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My sister who was 75, lived alone and was ready to be released from rehab. She told nurses and social workers that she had friends who would help her. She had an extra bed for them. Her friends are her age and older and not in good health. She figured that since they were retired, they could each move in a few days at a time. The "extra bed" was a blow-up mattress in the living room of her small one-bedroom apartment. The social worker called me to make sure that things were set up with her friends and I was shocked. I do not live in the same state and had spoken to nurses and social workers several times. Told them she did not have care at home, but they did not listen to me, only to her. She went to a nursing facility. She was not happy, but I am not sure what would have happened if she was delivered to her apartment and left there. Stand your ground.
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I'm sure all of this is extremely difficult for you. I don't know if the guidelines/laws vary from state to state but I thought hospitals and rehab facilities were not supposed to release someone to home if they are unable to care for themselves at home. I assume you have been working with the rehab facility social worker or case manager on all of this. I also am quite aware that they do release people like your dad anyway, particularly if the person can clearly state that they want to be released to home. I experienced this with my mother after multiple falls and trips to ER and urgent care. If you can get him to sign for you to have POA that would be a good and might be all you need to place him appropriately. The arrangements you made for placement with Medicaid payment sound perfect and I understand the whole process of applying and receiving Medicaid is quite difficult so you have really accomplished something.
I guess the next step would be to be granted guardianship which is also not easy. I ended up paying for an evaluation by a Neurologist/Psychiatrist to have someone of authority clearly state that my mother was incapacitated and unable to safely live on her own without 24 hour care due to early stage dementia as well as all of the physical and medical issues she had at age 97. What you report of your parent's incapacity and needs doesn't seem to matter much so the professional opinion seems to be important. I used an elder law attorney to help with the process but you can do it yourself. Do a search for Adult Guardianship on your county or city website and you should be able to find all of the forms etc that would need to be submitted. I know how exhausting the caregiving role can be and how emotionally difficult it is to get your parent to move to the safer care facility when it is not what they want. Good luck
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rawbar: An individual who is "covered in butt to heels in thick feces" should not be sent home.
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ConnieCaretaker May 2022
I've learned not to eat while reading this forum.
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Not so fast there..........how about you calling Adult Protective Services (APS) because he has no one to take responsibility for him. I believe they can do a 72hour psych eval and take responsibility for placing him in a Psychiatric hospital for his safety. If not, you take him to the ER right after he doses with morphine and leave him there.

Be sure to share a copy of this posting you made with the social worker. If you can get pictures of the crazy behavior(s), that will help the APS. You can also tell his doctor to revoke the no transport document or be held responsible for whatever happens in his home while unsupervised. Get tough and don't take no for an answer.
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rawbar May 2022
APS has been involved for months
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It isn’t true that no one can stop him from going home if he wants. They won’t send him home to unsafe living conditions. You need to make clear what his situation is and has been. Talk to his doctor and social workers.
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Maybe he should have been at a facility that was near me (now closed) they would have set him up with a company of their choosing before discharge
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Ugh--I once found my FIL sitting in his recliner, hip deep in fecal matter. As soon as I opened the front door, the smell hit me. DH was with me, but due to a major shoulder surgery, he was unable to help me lift of clean his father. He sat on the couch and gagged. GREAT SUPPORT!

It took a couple hours to get dad cleaned up. I was fairly new to CG and really didn't have the 'lingo' down. DH took dad out to eat(!) and I stayed behind and cleaned. Luckily there could have been a ton more poop, but it was still a huge job.

I had to throw away the recliner, and we bought him a new one that I covered in layers of chucks. The couch had been peed in, but I just cleaned that and the pile of blankets he slept on as a bed. Dad refused to wear real underwear, only thongs and he'd blow out those in 10 minutes. I was literally peeling them off of him and throwing them away, slowly replacing them with 'real' underwear.

The first time I had to deal with this I was taking some strong steps to get him placed. He refused outside help, except for me and SIL, who had been his primary CG for ages, but needed a break.

After the fact, I realized that his fecal matter was a source of bacteria that was actually dangerous to me. Luckily I glove up to the elbows, but I know his place was not 'clean'.

I made a ton of mistakes. My DH was on my case everyday to do a better job. I was also caring for my dad who had Parkinson's. Seemed many days like I was 'failing'.

Looking back, I should have stepped away and let his other son and daughter and DH take over. I was willing and stupid and this went on for months.

