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Mom had a stroke down in South Carolina a couple weeks ago. She is in her late 50s. I am in my later 20s and live with my grandmother who is in her early 80s. Grandma still works weekends and I work part time to help out. I have an older sister who is intellectually disabled that had been in mom's care but because of the stroke and another incident before the stroke happened, grandma and I had to drive down from Virginia to get sister. Mom was in the hospital and we could not stay. I was not able to drive back down to get her so my friend drove my grandmother and picked her up from hospital when they said she could leave. She had had a brain bleed. After three days of being with us in VA, she seemed to relapse. She wasn't eating, drinking, or taking her meds. She would fuss at us to leave her alone. Grandma had to call paramedics to take her to the local ER where they did a scan and saw she was still bleeding. They transferred her to another hospital where she was in the neuro ICU for day or two before transferring to another part of the hospital. She was there three days and just discharged on fourth day. Now, she has been home 1 night and already its apparent Grandma and I cannot care for her right now. She has a follow up doctor appointment in one month. Mom thinks she is alright and can travel to her home in SC by herself (and with sister but that cannot happen). Mom is very unsteady on her feet, cannot walk a straight line, is a serious fall risk. She also abuses her medications. Grandma has her meds and was giving her what she needed when it was time but mom has been fussing that she needs more of this or another of that. In the middle of the night Mom got into Grandma's own medication and took something. Didn't seem to affect her whatever it was, but it was a rough night. We all hardly slept. Mom is very stubborn and can't comprehend reason right now. She has tricare thanks to her deceased husband so a skilled nursing facility is covered. We just don't know how to get her into one. Apparently the nurses and doctors at the hospital even suggested that but grandma didn't feel like 'abandoning her'. But now it is evident she needs more care than we can give. What do we do? Do we call social services? Adult protective services? She is not capable of being on her own right now, especially not in another state where there is no one to look in on her.

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Your grandmother sounds *amazing*. What a brilliant lady.

I should go back to the medical team that recommended the SNF and say you've changed your mind. To get round your grandmother's anxiety about "abandoning" her daughter, remind her that your mother is acutely ill and needs this care to recover. Given how young your mother is, and the nature of the stroke, it's not unreasonable to hope that there will be a good recovery: you're not lying or being euphemistic. But for that to happen your mother needs structured, planned care; and you can ethically override her own wishes on the straightforward grounds that right now her brain is injured and not working.

I hope the social workers your grandmother's in touch with are helpful - please let us know how you're getting on.
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The only thing I would think is that you, grandma, anyone else has to tell hospital that no one can take care of her and they must find a place for her to rehab. Do some google searches and show mom the statistical data on recovery in professional rehab verses just going home, this may scare her enough to go willingly.
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I would encourage you to find out why mother was not admitted to rehab post stroke. This is usually the course of action to have the patient go to out patient rehab for a few weeks (usually less than 21 days if on Medicare).
Can mother swallow? Any one sided weakness? Can she ambulate?
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Jay
Thanks for letting us know what happened. Taking GMs meds might have been a blessing in that it gave the authorities a reason to take her to the hospital. Hopefully they will help her. I know this is so hard for all of you. Glad you have good neighbors. Hugs
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Jay, let your mom be. If there is no one there to support or pick her up, she'll get the help she needs.

Point out to gma that mom would have walked out of a SNF as easily as she did the hospital.

Mom clearly has mental problems that have been exacerbated by the stroke. She is someone who has needs beyond those of family's capability to tend.

Your job right now is to help your sister; mom is is no shape to care for herself, much less another vulnerable person.

Don't go and rescue mom. Repeat, leave mom be. She will have to be found incompetent before she can be forced to get help.
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Jayless, i am so sorry to hear about all you have been going through. You and your Grammy have done everything you could do. You checked everywhere for help and found no support. It sounds like your Mom is addicted to drugs and is going back home so she can do that without someone trying to stop her. You and Grammy tried. It's her battle now. I pray it won't turn out horrible but you can't make her change. Drugs are powerful and destructive. Again, I am so sorry...
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If she's a heroin addict I imagine her life has been a train wreck for a long time, I think you need to go back to doing whatever your lives were before this new health crisis sucked the family back into her dysfunction, you are powerless to help her... (sorry if this sounds too blunt)

I just re-read your original post... where is your sister, is she safe?
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Garden Artist, thank you for replying. While Mom has tricare, she herself is not a veteran, just a spouse of one and he has passed. Tricare will cover skilled nursing facility.
The discharge papers just mentioned the follow up doc appointment in one month. No other therapies mentioned. But its clear she needs something.
Grandma is currently on the phone with the hospital social worker.
Mom will not go anywhere willingly, which is the problem. She is very stubborn, even when in a sounder mind.
We will check into the stroke recovery programs in the area, thank you.
We love mom very much, but we cannot keep going on like this with her. She needs more help than we can give her and she's too damn stubborn to go along with it.
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Good luck and please keep us posted. Sending you all peaceful and healing vibes. I'm so glad you've got your grandmother and sister and you're all on the same page. Your mom is lucky to have you.
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Update:
Well we thought we'd have a day or two of reprieve from Mom to figure out the next steps. Grammy spent yesterday on the phone talking to social worker at the hospital, adult protective services, and even the local behavior health center that has crisis counselor that could come out and evaluate mom.
Guess what?
Mom checked herself out of hospital AMA. No one stopped her. The psychiartrist didn't come to evaluate her. The nurses couldn't make her stay. Social worker, adult protective services, nor the crisis people would do anything.
So mom checked herself out while I was at work. Grammy and sister had to go get her. Apparently she came out still in the hospital gown. She was in the damn ICU with a central line after ODing on something she had taken and yet, she was allowed to leave with no evaluations from anyone.
So what could we do? Nothing. Mom booked herself a train ticket and left last night back to Charleston.
When she got to Charleston, she fell getting off the train. Got a gash in her head and thinks her wrist is broken. She's still at the ER but god knows for how long. Mom has already called saying she'd like to leave because apparently she isn't in a room but on a bed in the hallway and no one has seen her. Grammy talked to the nurse before Mom called and it seemed like they were going to have neurology come look at her but who knows. Update to this: she is leaving hospital soon. 
I'm done.
We tried everything. No one would help us. Hospital, social workers, magistrate, etc. No one. Everyone kept saying 'well, if she wants to leave'. So we let her leave.
The few friends down in SC said they'd look in on her. Mom also said she'd come back soon to see that doctor but who knows. Mom thinks Grammy is the one that has done all of this. Put her in the hospital, said sister can't live with her, etc.
Grammy is worried and is blaming herself for not listening to the nurses last week about putting mom in the skilled nursing home. Grammy remembered when her own mother decades ago had had a stroke or something and how she seemed to do better when she came home. I told Grammy its not her fault. We tried everything.
In the end, you can't help someone that doesn't want to be helped.

Thank you to everyone that has offered advice and support on here. It means a lot.
I will update again if anything else happens. Right now I'm just mentally drained from these past few weeks and need to rest.
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