Needs more help that I can give. What options do I have?

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Needs more help that I can give. What options do I have?

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My father had a massive stroke that caused him not to speak and have mental issues. I have Conservatorship over him and after his hospital stay from the stroke he was admitted to rehab. The rehab had wanted to transfer him to nursing home care but I thought I could take care of him. I was wrong. He needs way more help then I can give him. I wasn’t aware he had mental issues until last month. He’s put feces on my wall, floor, etc.. He plays with it. He uses the bathroom on himself. He can take short walking distance. He can’t talk. His right hand is really weak and doesn’t really use it. He exposes himself naked to my children and gets agitated. He was hospitalized in October for pneumonia and fluid around his heart. He was hospitalized in November for colon infection and fluid around his heart again. I explained to his caseworker he needed long term care because I’m not able to take care of him. Plus his doctor ordered him to go to skilled rehab from the hospital. Is what was discussed. Now His case manager waits a week later to tell me he was denied skilled rehab from his insurance (Medicaid). She said he can get in-home care but he doesn’t have a home. He temporarily lives with me and I can’t bring him back to my home. I’m not understanding because my father can’t do anything for himself at least that’s what he acts like. He doesn’t even think to take a bath unless you tell him to. His doctor said he has early stage of dementia and that’s why he’s been acted the way he’s been acting. I don’t feel like he’s safe at my home. It’s only a matter of time he gets agitated and go in the kitchen and mess with my oven or walk outside and try to leave. He needs 24 hour care that I can’t give. I have to go back to work and I have young babies. She said once he’s ready to be discharged if I don’t get him I can be charged with abandonment. What are my options if the doctor is saying he needs long term care?

Activities of Daily Living Care Decisions Mild Dementia Stroke

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Yahoo, I am so happy for you.

If he can sign I would have him do it. Anything that he can do he should be doing.

You always want to sign his name and then yours as POA. If you even have to sign, which I don't think you do if he can. I made my dad sign everything with a simple explanation of what he was signing, if he refused I signed his name and mine as POA.

Well done! Great big high five!

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I’m writing again about the ‘abandonment’ issue. I looked up Worried’s citation https://elder.findlaw.com/elder-abuse/elder-abandonment.html. The first thing is that it’s a trade site encouraging you to go to lawyers. The second thing is that it’s fairly vague. It says “Elder abandonment is generally defined as the purposeful and permanent desertion of an elderly person. The victim may be left at a hospital, a nursing home, or in a public location.” We have similar legislation about dropping off unwanted kittens. This is a very different situation from OP’s.

I’ve been told two or three times that my comments are wrong on US law, always when the OP was being threatened unnecessarily. I have more respect for the US law than to expect stupidity in your law or your courts. I don’t regret questioning these threats of criminal action, and I do wonder why they are made.

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I’m ecstatic for your outcome and I hope you have your home life back to happy and healthy for you and your children’s sake. I learned an awful lot while reading this.

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Chacaretoomuch8 - HOORAY!!!!

Now that he will be cared for elsewhere, you have to set new boundaries. I noted that you really didn't have a good relationship with him prior to this, so I would limit my visits. Maybe once/week, just to ensure he's being cared for properly - helps makes you known to the staff too. If this would be/becomes too much, reduce it as needed. With dementia sometimes their personalities do change and might tone down given time, but no guarantees. Just do what you feel comfortable with and adjust as needed.

Just having that whole scenario off your back is such a relief! You won't have to provide care, you won't have to be concerned about repercussions, and he is in a place that is better equipped to help him.

Even if he continues his "good behavior", don't let it fool you to change your mind! He's in a safe place now, there he stays.

So happy for you!

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Thank you!! You’re so right.. He’s finally going today to a nursing home.. After he was approved for long term care it still was a little process after but I managed to take care of it and found a nursing home that’s going to take him.. I’ll take your advice and do once or twice a week for now.. It’s been so stressful with all this.. I learned that love for someone that needs 24/7 care isn’t going to be enough.. I thought I could take care of him. I tried and it just didn’t work.. Now he can go to a long term care and hopefully we can build a relationship that way.. I don’t know.. But on the admission application do I sign my name with POA because I’m not trying to responsible for his care even though Medicaid is paying.

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Well done!

Be prepared for the tantrums that will be used to try and guilt you for ensuring that he is getting the care he needs.

Learn to say, I am not going to be treated that way, I am leaving now and will be back later. Later should be longer everytime he treats you ugly.

Don't get guilted by anything he says, you are doing the best you can and he is exactly where he needs to be. Remember that every time you feel bad about his situation.

Hugs! You did it!

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Update**** Thank you all who told me to stand my ground and protect myself and my children. He was approved for long term care... He’s going to a long term care of my choice from the hospital. Now my father can get the help he actually needs. In the hospital, my father was there for over a week and he never put feces on their wall or floor. He doesn’t even act out as he did in my house. The nurses said he was sweet at the hospital. Every time I visited he pointed at the door and wanted to go home. I had told him he was going to rehab once he leaves the hospital. He rolled his eyes and turned the other way. He wasted no time soon as I walked in the room to start pointing to things he wanted me to do.. His nurse literally had walked out the room but he wanted me to do it. I really think he’s been on his best behavior at the hospital because he thinks he can come home. It’s like was he intentionally doing that at my house for attention? The feces on my wall and floor multiple times a day. The walking around naked in front of my kids. The yelling in my face. I literally was cleaning up feces two or three times a day and he wears a diaper.. Smh anywho, I’m glad I can finally get my peace back and despite how he’s treated me. I was no good for my father being a burn out care giver.. He went from the emergency room to long term care.. Thank you all once again. Your replies helped me a lot!!!

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That’s fantastic that he was approved for LTC! Great news! So happy for you.

Let us know how the transition goes.

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I think that everyone that is saying that you can not be charged should read all answers and information provided. Being conservator changes everything, it is a different level of responsibility than most of us have as POAs or just relatives.

Please everyone read what is happening with this situation and the realities that she is facing. Counseling that she can't be charged, when in fact she could only causes confusion.

She has options, but abandoning him because she says unsafe discharge is not one of them. It sounds like the doctor is finally getting through to the social worker that he requires rehab and LTC. She is also going to check into resigning as conservator.

Thank you to everyone that brought it to our attention that conservatorship is a different journey entirely.

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I would consult an attorney then to be absolutely sure if I were OP. I still can't fathom the hospital releasing him to that environment. I could envision repeatedly calling 911 if he were back at home (if I were OP). But I would pay for a good local elder law specialist to help me in this case.

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I was in exactly the same position that you are.
I am my Mom’s guardian and she was being discharged from our local emergency room. However, I knew that she needed more help than I could provide, especially because of her combative behavior. When I refused to accept Mom back into my home, the Hospitalist threatened me by saying that I would be charged with abandonment.
I telephonically checked with The Alzheimer’s Association and was told that I could indeed be charged with abandonment. Their advice was that the next time Mom required hospitalization I should try a larger regional hospital, which is a little more distant but has a Geriatric Psychiatrist and more resources. I did and they ultimately helped me to get her placed in Memory Care.
Note: I don’t want to make this seem like an easy fix. Before getting this help, I knocked on many, many doors! At various times, I have called the police (who refuse to deal with people with dementia because they don’t see it as a criminal matter), our Community Service Board (that deals with people with mental issues, but NOT dementia), Adult Protective Services, the Agency in Aging, and several Assisted Living facilities. I was shocked at how unhelpful these places were and believe that people with dementia are being denied their human rights! Nevertheless, what I have learned is that you may need to knock on many, many doors before one opens for you (and your ailing loved one). Just don’t give up because you are their only advocate!

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I would steadfastly refuse the social worker and call the bluff on abandonment charges. To me, its an unsafe discharge. I'd be prepared to fight, contacting any news agency and would be prepared to go to court if necessary if I felt I couldn't adequately take care of my family member at home without sufficient support. I went through a similar experience, but the hospital was terrific and did all they could to help and find placement and a safe place. That is what they are ethically supposed to do.

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This is way OUT OF CONTROL for any ordinary non-medically trained person. You must tell his doctor what you have said here.

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Does he need skilled nursing care? It sounds like he might be a candidate for Memory Care rather than a skilled nursing facility.

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Please talk to social worker. Explain everything you have in this message. Tell her that you can not take care of him and he needs nursing home placement. Social work can help you with options based on his income. Keep them working on it until you have a placement for him. Be persistent, be firm, and get dad into the kind of care he needs.

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If you have only told them that you cannot take care of him, you need to tell them EXACTLY what you have told us - all of it. Just saying you can't care for him, they are not seeing the whole picture. Feces on the floor, walls, cabinets, etc multiple times/day. Threatening you. Exposing himself to the children and frightening them. Endangering all of you. Who cares if you air the dirty laundry? Better that than taking him back into your home!

If you have told them all of this, then SHAME on HER, not you, for even thinking this would work. If she is that dense, you need to elevate this to her supervisor. It helps to get the doctors and everyone else on board, but this chick needs a reality slap. Even the recurrent hospitalizations and the reasons for them would tell me that he needs skilled nursing care, not what a working young mom can provide!!!

This isn't just about taking care of him (which is ridiculous, even with the minimal home care they are offering, given his needs, both physical and mental.) It's about the danger he is to you and your family.

It's also a shame that you have to spend your hard-earned money to pay for him. Being conservator would mean you manage his funds and pay his bills from those funds, not that you have to pay his debts from your own money.

That said, definitely continue pushing back on this SW or CM... Meanwhile, it would be worth spending your own money on a good elder care attorney. Unfortunately you are in one of the filial law states - according to Wikipedia, most states have not really enforced these laws, BUT more are expected to due to the amount of people who need/use Medicaid. While it is a Federal program, states have their own rules and as noted some may try to enforce children to pay for their parents.

You might be able to check with multiple EC attorneys if they offer a free initial consult. Have your questions ready/written up before, to make best use of the time, and take notes. Ask about qualifying for Medicaid NH care (why was he declined?) Ask about giving up the conservatorship. Ask if there is any concern about charges (personally I think that is ludicrous, but I'm not an attorney and don't know the laws - it sounds more like a scare tactic.) Ask about Baker Act. Call ombudsman. Call your senators and representatives. Bang on any/every door you can! There has to be help out there for cases like this. Medicaid generally allows a spouse to retain some income and assets, they shouldn't be forcing a child to give up what they earn to provide for their own family!

BTW, if he has early dementia (sounds like it, could be due to the stroke), he is quite likely "show-timing". Basically what that means is he can muster up enough to "behave" and "do what they ask" while he is there, but at home, the charade stops. Many people can even pass the mini exam doctors will do in their office. Because they don't see the person for long and don't observe this behavior, and the person 'passes' the test, they are clueless!

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Before I read all of the other responses, NO, the nurse does not know what she is talking about. You cannot be charged with abandonment. You can't do it. The SW/CM HAS to find alternative arrangements.

Does your father have Medicare? If he has Medicare, rehab is considered skilled care and is paid by Medicare up to 100 days, possibly longer with exceptions, i.e. significant progress that will take longer.

If he will need LTC custodial nursing home care after rehab, the facility business office will apply for Medicaid Nursing Home; it's separate from regular Medicaid.

If he does not have Medicare, then everything has to be done through Medicaid and it's harder, but definitely NOT impossible. Again, the SW from the hospital will have to figure this out when you tell them NO, he canNOT come to your home. No law says he has to. Do NOT let them guilt you into it.

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Medicare won’t pay up to 100 days at 100% and people here keep failing to mention that. Only the first 21 days are fully covered by Medicare.

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Immediately, get a list of his meds before he goes anywhere. Hospitals and NHs put patients on strong anti-anxiety drugs like atavan or worse, Seroquel. Make them stop. Often, dementia patients aren't helped eat or drink, and dehydration can make dementia worse. My husband was in the same mental shape described, incontinent and on a feeding tube, bedridden with Vascular Dementia, but I insisted he come home to me as I could take better care of him than the NH. I can and do, now just short of two years. They sent him home on 17 medications, including Seroquel and Lexapro. Thanks to a bit of time on the internet, I slowly eliminated the Seroquel and all but three meds: Plavix, a prostate drug, and baby aspirin. Much of the bad behavior is gone and the dementia is tolerable for both of us. Months later after stopping the Seroquel, I came across a medical paper describing some success with an Alzheimer's drug in Vascular Dementia patients WITHOUT Alzheimer's. Works beautifully, visual and auditory hallucinations are mostly gone, except when he's very tired. We can now sit and watch a tv show, hold hands, and have small conversations. No more poop on the walls or torn catheters! I miss who he was terribly but I am (mostly) happy and proud to care for him as long as necessary. He's 84; I'm 75. Good luck with whatever you decide, and lots of hugs.

