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  #1  
Old 09-14-2012, 01:50 AM
grude grude is offline
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Can an elderly adult be forced into a nursing home by the state?

Assuming of course they are not profoundly senile and can care for themselves, and yes I realize there a big margin for abuse here by whoever makes the determination(you can't sweep snow off your sidewalk? INVALID!).

I'm curious because I see a lot of stuff in the media that suggests it is a real thing, but it seems bizarre. A usual plot will be an elderly person without kids being "forced" into a nursing home.
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  #2  
Old 09-14-2012, 06:04 AM
IvoryTowerDenizen IvoryTowerDenizen is offline
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Can you give an example of independent folks being forced into a nursing home in the media, because I'm having trouble picturing what you mean.
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Old 09-14-2012, 06:32 AM
Fionn Fionn is offline
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Wasn't this a plot point in Up?, with the developers wanting Carl's property?
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Old 09-14-2012, 06:52 AM
grude grude is offline
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Originally Posted by IvoryTowerDenizen View Post
Can you give an example of independent folks being forced into a nursing home in the media, because I'm having trouble picturing what you mean.
UP as already stated, an episode of the old Beauty And The Beast show, it seemed to be a popular trope in the past(greedy developer trying to get old people in a nursing home).
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Old 09-14-2012, 06:52 AM
IvoryTowerDenizen IvoryTowerDenizen is offline
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I never saw Up, or B and B show, so I can't say. But we're these characters really independent? Otherwise, why wouldn't they just sell and buy someplace else?

You can't just take someone's home without compensation.

Last edited by IvoryTowerDenizen; 09-14-2012 at 06:54 AM..
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  #6  
Old 09-14-2012, 07:01 AM
Hari Seldon Hari Seldon is offline
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Here in Quebec, there must be a formal finding (by a judge) of incompetence before a person can be forced into care. I know of two such cases recently. The first is a friend of my wife's, around 80 and with diagnosed Alzheimer's. The second is a (former now) colleague of my who is suffering from Korsakoff's syndrome (http://en.wikipedia.org/wiki/Korsakoff%27s_syndrome), the result of extended Niacin deficiency, caused by being an alcoholic. Although in decline for years, he rather suddenly entered a state of dementia this summer and was recently declared incompetent. Since the treatment (large niacin doses) has had little effect, he will spend the rest of his life in care.
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  #7  
Old 09-14-2012, 07:09 AM
Mangetout Mangetout is online now
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Quote:
Originally Posted by grude View Post
UP as already stated, an episode of the old Beauty And The Beast show, it seemed to be a popular trope in the past(greedy developer trying to get old people in a nursing home).
Also, Batteries Not Included, probably episodes of The Dukes of Hazzard, almost certainly episodes of The A Team - and more than likely any other series where the format included some sort of vigilante justice.
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  #8  
Old 09-14-2012, 07:26 AM
WhyNot WhyNot is offline
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I'd like to see a couple of real life examples of this, if you don't mind.

Otherwise, I'd like to know if cops really disproportionally get shot the day before they retire, if a man whose family is killed by a psychopath can hunt him down and kill him without going to jail for murder, and if all dogs really go to heaven.
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  #9  
Old 09-14-2012, 07:29 AM
Floater Floater is offline
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I know a person this happened to, but that was not in the USA and some 60 years ago.
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  #10  
Old 09-14-2012, 08:16 AM
md2000 md2000 is offline
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In Canada, in my somewhat limited second-hand knowledge... If a person ends up in hospital for whatever reason and in the doctor's opinion they cannot care for themselves, they will only release them into a nursing home. Sadly, in some provinces this means they have to wait in a hospital for weeks for an appropriate spot to become vacant. I suppose the same could happen if the authorities - police, paramedics, fire department etc. - have to be called to the person's home.

In the case I heard of, the lady was going blind and not eating well - so ended up with cracked spine. By the time the doctors finished with the 10 or 12 medications they put her on she was throroughly delusional and not going home. She had managed to walk to the grocery store, etc. but could not see or tell the food in her fridge was going bad, had malnutrition issues including bone loss - she really was one of the borderline cases that had to finally go.

As for perfectly healthy seniors (a la Hollywood) the homes are so full to overflowing they spend hundreds of dollars a night to keep some needy old folks in hospitals waiting. I doubt they are going to send a capable person into such a home. Besides, most people who did not have a great job have only heir old age pesnion, so the government subsidizes many occupants. They are happy when someone can remain in their home, as long as they are not a danger to themselves or others.

