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My father was release from a Rehab/Nursing facility 2 weeks ago. We thought when he was release he would be able to take care of himself. He has fallen 3 times, thankfully no injuries. He has 41 days left of coverage, and I think these days will strengthen him and be very helpful. He is very stubborn and refuses. All the nurses, PT and OP who have visited him in the past two weeks state he is unstable. I would hate to force the POA and admit him. Any suggestions on how to approach him. I work full time, and have bitten off a little more than I can handle. I tell him the next fall could be the one that lands him in a home for the rest of his life. First time posting, but have read this blog over and over. I feel sometimes it lets me know I am not the only one going thru this. My life or what I have of it has been consume with him for the past year. He fell in March and broke his femur and is a critical heart patient. Any suggestions who be appreciated.

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I'm so sorry to hear you are going through this. I believe the only way to get him back in a rehab and then possibly placed long term would be to take him to the hospital the next time he falls. You would then have to have him admitted for 3 days before Medicare will pay for rehab. Once he does go to the hospital, you have to dig your heels in and keep telling them it is an unsafe discharge. I had to do the same with my mom and it was very difficult. The hospital essentially just wanted me to say I would take her home and care for her. It got to the point that I had to leave the hospital. They told me if I didn't agree to take her home that they would have to call Adult Protective Services and that APS might put her in a nursing home. I said, do what you have to do and left. Suddenly, they were able to agree to send her to rehab and admitted her for the 3 days. She has been in the nursing home ever since and that was in December.

Your other option is to apply for Medicaid immediately so that he can get home care. The sooner you apply, the better. I am pretty sure that as long as he doesn't have a lot of money, a home care agency could begin services while he is Medicaid pending... meaning you have applied and are just waiting for the approval to come through.

Best of luck and hugs to you.
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Also, try calling the rehab that released him, explain what happened and that it wasn't safe for him to go home. There might be an appeal process that would allow you to get him back in rehab without going back to the hospital first.
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staaarrr: "The hospital essentially just wanted me to say I would take her home and care for her. It got to the point that I had to leave the hospital. They told me if I didn't agree to take her home that they would have to call Adult Protective Services and that APS might put her in a nursing home. I said, do what you have to do and left. Suddenly, they were able to agree to send her to rehab and admitted her for the 3 days."

I think that someday this scenario will be what happens to me. My mother will fall, end up in the hospital, and then be crying and shaking at the thought of a rehab facility. (My father died in one, and of course I would never make her go to that one, but there are plenty of others.) She will say something absurd like she will hire caregivers, but then would get home and not do it.

I hadn't thought of the threat to call APS. Now I will be ready for that! My mother doesn't live with me, and I will make sure they know that she lives alone, and that I am unable to be her caregiver. And I will be ready to repeat that.
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This hits too close to home. My FIL had CLL (A type of leukemia) He fought the good fight and lived many more years than we were initially told he would. But, the falling, in the end, was what did him in. We had arranged for in home care with a really lousy company--they'd ring the doorbell and KNEW he couldn't navigate the stairs to let them in!! (They knew where the spare key was and were supposed to just let themselves in) but if he didn't answer, they'd just leave. Several times I'd show up a few hours later and he'd be lying on the floor with fresh skin tears and once, a broken collarbone. After this, we said "Dad, we have to move you to secure facility. You're just scaring us all so much". He wept and fought us, but in the end, he went to the hospital (hubby and I took him) we talked to his oncologist who then stepped up and said he wouldn't release him to anywhere but a secure facility. Dad didn't take it well, spent a few days in the hospital fighting pnemonia as we worked to find a place for him--and he gave up and died. I'm not saying the dr's decision did it, but all dad lived for was going to his coffee shop everyday and hanging around. He was dying already. We just didn't want him to die at home, alone and unattended.

Sadly, I, as a DIL, had to be the one who "outed him" to his dr. He'd lie and say he was eating well (no) and walking fine (no) and wearing his oxygen (no) and taking all his meds (after he passed and I was cleaning I found an enormous pile of his pills under his recliner--he was sick of them and the s/e they caused.) Dr didn't know any of this.
Sometimes you have to be the "bad guy" to get what is needed for your loved one. I do not regret telling the dr about all this. My hubby wouldn't. My SIL wouldn't and it fell to me. I looked at it as advocating for him, not trying to ruin his life.
In the end, he was allowed to die with the dignity he deserved.

In dad's case, it took the dr to say "you can't go home"....and dad respected that. He ignored us "kids". Let his dr make that decision and help you to facilitate a move.

Good luck. This is very hard, I know.
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I really empathise as I have the same problem. We must absolutely stand our ground and say it's unsafe discharge. It's really really hard and my father has cried. It tears me up but I'm at breaking point . Good luck. Thinking of you x
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It sounds to me like your dad really wants to be the same person he was when he was younger and he doesn't want to lose his home, I don't blame him. 

