He takes off his oxygen and gets confused and can’t breathe so calls 911. He’s been in the hospital with pneumonia twice in the last month. Hospital Dr let me make the medical decision and said I could send him to a nursing home but it changed when my dad refused. The Dr said he could go home and could make his own decisions. Now that he’s home he’s confused, weak and is found without his oxygen at times and calling for help. Idk what I can do next bc I’ve been told he’s allowed to say he wants to be home if he’s able to say it. Plus I feel bad for the many calls the EMS gets. I live an hour away, work and have a family so I can’t be there 24/7. Any suggestions?
The caregiver can monitor and make sure he is using his oxygen as well as do other household chores.
I would also put cameras in so that you can monitor him when he is alone and if you see that he is without oxygen you can call him and remind him.
Has he been diagnosed with dementia? if so that may be an "out" if he refuses to go to a Nursing Home.
Or next time have him sent to rehab first they will evaluate, help him gain strength and it may be that they will not recommend that he return home if he is going to be living alone.
If he is not competent, you may want to also consider a legal guardian which means he can be put in a nursing home even if he objects to it because of a court order. Psychiatric wards usually have a visiting justice, which can rule things like legal guardians.
I've personally seen when acceptance financially comes (after countless loops) to move to permanent care. Tears, sadness, grief 😞
Seen elders accepting permanent care as after-rehab option that was *sold* as 'respite until you are stronger/better'. (Just a teeny weeny little white lie).
Heard of stubborn elders locking out home visiting help so often it results in their demise.
Maybe time to have an honest chat with Dad. What does he really want as he ages? What does he value?
Or… do as others have and admit him on a “trial basis” and he will see how much better it is, hopefully.
Have a one button phone set up for him to dial you instead of 911.
You can see on camera his problem and have him put his oxygen back on.
Well, one morning I came in to work and found the fire dept there yet again and when I went over and asked them what he did this time, they said this was the last straw. He was occupying too much of their time and they were going to start charging him for the responses as well. This time, he had gotten up, pooped all over himself and the floor, fell in it, and smeared it all over himself and the floor. They told me they were going to report him to social services as not being able to care for himself anymore.
This worked out b/c his son told me they had tried to get him to go to a facility for years but, b/c he could speak for himself and wasn't technically 'crazy' (alz or dementia) they/judge couldn't force him. But now, the family finally had the ammo they needed to force him to go somewhere where he could get help and live.
My advise, get the first responders to file something with social services stating he is over using the service and can't care for himself anymore. It carries weight.
Good luck,
If your father is not mentally competent, then you will most likely be able to arrange for him to move to a residential facility.
If your father is adamant he stay home AND mentally competent to do so, it might be time to discuss with his doctor is hospice is an option. Hospice would provide the care and comfort he needs without trying to cure his disease processes. In most cases, the client must be considered terminal with a life expectancy of about 6 months. Most insurance will cover hospice - in a facility or at home.
Then you have the issue that many hospice providers require someone to be with the patient 24/7.
These really are no win, no solution situations when an ignorant hospitalist sticks their nose in and asks someone that doesn't have the mental wherewithal to keep there oxygen on if the want to go to a NH. It's kinda like asking a kid if they want a spanking, when was the last time you heard one answer yes?
Next - the next time he goes to the hospital advise them that he is an unsafe discharge and you will hold them responsible for anything that happens if he is discharged home.
He needs supervision and his doctor needs to realize it. Another idea is to take him to the doctor with his oxygen, have the oxygen removed and let the doctor see for himself the change in mental status and possible drop in his blood oxygen levels. Then push for him to receive care full time wherever is financially and medically best for him.
I once has an inpatient who was a former professional boxer. He had neck, throat surgery, a trach tube in his throat and was on oxygen. We always knew when his levels were low as he would stand up, put up his fists as though he were in the ring. We ended up putting around the clock nurses on him. One night at midnight I heard a sound no night nurse wants to hear. I RAN to his room, found the bed half way across it, his nurse on her knees gasping for breath. Yet she was still holding on to both of his hands. He had tried to pull out the breathing tube. When she grabbed his hands, he kicked her in the chest, sending the bed and her. (I grabbed him to allow her to curl up to breathe, and another nurse and I cleared his airway). After, with oxygen restored, he apologized as he knew he had 'done something to hurt someone'.
Low oxygen levels need immediate attention. Involve Elder Services.
If you don't have Medical and financial POA, get it ASAP.
Best of all in this very difficult situation.
Waterspirit (in the comments) is right and EMS will start charging for his calls if they are responding to so many non-emergencies.
My advice to you would be to not interfere. Let him keep calling 911, then let the state take over and place him in care facility.
The reason is that that they don't care, but the court battles for guardianship that rest on competence (as determined by an MD) can be ferocious, nasty, and expensive for all involved. Loss of wages due to repeated court appearances are a big reason MDs avoid this area.
A health care POA is either 'durable' -takes effect immediately OR 'springing' -takes effect when the person voluntarily gives up the responsibility of making decisions OR when a treating MD determines that the patient lacks capacity to understand complex information needed for decision making about health care choices.
He may qualify for a home health order, which would bring nursing staff to him at home to help him out a bit. They can assist and educate him so he's not calling 911 all the time.
APS can be very helpful in sorting out the muddle.
At that time she had just been argumentative but her memory was fine. doctors would ask her a few questions like her DOB, her age, her phone number, who the president was etc. Then they deem she was ok. On that visit the same thing happened. The doctor left the room and I excused myself and talked to him in the hospital hallway explaining what was happening and showing him notes she had written that various family members might be trying to poison her or stealing things. With that he said he would try to get her in the hospital. To get her in the nursing home we had to refuse to pick her up due to not being able to take care of her. After a 3 day stay we were able to get her to sign herself in to a nursing home which was supposed to be for 2 weeks but was for 6 years till her death.
These things happen, sad as they are, we have to sometimes do things that seem unfair and unpleasant. I hope this helps you in whatever decisions you have to make or have made already. God Bless.