How do we begin the process to move Dad to a nursing home?

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My Dad's health has suddenly deteriorated and my Mom can't care for him. My dad has terrible gout in addition to incontinence problems with his bowels. He recently was in the hospital for a week, and has gone downhill every since. His gout has gotten so bad that he can't move from bed and can't visit the bathroom. We have tried changing gout medicines and dosages, with little improvement. My mother has mobility issues herself, refuses to cook appropriate foods for his gout and diabetes, and is in no shape to help him get around. She wants to put him in a home, but she is probably in need of one herself. The trouble is, they refused to talk about this for so long, and now that she has reached her breaking point and wants to do something about it, we are not prepared! It's not like checking into a hotel!!!! On top of all of this, I live in a different state, and my brother is a single father with very little spare time to help them either. How do we even begin this process???

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Good idea Babalou.
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Kid, how recently was you dad in the hospital ? Who signed him out? If the discharge folks were recommending rehab, and it was recent, there may be a chance you can get them to reconsider their discharge and have him admitted to a nice rehab facility , many of which are also skilled nursing facilities. I would call on Friday and see if you can get a "do-over" of that discharge.
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I'm not sure what your parent's financial situation is, but it wouldn't hurt to consult with an Elder law attorney, though it seems there may not be much time to do that at this point. There are legal ways to protect assets. Do your parents own their home? The home is normally exempt for Medicaid purposes, but I would still read a lot on this site about that if you think your dad will need or qualify for Medicaid. If not, then I would proced with what your dad is in need of immediately.

Your dad's doctor should be able to complete and fill out paperwork that lists what kind of care he needs, with input from the family. I'm surprised all of that was not done before he left the hospital. They are supposed to make sure he has the proper care available at home. Didn't they realize your mom couldn't do it?

You will need something in writing that would determine what kind of place he needs and what level of care he needs. Most states have standard forms that are available online.

I know that bowel incontinence in my state, is likely to require nursing home care. It sounds like your dad is likely to require assistance with everything at this point.

You might gather the information you need for the state they live in by contacting their county office of social work, the hospital's social worker, or that county's Counsel on Aging.

If there is a case worker in the hospital where he was recently released, they may already be familiar with his case and able to jump right in to help transition him somewhere.

Is your mom able to handle all the paperwork, visits to the prospective facilities? They both need to have a Durable Power of Attorney and Health Care POA, so someone can act on their behalf if they are unable. That's difficult to do from another state. If their son is not able, I would find a family friend or attorney who will do it, though they may charge for it. I wish you all the best.
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Personally, I would be calling their police department to check on their welfare and ask them to bring in the county social services. Police can call in a social worker to sort things out.
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First off, you need to consult with dad and mom's doctor (s) about what level of care they need. Nursing homes and Assisted living facilities have different regs in different states. It behooves you to find out the rules in whichever locality you might move them to.

At this point, they certainly need to be moved close to someone who can get to the hospital with them in an emergency. A nh will call 911, but once the are in the ER, your elderly parent is on his/her own. For this reason, we chose to move mom close to one brother who has poa, rather than keeping her equidistant from the 2 of us. More driving for me each week, but better care for mom overall.

What are their resources? Income stream, savings, investments? You probably want to sit with an elder care attorney who is familiar with Medicaid. Even folks with substantial resources end up on Medicaid. My mom's NH is $15,000 per month, private pay. We are fortunate that she has the funds to pay for this for a few years, but it looks like we will have to apply for Medicaid in a year or so.

If one of your parents needs to be hospitalized, that can be a bonus ( I know, it sounds weird, but true). They can be transferred to a nh for rehab and then admitted there for long term care.

Start with a conversation with the doctors and touring facilities. Best of luck, and let us know how it goes.
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Was there a social worker at the hospital who can help you? Call his family doctor and tell them what you need and let them help you!
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