Can a medical care team legally determine someone is unable to return to home care because they are a "threat" to society?

1 answer | Last updated: Sep 14, 2017
A fellow caregiver asked...

My mother has dementia and has been hospitalized due to agitated aggression. She is currently being evaluated by a psychiatrist and care team members. If they determine she cannot be returned to a dementia unit of assisted living but rather must be placed in a nursing home or other such facility,  can a child be allowed to take her to their home for private care? Or can the hospital team determine that she is a "threat" to society or her self and cannot be released to private care. And does this differ by state?

Expert Answers

David Green works as a geriatric care manager for the City of Oakland, California. He has more than 20 years' experience addressing the needs of older adults.

You can take your mother home to care for her if she’s not a danger to herself or others at the time of her discharge. If you’re capable and responsible, it’s unlikely hospital staff would prevent you from taking her, in any state in the country.  But before you decide to do so, you should ask yourself if it’s really the best choice for both you and your mother.

Chances are, the psychiatrist and the care team members, with a combination of behavioral interventions and medications, will be able to reduce her agitation. Once the right combination is found, she could do very well in a nursing home. And if you’re able to find a nursing home with which you’re comfortable, you might do better maintaining your relationship with her by visiting her frequently in the role of daughter and friend rather than by becoming the primary caregiver at home. Agitation and aggression aren’t unusual when people have a dementia. expert, Anita Silverman, provides some useful information about how to work with nursing home staff to help calm down a woman with dementia who has been throwing food, hitting, and trying to run away.

You didn’t say what kind of dementia your mother has. You should consider her diagnosis when deciding whether you want to take her home. Find out from her psychiatrist if what she has is progressive and will likely become more challenging over time, or if, once she is stable, she is expected to remain so. Check out the topics on Alzheimer’s and other dementias for more information about the differences.

If you do decide to take your mother home, you’ll need to consider many issues: Will you be taking care of her alone, with other family members, or with paid in-home help? What are your mother’s physical needs? What are her social and emotional needs? How do you meet these needs? It’s a lot to think about, but you’re better off thinking about it now than after she’s home with you and you’re in the middle of it.

Many people do find it very gratifying to care for an aging relative at home. These are the people who do a good job not only of taking care of their relative, but also of taking care of themselves. Don’t forget to think about how you get respite for yourself from the demands of caregiving.