Only when his oncologist told him he could not go home, ever, did dad lose faith. He died 2 days after realizing he would not be able to die at home.

It's awful being the only voice of reason. Esp when it's NOT your relative and you are being treated like a serf. It took me years to overcome the feelings of being used by the family.

I'm MUCH tougher now and more aware of the ins and outs of elder care. IMHO, once you have someone who is having constant fecal accidents, then it's really time to evaluate the living situations. We waited too long with FIL. After his passing we had to throw out most of his furniture and replace all the flooring. He had really trashed the place due to feces being everywhere. And urine. My DH kept telling me how mean and selfish I was, but he never so much as put a load of stained undies in the wash.
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sp19690 May 2022
Your DH sounds like a real tool. I am surprised you never kicked him to the curb.
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Talk to case manager or social services where he is getting rehab. Seems he qualifies for skilled nursing care and should not be allowed to go home.
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Say that it's an unsafe discharge. He lives alone and you are unable to provide additional support that he needs. Do you have POA?
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Say that it's an unsafe discharge. He lives alone and you are unable to provide additional support that he needs. Do you have POA?
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Rob, Please just make him comfortable. He has lived, loved, laughed. I have watched four people pass and let me tell you I just let them be comfortable. He will soon forget that he smokes, he will stop hydrating, he will stop walking, stop opening his eyes. Just love him and let him be comfortable. My Mama was a chain smoker until two weeks before she died. She forgot how to smoke, that she loved coffee and she loved Judge Judy. My Daddy forgot how to tell stories, sing songs and eat his favorite food. My sister forgot how much she loved to run marathons and how much she loved her work. My grandmother forgot how to smoke and she loved to be right. So in all four I just made them comfortable. Keep them in your heart and just love them. Prayers for you and yours.
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"I'm told by hospice, hospital and rehab nobody can stop him from going home if that's what he wants."

That's not true. Hospital and rehab personnel will tell you anything to get you to take your loved one home and be your responsibility. If your father is not safe at home and doesn't have support, it's considered an "unsafe discharge" and hospitals and rehabilitation places (usually in NHs) are very much responsible. And THAT'S why they want YOU to take responsibility and take him home.

If you've found him "naked, crawling on the floor, covered in butt to heels in thick feces, it looked like a sewage truck exploded in his bathroom", then he is NOT safe to be at home. Period. Get together with the NH/Rehab facility's social worker and start discussing placement there.

If not, you will just be repeating this cycle again and again. Do you want to do that?
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Countrymouse Jun 2022
Unfortunately for the OP's peace of mind, I'm afraid it is true. The OP's father has been assessed and is considered to have mental capacity - to be able to make his own decisions. In which case, no one can legally prevent him from leaving and going home, because a person who has mental capacity thereby has the right to make even unwise decisions. Anyone else's judgement that he is not safe at home does not overrule this.

Every time a poster tells the OP to stop his father going home, to make the hospital staff or the social workers do this, that or the other to keep his father in care, that poster is making the OP feel responsible for decisions which are not his to make. He *can't.*

The decision is the father's. It is the father who is going to be repeating the cycle, and a very frustrating cycle it is. But it is NOT down to the OP.
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I think the OP has done everything that can possibly be done. Adult protective services has been involved for months. If Dad has been seen and evaluated by a geriatric psychiatrist, who has deemed him competent to make his own decisions, the medical facility will have no other legal choice that to let him go by signing out against medical advice (AMA); they are not prisons and cannot hold a person (even one found crawling naked through his own feces) against their will if the psychiatrist has ruled them competent. He can go home and burn the house down in two hours as long as he left AMA, the medical facility is clear as is his son, the OP. There are numerous cases where this happens everyday in every state.

The OP has a wife and two children and a job. He needs to do what a good parent would want him to at this stage of life. Having done his best to secure his Dad a safe and secure living situation, he needs to enjoy his marriage and his children. Not being God, he can do no more.

I wish him, his family and his Dad peace during this difficult time.
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Just figured I'd share a quick update. There have been no further arguments, issues, etc. He's been asking for stuff, I've been bringing it. He has energy, he is alert and is a completely different person. He says he's put on 25# (I'm sure he's put on weight but don't know about 25). His favorite movie is Top Gun (he is a USN Vet) and today I'm taking him to see the new movie. He was given a 4 hour pass and is just bringing his walker, no wheel chair.

