnosis. We don't decide what level of care our loved one needs. js
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If you can got her in the SNF without a doctor's order, her PCP may become moot. There's usually a facility doctor who handles most patients there -- at least that's been the case in the two places my mother has been in. I've been very happy with the facility doctors, and really happy to get rid of her former PCP. (I'm sure she was happy to dump a patient, too.)
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I had POA for my Dad. He was living on his own in an apartment. He wasn’t taking care of himself, and was hospitalized several times in a few months. He would call a taxi and go home whether it was advised or not. Finally he was evaluated at the hospital and determined to no longer be able to care for himself. He was delusional, and has vascular dementia. It was that paper that enabled me to get him into a nursing home. But we had to get guardianship through the courts because Dad refused to stay and kept leaving the nursing home.

Your physician is your MIL’s doctor, not yours. POA gives you the ability to make decisions if they cannot. Maybe call the doctor’s office and ask for evaluations to get the documentation you need.

We did go to an elder care attorney to find out what we needed to do. It is different in every state. He helped us through the process. The bill was paid through my Dad’s account so we did not have to pay.
I don’t think anything prepared us for how difficult it is when the parent doesn’t understand what is happening. My Dad is still mad at us, but he is where he needs to be. None of us could handle him.
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First may be to find out your state laws and rules, I am just now hitting this sort of wall with my situation. In his case, there is no POA nor guardianship, and unless he is taken to court and legally found incompetent, they have to do what he says, even if he seems delusional or unrealistic. Patient freedom and autonomy supercede even common sense in some places.
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Yeah, I agree with others...why do you need a dr's order to place her in a nursing home?  I thought they did their own evaluation and will ask for medical records from her physician for continuation of care.  I would find a facility and get the ball rolling for placement.  There is no doubt that your mom will be scared and agitated and maybe even angry if she has enough where-with-all to understand what is going on, but these facilities have the appropriate equipment and staff to take care of her and that is what you want ... and that is what she needs.

Some of these dr's are scared they are going to assist in putting someone away against their will and get sued.   It's ridiculous...if he knows your mothers medical condition, then he knows she can't be managed by someone at home.

There are some great facilities out there.  Do your due diligence and check several out and find the perfect fit for mom.

Take care.
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You need a DPOA . Your mom needs to be found incompetent and diagnosed as AlZ . Medical POA doesn’t give you any rights to sell property, or handle financial affairs . When you she goes into a home SOMEONE has to sign for financial responsibility .

Thats probably why the doctor isn’t talking .. you don’t have POA .

Good Luck
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IMO your mother's doctor is not providing service to your mother! Others say find a different doctor, but any new doc will require seeing/examining your mother. Since she has been to a neurologist, have you tried their office to get what you need? They would have a much better handle on her cognitive issues.

We have had POAs in place a long long time. Despite that, EC atty told us we couldn't force mom to move - she was adamant that she wouldn't move, esp not to AL and that she was fine, independent and could cook. She wasn't and couldn't. POAs allow you to step in for someone else, to sign documents, make financial and/or medical decisions according to the person's wishes. Unfortunately they are not enough to force a move, per our EC atty. He said we would need to get guardianship, but the place we chose wouldn't accept committals, so guardianship would be time consuming, expensive and useless to us!

We moved forward with plans anyway. Made deposit and arrangements for when the MC unit was up and running (rebuilt facility, MC was the last unit to open in IL/AL/MC.) I left it to my brothers to do the actual move (I did MOST of everything else, and wanted to keep the blame off me if possible!), but they really didn't have a plan. I made suggestions, but was ignored. Days before the planned move, she injured her leg and developed a serious infection. It delayed the move a few days, so YB used the time and incident to draft a phony letter from 'Elder Services' at the hospital, which stated she either moves to a place we choose, or they would place her. She was mad as all hell, but she went with them.

We had NO doctor Dx, NO doctor letter, nothing. Facility staff had seen her and knew her condition (YB kept insisting AL, but they said no, MC, so they could tell.) They said to just get her there, they would take it from there, which is what we did.

So, in your case, if you think she needs a NH (doesn't sound like she needs specialized nursing care yet), either push back harder with the doc, or try the neurologist. If MC would be enough, check with the place you have chosen. Do they really need doctor orders? If not, YOU sign everything as DPOA and find a way to get her there (going out to lunch, visiting someone, etc, any fib that would get her to go with you.

Another option is to get an outside assessment. When we tried hiring aides to keep mom in her condo longer, they sent a nurse who did a FULL test in mom's condo with YB and me present. Medicare covers the cost for this. She even came a few more times, due to UTI during this "transition" and her services were covered by Medicare. We did NOT use the results of this test to make the move.

Obviously it is hard on everyone to make this move. You feel guilty for "giving up." They might be angry for a while if you make them move. Honestly, I don't think ANYONE with dementia is going to ever agree that it's time to move. We have to make that decision and somehow make it happen. Sometimes everyone involved works as a team and it can go fairly smoothly. Other times you have docs like your mother's, who just don't get it!

BTW, mom's doc at the time promised a letter I needed to become rep for her federal pension. Federal entities do NOT accept POAs (SS, Medicare, VA, IRS, etc.) They all have their own forms and process. NINE months later, despite MANY phone calls and portal postings, giving them copies of what was needed and why, plus multiple POA copies, some before the appt, some after, I still had no letter. Office staff was the problem. The move was going to require a change in docs, so I made arrangements with the new doctor and eventually (took almost 2 years and 2 letters!) I was able to be approved! SS rep payee was a snap in comparison!

So, you aren't alone when it comes to doctors not being helpful or receptive. If you can, find a way around her.
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