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

Thank you CampyBj, my faith is restored.

I am having the same issue with my husband who I left 14 years ago. He is 61 and after numerous detoxs that didn't work has alcohol related dementia, combined with a new head injury that has left him with 3 blood clots on his brain. After I left he took up residence with a wonderful woman whose also left him after too many years of his abusive drinking. He has no one, so we are working as a team. We got him placed in a nursing home where he is getting the proper care. Now I'm dealing with them saying he's competent enough to transfer our home over to me, this way medicaid won't get it. You are allowed to transfer to your spouse. I'm trying to save it for him,the money. He wants out of the nursing home but cannot take care of himself and neither I nor his girlfriend feel w are capable and frankly he spent too many years damaging our lives already. We are concerned that when he is ready for discharge he cannot live on his own. Maybe a group.home or leave him there? We are so lost at what to do. Finally we've gotten him to a place where he is safe , warm, fed and cleaned. No more drinking. Once released he will start again as he's been through 6 or 7 detoxs. The nursing home has Discharge Planners so I guess we'll.look to them for assistance. It is a horrible position to be in.

I am glad to see this question! I have asked in myself many times. My Aunt Iris, whose has no contact/relationship with her own children -don't know why, but I suspect- fell and was in the VA hospital. I was out of town and didn't know. (There was only one person who could have called and I will never understand why they didn't.) Long story short, I was to given the permission to give the permission to move her to rehab. (Read that again, if you like.) Eventually, I got the POA and began the journey of being responsible for her care. Questions abound; what should I do, how should I do it, when, where, what if!!? I have often wondered, what would the hospital have done, if I had not stepped up? As best as I can remember, the care manager, a lovely lady who was so glad to see me enter the picture, gently explained that they would have sent her to a state facility wherever there was a bed. It's quality would have been questionable, perhaps, but she would be there and I suppose, some poor soul would have been assigned her case. The state would have taken whatever actions suitable to their needs. Certainly, I could have gone to visit and just nod my head, but also, could have said, Sorry, Aunt Iris, I can't do anything for you, or about your situation. I can only visit you. Would I have saved myself heartache and sleepless nights? I'm not sure. Certainly, now I must see this through and wait to see if the "cousins" will come after me later. I have been assured they will. Kind of sorry, isn't it? So, BlueRidge, I feel for you. It's a tough call. Ask any caregiver here, "does it get any better?" (no) You've got good advice from ba8alou above. One step at a time. Good luck. P.S. I'm in NGA and my Aunt is in FL. If I had brought her here (against medical advice) she wouldn't be any different in her situation or attitude, but at least I could see her more often. I did hire a Visiting Angel to see her 3 days a weeks, but it's a financial struggle, but certainly gives me the ability to step back and breathe.

Correction: I was given permission to give the permission to move her.

To Camp BJ, hugs, hugs, hugs! This is my refuge, too.

My guess is that, if you didn't pick your father up, they would transfer him to a Medicaid nursing home. Some are very good. Others are awful-- people lying unattended for hours on end, stuff like that. If you're motivated, you might want to be involved in the process of choosing where he goes.

My suggestion would be to investigate using a geriatric social worker. They're very expensive (here in NY a good one is $200/hr-- like a good lawyer), but a good one can make an incredible difference in terms of stuff like understanding and applying for benefits and knowing about the best local services that are available for your father. If you're planning to spend down, this might be a good place to put some of that money. In terms of looking for a geriatric social worker, your local Alzheimer's Association is probably a good place to start.

You know, you might want to think about the language you're using to describe your situation and feelings. If your father is 87, with the problems he's got, it's obvious you have done a lot for him-- perhaps even more than he did for you as a father. And "that I've put myself in a lather trying to figure out what to do with him" shows that you still care, and that you're a responsible adult. I understand that you're angry and frustrated. It's a frustrating no-win situation that isn't fair to you. But you're the good guy here who should maybe put some effort into getting people to sympathize with you.

An Alzheimer's Association might be a good place to start venting some of your feelings about your predicament.

