Dad wants to bring dementia mom home with 1/3 of the doctors' recommended care. Any suggestions?

Does anyone have medical POA for her? If so, they can put a stop to this. Immediately seek out the social worker at the nursing home and impress upon them that should your stepmother be released, she will be in an unsafe environment in the home.

Your father most likely feels guilty and your stepmother may be blaming him for being in the facility. He wants to “make it right” by bringing her home but he obviously is not thinking clearly, which means you’ll need to step in. Speak with not only the social worker, but the facility's Doctor, the Director of Nursing and anyone else who has contact with your stepmother. Do not allow her to be released to your father and brought home. By informing the facility that they would be releasing her to a potentially unsafe environment, yiu are putting some of the responsibility on them.

24/7 care just means that she must not be left alone, even in a nursing home people don't get that level of one on one care. People with dementia do live outside of facilities, is your father capable of supervising her for the other 20 hours each day? Does she need skilled nursing care? Is she violent? Most importantly, does she still recognize your father and remember her home?

I'm not saying I think this is a good idea but nursing homes are not jails, unless she needs the specialized care for a physical need that can't be met in her home your father has no reason to make up stories, as her spouse (and presumably POA) he has the right to direct her care in a way he deems best. If you have any idea what is troubling him about the care she is receiving at the NH you might want to work to alleviate that problem, then he may feel less compelled to bring her home.

Before she is discharged could Dad spend 1 full day with his wife to see if he can provide ALL the help she needs in a controlled setting? Instruct the staff to do NOTHING unless it is critical.
This way he could see for himself what it would be like caring for someone. And this would not be like it would at home where she is the doors are wide, the bathrooms are accessible, no carpeting, no stairs but at home the set up might not be as ideal. But it might be a glimpse what it would be like.

Has dad had any mental assessments lately? Is he afraid of the costs? Is he afraid to be by himself? WHY does he only want 1/3 of the recommended care? Lying about this makes me think he is losing his marbles himself. Thinking 98 year old grandma, who needs help herself and would have to be uprooted, will be able to help out, is delusional. Take another look and see what's wrong with him. I doubt if he's capable at all of making a sound decision. Tell the truth about the situation to the nursing home. It sounds like dad would be endangering mom with his planned inadequate care. Potential APS situation is just over the horizon. Stand up to him for mom's sake.

I like what Ahmijoy said. Tell the facility that Dads home is not safe for Mom. That he himself cannot care for her and the money is not there. If there are reasons why u can't help, bring them up. Let the pros tell Dad he can't do it. Maybe APS could be brought in to look over the situation.

If it hasn't been done yet, apply for Medicaid if there is no money for her care. Dad as the Community Spouse will not be made impoverished.

The nursing home may, at it's discretion, call APS if it feels that your stepmom is in any kind of danger. Your Dad needs to stop being so selfish and start looking after your stepmom's best interest.

It had been Determined by her Insurance I am sure....Work out the Rest, It so Far sounds Best.

What are dads objections to the arrangements you have made.

If she is really in potential danger then someone is going to have to get in dad's face and make it clear that she could be seriously injured or even die because of a bad choice.

Can they move to an AL together? I understand not wanting to be separated, if you took me away from my husband, I would be a very unhappy camper and visa versa.

I had a doctor and I use that term loosely, tell me that my dad needed a memory care facility. Where I live, that is a locked unit, people all in wheel chairs, very disabled and far gone in dementia. I said, no. I put him in a care home and he was able to live just fine. Getting his meds on time, with proper nutrition and medical attention he actually recovered enough to move out. He still needs help, but not 24/7 in a locked unit. My point is that doctors are not always the authorities they pretend to be. It could work.

As far as relocating his 98 year old mom to help him, stop that nonsense at any expense. That leads me to think that he has mental decline as well. Nobody in their right mind thinks a 98 yo is able to do physical care day after day.

You have your hands full. Best of luck keeping this from becoming a tragedy.

Is anyone able/willing to say “No, Dad, it isn’t safe or fair to reduce (name’s) care.”

“She needs full time care, and that can be provided here or at (residential care center). “

”We understand that you don’t like people coming in and out of your home, but that’s the only way this can work”.

”If you don’t report her situation truthfully you may be opening yourself to legal consequences.”

”Please plan to (visit a nearby residential care center/interview inhome caregivers,/talk to a social worker about this.....) with us.

“Those are your only options, Dad. She’s not well enough to be here without professional care”.

Whatever reason, your father’s inability to comprehend the seriousness of his spouse’s condition is a significant red flag that he is no longer competent to manage her care. You have attempted to provide reasonable, justifiable alternatives and he has refused them. Someone needs to step forward and take charge even in the face of the inevitable unfortunate circumstances. There is no “good” “easy” “pleasant” way.

Why does your father want to remove your stepmother from her current Nursing Home?

Legally? Yes, I'm think that if he signs the papers, they can and will release her.

If he does this get a licensed mandatory reporter in there at least once a week. They have to report if care is unsafe or inadequate. You may have to pay for it, but if things are as you say...his flawed & risky plan will be exposed. Just hope facility still has a bed available.

He may be on overload right now and trying to maintain some part of their former life? Hopefully, once they’re home, he will realize he needs more help! Being 85, there’s only so much he can do before he becomes exhausted and frustrated. I personally wouldn’t call the authorities. I would work behind the scene and line help up as your Dad will not be able to provide good care and hopefully realizes it sooner than later 🤞🏻 It’s a difficult time in his life. Prayers for all.