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Just curious , what drug was this? My mom experiences hallucinations too and is up through the night loudly talking.

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I would contact every single aging professional and agency you can find. You may also have to get an eldercare attorney involved. You can have a doctor state that YOU are UNABLE to care for him, it would harm you, you can't physically handle, etc. WHATEVER YOU DO, THIS MAN MUST BE REMOVED FROM YOUR HOME AT ONCE - NO MATTER WHAT IT TAKES. I don't know all the answers but there has to be help for cases like this. He cannot stay with you - no matter what anyone says.

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Thank you! I will do that.

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If I understand the scenario, I think you are saying you took him to live with you - but not to your home. It may be that you broke the sequence of events that could have been put in place had you left him at a rehab facility.
What you may need to do is take him back to the hospital via the emergency room or by taking him to his doctor. It is much easier to leave a hospital setting to transfer to rehab or nursing home than it is to go from home to facility.
You say he's on medicaid - which is different from medicare - so, based on that statement, many nursing homes have medicaid beds. You just need to find one that has an empty bed. The doctor may also have some input to help you find one. Many doctors are in partners with facilities.
Start with the doctor to ensure the paperwork reflects the need for nursing home instead of rehab.

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He’s not in a rehab facility. He’s at the hospital and his doctor ordered him to go to rehab and haven’t discharged him but his social worker is saying she could get me for abandonment even though he’s not discharged yet and I’m In contact with his doctor plus still visiting him at the hospital.. She doesn’t want him to go rehab she wants him to do in home care is what I’m gathering. Although I told her it would be a unsafe discharge because I can’t give him the 24 hr care that he needs. He needs professional care that I’m not trained in. So she’s making threats..

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For your children's sake you need to get him out of the home and into a nursing facility.

You could call the cops and get him Baker acted and have a full psych evaluation if you think he is a danger to himself or others. maybe his behavior will improve with the right meds? Who knows. if he's deemed incompetent the psych ward will work toward discharge to nursing home.

If this behavior is new need to rule out possibility of infection like UTI or blood infection, or pneumonia. Infection can cause very unruly behavior.

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There are nursing homes that accept medicare so if dad runs out of money they won’t throw him out. Tell the social worker you are unable to care for dad and she needs to place him in one such place. As others said Dept of Aging can be a great resource.

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Medicare only pays for outpatient rehab and they have to be in the hospital for 4 days. further they have to show improvement or they will be discharged

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Neither Medicare nor Medicaid will pay for long term care after
medical discharge from hospital or rehab.
We are own when it comes to paying for long term help.

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I don't believe that is correct. There are posters here who have a parent in a NH facility that is paid for by Medicaid. There are facilities that take patients with Medicaid pending. The parent is not expected to be released from said facility.

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Do not sign the financial paperwork at the care facility. Seek legal advice. The lawyers can maneuver his money/social security/insurance to last his lifetime. If you sign over his income to facility he will run out of money and get kicked out. Free hour consultation with an Elder Law attorney is very helpful. Make sure your atty is certified in this area (medicaid/medicare/trust funds/ annuities)

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You can find a certified elder law attorney at www.nelf.org.

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Consider calling adult protective If you can’t get LO placed. Prayers being sent .
I believe The message from thepianist is on target regarding financial.

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Talk to a Social Worke rin This Facility and also Call ADULT PROTECTIVE SERVICES to Intervene. Dad is Allowed 21 Days of help on his Medicare and Then, Though they will Cut That Off because of the Time Factor, maybe something then can be Done, hun..Keep on it.

