What if I didn't pick Dad up from rehab?

Yikes!

Did he live with you? Are you living at his house? Did you use to care for him prior to the surgery? Do you visit him or interact with him?

Sorry, it just seems very harsh.

If medicaid is dropping a bomb on you, I think it means somehow you've been involved or have some investment? POA? MPOA? DPOA?

man oh man.... I had to read what you wrote 5 times. I simply could not believe what you wrote and if that's how you truly feel, call your local Area on Aging and please do not bring you father back where you are. Neither of you are safe.

Yuck......It could be that I am semi new to this sight but holy h*ll...I've not seen harsher words than yours spoken about anyone. WHY? If my parent had of been that d*mn bad you could bet your butt I wouldn't know a darn thing of what's going on in their life!

Shutting up now because I don't know your circumstances... but it seems you'd like to pretend he never existed.

Talk the social services group at rehab. They won't release him without knowing where and who will be taking care of him. Normally this conversation is well before discharge date. Just be honest with them. Sounds like you have done all you can. That is fine and nothing to feel guilty about.

You want him to have the best care but that doesn't mean you have to do it physically yourself. Your life is important and you deserve to enjoy it!

Best of luck!

You sound overwhelmed! First, let's break this down into small steps. 1. Make it clear to the discharge folks that you are unable to care for dad any longer. 2. Find an eldercare attorney who can help you sort out paperwork and finances. 3. Find out if his current facility wil take him as Medicaid pending. If not, work with the discharge folks to find one that will. It sounds like right now dad needs memory care, but you should probably look into a continuous care community that will care for him throughout his last years.

The rehab will call you and tell you he's your father, and you're obligated to take care of him - just as he did when you were a child and growing up. If that doesn't work, they will call APS (adult protective service). They will do the same song and dance to you that the rehab did - but worse - threaten you with neglect. If you truly don't want to care for him anymore, just keep saying no. If you give in, and he moves back to your home, he would be the wiser. No more voluntary hospital visits because this time you really won't pick him up. He's out of your house, and now is the best time to stand your ground.

I just wanted to voice my support in whatever decision you need to make to keep your sanity and your dad safe. I don't think we can criticize another caregiver for their decision to opt out of caring for a parent. It's a daunting task for anyone and when someone has dementia, it's all the more daunting. Hugs to you. Wish I knew the legal ins and outs, but I don't, so will leave that for others to advise you. But I think ba8alou has great advice. {{{Hugs to you}}}

I agree with those who say that if you feel you cannot caregive any more, then be honest and say so, and say you cannot take him back home, as suggested by some of the posters.

To the others - there are some here who care for a parent who has mentally, emotionally and or physically and sometimes sexually abused them all their life. It is not recommended by experts that those care givers give hands-on care, but rather see that others care for their parent. Blueridge seems to fall in that category - "his manic/depressive/egotistic/delusions of grandeur personality is as bad as ever". I fall in that category and would never do hands on caregiving of my mother, but see that she is cared for at arm's length. Yes, the parent has been that bad, and yes we are still involved, as we do care. Staying at arm's length is done for self preservation.

BlueRidge - sounds like it is time to hand over the responsibility to the professionals, step back and start looking after yourself. If you refuse to take him back, saying you are not able to care for him - say so, stand your ground to whoever, and then they are obliged to find a placement for him. Tell them that you are past the end of your tether, that he has been abusive all your life and you cannot take any more. Good luck and come back and let us know who you make out.. ((((((hugs)))) do something good for you today.

correction - *** a parent who has mentally, emotionally and or physically and sometimes sexually abused them all their life *** should read *** a parent who has mentally, emotionally abused them all their life, and/or physically and sometimes sexually as a child. ***

I need more coffee!!! :)

DON'T tell anyone you don't want your father back with you!

Tell them YOU CAN'T take care of him physically, medically (and maybe emotionally).

Just don't refuse outright to care for him. Take the position that you've been doing this, you no longer feel you can provide adequate care, and that it's physically impossible for you as a human being to continue it.

Make the home care issue a physical one of your capabilities and don't even mention the abusive personality.

