Mandatory Assisted Living? Need advice

[This Won't Hurt Much]

My boyfriend's coworker has a 90 year old aunt who has been living independently and fairly well by herself for some time. A few weeks ago, she fell and hurt herself, and the doc ended up telling her that she would be required to live in an assisted living facility. I don't know the details, but she was upset about that and still not feeling physically better a few days later, so her nephew took her to another doc who noticed a massive bruise all up and down her spine from her fall. (The initial doc had not examined her or noticed this.)

Now, like I said, I don't know the specifics, but this coworker is quite distressed, saying that the assisted living facility is going to cost $10,000/month, isn't covered by medicare, and says that his aunt still wants to stay in her own home. She has been on morphine for something else (I don't know what), so I'm wondering if the morphine dose or med may have put her at risk for falls? does she need to still be on that med or would another be more appropriate (less risk for falls)? when was her last assessment? would a walker not be an effective aid?

My question essentially is this....Isn't she entitled to a second opinion about her ability to live on her own still? The understanding is that she manages quite well for the most part, and the doc who has required assisted living is the same one who didn't assess her properly or notice her bruises anyways. How can he say she must go to assisted living without examining other aids or potential problems? My boyfriend (and his coworker) are under the assumption that it is a state mandated requirement that she go to assisted living. Any advice or suggestions on how this can be contested or reassessed at all? She lives in Texas, and that's all I know. Thanks for your help!!!

[morte, LPN, LVN]

if she is of sound mind, i would think she gets to make that decision...does the doc have part ownership in the assisted living facility?

[This Won't Hurt Much]

I don't know; I wondered that myself. I don't know the details about why this is now out of her hands and "required", but do you know of any rules/provisions that make it so? Any advice on how she should proceed?

[RaspberryTX, RN]

I am not a physician or a nurse, nor a lawyer so I'm not in a position to give any sort of opinion. However, the family member could call the Texas department of health for information and/or referral.

[SuesquatchRN, BSN, RN]

The coworker needs to get his aunt a lawyer.

[morte, LPN, LVN]

The coworker needs to get his aunt a lawyer.

yup......asap....hopefully she hasnt signed anything yet

[HouTx, BSN, MSN, EdD]

We do a lot of screwy things in Texas, but arbitrary removal of individual choice is not one of them. In fact, we tend to go more strongly in the other direction. Physicians - even in Texas - do not have the power to force anyone to do anything.

Unless things have dramatically changed, there is only ONLY way an adult can be subjected to healthcare decisions that are not their own & that is if they are found to be incompetent via a duly appointed legal process. The court system can order involuntary commitment to a psychiatric facility when warranted. They can also appoint a legal guardian if an individual is found to be mentally incompetent. The appointed guardian would be able to make health care decisions on her behalf.

Sounds like this feisty old lady is not mentally incompetent - just suffering from the infirmities we will all have if we're lucky enough to get to 90 years. old. The people who are most able to provide guidance are Medical Social Workers. They know all the rules & funding options. Care for the elderly is not an "either - or" proposition with only two choices; independent living or nursing home. There are all types of arrangements in between.

[This Won't Hurt Much]

THANK YOU rbezemek!! This is such an awesome response that clears up a lot of confusion! (Eloquently stated at that!) :) I am in nursing school myself and couldn't imagine such circumstances, but I surely wouldn't know without a doubt, and most certainly in Texas! By the way, I LOVE your state! Thank you to everyone for your responses, support, and words of wisdom. This is always such a great place to come for answers! :flwrhrts: