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I'm the POA but feeling overwhelmed by the pressure to manage everything and have a life of my own.



He and my mom are in the nursing home together but only she qualified for Medicaid since she has dementia. My dad is physically disabled, left side immobile from a stroke and requires max assistance for transfers and not able to walk etc. No issues with cognition or behaviors and not meeting medical necessity for nursing home level of care. I'm still trying to wrap my mind around how they can deny someone who needs so much help but they say it's only custodial care which isn't covered by the Texas Medicaid rules.



He can't afford to privately pay so the nursing home wants to discharge him to his home and asking me to come up with a plan. I'm looking into paid caregivers to help and there is some assistance under a Medicaid program for personal attendant services. The large part of his care falls on me if he is home. This is causing me so much stress and anxiety I can barely keep up with my job. I work from home, been living in my parents' house for 6 months thinking it would be temporary. I am spending a lot of my own money as well and just feeling so alone. What else can I do?



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Tell them it's THEIR job to come up with a plan.

You are NOT the plan.

If they say "oh, the state will take guardianship" say "that's just fine with me."

Two can play this game of hardball.
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Why can he not qualify?
Is it because he has too much money saved or because he has too much income coming in.
Firstly tell them that your Father cannot return home.
If you do not wish to serve as POA know that you don't have to, but because you took the job on in the first place you will now have to attend an Elder Law Attorney to find out how to resign. It will include a letter to your Mom and Dad if they are competent, and it will include notification at the Nursing Home that you are no longer the POA as well as notification of any entity (bank, etc) that you are no longer POA. At that point it is up to the State to seek guardianship. Do know at that point you will have nothing to say about where placement occurs, finances or anything else. If there is a home that is an asset it will be sold, in all likelihood, to pay for care.
Speaking of that home, rather than Dad returning to it for care it is better it should be sold to pay for his care. If your POA is well written and your father and mother no longer competent, you can do the sale and use the proceeds. When those proceeds and any other assets are sold they will be ready for medicaid.
Do know that you can hire a Fiduciary (not one of the financial folks that call themselves a "fiduciary" but a real Licensed, trained Fiduciary) to manage all of this with Dad's assets. Will run about 90.00 an hour.
I am so sorry you are going through this. But step one is to keep Dad in care and tell them he is not a safe discharge to home and there is NO ONE THERE to care for him.
You should not be spending your own money on your parents care. Dad's money if he has too much of it for medicaid will pay for Attorney, Fiduciary and etc.
Is there anyone else in family willing to and capable of managing the difficult record keeping and care decisions of POA if your Dad is still competent to change his POA?
If not it is guardianship by the state as a last option and it IS a desperate last minute thing.
Meanwhile don't get anxious and pushed to act fast. If Dad is not qualifying for medicaid then there is money somewhere. USE IT to keep him in care. Spend it down with attorney and care. And do NOT accept him home nor even DISCUSS such an option or Dad will be there and you will have an awful mess.
Take it careful one day at a time and see an elder care attorney. Your POA allows that to be paid for out of Dad's funds.
Take all the information with you. All about applications, assets, reasons for refusals and everything.
Good luck.
Hope you'll update us.
Keep records and diaries and folders of EVERYTHING that is happening.
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Are they saying that he's okay to live alone, without help?

If that's the case, yes, they can drop him off.

Be aware that DAD may be telling them that you will be there.

Please assure the NH that you will be out of town and if they "drop him off", the press and local elected representatives will be called.
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MJ1929 Apr 2022
The press has absolutely no interest in stories like this. Don't even bother.
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If your father is unable to transfer on his own from bed to chair, chair to bed, chair to toilet on his own, wouldn't he be an unsafe discharge if there isn't 24 hour care at his house?
You are not obligated to become a caregiver to your father, nor are you obligated to pay for his homecare.
BarbBrooklyn is right. Talk to his doctor.
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Jaxsann Apr 2022
I agree not a safe discharge if 24/7 care isn't available. Technically I am at the house but this isn't my permanent residence and never intended to live here beyond the temporary stay to arrange the long term care for mom and dad. They say they will put him on a van and drop him off at the house. It's all an attempt to get me to agree to his care at home or find a way to pay them. I don't want to turn my back on him but could he be taken over by the state if I refuse?
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What do you think would happen if you weren’t there nor any other family was there? They wouldn’t throw him to the curb right? No, they would call the state and the state would have the court assign a guardian. It’s up to you but you do not have to be his caregiver if you are unable to. You need to strong and firm and tough. Call APS and report a vulnerable adult. I agree with what others have said, take our advice and don’t give in.
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igloo572 Apr 2022
fwiw TX court appointed guardian system is very very proactive, should it actually get down to one being done by the court. But imho will not at all be in the OP favor. Ever….. if OP was to do this that new guardian now in control legally over all assets of both the mom and the dad as they are married. They can evict her from the home if she can prove that she is a tenant (longer process) or have sheriffs Dept come and remove her asap as a squatter if she doesn’t. They can change the parents income to go representative payee status to the NH or move them solo or both to another NH and do the same rep payee. House gets locked and then goes into purgatory between the state and local tax assessor district till they die. That court appointed guardianship trump any of her standing as their POA or child or family or heir. It will not be pretty.
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Jaxsann,

Your father's nursing home, like every nursing home in the country is trying at intimidation tactics. They cannot put him in a van and drop him off at his house. He is a senior, unable to transfer on his own. He also has permanent income and owns property. All nursing homes are far too greedy to let that go.
Have they been putting pressure on you to list his house for sale and to give them access to his bank accounts? My guess is yes.
Don't give into their threats. Also, tell them that you moved and don't live at your parents' house anymore.
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Just curious. If he has a house and they are both in care, why isn’t the house being sold?

That may be the solution to your problem.
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Jax, does dad have a regular doctor who can document his medical needs?

I am hoping that our pal Igloo, who knows Texas Medicaid, will chime in.

You need something more than a once over.
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Concentrate on an ongoing solution. Six months is getting to be too long to be called temporary.

Living in their house looks like you intend to default to taking on 24/7 responsibility while trying to patch in whatever programs are available. You need to figure out where you want to live and work towards that instead.

If their income can’t pay their bills, don’t use yours to cover the difference. Don’t assume you can “save” the home by living in it.

The POA lets you help them with decision making and implementation. It does not have to include hands on care.
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What are you spending a lot of your own money on?

Your profile says you left Kansas to stay with your parents. You must not jeopardize your job.

Please heed the wonderful advice by the posters below. The NH is trying to guilt and shame you into taking responsibility for your father. Don't fall for it! YOU will be the default caregiver. And don't believe any promised "help" that they will provide if you agree to take him home. There won't be any.

Please keep us updated.
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