A common question I get from people who come to see me for a consultation goes like this:

“How do I get my mom to go to a nursing home? She doesn’t want to go to a nursing home, but she needs to go.  The family simply cannot take care of her at home and she’s a danger to herself, but she doesn’t think she is.  She thinks she’s perfectly fine and just wants to stay in her home.  We’d love to keep her in the home, but it’s just not possible any longer, so how do we make her go to a nursing home?  Can I get power of attorney for her?”

Now, I completely understand where this question is coming from. My mother lived to be 94 and lived the last six years of her life in a nursing home.  My mother would say “Just shoot me” whenever the subject of a nursing home came up, and I can tell you that she was not joking.  In my mother’s case, several strokes stole her cognitive abilities, so even though she ended up living in a nursing home, she thought she was still in her home.  Living in the nursing home didn’t upset her any longer because she didn’t realize she was living in a nursing home.

In a way, suffering a second stroke was beneficial for my mother because it allowed her to receive the care she needed in a nice setting, and it allowed her to live for six more years. If my mother remained at home, she would have died many years earlier than she did because she simply won’t have received the care she required.

Right now, there are many elderly individuals who are living in their homes who shouldn’t be living in their homes any longer, who aren’t receiving the care they need, and who could seriously injure themselves at any minute because they are living in a dangerous situation given their care needs. When family members come to see me and ask me how they can make their parent get the care the parent needs, this is what I tell them.

People who are still competent are free to make good, bad, or no decision at all. Just because someone is elderly doesn’t mean that they are less of a person, so that elderly person who is making absolutely horrible decisions is free to make those decision in the same way that someone who is twenty years old is free to make very poor decisions.

There is no way to force someone to do something that they do not want to do, assuming the person retains their mental capacity. My dad is 91 years of old.  I was able to make him a resident at a beautiful assisted living residence.  He didn’t like the place and came home after two weeks.  In my opinion, his decision was silly, but it was his decision and I couldn’t force him to make another decision.

Now, if someone is mentally incapacitated, you can file for guardianship over the person. A guardianship action is a court action through which you are declaring the person to be a mentally incapacitated individual.  Once the person is adjudicated as incapacitated, his guardian makes all decisions for him (financial decisions, medical decisions, and residential decisions).

With that said, I always tell people that a guardianship isn’t necessarily the answer to “forcing” their mother to live somewhere she doesn’t want to live. Few assisted living residences or nursing homes want residents who are trying to run out the door or who are causing disruptions for their fellow residents because they hate living in the assisted living residence.  So, if mom doesn’t want to live in an assisted living residence, the assisted living residence probably doesn’t want mom as a resident.

The bottom line is, when an elderly person doesn’t want to live somewhere, there is no easy answer to the question of how to get them to accept the care they need. Trying to reason with them, over and over again, is the best solution to a big problem.