I'm not sure whether or not you would have enforcement powers with just POA, but you definitely would with guardianship. Guardianship gives you for powers over everything involving that person. I'm not sure if you're cut out for this kind of job, not everyone is though you may be willing. 

I don't know what kind of rehab he's going through, you didn't quite say. Did he have a stroke or did he break something like a hip? It sounds like he may actually benefit from a walker or even a wheelchair, I would definitely look into these. You can usually find these items fairly cheap through private sales or even secondhand shops such as Goodwill. I would look for a real good used walker or wheelchair so that he won't fall anymore. I don't know if he would be able to successfully use a walker, but if he needs one then try that. I would also have a wheelchair handy because it sounds like he may need one right now. He should be using a wheelchair for sure but definitely a walker if he still walks. A walker would help him to safely transfer between the wheelchair and other furniture. He may or may not need both but he definitely needs at least one of the two but having both handy would be for safety and fall prevention
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My girlfriend and I are having a similar problem with her mom. She almost died before we intervened. She was a hopeless manipulative alcoholic who play(s) food games with her daughter who has an eating disorder. So much so she almost died herself dropping down to 70 lbs. Since going thru the geriatric ward and inpatient for several months they determined she has moderate to sever dementia. Since having come home her "dementia" has all but reversed. All thats left is wet brain syndrome but THE FOOD GAME CONTINUES! Its to the point she becomes defiant and we fight weith her every meal to eat. We're set on sending her back to the geriatric ward but I honestly don't know what good it will do at this point. We've gotten her as healthy as shes ever going to be but shes still the same manipulative b*tch (pardon the language) shes always been and always will
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Staaarr, I am so sorry you have to go through this. I knew this was coming with my mom, and also may happen in the future with my husband. I "lucked out", if you can call it that, when my mom was placed in Skilled Nursing. It had been coming for a long time, but as her daughter, I was hesitant to "pull rank" on her and explain to her that I was afraid for her to live on her own. She had a bladder infection and began to hallucinate, and wound up in the hospital, where she got (mentally) worse. She had psychological testing and the social worker told me she could no longer live on her own. The decision was out of my hands (and Mom's). She was very unhappy and it took her a while to accustom herself to her new surroundings, but we all knew it was for the best. Enlist the aid of the social worker at his rehab for help. Don't try to deal with this on your own. Good luck!
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Bean91660…. I'm in the same boat as you with regards to my "stubborn" dad. Long story short about my mom. Last year, Mom was falling too many times and then she ended up with broken arm, leg and she had dementia. After putting her back in the hospital, the social worker at the hospital recommended that I had to find a facility for Mom. I am the health surrocate for both of my parents. So, I ended up asking the people from the facility to keep her as long term care (in my heart, I didn't want to). Mom kept begging us to take her home. Mind you that, I have cerebral palsy and Dad was 89 years old. We couldn't take care of her. She was getting for about 6 months until she had blood pressure problem, pneumonia, UTI, etc. She died peacefully about a week after her birthday.

Right now, I am starting over with my dad who is 90 and extremely stubborn. He fell twice and the second time, his face is all black and blue. So, I had to hire an in home agency last week. He agreed to it at first. Since he doesn't remember that we hired the agency, he got combative and nagging about not wanting any help from the aides and taking showers. Dad wouldn't and don't believe me that if he falls again with broken bones, he will go to the nursing home. He threatened me that he is going to kill hhimself. I know that he doesn't mean that because Mom used say that. It is very hard and very painful to see Dad going through this situation. Even though, he yells at me, I know he is not my dad who used to be, but I love him.

So, if your dad went to the rehab center before, talk to the social worker at that place and see what they think.
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Bean, you do not say under what conditions he was discharged. Had he achieved a pretty full recovery or was he discharged due to a lack of continued improvement? Medicare requires continuing measurable improvement to continue treatment. If the patient stops showing measurable improvement (including due to obstinacy) a patient will be discharged even though they have not recovered. In essence the rehab has achieved all they can with the patient.

If he is willing to cooperate and apply himself they may take him back and see what more he can achieve. If he had become obstinate and would not do his exercises to the best of his ability, they may not take him back.

Tell him every fall moves him closer to a broken hip. The rate of decline for elderly persons who break their hip is well established. He can start working toward strength, or continue moving towards the likelihood of a broken hip, with an increased likelihood of death. Before death, they will put him through a hip surgery, in less than a week he will be back in rehab for a heck of a lot more work and pain than he would have if he returns now. And with a broken hip he may still not make it through rehab alive. My mother broke her hip, but while in rehab began her decline. I took her home for hospice and she was gone in three weeks. He has a decision to make. From his perspective both choices are lousy, but one is clearly better than the other.
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