Usually the Hollywood theme requires the old person to be provoked into some action that can be held up to the judge as evidence of senility and loss of control. (although some stories skip that step to keep the story faster-paced)

Last edited by md2000; 09-14-2012 at 08:17 AM..
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  #11  
Old 09-14-2012, 08:58 AM
Sally Mander Sally Mander is offline
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Originally Posted by md2000 View Post
In Canada, in my somewhat limited second-hand knowledge... If a person ends up in hospital for whatever reason and in the doctor's opinion they cannot care for themselves, they will only release them into a nursing home. Sadly, in some provinces this means they have to wait in a hospital for weeks for an appropriate spot to become vacant.
....
As for perfectly healthy seniors (a la Hollywood) the homes are so full to overflowing they spend hundreds of dollars a night to keep some needy old folks in hospitals waiting. I doubt they are going to send a capable person into such a home.
In the US, no one who isn't at death's door is going to spend weeks in a hospital just waiting for a spot to open up in a nursing home. They'll be sent to some sort of assisted living facility or even back home with an aide, or even to a family member's house, with or without an aide. There's no way Medicare or Medicaid or any private insurance company will justify a long term hospital stay to wait for a nursing home room. They'll find them a room somewhere, anywhere, even in a crappy place, while waiting for a room in a better place to open up.
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Old 09-14-2012, 09:20 AM
md2000 md2000 is offline
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Originally Posted by Sally Mander View Post
In the US, no one who isn't at death's door is going to spend weeks in a hospital just waiting for a spot to open up in a nursing home. They'll be sent to some sort of assisted living facility or even back home with an aide, or even to a family member's house, with or without an aide. There's no way Medicare or Medicaid or any private insurance company will justify a long term hospital stay to wait for a nursing home room. They'll find them a room somewhere, anywhere, even in a crappy place, while waiting for a room in a better place to open up.
Yes, this is the difference with Universal Health Care - nobody gets forced out on the street or dropped off on skid row if they have nowhere to go. The real costs get hidden in hospital operating costs, while the allocation of funds to create long-care spaces proceeds at its usual glacial pace. Governments are no different anywhere - penny wise pound foolish.

Last edited by md2000; 09-14-2012 at 09:21 AM..
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  #13  
Old 09-14-2012, 10:07 AM
Sally Mander Sally Mander is offline
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Well, they're not going to just shove a patient out the door and prop them up on the curb. There are social workers who will find them somewhere to go. A patient might prefer, and be able to afford to go to Ye Olde Le Ultra Chic Nursing Home that has private rooms and serves filet mignon every Sunday, but it's currently full and has a waiting list. The social worker will call around and end up finding a spot at Happy Jack's Budget Busters Assisted Living Facility, where there are two people to a room, and get PB&J every day for lunch. The attitude is basically, "Suck it up, Buttercup. You can move to the nice place when there's room."

Of course, if they have money, they can go home and hire a private nurse or aide to be with them 24 hours a day.
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  #14  
Old 09-14-2012, 03:27 PM
dracoi dracoi is offline
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Here's my experience: old people have a really poor sense of how independent they are. They protest that they are independent even when any rational person can see that they are not.

My mother in law was a perfect example. We were having a conversation with her about assisted living because of her degenerating Parkinson's. She was insisting that all she needed was help for 3 hours a week to do the dishes... and in the middle of this, asked someone to get up to adjust a pillow because she was uncomfortable. She had to ask us because she couldn't even sit up by herself. She couldn't walk, couldn't use the bathroom, could barely feed herself (and even then, had a tendency to injure herself by spilling hot soup or coffee on herself).

Truth is, she should have been in a nursing home a year before we finally forced her to go. And we did literally have to force her.

For someone without kids, the government (or at least a social worker or doctor) would need the power to do this. I think we can all agree that society should prevent little old ladies from sitting in their own urine and dying from coffee burns on their thighs, no matter how much they protest that they only need help with the dishes once a week.

(Of course, we also know that Hollywood will cast this as a spry 70-year old being unfairly ousted. They need conflict and truth is not their strong suit.)
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Old 09-14-2012, 03:44 PM
Fuzzy Dunlop Fuzzy Dunlop is offline
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Originally Posted by md2000 View Post
Yes, this is the difference with Universal Health Care - nobody gets forced out on the street or dropped off on skid row if they have nowhere to go. The real costs get hidden in hospital operating costs, while the allocation of funds to create long-care spaces proceeds at its usual glacial pace. Governments are no different anywhere - penny wise pound foolish.
We have universal health care in the United States for people 65 years and older. If they spend 3 or more days in-patient at a hospital they're entitled to 100 days at a skilled nursing facility (i.e. a nursing home). In my experience, once the patient's physician determines they're ready to be discharged and has determined that they need rehabilitation at a skilled nursing facility, their caseworker will find one to take them very fast and then Medicare will pay for the stay at the nursing home.

