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He refuses to even have a conversation about it. He insists he can rehab at home, but he's been in the hospital/rehab with a broken patella for a month and literally cannot walk. Any advice?
Sorry. This is no longer your father's choice. Let the Discharge Planning nurse know that father has no help at home and cannot be sent home without adequate care, which is not possible. They will help assist you with temporary guardianship by next of kin or whatever is required for care placement. Be ready with all assets information, or to assist you father in finding it for the discharge planners. And do let him know that he will not now be allowed to go home until he improves. Again, this isn't a matter of his choice any more.
Hello Alva Deer, I always appreciate hearing your thoughts on these matters . I just wanted you to know that I appreciate you, your candor and advice. Thank you. Beth
Rehab will not keep him if he does not make PT progress. He may be expecting family will take care of him. It does not sound like this is your plan. At this point he can eithr co-operate with Rehab or be placed in a facility like a SNF.
AlvaDeer is truly wonderful and an angel sent to all of us x I read all AlvaDeer’s posts and have gained so much knowledge and support over the years. Factual, intelligent, truthful and amazing common sense.
AlvaDeer has kept me strong with her knowledge and advice as I care for my aging father of nearly 96 years at home. Please all take note of this beautiful lady, her advice and clinical excellence has kept us strong.
Thank YOU AlvaDeer for being the beautiful, thoughtful, patient, devoted, committed and sincerely the best heart ♥️ helping ALL of us each and everyday xx Thank YOU 💕xx
I second your post. AlvaDeer has a wealth of knowledge and experience to share--and she shares it willingly with all of us. I hope to follow her when/if my husband and/or I (ages 95 and 88, respectively) need to make hard choices about our future.
How old is your father? Does he have dementia or cognitive decline? Has his health been steadily declining recently? Does medical PT and staff think he will be able to walk with PT? Has he given up due to his illnesses? Does he live with you or alone? The advise you are given depends on many factors.
Broad advice I have is If he lives with you I would not allow him to come back until he has shown immense impovement physically and metally or else you will run yourself into the ground careing for him.
Speak with the social worker at the hospital and let them know that it will be an unsafe discharge since there are no care givers that can help him. They will find a rehab or LTC bed for him. No wavering or else the responsibility is all yours.
Then talk with your father and explain that since he is unable to walk his only choice is to impove in rehab and not refuse PT. Have empathy that he wants to be home but steadfast that you will not be providing 100% care. If he is stubborn and refuses to listen (as many parents do) tell him one sure way to a nursing home is stubborness.
Remember, it isn't about what he wants, it is about what he needs and that is PT to properly assess what his long term health will be.
Tell physical therapist what his home is like. Ask them to be the "bad guy" and insist he must be able to do... in order to "climb those stairs", "walk that hall," "make it from his bed/chair to the bathroom and back"... before he can be allowed back home. Let them tell him if he doesn't work at it they will be recommending a skilled nursing facility as his new home.
Dad is an unsafe discharge when they start making noise about it. And he needs to be told that he won't be returning home in his current condition. In our case, telling FIL that it he didn't at least TRY to help himself, he would end up in a SNF seemed to do the trick in the short term. He had a complete 180 and was back to his "normal" self after a month of practically catatonia that necessitated a hoyer lift.
You may also have to come to terms with what we did as well. For a long time my FIL didn't bother to try, wouldn't do PT at home, wouldn't comply with PT in rehab, wouldn't eat right, wouldn't wouldn't wouldn't.
Then...we got to COULDN'T. It took us a while to realize that he had made that switch. That it wasn't that he was being stubborn. He had spent too much time choosing NOT to do things, and as we warned him - he got to the point where he LOST those abilities. When you realize that someone no longer CAN and no amount of rehab or trying is going to change that - its a hard pill to swallow too.
Do NOT bring him home. Period. A grown man that is completely immobile will put a tremendous burden on your family and dominate 24/7 attention. Consider toileting; can you lift and clean him, even overnight? Bathing? Appointments? He will PROMISE to faithfully apply PT directives. It will not last. Unsafe discharge and placement is really best for all.
First, stop having a conversation with him about it. Let his doctor, and rehab therapists tell him what he needs to be able to do before he can go home. IF you, or a family member can take care of him and all his needs at home, or hire aides to come to the home, then he could be released and go home if he wishes.