BlueRidge - what likely has happened is that the rehab reports for your Dad @ the NH show that he is "not progressing sufficiently" & so MediCARE which is paying for his stay @ the NH will not continue. For post hospitalization discharges to a NH for rehab MediCARE routinely pays for 3 weeks and can go to 100 days (with a co-pay, although there has been a change in what "progressing" means but if a patient is non-compliant they will be discharged without appeal). For a NH, Medicare is great as the reimbursement is set by the feds & pretty good and fast. But as Dad is not progressing sufficiently, he is about to go off Medicare and the NH needs to figure out & fast, how they are now going to get paid.

Therefore the 5 year documentation time-bomb. Now since like 70% of all NH residents are on MedicAID, the NH just assume that Dad will need to apply for Medicaid. So therefore you (as I bet you were the one who signed Dad into the facility…more on that in another post) have gotten the list of documents required for the state's Medicaid application & also what the NH wants to see to determine IF they (the NH) will accept Dad as a "Medicaid Pending" resident. The NH doesn't know just what Dad's financial situation is, they just assume he will need Medicaid as most do. NH costs between 5K - 15K a month and they cannot be left with a non-paying resident. The NH will have no choice but to take some sort of collection action if Dad does not apply for Medicaid or private pay or family does not sign off a payment contract.

If Dad has non-exempt assets over 2K and income over whatever your state has as it's monthly income ceiling, he will NOT qualify for MedicAID. Like for my mom in TX, when I did her application she had about $ 1,500 in bank account & $ 1,800 a month from SS and retirement so she was under the 2K in non-exempt assets and under the $ 2,094.00 in income allowed. She still has her home (exempt asset) a prepaid NCV funeral policy, a smallish term life policy and that is it. Basically for Medicaid, they have to be "at-need" which financially means impoverished. If they live long enough, imho, they will eventually run out of $$, the caregivers will run out of ability, and they will need to apply for Medicaid unless they are generationally wealthy or plan a decade ahead (which most just won't do).

As dad owns rental property (a nonexempt asset), NO Medicaid for Dad. I bet he has over 2K in the bank too and likely other investments, so NO Medicaid. You can go ahead and apply but it will come out and he will be declined. Personally I would suggest that you do NOT apply for Medicaid but instead contact a elder law attorney and get all those documents together and take them so that you can get some insight on just what Dad's options might be. You might as well tell the NH that Dad has too many assets for Medicaid & pay the huge private pay for the next couple of months so that Dad can continue to stay @ this NH. This period of time that the private pay covers is what you use to come up with a plan (based on what the elder attorney suggests) to deal with paying for Dad's NH. I hope you have DPOA with finances for your dad or you have a sibling who does, otherwise you will have to go the guardianship or conservatorship route first and that is a pretty good expense (i'd say 10K - 15K alone for a G/C).

BlueRidge - so who signed Dad into the facility? Whomever did will be the first person that the NH bills once Medicare stops paying. At 8K a month for just the basic room & board costs, plus all the incidentals, you are looking at 30K in 3 months easily. It is enough for the NH to turn over to collections.

This can get ugly too. At my mom's NH#1 there was a lady who's son refused to pay her bill. He had applied for Medicaid for her, but was declined at about month 4 in the state's Medicaid application process as her home had been sold by Sonny and he did not use the proceeds from the sale for her care and so there was a pretty good transfer penalty. So although she was now impoverished and qualified for Medicaid, she was ineligible for any Medicaid payment till the transfer penalty was worked through. Son (a real Ahole imho) just flat refused to deal with it; I had been there other times when he was visiting and lots of yelling and demanding by him on staff not doing their job.... NH contacted APS and lady was placed under emergency temporary guardianship by the court. The guardian then moved her to another NH. Son - as he was not her guardian - was not told of the move either. It was some kinda ugly, police called and all sorts of threats by Sonny. NH turned lady's account over to collections too and all was in Sonny's name.

Now all this is extreme. But my point is you don't want the situation with the NH to become adversarial. If you private pay a couple of months, it gives you time to plan just how to divest dad's assets & NH is happy. I would also suggest that you do a smallish personal needs account ($ 200.00) for Dad @ the NH too - like for barbershop. Dad because of his assets will not qualify for Medicaid. You probably are very limited to just what you can do with his assets but you want to do whatever to maximize things that are best for his needs. Another reason not to apply for Medicaid right now is that once he is declined by Medicaid, it will be in the system and he will be toast on getting into any other facility unless it is private pay with a signed contract by family.

