My father had a massive stroke that caused him not to speak and have mental issues. I have Conservatorship over him and after his hospital stay from the stroke he was admitted to rehab. The rehab had wanted to transfer him to nursing home care but I thought I could take care of him. I was wrong. He needs way more help then I can give him. I wasn’t aware he had mental issues until last month. He’s put feces on my wall, floor, etc.. He plays with it. He uses the bathroom on himself. He can take short walking distance. He can’t talk. His right hand is really weak and doesn’t really use it. He exposes himself naked to my children and gets agitated. He was hospitalized in October for pneumonia and fluid around his heart. He was hospitalized in November for colon infection and fluid around his heart again. I explained to his caseworker he needed long term care because I’m not able to take care of him. Plus his doctor ordered him to go to skilled rehab from the hospital. Is what was discussed. Now His case manager waits a week later to tell me he was denied skilled rehab from his insurance (Medicaid). She said he can get in-home care but he doesn’t have a home. He temporarily lives with me and I can’t bring him back to my home. I’m not understanding because my father can’t do anything for himself at least that’s what he acts like. He doesn’t even think to take a bath unless you tell him to. His doctor said he has early stage of dementia and that’s why he’s been acted the way he’s been acting. I don’t feel like he’s safe at my home. It’s only a matter of time he gets agitated and go in the kitchen and mess with my oven or walk outside and try to leave. He needs 24 hour care that I can’t give. I have to go back to work and I have young babies. She said once he’s ready to be discharged if I don’t get him I can be charged with abandonment. What are my options if the doctor is saying he needs long term care?
Go to her supervisor and explain whats what’s going on. Your father cannot come to your home. It’s not safe for any of you, especially your children. You are not medically trained to deal with his physical and mental issues. The Case Manager or her supervisor needs to find a facility that accepts Medicaid for him. Explain in no uncertain terms that if they don’t cooperate you will be contacting Adult Protective Services.
Go to her supervisor and explain whats what’s going on. Your father cannot come to your home. It’s not safe for any of you, especially your children. You are not medically trained to deal with his physical and mental issues. The Case Manager or her supervisor needs to find a facility that accepts Medicaid for him. Explain in no uncertain terms that if they don’t cooperate you will be contacting Adult Protective Services.
Two things to keep in your mind:
"I explained to his caseworker he needed long term care because I’m not able to take care of him."
Don't back down -- you cannot take care of him.
"She said he can get in-home care."
That won't be enough -- it is NOT 24/7 care!
It's easiest for these caseworkers if the family assumed responsibility for the elder. Remember this -- do NOT accept any "temporary" placement back to your home as they "work to find someplace." Temporary becomes permanent. You will be stuck.
I hate when people use God to hurt people. I am a believer but I feel atheists who are good moral people are better than hypocrites. Even Jesus Christ despised hypocrites.
I don’t think any less of non believers. If my only example of a Christian would be my my brother and those like him I would never be a believer. Fortunately, there are wonderful Christians who don’t behave anything like my brother.
Sorry for the rant. Having a very bad day. Went for my check up at the doctor and she ordered more lab work. Grrrrrr. I took such good care of my mom that I suffer emotionally and physically.
I am paying a hefty price for sacrificing everything for a woman that turned on me like a snake along with my brothers. Honestly, no amount of money is worth it!
You have vulnerable children in the house and he is a danger to them. Your home is not a safe discharge plan, period. Repeat as needed.
I would put a letter together that has the doctors recommendations for long term care, that you can not safely care for him in your home and that he is a threat to your children's wellbeing and say that you have been threatened by the social worker and you will not be taking him into your home and that you will hold the hospital and social worker responsible for releasing him against doctors orders. Give a copy to everyone involved in his care, to the social worker and their supervisor and maybe their supervisor.
You don't have to take him back into your home.
You need to explain to the caseworker that your children are scared of your father. That he has gotten close to hitting you in front of them. Tell her that homecare will not be enough. You have to work and have 2 small children to care for. You are afraid of him and will not take him back in your home. Conservatorship is just to handle his money, correct? U don't have POA? Even if you do, you can not afford to care for this man. Tell them the state will need to be his guardian. If they call APS. When they talk to ur son, I think they would be on ur side.
Your son saying something to the teacher may be a good thing. If CPS got involved pretty sure Dad would be taken out of the house so the children would be with their mother. This is one of those "no good deed goes unpunished". The people u owe anything to is your children. Have u talked to sons teacher just to see if there has been a problem in school. Like, his grades have come down or he has a hard time keeping his mind on things. If she has seen a difference, had her write a letter to that effect on School letterhead.
Good Luck and come back and update us using this thread.
I would be asking how you get him placed as conservator if you can be held responsible as tacy22 indicates then you have the authority to place him.
I would also be finding out how to get out of being his conservator if you can't get any help to get him placed in care.
a conservator of an adult is legally responsible for providing supervision, protection and assistance. It her legal duty to make sure her dad has proper care. So yes, the social worker is right. Elder abandonment in this country and the state of TN is when a person who has assumed responsibility for an elder deserts that individual. The OP needs to get her dad in to a nursing home. It’s her responsibility. Conservatorship in this country is something you obtain through the court and it is no joke. She is legally responsible for her dad.
I believe The message from thepianist is on target regarding financial.
medical discharge from hospital or rehab.
We are own when it comes to paying for long term help.
You could call the cops and get him Baker acted and have a full psych evaluation if you think he is a danger to himself or others. maybe his behavior will improve with the right meds? Who knows. if he's deemed incompetent the psych ward will work toward discharge to nursing home.
If this behavior is new need to rule out possibility of infection like UTI or blood infection, or pneumonia. Infection can cause very unruly behavior.
