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Hello! My dad has he cirrhosis of the liver for some time now. Almost a month ago, he fell on the floor and was there for over a day. We rushed him to the hospital where he was given a meld score of 31. Physically, he is able to get himself up but mentally, he is very confused. He did not remember who I was the other day. We have been trying to get him into a skilled nursing facility but for some reason his insurance kept denying him to certain places. He has anthem blue cross and Medicare. We finally found a place but he cannot go since we have to continue putting restraints on him. The facility said he has to be off restraints for 24 hours which has not happened in days. Today, the doctor called my sister and told her that since the social worker cannot get him in anywhere, that we should probably just take him home. That is not an option for us. He goes potty all over himself and cannot even form a functional sentence. My sister and I both work full time and I have a 1 year old daughter. My dad will essentially die if we take him home and will be left alone for hours. We are not sure what to do anymore. Can anyone guide us in what next steps we should take to get him into a facility since this hospital obviously isn’t helping us and wants my dad out?

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Has he been seen by a psychiatrist?

Has anyone suggested that hospice may be an appropriate choice, along with meds to calm his agitation and delusiins?
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Jrb8661 Sep 2021
He was going to a psychiatrist but stopped about a year ago.

No one has suggested hospice. They seem to believe that a SNF or at home care would suffice. However, it’s clear he needs 24/7 care. It almost feels like they just want us out of their hair.
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There has to be something they can give him for the confusion.
He is really young. If he has Medicare then he is on SS disability?
He has a suppliment that will care for him in a NH? Because Medicare won't. They only pay for rehab and Hospice. Otherwise a NH is private pay. Not sure if he qualifies for Medicaid but may if considered disabled.

Boy, you are between a rock and a hard place. I agree, tell them releasing him to home is unsafe because you cannot care for him. If Money is a problem, he also cannot hire someone.
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What state are you in? Resources vary by state. Can maybe help more if I know this.

Medications must be discussed with doctor due to allergies, drug interactions, specific symptoms within your father; however most common drugs are Ativan, Seroquel, Vistoril / Atarax. They are sedative for restlessness and agitation HOWEVER they will likely increase confusion and therefore they may be trying to avoid them. This is what's happening with my father, which is frustrating due to his agitation.
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JoAnn29 Nov 2021
This is an old post. No response or update from OP since Sept 23.
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You absolutely have to refuse to take him home! Oops, I just realize this is an old post that was for some reason bumped. I wonder how it turned out. It would be nice if the original posters would update us.
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Just for general info:

End stage liver disease is miserable. Unless he has quality at home care, it will be hard to take care of him.

Plus he'll be actively sick in many ways, as the liver detoxifies the body and can no longer do that. He will turn orange as bile builds up--and this is horrifying to see.

A MELD score means absolutely nothing if he is not listed for transplant. Sounds like that's not an option.

My DH was blessed with 15 more years of life after primary Liver Cancer. He got the transplant 9 months after dx and he never looked sick until he got the transplant, but his liver was shot. He's still with us and has had a lovely life.

We thank God daily (well ,I do anyway) for the wonderful donor who gave her organs. She didn't die for him, but because she died. 6 people have a life.

SIGN UP TO BE AN ORGAN DONOR!
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Medicare and Blue Cross do not cover NH care. He would have to self pay or get him approved for Medicaid. If he is terminal try to get him a Hospice facility.
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