The only other option is you have to move him back home (email me your address, I send you a case of Prosecco). And that is just not feasible, now is it?

Really find a experienced elder law attorney asap; start culling through Dad's paperwork; get binders going on all his assets to stay organized; and keep the lines of communications open with the NH. Good luck!

Why does the 'system' assume it is the adult child's responsibility to care for an abusive parent? When a parent abuses a child, the 'system' steps in and takes the child away from the parent. They do this because they want to protect the child from further verbal and physical abuse and Neglect. So why can't this so called 'system' work for the adult children of parents who are 'abusing' them? Readers can define 'abuse' as needed. The 'system' steps in when the husband abuses his wife, so I wonder if one can get a restraining order against the abusive parent? BlueRidge, please do not let the 'system' bully you into taking your dad back. Change your phone number if you must and change your home address to a POBox and do not tell anyone but your creditors. Do get removed as the POA. Why can't adult children go to court and get emancipated from the parent like teenagers are allowed to do. Heck! Why can't adult children 'divorce' their parents, there must be a legal term for that. I wonder if there is any family left on your 'ex-dad's' side whose name you could give to 'the system' on your way out of his life. I am not some heartless person for those who will think that but I know when a person has done all they are able to do and when that happens, they need to walk away, not feel guilty and live out their days recovering from a life time of abuse.

BlueRidge, I think you have done your part. You deserve to be able to live your life. Sounds like your father was and is abusive. I have a 91yr. old uncle that has nobody but me to look after him. He still lives on his own in his own house close to me. He depends on me to cook meals and take care of any problems he gets himself into. Almost every time I see him, which is practically daily, he tells me I am going to get everything when he is gone. He abused me when I was a child and my greatest wish is that I will live to see the day he is no longer in my world. I am 61 and actually had a nightmare about him night before last. Creepy, I know, but just goes to show the impact of abuse. He tells me that the longer he stays out of a NH, the more I will get. I honestly don't want his stuff. I would rather he be out of my life and in a place where I know he is being looked after than to have a single dime of his money. I can understand exactly where you are coming from and no, it doesn't sound heartless to me. Do what it takes to get on with your life.

Two thoughts:
1) Do you have a medical or mental health provider that can help you determine that you are physically / mentally / emotionally unable to provide your father's care without physically / mentally doing harm to yourself? A caregiver does no one any favors by being too run down to care for the parent. Wouldn't your father's quality of life be compromised if he was cared for by someone who just could not do it?
2) I have the same thoughts and feelings towards my mother more often than I'd like to admit. By having professionals provide care for her, I can just visit and hope to salvage a little bit of the relationship. I have been to visit at times when her meanness pushed me to the edge ..... and I was able to just LEAVE. It's impossible to stay in the room (much less provide care) for someone who can make your blood boil.

As usual, Ba8alou is right on target. An eldercare attorney would take a load off of you and be paid from your father's funds while it is all sorted out.

Best best wishes to you. Please take a deep breath and realize "we got your back", then find something to do today that makes you smile!

You're doing the right thing - telling them you can't do anymore. You've put in your time and now it's time for someone to help - namely care providers. If selling the property is an option, I would probably do that first. Once those assets are used, Medicaid usually steps in. Maybe an attorney can advise you on the most expedient way to accomplish this. You need this responsibility off your shoulders. You deserve a life too. Bottom line - don't take him back. I know when they were going to discharge my husband following hip surgery, I was very adamant that I would not pick him up, if they put him curbside I would not put him in the car, and if he showed up at the house in a cab, I would not take him in. The only reason? I could not physically lift, move, or transfer him. I reminded them my husband could not get good care from me and it would put me in danger too. What bothered me so much was they told my husband he had to be released. He went through some initial rehab and that was very good. It just wasn't enough. My husband called me one day and said they may send him to a rehab hospital but he did not know how they would get him there. Later they told him he could transfer by ambulance. 2 weeks later when discharge was being discussed, I told the rehab nurses I needed in-home help as I just couldn't do any heavy stuff. He got very good care. If I brought him home the first time they tried to discharge it would have been an entirely different outcome for both of us. Stick with your decision to not bring him home. If you're concerned about the string of conversation you may want to put your concerns in writing to the nurses and doctors. