What happens when your cognition deteriorates during an illness and you are in the hospital?
I speak from experience here, you really don't want to find yourself in this situation. The best way to avoid it? Make a plan now, long before you ever think you will need it. Make sure you have a Power of Attorney, a Living Will, and that you are in close communication with your designated person or person. Also important to make sure you know where your documents are, and the designated person also knows where the originals are!
This is the only way to have any control of what happens to you when you are incapacitated for any reason.
I recently helped a family where my client was in the hospital for months. She was already having some cognitive impairment, and it was later discovered she was also hoarding at her residence, a sign of additional impairment, but not reason enough alone, to not be able to return home. My client suffered a heart attack and went by ambulance to the ER. She was admitted, and underwent several procedures before hospital staff and physicians noticed her cognition had declined. She was angry and refusing to take any cognitive evaluations, and this made the situation worse!
The hospital was able to reach her daughter eventually, and she was the predesignated Power of Attorney to make decisions on her mother's behalf, however, the original documents were buried someplace in her house. It took weeks and weeks to finally find them. Once the documents were located and the daughter could begin acting on her appointment, the client had been in the acute setting for months. Tragic, a terrible circumstance for everyone.
You must have a safe place to discharge someone before they can leave the hospital. This client was physically very able, so she was denied by rehab. NOW WHAT?
This is when the hospital called me to help. The daughter finally got access to her Mom's banking information to know if she could afford assisted living at all, or, if there was a need to pursue Long Term Care Medicaid (which also can take months to be approved).Thankfully, the client had been working, and almost up to her admission, and did have some resources to prevent her from going to a nursing home (no need for nursing care, but there are so few medicaid assisted living beds that many folks end up in a nursing home prematurely, simply because there is more supply of medicaid nursing beds than there is assisted living.)
Again, I am sharing this story to highlight the need for A PLAN before you need any care at all. Make sure to have money set aside or even better, make the investment in your future with a Long Term Care Insurance Policy! We don't talk about this enough! Medicare and Health Insurance does not pay for assisted living! No one wants to think about their life when they need help, but since we are all living longer, there is no reason to avoid this topic. Avoiding it is a sure fire way to have someone else making decisions for you. And I am pretty sure, nobody really wants someone else making their life decisions for them!
Like the client in this case, she had planned who would make decisions for her, her daughter, but her paperwork was MIA to prove it. The result was a very long hospital admission. OK now for some silver linings: The client had some financial resources! We were able to find a community that met her financial needs, allowed her the most autonomy and independence she could get with the medication management and meal support she needed to stay strong and find her path post hospital discharge. But none of this was easy or fast.
She is getting back on her feet now, but I hate what she had to go through to get there.
The other silver lining, it took so long, and she was frequently very (rightly-so) frustrated and angry, she even kicked me out of her room on our first meeting! BUT THEN... the next day she called and asked if I would be her friend, and I said yes. We talked everyday until she was released to her new apartment. She holds a very dear place in my heart, and I feel honored she asked me to stand by her during this very difficult time.