This is something I just realized. I'm new to this. My Dad is 74 and recovering from a ski accident/broken neck in a Rehab hospital. I've talked to two Social/Case Workers. The 2nd one asked me right away if/when he leaves the facility he is in now if he can live with me or my brother. Then I realized I'd already been asked that by the first social worker I came into contact with in the hospital at the beginning of all this.
This explains why we 'sudden caregivers' get wayyy in over our heads. In my case my brother's house is really messy, I live in a 695sq ft 1br condo with a flight of steps and my Dad has the best house out of all of us, a 3 bedroom.
Initially I can see saying 'yes of course' he can live with me because by all means I want to help and 'make it better', or I will move in with him etc. Which gets the institutions off the hook. But wait don't we pay taxes and ungodly insurance premiums all our lives so these institutions can step in and help when we need it? (Another rant for another time).
But when you say 'yes I'll live with them/they can live with me' honestly I have no idea what I'm getting into. I work in accounting, know nothing of the caregiving world, what's involved how exhausting it is. But sure, I'll sign up he needs help, right???
Anyway just some thoughts and an observation of what the institutions think the solution is to this problem. Pay in your whole life and when you need help, dump it on the untrained unprepared family.
So tomorrow bright and early you call the Nurse Manager and the Social Worker in charge of Dad's care. You tell her this:
"Gee, I am so sorry, but I had never considered caring for my Dad in my home, and on a phone call I got it kind of sprung on me, and I answered yes. Now I need to tell you there are utterly NO CIRCUMSTANCES under which I could care for my Dad in his home. So now we need to get together on placing Dad for his own safety into in= facility rehab and then assess as we go as to whether Dad can go back home, or must go to Assisted Living or some other level of care; I depend upon you to find the best placement you can during this discharge planning period. Sorry I misled you; Dad was always so vital and off skiing and I just never thought about this before."
You can see it will do not good to tell US you can't do this. I couldn't either; not for a single second. You must tell THEM so they can begin planning for his rehab and deciding what level of care he needs.
Now, as to his care. Whatever insurance, then assets your Dad has will go to pay his expenses for his care until those assets are gone. If he has a wife there will need to be division of their assets so that Dad will have his own portion to spend without robbing all of MOM'S money. If Dad owns a home the home will not have to be sold for his care unless that's how he wishes to do it (or his POA if he has dementia and has a POA). There will be "clawback" by the government to pay for Dad's care after his death should he need now to enter care ( when/if the home is sold.) That is to say the home will have a lien on it. Other than that, the POA or the state if they have guardianship will apply for medicaid. The taxpayer will pay. Yes. That is what the taxpayer picks up, the care costs for those who have run out of their own savings.
As to what we pay taxes for???? I was an RN all my life and made quite good money and was proud and happy to pay my taxes. When I retired early at age 62 I began to collect Social Security. I am now 80. While I paid a whole lot of taxes, guess what, the Government in these last many many years has repaid me all of that and MORE. So figure it out. I am now using YOUR tax money, as well.
My Dad has a saying about taxes and insurance. It was "Let me pay a whole lot of taxes and let me get a whole lot of insurance, and let me hope someone ELSE needs it and I stay healthy and without any monitary help for my needs". I feel the same.
I doubt they called you to DUMP (as you say) Dad. I think more they wanted to sincerely know if you were that rare one with the courage to attempt to take on elder care with in home rehab, with the WISH to do so.
You aren't.
That's just fine. Either am I. I loved nursing, but doing it 24/7? Nope.
So on you go now.
Get in touch with Social Worker and Nurse Manager and Discharge Planner and lay down the law as to what you will not do.
They will ask you who is POA and who is familiar with Dad's finances if he cannot discuss that himself, so they can get him the very best care his money can buy. Do know that he will have at least 20 days of rehab at medicare cost to get his ADLs and mobility going. Time will tell.
I wish you the best, and your Dad as well. Hope he recovers well and is soon back on his feet. Sounds like he was real active if this was a ski accident. A month of rehab and he may be right back at his near normal level. I sure hope so.
He sounds like a fit guy, used to being independent. That to me is the biggest red flag. To go from that to being suddenly dependant on his daughter, for care, to get home (or live at yours) would be a major transition with much potential to damage your relationship.
You summed up the discharge plan well.
'Supportive family' can mean the discharge planner adds a tick & goes home early. Job done.
Just consider it's not black & white. It's not this: Helping Dad = live with him or Don't live with him = not helping/caring. Not at all.
There are MANY ways to help & care.
Asking what Dad wants, being emotional support while he adjusts to his new situation, being supportive, cheering on his recovery.
Standing up for a safe discharge plan is an excellent role to take.
Being his advocate. (Or you could say, being his daughter, not his nurse).
Your dad's situation is unique, in that he is in this position in a different state from which he lives.
I would speak with the social worker and enlist their experience in getting him transferred to a facility in his home town. Other decisions can come later. He is still a long ways from being released.
Best of luck, this is a challenge for the best prepared person.
Don't let brother off the hook, either. Daughters don't have to always be the ones who are the responsible ones! Brother apparently has no intention of disrupting HIS life, so don't you disrupt yours, either.
What is your father's prognosis?
Some folks would be mortally offended at the idea of sending their parent to a facility. To avoid getting off on a bad foot, SW asks if family will be the plan of care.
Agreed though, I want to be the daughter, not the caregiver. That's what he wants too. The logistics and understaffing due to Covid will be a bit of a challenge I would guess.
Usually there is a "care plan" meeting prior to discharge. Basically, someone has to step to the plate and assure the hospital/facility of a safe discharge. The PCP can write a script for VNA services. In my case I asked the doc to send in the troupes. By that I mean, physical therapist, occupational therapist, nurse, home blood draw, etc. Whatever your dad's coverage offers.
I found the aluminum gray walkers given out upon discharge make the patient all hunched over, eyes to the ground, poor posture and breathing as well as sore wrists after a while. One the crutches, etc. are put away I would check with p/t about an UpWalker Lite or something similar. You can check out Amazon but have a paper trail (scrip from the PCP) so insurance will cover this.
Everything needs to be modified (the dwelling) before discharge. Your dad is probably going to want a "male" wash him, a CNA. A shower chair, commode, all of this is covered under the health insurance, you must have a scrip so everything will be covered.
A hospital bed chosen by the p/t or PCP may be needed. Again should be covered by insurance--you need a paper trail. Make sure you have help in hand and that if for some reason brother doesn't keep his word (like in my case) you're not stuck without help. This does happen. Don't be shy and refuse any services that are offered by the insurance.
A lot of this caregiving is knowing the person well and learning along the way, books, this blog, etc. You can put a camera on the door and a text will come up on your phone should something happen. Your phone/internet provider can install this for about $20 per month plus installation.
Shower bars can be installed, again medical insurance should cover the bars. If your dad is a Veteran, services may be available.
You'll learn along the way...The fact that you are on this blog shows you are quite capable!