What you may need to do is take him back to the hospital via the emergency room or by taking him to his doctor. It is much easier to leave a hospital setting to transfer to rehab or nursing home than it is to go from home to facility.
You say he's on medicaid - which is different from medicare - so, based on that statement, many nursing homes have medicaid beds. You just need to find one that has an empty bed. The doctor may also have some input to help you find one. Many doctors are in partners with facilities.
Start with the doctor to ensure the paperwork reflects the need for nursing home instead of rehab.
Does your father have Medicare? If he has Medicare, rehab is considered skilled care and is paid by Medicare up to 100 days, possibly longer with exceptions, i.e. significant progress that will take longer.
If he will need LTC custodial nursing home care after rehab, the facility business office will apply for Medicaid Nursing Home; it's separate from regular Medicaid.
If he does not have Medicare, then everything has to be done through Medicaid and it's harder, but definitely NOT impossible. Again, the SW from the hospital will have to figure this out when you tell them NO, he canNOT come to your home. No law says he has to. Do NOT let them guilt you into it.
If you have told them all of this, then SHAME on HER, not you, for even thinking this would work. If she is that dense, you need to elevate this to her supervisor. It helps to get the doctors and everyone else on board, but this chick needs a reality slap. Even the recurrent hospitalizations and the reasons for them would tell me that he needs skilled nursing care, not what a working young mom can provide!!!
This isn't just about taking care of him (which is ridiculous, even with the minimal home care they are offering, given his needs, both physical and mental.) It's about the danger he is to you and your family.
It's also a shame that you have to spend your hard-earned money to pay for him. Being conservator would mean you manage his funds and pay his bills from those funds, not that you have to pay his debts from your own money.
That said, definitely continue pushing back on this SW or CM... Meanwhile, it would be worth spending your own money on a good elder care attorney. Unfortunately you are in one of the filial law states - according to Wikipedia, most states have not really enforced these laws, BUT more are expected to due to the amount of people who need/use Medicaid. While it is a Federal program, states have their own rules and as noted some may try to enforce children to pay for their parents.
You might be able to check with multiple EC attorneys if they offer a free initial consult. Have your questions ready/written up before, to make best use of the time, and take notes. Ask about qualifying for Medicaid NH care (why was he declined?) Ask about giving up the conservatorship. Ask if there is any concern about charges (personally I think that is ludicrous, but I'm not an attorney and don't know the laws - it sounds more like a scare tactic.) Ask about Baker Act. Call ombudsman. Call your senators and representatives. Bang on any/every door you can! There has to be help out there for cases like this. Medicaid generally allows a spouse to retain some income and assets, they shouldn't be forcing a child to give up what they earn to provide for their own family!
BTW, if he has early dementia (sounds like it, could be due to the stroke), he is quite likely "show-timing". Basically what that means is he can muster up enough to "behave" and "do what they ask" while he is there, but at home, the charade stops. Many people can even pass the mini exam doctors will do in their office. Because they don't see the person for long and don't observe this behavior, and the person 'passes' the test, they are clueless!
I am my Mom’s guardian and she was being discharged from our local emergency room. However, I knew that she needed more help than I could provide, especially because of her combative behavior. When I refused to accept Mom back into my home, the Hospitalist threatened me by saying that I would be charged with abandonment.
I telephonically checked with The Alzheimer’s Association and was told that I could indeed be charged with abandonment. Their advice was that the next time Mom required hospitalization I should try a larger regional hospital, which is a little more distant but has a Geriatric Psychiatrist and more resources. I did and they ultimately helped me to get her placed in Memory Care.
Note: I don’t want to make this seem like an easy fix. Before getting this help, I knocked on many, many doors! At various times, I have called the police (who refuse to deal with people with dementia because they don’t see it as a criminal matter), our Community Service Board (that deals with people with mental issues, but NOT dementia), Adult Protective Services, the Agency in Aging, and several Assisted Living facilities. I was shocked at how unhelpful these places were and believe that people with dementia are being denied their human rights! Nevertheless, what I have learned is that you may need to knock on many, many doors before one opens for you (and your ailing loved one). Just don’t give up because you are their only advocate!
Please everyone read what is happening with this situation and the realities that she is facing. Counseling that she can't be charged, when in fact she could only causes confusion.
She has options, but abandoning him because she says unsafe discharge is not one of them. It sounds like the doctor is finally getting through to the social worker that he requires rehab and LTC. She is also going to check into resigning as conservator.
Thank you to everyone that brought it to our attention that conservatorship is a different journey entirely.
Let us know how the transition goes.
Be prepared for the tantrums that will be used to try and guilt you for ensuring that he is getting the care he needs.
Learn to say, I am not going to be treated that way, I am leaving now and will be back later. Later should be longer everytime he treats you ugly.
Don't get guilted by anything he says, you are doing the best you can and he is exactly where he needs to be. Remember that every time you feel bad about his situation.
Hugs! You did it!
Now that he will be cared for elsewhere, you have to set new boundaries. I noted that you really didn't have a good relationship with him prior to this, so I would limit my visits. Maybe once/week, just to ensure he's being cared for properly - helps makes you known to the staff too. If this would be/becomes too much, reduce it as needed. With dementia sometimes their personalities do change and might tone down given time, but no guarantees. Just do what you feel comfortable with and adjust as needed.
Just having that whole scenario off your back is such a relief! You won't have to provide care, you won't have to be concerned about repercussions, and he is in a place that is better equipped to help him.
Even if he continues his "good behavior", don't let it fool you to change your mind! He's in a safe place now, there he stays.
So happy for you!
I’ve been told two or three times that my comments are wrong on US law, always when the OP was being threatened unnecessarily. I have more respect for the US law than to expect stupidity in your law or your courts. I don’t regret questioning these threats of criminal action, and I do wonder why they are made.