I have mixed feelings about raising the abuse you've suffered because independent parties can treat this subjectively - it's your conclusion, not theirs, unless you've called the police and there's documentation for his abusive behavior.

My point is that don't get yourself in a situation where nursing home staff or any authorities they call in to back them up can say that you "just don't WANT to care for him." Don't give them the option to re-interpret the situation.

They can't force you to take a medical exam, and so have no way of knowing what physical limitations you have that may prevent you from caring for him.

Also, on the Medicaid issue...what's the status now? Did you sign any acknowledgment of financial responsibility for him when he was admitted to the rehab facility?

Does he now have Medicare? I'm confused why they would be considering Medicaid if they're even considering releasing him, which from your queries sounds as if it may be the case.

Maybe this will help:

1. Find out from someone in authority at the rehab facility what his progress has bee, when his Medicare day payment will be exhausted, and why they feel that Medicaid is necessary.

2. Don't let them force you into direct answers. Say you're in a data gathering stage to determine options. Let it go at that.

3. Talk to the physician who treated him for his surgery and authorized his current placement about his progress and appropriate potential placements. If his doctor concurs that he needs institutional placement, that's leverage for you.

4. It sounds as if the rehab facility is expecting you to apply for Medicaid for him after you go through the spenddown. Get as much information on their intentions as you possibly can.

You might want to start researching elder law attorneys in your area in the event you need one to protect yourself and ensure that your father doesn't come home to your care.

gardenartist -the point some of us are trying to make is that the way the system works is that if you say you cannot provide adequate care and stick with that and that you cannot take him back home the system is obliged to find a placement for him. If you take him back home and tell them you cannot provide care, you, by the very act of taking him home are implying that you will continue to care for him. In many cases, you can say you cannot do this till you are "blue in the face", but no one will provide an alternate until the care receiver does not have anywhere to go. This type of advice has been given to and followed by other here. Maybe we are not disagreeing and it is just a matter of semantics.

Emjo, I appreciate your clarification. I thought that's what I was trying to say as well!! Perhaps I did misunderstand the issue of providing alternate placements until there is nowhere else for the patient to do, as it isn't the responsibility of the facility to find a placement.

Perhaps it is an issue of semantics, but I did want to emphasize that I thought any refusal of the OP to take her Dad home could be misconstrued as just not wanting to tak care of him.

Thanks for your insight.

GA - as I understand it once a person is in hospital and they do not have anywhere to go - i.e. the caregiver will not take them back home because they cannot provide proper care, a hospital must find an appropriate alternate placement for them. Also, as I understand it from other posters on other threads, the hospital staff, social workers etc. will pressure the caregiver to take the care receiver back home, but if the caregiver stands firm and says no, another placement will be found. Your point about not being able to provide proper care, as opposed to just not wanting to, is well taken. I don't think that saying you cannot provide proper care any more will be construed as being that you just do not want to do it. At least, I have not seen that happen in the few years I have been on this board, but have seen instances where impossible situations have been rectified when the caregiver said they could not continue to do this. In those cases, the care receiver has been evaluated and placed appropriately. I am not so sure about who does the Medicaid application. If BlueRidge has POA financial then she probably is responsible for that. However she can get help in doing that and pay for that help, if needed, from her father's account. It is complicated but the local Agency on Aging can probably give some direction, or and elder lawyer.

You need to talk with a social worker through the rehab. Tell him/her you can no longer care for your father. He should be able to get medicare and be placed in a nursing home. Basically what you are doing is turning his care over to the state. Sometimes this has to be done especially if you don't have DPOA to make decisions for him. If you go this route, the state will step in and cease control of all his assets including his home so hopefully you are not living in his home as you will be locked out.

This is a very difficult situation and I understand because I also have a PD mother (personality disorder) who also has Alzheimer's. My heart goes out to you.

I think your feeling like this ***now that he's in rehab*** is significant. It's only when you've briefly stopped banging your head against a wall that you can think clearly enough to see what a bad idea it would be to start doing it again. I'd guess you've been overstretched for a terribly long time.