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Instead of being threatened by the hospital social worker, contact your Dept. of Aging and report your father's situation and explain that you need their help to get your father into long term care because the hospital seems unable to do this. Contact everyone you can: your county ombudsman, Dept. of Health, etc. The hospital has an obligation to ensure that your father will be safe when discharged, but they are too under-staffed to take care of this.

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PS: being conservator or guardian does not usually mean that you have a legal obligation to spend your own money to care for your father. But if you have spent his money for either his care or for your own expenses, you need documentation for all that you spent and if not you may be liable to repay whatever was used for yourself beyond that the court thinks is reasonable, including gifts your father might have made.

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I don’t know the fine print about conservator responsibilities, but I have real doubts about whether you could be charged with abandonment in the circumstances you are describing. Next time she says it, ask her to give it to you in writing on letterhead. If she won’t, tell her that you don’t believe it, she is threatening you. Threatening to accuse someone of a crime if they don’t do something, is usually within the crime of blackmail.

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I am not intending to be rude but the OP is in the United States and you are not. I hate to break it to you and the OP but.....under Tennessee law,
a conservator of an adult is legally responsible for providing supervision, protection and assistance. It her legal duty to make sure her dad has proper care. So yes, the social worker is right. Elder abandonment in this country and the state of TN is when a person who has assumed responsibility for an elder deserts that individual. The OP needs to get her dad in to a nursing home. It’s her responsibility. Conservatorship in this country is something you obtain through the court and it is no joke. She is legally responsible for her dad.

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It sounds like they are starting to listen to the doctor.

I would be asking how you get him placed as conservator if you can be held responsible as tacy22 indicates then you have the authority to place him.

I would also be finding out how to get out of being his conservator if you can't get any help to get him placed in care.

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You’re so right! I’m definitely going to look into stepping down from being his conservator.

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You need to go to Medicaid. I would not count on the caseworker to do her job completely. Were you asked for bank statements plus financial info? There's other things needed too. If Dads income is under the Medicaid cap and he should have no problem getting Medicaid for LTC. Get his case# from the caseworker. Call Medicaid and find out why Dad was denied. There is an appeal process. Medicaid should be able to find Dad by his SS# too. It could be caseworker didn't get info to Medicaid in time.

You need to explain to the caseworker that your children are scared of your father. That he has gotten close to hitting you in front of them. Tell her that homecare will not be enough. You have to work and have 2 small children to care for. You are afraid of him and will not take him back in your home. Conservatorship is just to handle his money, correct? U don't have POA? Even if you do, you can not afford to care for this man. Tell them the state will need to be his guardian. If they call APS. When they talk to ur son, I think they would be on ur side.

Your son saying something to the teacher may be a good thing. If CPS got involved pretty sure Dad would be taken out of the house so the children would be with their mother. This is one of those "no good deed goes unpunished". The people u owe anything to is your children. Have u talked to sons teacher just to see if there has been a problem in school. Like, his grades have come down or he has a hard time keeping his mind on things. If she has seen a difference, had her write a letter to that effect on School letterhead.

Good Luck and come back and update us using this thread.

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CPS doesn’t take adults out of homes Joann. They wouldn’t take dad out of the home. If anything, they would take the child out of the home.

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I think that I would be calling the social worker's supervisor.

You have vulnerable children in the house and he is a danger to them. Your home is not a safe discharge plan, period. Repeat as needed.

I would put a letter together that has the doctors recommendations for long term care, that you can not safely care for him in your home and that he is a threat to your children's wellbeing and say that you have been threatened by the social worker and you will not be taking him into your home and that you will hold the hospital and social worker responsible for releasing him against doctors orders. Give a copy to everyone involved in his care, to the social worker and their supervisor and maybe their supervisor.

You don't have to take him back into your home.

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Great advice 👍

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Caregiving ruined my life and my relationship with my mom. Never had a good relationship with my brothers and this only made it worse. Now no relationship with anyone and I am the one in therapy because they are perfect and smarter than God. To hear my brother twist scripture always made me sick to my stomach.

I hate when people use God to hurt people. I am a believer but I feel atheists who are good moral people are better than hypocrites. Even Jesus Christ despised hypocrites.

I don’t think any less of non believers. If my only example of a Christian would be my my brother and those like him I would never be a believer. Fortunately, there are wonderful Christians who don’t behave anything like my brother.

