Father in law is in skilled care nursing home from a fall at home. Rehab staff recommends LTC upon DC and family agrees as just before his fall we were noticing several instances with dementia like behavior. He was never one to spend anytime with family so awareness of this by family was limited. On the surface he can carry on pleasant conversation and can recall recent events but is lacking in very many other areas to be independent and care for himself or make decisions. Awaiting to get a diagnosis as the mini mental exams do not capture all his deficits. He is Medicaid pending awaiting approval. My husband is his POA as we realized quickly that things were a mess recently after his fall. The skilled facility he is at states that upon his DC day they cannot keep him if he doesn’t want to stay, which of course he will say because naturally wants to return home but has no insight to his inability to walk and care for himself. No one in family are able to take him in to their home and that has been made clear to social services. We and rest of family are extremely distressed when DC day comes what will happen and he wants to leave. He of course has been very difficult and argumentative as we have tried not to upset him but plan accordingly for his best interest. We are extremely stressed dealing with all his affairs. And concerned that facility will dump him on us to care for if he states he doesn’t want to stay. Can they do that? Especially since he has not been diagnosed with dementia officially. He hasn’t been able to be assessed by a neurologist. Soonest appointment is made for September.
Point out to discharge staff that it would be an "unsafe discharge". They are obliged to get a plan in place. YOU are not the plan
You are under no obligation to provide care or housing.
Don’t discuss this with him, just do it. If you need to tell him that he needs “an assessment” before deciding the kind of help he needs, tell him that, without getting into specifics about his behaviors.
As stated by others, all family members must be on the same page that no one can take him home. At worst case, you will need to have an aide with him 24/7 in his previous housing until you can get a documented report indicating that he’s incapable of managing for himself.
If the assessment has been scheduled, be like water on stone- say you cannot plan appropriately for him until it is done, prepare a list of the questionable behaviors you have observed, determine objectively what would be needed to make his house safe for him.
You stress is totally understandable, but the fact is that HIS WELFARE depends on full time care, so therefore his future depends on being declared cognitively incompetent.
Final thought- you need to accept the fact that there will be no good, successful, comfortable solution for himself or for you. Dementia is a capricious, vicious, brutal enemy, forcing us all to make choices from the best of the terrible solutions.
Good Luck.
Find a facility I was comfortable with and explained that this is a rehab hospital and when you can do ABC and three of your doctors release you then you can go home. Mine accepted that after a bit of a fuss, but it worked.
He is really unhappy about it but we are hopeful that he will accept this new normal eventually. He also was not doing well at home but the extent of his decline wasn't apparent until he went into the hospital.
Does he have a car at the facility? Take it away and/or immobilize the car so it won't run. I'm not a mechanic, but I'm sure there are at least a few ways to render a car undriveable; disconnecting the battery or removing all the gas are a few examples. Of course, tell the facility that you cannot take him in, he cannot safely take care of himself alone at home, and that you and your family don't have the ability to take care of him and all his needs in your home.
I'm so sorry you're having to deal with this situation in these troubling times; it's a difficult scenario to begin with, but with the pandemic added into the mix, it sure is even More Stressful!!
they wanted him “out of there”.
I wish I had known this group then.
They kept telling us what HAD to happen. It was like having drill sergeants on all sides and was VERY difficult to fight back during the high stress time.
Please get with family and try to discuss dad sanely ( away from the furor) and do what is right.
These people are NOT family.
Please let us know how you were able to deal with this terrible situation.
We just are keeping fingers crossed trying to keep him calm and willing to stay until Medicaid approved then we are looking into a facility that will take him long term and allows residents to smoke in monitored specific area as this seems to be, for the last 40 years, his favorite social activity. We keep holding the card of there is no safe DC plan in place but if he is adamant and walks out ( which he can’t. His main form of mobility is the WC). I feel like facility is so bent on protecting his rights to leave despite also seeing clearly that he is unable to care for himself. I wish they would work with us not against us. So confusing and stressful for us. Oh and regarding his car. He does not have it. He totaled it when he drove off the road when he became disoriented and didn’t know where he was. He was less than a mike from house but got confused when attempting to return home and was about 7 miles from home when it became stuck running off road. We were just beginning to add things up and see the problems when he fell and this journey began. Again thank you so much!