So, what if you refused to pick him up from rehab? That is the right question: find out what the next steps are, based on the firm premise that his coming back to your care is Not An Option.

Also, re-reading, it sounds as if there may be no problem. If the NH has set the financial process out for you, and you're content to comply with it, is there any reason you can't just go along? And further if you're happy with the NH's standards and they also provide long term care, so much the better: long-term solution, right first time. I'd call that a result.

Emjo, thanks for the additional clarifications. My experiences thus far have all been that we've wanted to bring family home, so I don't have the insight that others in more complex situations have had. But with the exception of when my sister had cancer, the return home was after rehab and they were well enough to come home.

The most intense caregiving has been for my father, but he's also been strong mentally and very independent, so the issues I've faced are not (yet) ones of alternative placement.

With a lot of volunteer help, we've struggled by thus far, although I would like to get some help in to give me some relief.

It is good to be aware of the alternatives if that ever becomes the issue in our situation.

Again, I appreciate your insights and comments on my posts.

Just to be clear. My response to the OP was not meant in a negative, not at all. Just that the OP was very tired, wore out and wanting their life back without the father.

Without knowing more of the circumstances it's hard to say what she can or cannot do and what Like who owns the house, who lives in the house and who has been the primary caregiver before the NH. If you look back on the other posts that were made, it appears the father has been with the OP for quite some time and the OP has been wanting OUT for quite some time.

None of this is easy and my heart goes out as well. However, most of us volunteered for this job ( probably didn't know just how much h*ll it was going to be) and to me, if I was ever to want to dump my mom, my conscience wouldn't allow me to do it in a heartless way. I'd have to bite the bullet and do it in the best way possible. Besides, I'd be scared to death of the Karma when I get elderly!

OK, I am crazy burnt-out and do not want daily custody of him. I have had enough of him - sane and demented. But I'm not abandoning him. I know that eventually he will end up in this nursing home on the 'memory floor' anyway. (he's on the rehab floor) I've had control of his finances for about 18 months, but they want records back 5 years - good luck with that. When I turn over the records (I figure I'll have to take a week of vacation from work) , they'll 'spend down' his assets. So I get to declare what he has and then they take it all. What if I just don't do anything? Will they keep him and apply for medicaid themselves? My assumption is that they'll keep him there. He won't know the difference either way. He'll be upset that I don't see him for a while, but that's OK - he's been upset with me for almost five decades. It's really a financial question. Does anyone know?

Reading through the answers I need to respond: The social worker works for the NH, so she wants me to generate the mountain of paper. Part of this is that he actually has a good-sized estate, so I'm afraid there's a profit motive here.

Clarify for me, are you living in his home? Does he own a home?
If you are not there and live elsewhere, I would inform anyone that contacts me, that he can no longer live alone.

By the way, I support you. Crazy is crazy, no matter how you dress it.

Blue Ridge, sometimes family members just can't do it any more. You tell the rehab you can't take him back, you don't have access to his financials and you let the social worker and discharge coordinator take it from there. They will set the legal process in motion to have the court appoint a guardian. You are allowed to decline guardianship without penalty.
On the other hand if you just don't show up, I can foresee problems.
If you are POA, you resign that immediately, while he is still in rehab.
If you are living in his house, out you go, immediately.
As for the five years of bank statements, I sincerely hope his money was in a separate account and not thrown in with yours, because if you have been living on his money, as some do, it will be revealed, and you will be looking at a very grumpy Judge in the Illinois Surrogate's court. People who can't remember where the money went get an 8x10 room they will never forget.

BlueRidge big hug to you for having the courage to post your question, no judgements here should be had we all have reasons for what we do. I work in the health care system in Canada and if this were to happen here (and yes it does happen) the person is unable to care for themselves or make their own decisions is placed under a court appointed Public Trustee. This professional person is appointed by the courts and takes over the patients finances and makes all health care related decisions including hiring private care if finances can afford and if living at home is a viable realistic safe option. If your dad has appointed a POA and that person or you has enduring POA that will need to be revoked prior to be placed under Public Trustee. Please don't feel like you have to hide from the medical system or his caregivers if you choose to do this. You still have the right as does your dad to have a relationship with you. Parents can place kids up for adoption, adult children don't have the same luxury when we know we can't 'parent' our parents. Take care

At this point, you private pay until you can't. Whether you pick up dad and enroll him at at NH or the hospital does, the process to pay for services is at a high level, the same. If the assets were not protected years ago, they are now fair game to pay for his care whether you are his guardian or the state is. Having said that, there are a lot of variables in the rules that vary by state. Ultimately, you can't hide assets or avoid their disclosure by not picking dad up.