Sorry for the rant. Having a very bad day. Went for my check up at the doctor and she ordered more lab work. Grrrrrr. I took such good care of my mom that I suffer emotionally and physically.

I am paying a hefty price for sacrificing everything for a woman that turned on me like a snake along with my brothers. Honestly, no amount of money is worth it!

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Oh I understand, I don’t speak with my siblings anymore. Although, my father wasn’t there for us(His 4 kids) growing up not even when we was adults.. But I felt like he had a decent relationship with my sister and brother as they was grown. He would do things for them. I felt like he only called me when he wanted money or me to pay for something. When he was healthy and in his right mind I had helped him out with his bills and he started making it a habit and one day I told him I can’t pay your books anymore I got my own.. Plus that’s the only time you call me. He got mad and stopped talking to me for a month. Didn’t even call to say happy bday!! I guess I always held on to one day I’d have that daddy and daughter relationship that I always wanted not realizing it was never worth it. So I don’t think he genuinely ever cared for me. But when he had got sick I had tried to step in and help him. He had nothing. No insurance and still no money but I still tried to help him. His other kids are nowhere around. They refuse to help me with him. I even told them that you all could help me. I was always there for them. Always the one being a solution to their problems and now that I have a problem no one to help. It’s like my Father doesn’t care that I have kids as long as I’m able to do what he wants and keep him out the nursing home even if it cost me my life. He’s always been selfish even in his sickness. He doesn’t care. He gets home and is a whole another person but goes to the hospital and does everything they ask him to do. So I don’t even know if he’s pretending or if it’s the early stage of dementia.. My house use to be laughter, fun, and peace. Since he came it’s been nothing but hell... Sometimes I feel like he punishes me for the way he is but you wasn’t there for me for 30 something years and I’m still trying to do right by him even though I owe him nothing.. Having a good heart got me in the situation I’m in.. I should’ve turned the other cheek like he did my whole life to me.. But I suggest his social worker do her job because today I choose my peace and happiness..

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Ahmijoy is right. Don't be tricked into bringing him home!

Two things to keep in your mind:

"I explained to his caseworker he needed long term care because I’m not able to take care of him."

Don't back down -- you cannot take care of him.

"She said he can get in-home care."

That won't be enough -- it is NOT 24/7 care!

It's easiest for these caseworkers if the family assumed responsibility for the elder. Remember this -- do NOT accept any "temporary" placement back to your home as they "work to find someplace." Temporary becomes permanent. You will be stuck.

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Thank you all! I’m going to stand my ground. If I don’t with the route I’m on dealing with him I’ll be in the hospital or dead myself. He’s done got in my face a few times, pointing and yelling at me In front of my children and they’ll be right there watching with fear in their eyes. I’m scared that my 6 yr old is eventually going to go to school and tell his teacher. He said mom don’t let granddaddy come back. Breaks my heart. He wears a diaper but he would still manage to put feces on my floor and wall. Touching the cabinets and refrigerator with it. Which I never understood that. He would do it at least twice day. So I spent half of the day bleaching just to turn around for him to do it again. I can’t sleep when he’s in my house because I fear he will burn down my house or I feel like eventually my kids are going to get sick or I will and I don’t even trust him around my kids from the behavior he has showed me. If I get in trouble for protecting my children then so be it. But I can’t take him back.

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Agree with Ahmijoy 100%. Please follow her advice. It is an unsafe environment in your home for both your father and your family. The case manager is trying to scare you but you will not be charged with anything. You do not have the resources to care for him and you must work to earn a living for your family, tell the case worker she needs to do her job and find an open bed in a skilled nursing facility.

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You are being strong-armed by his Case Manager to force you to bring him into your home to care for him. The next time she says you can be charged with abandonment, tell her the facility could be charged with an unsafe discharge.

Go to her supervisor and explain whats what’s going on. Your father cannot come to your home. It’s not safe for any of you, especially your children. You are not medically trained to deal with his physical and mental issues. The Case Manager or her supervisor needs to find a facility that accepts Medicaid for him. Explain in no uncertain terms that if they don’t cooperate you will be contacting Adult Protective Services.

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Needs more help that I can give. What options do I have?

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