What we don't have is government provided 'insurance' payments for long-term care under Medicare. Medicare will pay for rehab up to 100 days at a nursing home but if you need to stay permanently, well Medicare was not designed to support people's daily cost of living long term.

People unable to afford the extreme cost of long term nursing care (often $10,000 / month) can apply to Medicaid once their financial resources are exhausted. Medicaid will pay to keep them in a safe but inexpensive nursing home indefinitely - the nicer facilities avoid Medicaid patients because they can't get nearly as much money.
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Old 09-14-2012, 03:47 PM
Crab Rangoon Crab Rangoon is offline
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Originally Posted by dracoi View Post
She had to ask us because she couldn't even sit up by herself. She couldn't walk, couldn't use the bathroom, could barely feed herself (and even then, had a tendency to injure herself by spilling hot soup or coffee on herself).

Truth is, she should have been in a nursing home a year before we finally forced her to go. And we did literally have to force her.
This is very close to my experience with my grandmother. She resisted leaving her home - which is very understandable - but she could not toilet herself - and she was expecting neighbors to come and feed her everyday and change her bedding. Um.....no. That's not really going to work, Nana.

So we ended up having to get her admitted to a hospital (made up a reason) and evaluated there. The social worker who came (after 8 hours of waiting) told us that we still could not force her to move out of her home. He said "A person can be neck deep in shit and we still can't force them out."

What did end up happening is the hospital realized they could not just release her back to her home - I'm not sure if one of the doctors made this decision or what - but they ended up finding a rehab facility for her and eventually she ended up in a nursing home, since she did not improve in the rehab (alzheimer's among other issues).
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  #17  
Old 09-14-2012, 10:37 PM
Senegoid Senegoid is offline
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The direct answer to OP's question is (or was): Yes.

Corrupt professional conservators can (or used to be able to) go to a probate judge and get someone declared incompetent -- possibly without the subject even knowing of it. The victim (typically an elderly widow) then finds herself legally at the mercy of the conservator, who makes ALL decisions for the conservatee. The victim's savings may be plundered, her house and possessions sold, and she may be consigned to a nursing home, to be involuntarily sedated into near-oblivion.

The Los Angeles Times did an investigative series on this in 2005. Here is the article (or perhaps one of several articles) they ran on the subject. (Be prepared for some lengthy reading. It's 8 screen pages long!) As I recall from when I first read it, the article strongly implied (but didn't say) that the probate judge was corrupt too.

In googling up that cite, I also found this more recent one (2009), saying that as a result of the Times article(s), the CA legislature (finally) passed some laws putting some regulation on conservators, which had previously been less regulated than hairdressers and guide-dog trainers.

Googling for: site:articles.latimes.com 2005 conservators
turns up a collection of other articles on the subject.

Last edited by Senegoid; 09-14-2012 at 10:39 PM..
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  #18  
Old 09-14-2012, 10:57 PM
Simple Linctus Simple Linctus is offline
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I've never heard of this in the UK. What IS common however, especially in England, is old people being forced to sell their house to pay to go into a nursing home (which is not free to you if you can afford it, although it may be subsidised - I don't remember the details to be honest although I do remember that it is a lot better in Scotland where it might be free for everyone)
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Old 09-15-2012, 07:30 AM
md2000 md2000 is offline
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Originally Posted by Crab Rangoon View Post
So we ended up having to get her admitted to a hospital (made up a reason) and evaluated there. The social worker who came (after 8 hours of waiting) told us that we still could not force her to move out of her home. He said "A person can be neck deep in shit and we still can't force them out."
This is the difference. In Canada, (again, limited experience, wife's grandparents etc.) the social worker and doctor provide evaluation if hospitalized. Otherwise, if there is an "incident" like a fire or such, maybe just the social worker evaluates. Once the professional opinion is the person is unsafe living on their own, unable to care for themselves, then they must go to an assisted living facility.

The government will pay if there is a spot. Not sure how it works, but generally the govenment will put you at Happy Jacks; if you can pay for yourself, likely Le Chic will take you. However, spots can be so tight that Jack may be your only choice. Most of the homes that I am aware of are run by charities or non-profits; the legendary old-folks-home equivalent of slum landlording that we used to hear about south of the border are less prevelant in Canada, AFAIK. (Not to say we don't have our share of lazy attendants and people not being cared for properly - it' just not as systemic. I read somewhere of a nursing home staff being chaged with negligence for letting a woman suffer from sores and miss her meds etc. until she died.).