The other issue is the dysfunctional relationship between you that certainly justifies you not caring for him directly. A lot of us are in that boat now. I will not have my mother in my home at all. Not even for Christmas. But, I am her Dpoa, and take care of all her mail, bills, and arrangements. My face to face time with her is very limited now due to the past events.

To answer the main question: He owns a home and rental property. I've kept finances separate. I try to spend his money on his expenses, but if you put in my gas, groceries and stuff that I pay for, he's actually spending some of my money - I don't care. I make a good living. Not a problem. The problem is that he is a difficult person made more difficult by dementia. My spouse and I have had him at a senior apartment nearby, but caring for him every day - cleaning, laundry, cooking, medication, incessant phone calls and demands. We are both exhausted. Now we have my spouse's mother having difficulty physically and financially at age 78.
I guess I just sell his assets, get the paperwork together as best I can and watch a lifetime of work (and a lot of my work quite frankly) go away at $8,250 per month. Sigh....

'Fraid so. You'll feel better about it if he's getting decent care for his money, though. You seem to have all the logistics in hand; I just want to add I respect your recognising the end of your tether when you've got to it. Good decision.

Blue Ridge, the good thing here is that you can get him into a better facility by entering as a private pay. He keeps the rental property because it generates income. If he is a veteran, you may be able to get the VA to pay part under Aid and Attendance. You may make ends meet for longer than you think. Much longer.

Good point, Pam, about not selling the rental properties. Blue Ridge, you should really get some good legal advice if you haven't already. On your dad's dime, of course, because you need to maximize HIS ability to pay for his care.

Read pamstegman's posts !

Wow. Have you seen an eldercare lawyer? In some states to put them on medicaid you must pay back all that the parent has given you in the last 5 yrs. (those tax-free gifts, i.e.) They are allowed to keep their home and in 1994 it was $75K, not sure what the amt is now.

Your health and sanity come first w/o them you cannot take care of anyone. What a depressing situation... Has your doctor prescribed an antidepressant. Make time for exercise, eat nutritiously and if you can take a yoga class to meditate. All these suggestions will help you cope during these difficult times.

It was my impression that this was a "safe' forum to talk about how we feel and get constructive advice and feedback. I read over and over again from people who have been beaten down emotionally and, sometimes, physically, at the hand of the person they are caring for." Don't be ashamed of your feelings" we say, "you're not alone", "There is no shame in admitting when you are at the end of your rope". Those of you who are shaming this person for their feelings and the way they chose to express them have obviously not been "in the trenches as long as some of the rest of us OR you just like to condemn. Either way, please try to meet people where they are and try not to judge. Wow, seriously dissapointed in what I've read.

I see no problem with what you want to do. You just need to do things in the proper order as ba8alou and others suggest. I have no criticism for you, as I (caretaker of my husband with dementia) get terribly depressed, angry, mean and am frustrated. I have no one to talk to as both sons live away and I don't like to complain to them - he's their father. I don't want to complain to other family and friends since I don't want to be labeled as a complainer and don't want to start wallowing in self-pity. There are times (yesterday was one of them) that I actually fear for my sanity and/or physical health. I have little time to care for myself. On the other hand, my mother, who also suffered from dementia, was in Personal Care and then Skilled Nursing. We visited her 3-4 times a week -took her to lunch or had lunch with her there - and I could remain in a better state of mind. Therefore, I feel that I was kinder with her than I am with him. No one who is not in your shoes has a right to criticize and I have learned that the Caretaker needs as much help (if not more) than the patient. God bless you and HUGS TO YOU!