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Trinkado Asked April 2016

When a loved one improves in Hospice. Any advice?

My dad was admitted to Hospice at the local hospital. The hospice doctor called my mom and said he has improved and perhaps assisted living needs to be considered. How can theydeclare that someone is not going to live past six months, then change their mind? He doesn't qualify for assisted living. I spoke to several properties that said he was to far gone and it would have to be a nursing home facility. My mom doesn't have the money for that, and she can't take cate of him at home anymore. I don't know what to tell her and she's quite upset because she's 80 and can't take care of him at home anymore. He has dementia, he can't walk, and he's incontinent. Any advice?

Trinkado Apr 2016
Thank you for all of your answers. They actually have 3 insurance companies and are not Medicaire eligible due to high income. I had researched homes and he was to far gone for assisted living. I had not heard about memory facilities. When he was still conscious, he didn't want to go in a nursing home facility. Now, he can't talk and doesn't open his eyes. I suppose they would try to move him back home and Hospice would go there. Mom said she would look for a retired CNA to hire for things she physically couldn't do. I don't know what's going to happen. It's like he's in a coma.

jeannegibbs Apr 2016
Regarding memory care vs regular nursing home placement: Your dad is bedbound so he is not a wandering risk. That is perhaps the biggest factor that pushes for memory care -- and that is why those facilities have tight security.

The other common need for memory care is for persons who are disturbing to other residents or who have difficult behaviors beyond what an NH staff can handle.

Just having dementia isn't sufficient to require memory care.

The facilities themselves can help you decide where your father will get the care he needs.

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jeannegibbs Apr 2016
When my mother went on hospice the hospital didn't think she's last a week. But she steadily improved in the nursing home, and she "graduated" from hospice after 3 months. That was 2 years ago. At 95 she is still doing OK. No one can really say for certain when someone will die. It really isn't unusual for persons to improve on hospice.

It does sound like your father needs to be in a nursing home. How stressful for your mother! It is not at all unusual for middle class elderly people to not be able to afford the high costs of nursing homes. Help her apply for Medicaid. And disregard what you may have heard about Medicaid as it applies to a single person. When there is a spouse involved the rules are different, and they are set up to avoid impoverishing the "community" spouse.

Many nursing homes and other care facilities will accept someone "Medicaid pending." It sounds like it is time to begin that search.

Sunnygirl1 Apr 2016
I'm not sure what state you are in, but generally the doctor or authorized person conducts an assessment to see what the person's needs are. If there is no one to care for him at home, then the hospital needs to find placement for him. Check to see what the law is in your state to see what if any obligation the adult children have to care for parents. Some states there is no obligation.

Why has he been turned down for nursing home care.

What state are you in? In some states, Memory Care facilities accept dementia patients in all kinds of conditions, even incontinent and bedbound. Maybe, your dad has improved since you spoke with these facilities. However, with dementia, it's very difficult for them to manage in a regular assisted living once they have progressed. Memory Care Assisted Living offers much more hands on support and that's what I would explore. I know there is a cost, but, I would see if he qualifies. I know of people who have just tried and tried and finally got into a place. Have you actually gone through the process to see what is eligible for?

Hadnuff Apr 2016
Can you apply for Medicaid to get him in a nursing home?

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