So massive positive strides, though I'm sure because of that he is still thinking about going home. But I have not seen him this "human" in probably a decade, even before my mom passed. There is no way he would have left his house over the past few years to go to a movie and now he's looking forward to it. Without the 24/7 care he's been getting, he would immediately fall back into his old habits.

I live 2 blocks from him and over covid 2020, I re-did my back yard, put a fire pit and TV out there and made it wheelchair accessible thinking he'd really enjoy spending time there. 2 years later and I don't think he's ever seen it. I've seen him more in the past few weeks than I probably have in the past 6 months. I avoid going to his place like the plague. I can't take the smoke, darkness, dirtiness and depression. And he won't leave his place. I'd rather drive the 15 minutes to rehab. I hope he recognizes his quality of life has already taken a big move upwards.

I checked his answering machine messages and there was one on there from building management referring to discussing a letter they sent him. I have no idea what that was, I've been bringing him his mail and haven't been looking at it. Worst case would be it's a notice he has to be home by a certain date or give up his place. That could also be best case but since I'm the one who would have to arrange to have his place cleaned out, it's something I need to find out about.
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rawbar Jun 2022
As I figured, he mentioned today he was trying to get rid of a table and chairs to make more room to get around when he goes back home. Sigh ...
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Sounds like he could benefit from a psych evaluation and to get social worker and his primary care doctor and the doctor at the rehab involved. I can’t imagine the rehab therapists feel he is appropriate to go home. You now have documentation of the condition you found him in and together with a psych eval may be enough to convince a judge he is not competent to make health care decisions and that you should be appointed guardian.

Short of that, the other option would be for him to go home with 24 hour home health aides (private pay). Final option would be to look into a hospice care center…similar to a long-term care facility, but much more peaceful as the purpose is not rehabilitation so he would only get therapy if he requests it. He would get all the care he needs, including access to higher level of pain and anxiety medication to keep him comfortable. We went through hospice at home for my FIL and it was unpleasant as the aides can only stay for a week until he was closer to the end so all the daily care, including dealing with incontinence fell to the family. Not pleasant final memories to have of their husband, father. At a hospice center, you can focus of quality visits while he is kept comfortable and all his other needs are met. If he decides to stop eating, that is his right and they will not force him to do so. All that is required is a doctor to confirm he has a terminal disease with less than 6 months to live. Even if he lives longer, most hospital centers will extend his stay as long as a physician confirms he is still terminal. Do your due diligence and research/visit the hospice centers, but this has been the answer for many in similar situations.
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This is exactly what I went through with my Dad. Just switch out the word “smoking” with “chewing tobacco” and “drinking”! I had my Dad in Independent lIving and he just stopped taking is medicine, doing laundry, and keeping his apartment clean. He was hoarding with stuff other resident would discard into the trash room down the hallway.

He is now in a long-term care facility. They take care of him. He doesn’t have any opportunity to “hoard” like he was doing. So no bugs and stink like his apartment was. But I still feel guilty that he is there even though it is truly a blessing. If I had taken him back to his independent living apartment he would have been in the same of crap situation again within a week.

He is 78. He thinks he can live on his own but he can hardly walk without a walker. He stays in a wheel chair most of the time pushing himself around with his legs.

The guilt can be overwhelming at times but he has to have help. Not the retirement he thought he would have but he brought most of this onto himself through bad life choices.
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Quick update. Dad went home 6/17 and fell on 6/20. At that point he was immobile again in his chair, couldn't bear weight on anything. He wanted "2 or 3 days" to see if maybe it was just a sprain. on 6/23 I told him it's 3 days, it's time to go get x-rays. I had to bully him a bit because now he wanted "until Monday" but he went. It was very difficult moving him into a wheelchair, into a car, etc on my own but I didn't want his building management knowing he was out of his home again as they'd start the eviction clock. I was sick as a dog so would love to have just said sure, Monday and stayed in bed.

Broken hip. He's back in the hospital, he will be headed back to rehab and there is NFW he is going home again. He wasn't even home 72 hours, I didn't even have time to get all his hospice and other services in place since he went home on a Fri and Mon was a holiday.

When he left rehab, he actually wasn't doing bad with a walker, I didn't think he should ever have gone home but in my head I was giving it 2-3 months before he'd be back at the hospital, I definitely wasn't expecting 3 days.
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Llamalover47 Jun 2022
rawbar: Thank you for your update.
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