For my wife's grandmother, this is how I view Canadian old age care - if you have nothing, the government pays. If you have any income, the cost of the home will suck it all up. She had a pretty good income, thanks to her late husband. The care home was really sad to see her go, because she was providing a nice boost to their bottom line compared to the average patient, an extra few thousand a month. However, for years until she was no longer lucid, she clung to the belief that this was a temporary thing due to her medical condition and she was going home, so I don't think she sold the home until she was close to dying; the home could not force the sale, and her children split a nice inheritance because of that.

the demand for spots is outstripping supply thanks to demographics, and because the government is not keeping up (they subsidize spots for non-profits, but the groups need approval to build) people do spend months in hospital waiting sometimes.

Last edited by md2000; 09-15-2012 at 07:33 AM..
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Old 09-15-2012, 11:56 PM
Tom Tildrum Tom Tildrum is offline
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Originally Posted by md2000 View Post
...this is how I view Canadian old age care - if you have nothing, the government pays. If you have any income, the cost of the home will suck it all up.
Medicaid in the US works much the same way (although I would say "any assets" rather than any income).
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  #21  
Old 08-21-2013, 01:41 PM
jbsay jbsay is offline
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Absolutely

I am in the midst of a nasty and loosing fight with the local Elder services right now.
My father now 83 with Vascular dementia (MOCA 16) left fairly detailed wishes, and appointed an MPOA and POA long before he was incapacitated.

We have been caring for him from the point where his banks forced the activation of the POA to just a few days ago.

His mental decline attracted numerous vultures including another family member before the bank stepped in and stopped that. We had reported most of them to the police, and the local office of aging (repeatedly). As my father had not been legally declared incompetent (and still has not been), they claimed they could do nothing.

Yet just a few days ago on an emergency exparte court order filled with easily disprovable lies he was forceably removed from his home and our care.
He resisted, fell and ended up with a concusion in their care - he has never been bruised or injured in ours, we have tried to get an emergency reconsideration before the judge - he has refused to hear it essentially saying I had a hearing that you were not allowed to attend and found all this crap true, I am not interested in your side. Prior to this Office of Aging had been in twice and received full access to his care and financial records - which they never bothered to read, or they would have known the accusations were crap.
We were accused of giving him medications that would kill him by the doctor that perscribed them, we replaced those meds with placeabos while seeking a better doctor AND thoroughly documented that we had done so.

Nor are we finding this is rare. Apparently the greedy conservator game has been adopted by local elder abuse units. They step in - particularly with upper middle class olders, they take over generally without any hearing, they seize assets, charge exhorbitant fees for their lawyers and staff, and then dump the old people into a home. When their funds are bleed out Medicare takes over.

I would be very interested in similar stories from others. I am planning on bringing up a web site on this at www.thebrokenwindow.net, i can be emailed at jbsay@thebrokenwindow.net
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  #22  
Old 08-21-2013, 01:48 PM
Nava Nava is offline
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Originally Posted by IvoryTowerDenizen View Post
I never saw Up, or B and B show, so I can't say. But we're these characters really independent? Otherwise, why wouldn't they just sell and buy someplace else?

You can't just take someone's home without compensation.
Because it's their house and they want to stay there. Even if the amount of the compensation being offered is enough to pay for a move (irl it often is not), it will rarely pay to move a short enough distance to be able to visit with your neighbors of decades, shop at the same store where you always did and so forth.

From her relatives' point of view, the best thing about the old folks' home where my grandma now lives is the quality of care (her health has improved enormously); from hers, that it's less than 400m from her own home. The park where we take her for walkies is the same one where we always went in the summer.
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  #23  
Old 08-21-2013, 07:44 PM
NotDeadYet NotDeadYet is offline
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More often than not an individual cannot afford to stay in their home. Options in some places are limited. When there isn't an ACLF or other group home, a nursing home is sometimes the only choice. Of course, the value of the home (assets) will be used to pay for the care until the it runs out and then Medicaid will kick in.

Caring of the elderly is always tricky. My mom has Alzheimer's and is burning through her assets and will likely be broke before she dies. There are some funding sources but my siblings and I will have to pony up some big bucks until mom's condition gets to the point where she "must" be in a nursing home and then Medicaid will take over.
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  #24  
Old 08-22-2013, 11:51 AM
astorian astorian is online now
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We all know better than to take Pixar animated movies as gospel, but even in the movie Up, elderly Mr. Frederickson wasn't committed to a nursing home out of the blue just because a developer wanted his land.

Mr. Frederickson was forced to enter a nursing home because he committed a physical assault with his cane in front of numerous witnesses. That gave the authorities some legitimate reason to think he was senile and potentially dangerous.

IANAL, so I have no idea if that would be sufficient grounds for institutionalization in real life.
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