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ald565 Asked January 2011

My father is seeking to sign himself out of his nursing home. He says he doesn't need to be there and is refusing a psych evaluation. How do we proceed?

EXPERT Carol Bradley Bursack, CDSGF Jan 2011
I would think his doctor should be able to help. If he's in a nursing home, he has some medical attention.

In the end, you may not be able to stop him, unless he's been declared incompetent, but you can try through the doctor. Do you have a health and financial Power Of Attorney? That may help some. He does have rights, however. It's scary, I know. Try to get professionals to back you up. You could even contact a attorney to check out laws in your state.
Good luck,
Carol

JanN Jul 2012
It is very difficult when both parents are in the care home and one is more able than the other. I have a similar situation. My mother had dementia and my father suffered from chronic anxiety and is almost blind from macular degeneration. My mother had always looked after my dad and when she got sick he couldn't/wouldn't take care of her, allowed her to 'not eat' and drink too much, and eventually she got so bad that she needed to go into care for her own good (and I have to say that she is thriving in the care home and her diabetes actually cleared up once she was taken care of). My father did not want to live on his own and wanted to be 'taken care of' so he asked to go in with her. Now, a year later, when he is actually needing physical care - dressing/toilet/meals etc, he is railing against being 'in care' and thinks that he should be be moved to another care home where he won't have to see my mother (who now ignores him). I know his personality and he will hate being away from her as soon as I move him, plus he is so anxious that he would hate a new place with new people, but he still mutters about hating where he is and wanting to die. All of his life he has 'hated' wherever he is and wanted back to where he was before - the grass was always greener etc. What he really wants is for things to be the way they used to be, but of course that won't happen and any move now would just throw up the same old problems at the new place.

So I think you have to decide that you are the adult now and make a decision based on what to do for their best care. In an ideal world we would take them home, give up work (in my case I can't because I live alone and don't own property) and spend all our time being with them and they in turn would turn into sweet old people who enjoyed our company and it would be like the Waltons for the rest of their lives. But that isn't reality. We would give up our jobs to care for them, lose our homes because we couldn't afford to pay the rent, and the difficult parent would still be difficult and it would all have been for nothing and they would have to go back into care because we would become too ill or broke to take care of them.

Look at the reality of the situation and ask yourself if you are making sure they are being taken care of properly. If so then as long as you are visiting regularly and trying your best to be patient and caring when you see them (and its not always easy), then it is the right situation for all concerned. Do not allow yourself to be drawn into enabling the 'I want out' situation. If your father is as 'able' as he claims to take care of himself then he is also able to organise his own 'departure' without any input from you. When you step back and leave it like that you will see that he is not at all able to take care of himself and so will the nursing home.
I hope this helps.

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ald565 Jan 2011
He negated the document for POA for my brothers and me, which we shared, and we don't know who has it now. He said we put him in there against his will, but he has mental illness longstanding and we think frontotemporal dementia. My mother is actually very disabled, in the same nursing home, so if he signs himself out, the nursing home said they do not expect him to pay them anymore and we have to make arrangements. However, if he is still competent, then they should go after him, I would think, for payment....He has a lifetime history of mental illness and the nursing home said that based on what they know about him, they are not sure his FTD is so bad their doc can invoke the POA.

They seem to be asking US to do something about HIM, which we have never been able to do - he has been out of control his entire life and was put into this home for his and my mother's safety. He was my mother's sole caregiver (would not include us in her care) and she was actually in the process of being removed from their apartment by town services when we managed to swoop in and have her taken into custodial care due to his illness.

Also, he is a troublemaker at the nursing home so I don't think that they are worried about him leaving. They just want to ensure payment for my mother or they say they will send her to the state facility, which is terrible.

toadballet1 Jan 2011
If your parents are still married, your Mom is entitled to their joint assets. If the paperwork shows that your father is paying, why would that stop if he leaves? I guess he could withdraw support, but you should then look into having their assets frozen so your Mom can get her fair share.
It is so difficult to prove mental incapacity, even if your father is showing signs of it. He may be able to pull it together enough to fool authorities.
If your Mother is left without financial support, either her family will have to step in or the state (Medicaid) will take over. There isn't much in the way of Fed. Gov. support. Some states have programs, though.
I am so sorry for the distress your father has caused and is still causing...I hope you get to the right people who can help you.
Lilli

LME Jan 2011
I've been wondering if his family doctor could order him a psych eval and the psychiatrist make a determination as to his ability to make a proper decision about his ability to stay in the nursing home. If no one has POA and he is his own POA at the moment, I don't know if such a psych determination that he is unable to make proper decisions about health care, would mean anything unless the court/state is involved. I don't know anything about the law in regards to this, only an idea. You could contact the Adult Protection Department of your local Department of Human Services, or the local Dept on Aging if they can advise you.

7kids7sibs Jan 2011
Ohhhh, I only know too well about your situation! In the state of PA, the assisted living facility my mother lives in states she can sign herself out any time she wants. If she goes home, she'll die because she refuses to take care of herself, and fires any and all care givers we've hired to care for her. My mother uses a motorized scooter to get around therefore she cannot drive herself home though her van sits outside the facility for us to take her here and there. We tell her to go ahead and sign herself out, but NO ONE and I mean NO ONE will take her home! So she's stuck there. Granted she refuses to eat, shower etc etc, and sleeps all day (her way of throwing a tantrum) but the aids there do their best to make her eat and it's far better than her going home and dying a horrible, tragic death due to her stubborn foolishness. She is mentally competent, though we all know she's got issues, and refuses to see a psyche-doc (gee, I wonder why??). We get the "you put me in here against my will" shpeal too. For us it's a battle of will, but the bottom line if the parent has all their marbles they can go home any time. Scary isn't it!!! So, if your dad signs himself out, how is he going to get home?

ald565 Jan 2011
My father demanded his car when he left rehab and went to the nursing home, tho he couldn't drive it - it was a battle we didn't wage because he was in a wheelchair and this demand seemed reasonable AT THE TIME... As things started to change, we begged his docs to have his license revoked as that is the preference for his state. He is on his 3rd PCP and all are OLD so maybe that explains why he still has the license...empathy...Funnily enough, w/no ability to drive, he had been taking the facility's van to the mall and would sneak into the liquor store, buy liquor, then store his booze in the trunk of his car in the nursing home lot. We found out about this from the staff who did nothing to stop it, not sure why but I suppose it is again about which battles do all of us wage.

7kids7sibs Jan 2011
I'm sorry, but, that's hilarious! Ok seriously. Who would of thought a person would have so much trouble dealing with an aged parent?? All I ever heard of is "oh, granny died in her rocker" or "granpa died peacefully in bed". But nope, some just get folks who are too spunky for their own good. It's a day-to-day battle. Honestly, I think what it's going to boil down to is that somehow he's going to break out, and my mom will get herself kicked out. It's just a matter of time.

N1K2R3 Jul 2012
Your dad wants to " sign himself out" of the nurisng home that he is in, and my question would be: How did he get there in the first place? Who "signed him in?"
Is he capable of caring for himself? How 'bout the Activities of Daily Life?
Delete that bodyguard comment. Hire as medical asisstant.

Rosalynn Sep 2014
My mother is in a nursing home facility for therapy & nursing for twenty days. I and my family doesn't think she is ready to go home. She is saying she will check herself out when her twenty days is up, if we don't. She has slight dementia and has been falling a lot. She has fallen once while in the facility. My sister and I have POA. We both have daytime jobs and can't afford to have someone stay with her at home during the day. Can my mother check herself out the facility???

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