This situation is insane. Your father is 85 and wants your step mother int he home with four hours or care. And to expect a 98 year old to help is pure nonsense. Into whose home will these people go? If to yours, no way - you will be a prisoner and your life will be destroyed. And if it is to his home, that is not going to work. These people need far more care than anyone realizes. Do not give in. People with dementia do not belong home where they can cause all kinds of problems and havoc - do NOT do it. They must be placed for their own safety and the peace of the other family members. Go to the office on aging and ask for help. This is a dangerous situation.

You could do a trial run. See if dad will be responsible for mom's care in the nursing home for a couple of days, such as telling staff when her meds are due, changing her incontinent brief or getting her to the bathroom (even in the middle of the night), taking her blood sugar, helping her get from the bed to the chair safely, etc. Sometimes when loved ones see what all is involved, they realize how taking care of the one they love is just not feasible.

Also, try to get at the root of why he wants her home. There are many reasons a spouse may want their significant other to return home. If you father is wanting your step mother to come home so they can have intimate relations, she is allowed to have that in the nursing home---as long as she wants to. And, the facilty is responsible for making sure they have privacy. If he wants her to come home to cook and clean and wait on him and she cannot, that should be explained in no uncertain terms. If he is afraid of the cost, well, Medicaid may be an option. It is a misconceptoin that a spouse would have to be destitute for their spouse in the nursing home to qualify for medicaid. He should talk to an elder law attorney for accurate Medicad information based specifically on their situation. If he doesn't want to be away from her, maybe he could move in with her or they could both move to assisted living. If he always promised her he wouldn't let her stay in a nursing home, try to get him to understand if he loves her he would do what is best for her and she would want him to do what is best for him. Instead of being a hands-on caregiver at home, his role is just as important, if not more so, while she is in the nursing home. His role changes to being her advocate, to see she is getting good care at the nursing home and speaking up when things are not going smoothly. That way he can go and visit and spend quality time with her in the nursing home where they can just visit, hold hands or have sex. :)

It is important for him to know that if she were to go home and she is not receivieng the care, the doctor has determined she needs, Adult Protective Services (APS) may get involved and get a court order for her to go into and stay in a nursing home.

Best of luck to you, your dad and step mom!

I second Countrymouse - what is the reason?

I don't wish to upset or panic anyone... but I met someone this week who's Grandparent 'checked out at 85". In good health, apparently sound mind but very lonely. By checked out I mean bought pills over the internet (completely illegally) & took them. Left note for family to find.

I am.picturing a sweet old couple together packing a pact. Just my stupid imagination I expect.

Take all the action you need to protect them.

What are you thinking? None of this sounds like logical thinking - especially the 98 year old grandma helping. Wow. No - No - No - No - No. It won't work! Step mom must be placed in a Nursing Home.

From the OP's profile:

*****
I live in NJ & my parents live in PA. My recommendation is for mom (who has vascular dementia) to stay in nursing home because she needs 24/7 care. Dad is 85 and wants to bring her home. He has health, mobility issues too. Their finances are limited and full time nursing care is not financially feasible. Mom has fallen several times in the nursing home because she thinks she’s able to function normally. Im afraid if she comes home she’ll fall down the stairs thinking she can function normally. My other sibling lives in England and isn’t able to come home due to costs. I’m very frustrated because I don’t think dad is thinking about mom’s wellbeing and safety because he wants his wife home.

*****

Dad wants his wife home, it seems, because he is dissatisfied with the care she receives in the NH. He is being told she needs 24/7 care, which the NH is supposed to provide, and yet his wife has fallen several times while in their care. No wonder he's not impressed. What's the point of her being away from him and their home if she still isn't safe when she's there?

I expect he is thinking something like if you want a job done properly, you've got to do it yourself. He believes that his care plus four hours from caregivers plus whatever odds and ends he can rope in from volunteers, e.g. 98 year old grandma, is going to be better for stepmother than the NH.

He isn't necessarily wrong.

Can you get him to agree to an occupational therapist's assessment of the home? Can you work on increasing the number of caregiver hours? - for example, might he be entitled to additional assistance for himself? I shouldn't worry too much about the elderly grandma issue: that sounds to me like a kind thought that nobody is really going to put into practice.

The 24/7 care recommendation is an interesting point to examine. When you have a high falls risk person whose vascular dementia makes her oblivious to the risk - and there goes my nervous tic again, I feel for you oh so truly - in fact it isn't so much the hours as the caregiver-to-patient ratio. And you are not going to get one-to-one care in any facility.

But an 85 year old in poor health is not likely to have the stamina. I did this job, and I was 50-odd and fit, and I looked like Lady Macbeth after a rough night.

Have you asked him what is going to happen to stepmother if, God forbid, anything happens to him?

Based on your post, Your father needs to be removed from making decisions. Removing her from her current location, based on what your wrote,would result in a drop in quality of care/life. He is going to "allow" what?? A 98-year-old to help?? Something isn't right... If you are concerned talk to management to block the move. The nursing home, at least in my state, must approve of the next housing location. If your father is planning to lie, that must be told to your step-mothers PCP and the nursing home. Nursing homes encounter family conflicts, and normally work to protect their liability. Good nursing homes have staff who are trained to doubt everything, and thus will confirm and re-confirm through documentation. Adult protective services exist in every state, she sounds safest inside a secured setting.