Here's the important step: If you can not manage his care needs at home, DO NOT accept the responsibility of bringing him home! Refuse to pick him up! If he continues to refuse rehab therapy, they will have to kick him out - and if you do not accept him at home, he will be transitioned to a skilled nursing facility.
Start looking at nursing homes now. You might find one that offers better rehabilitation services. And some are much nicer than others. You will have to choose which care facility you want him sent to. The hospital/rehab he's currently in may have a recommendation.
You are in a pickle and it’s a hard place to be. You have to be straight with your father. Be sure he understands the situation and consequences of his actions. Ask for a meeting time with his doctor and CaseManager to have them speak with him directly so the cards are on the table, and you be present if you are his support system. Hospitals won’t just keep holding him, they loose money and are ready to move him to lower level of care. Unfortunately that is how it is. Get placement secured and have a matter of fact attitude (while trying to involve your dad in the discussion) I went through this with my father before he passed away. I feel for you. I was a Dir. of Case Management in acute care and LTACH (like Select Medical). You have to be strong and you have to be honest with dad that it is unsafe and you are not physically able nor trained to take on care 24/7. Let CM be the bad guy if you have too. But above all hold your ground even though it hurts you to do so. You are working in the best interest of your father and yourself. Keep that thought and hold onto it in the tough times to come, because all of this is easier said than done. You are in my prayers.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Let the Discharge Planning nurse know that father has no help at home and cannot be sent home without adequate care, which is not possible.
They will help assist you with temporary guardianship by next of kin or whatever is required for care placement. Be ready with all assets information, or to assist you father in finding it for the discharge planners. And do let him know that he will not now be allowed to go home until he improves. Again, this isn't a matter of his choice any more.
I read all AlvaDeer’s posts and have gained so much knowledge and support over the years. Factual, intelligent, truthful and amazing common sense.
AlvaDeer has kept me strong with her knowledge and advice as I care for my aging father of nearly 96 years at home. Please all take note of this beautiful lady, her advice and clinical excellence has kept us strong.
Thank YOU AlvaDeer for being the beautiful, thoughtful, patient, devoted, committed and sincerely the best heart ♥️ helping ALL of us each and everyday xx Thank YOU 💕xx
Broad advice I have is If he lives with you I would not allow him to come back until he has shown immense impovement physically and metally or else you will run yourself into the ground careing for him.
Speak with the social worker at the hospital and let them know that it will be an unsafe discharge since there are no care givers that can help him. They will find a rehab or LTC bed for him. No wavering or else the responsibility is all yours.
Then talk with your father and explain that since he is unable to walk his only choice is to impove in rehab and not refuse PT. Have empathy that he wants to be home but steadfast that you will not be providing 100% care. If he is stubborn and refuses to listen (as many parents do) tell him one sure way to a nursing home is stubborness.
Remember, it isn't about what he wants, it is about what he needs and that is PT to properly assess what his long term health will be.
Good luck.
You may also have to come to terms with what we did as well. For a long time my FIL didn't bother to try, wouldn't do PT at home, wouldn't comply with PT in rehab, wouldn't eat right, wouldn't wouldn't wouldn't.
Then...we got to COULDN'T. It took us a while to realize that he had made that switch. That it wasn't that he was being stubborn. He had spent too much time choosing NOT to do things, and as we warned him - he got to the point where he LOST those abilities. When you realize that someone no longer CAN and no amount of rehab or trying is going to change that - its a hard pill to swallow too.
Let his doctor, and rehab therapists tell him what he needs to be able to do before he can go home.
IF you, or a family member can take care of him and all his needs at home, or hire aides to come to the home, then he could be released and go home if he wishes.
Here's the important step: If you can not manage his care needs at home, DO NOT accept the responsibility of bringing him home! Refuse to pick him up!
If he continues to refuse rehab therapy, they will have to kick him out - and if you do not accept him at home, he will be transitioned to a skilled nursing facility.
Start looking at nursing homes now. You might find one that offers better rehabilitation services. And some are much nicer than others. You will have to choose which care facility you want him sent to. The hospital/rehab he's currently in may have a recommendation.
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