My dad is almost 79. He has Chronic COPD, on oxygen 24/7, Congestive Heart Failure, Obese, and several other major medical issues. His living conditions are not good. He lives in a camp trailer that doesn’t have a working hot water heater, very dirty (because he just throws things in the ground and doesn’t care), a bed smaller than a twin (my dad is a heavy-set man), doesn’t use his shower, hard of hearing, etc. Before anyone bashes me about his living condition, I tried to move him into one of my 1-bedroom apartments, and he REFUSED! He cannot live with me or government subsidies due to being a convicted offender. EVERYONE in the family feels he needs the 24/7 care. He keeps saying he wants to go home and is going to sign himself out of the skilled nursing. I have power of attorney but only kicks in when he cannot make decisions for himself. He is in and out of the hospital regularly due to breathing or swelling from excess fluid. The family that helps me with him and I all live 30+ minutes away from him so checking on him daily is not an option. He is hard of hearing and can’t hear his phone ring.
I am just struggling with figuring how to get him to understand that he needs daily help!! I cannot afford the cost of assisted living in California (it’s more than the mortgage on my house per month) & IHSS is not really an option because of his living condition.
It sounds like your situation is much worse. If you call Department of Social services, they will send a social worker out they come out to check his living conditions. If you don't want to take that route, you can call the sheriff's department and the sheriff and a medical social worker will come out. If they feel that he's a danger to himself, they may be able to take him to the hospital and evaluate him. It's called an involuntary commitment. Just call the non-emergency number at the Sheriff's Department and they can explain how it works. You have to really push the fact that he's a danger to himself to get them out there. Just remember, they're probably going to take him against his will if they think he's a danger to himself or others. Once he's in the hospital, then the medical social worker in the hospital can take over. If he's not assigned a social worker who works at the hospital, then you have to push the issue by asking for the medical social worker and tell that person he can't go back to his house because it's not safe and you can't take care of him either. This could start the process of getting him in a nursing home since he can't go back to his house.
What you can do is to stop enabling him in avoiding the truth, report him to APS, let them open a case and discuss with him. Make it clear to APS that you cannot care for your father physically, mentally, as a caregiver, or financially.
The hardest thing we heard from doctors - over and over - with my FIL - was that regardless of how stupid or ill-advised his choices were (and believe me there were some doozies) he was still allowed to make his own choices as long as he was considered competent and of sound mind.
We knew he was starting to slip cognitively - but he wasn't nearly far enough down the road for a doctor to declare him incompetent.
Now that being said- you have concerns - you have a vulnerable elderly man who refuses help, and is living in unacceptable conditions. You can call for help - be it APS or the sheriff's department for a welfare check. But don't hold your breath on anyone forcing him to do anything.
Then there's the problem of him affording facility care. Your Dad is in very poor health. If you can also get his doctor to recommend him for LTC, this is covered by Medicaid as long as he also qualifies financially.
A more extreme solution is for you to resign your PoA and report him to APS as a vulnerable adult. The courts will eventually assign him a 3rd party legal guardian who will then act as his representative. He will then be transitioned into a facility, at the state's expense. You won't have to manage anything for him anymore. This option is not as bad as it sounds. It was a blessing for my SFIL who had Parkinsons and was dead broke.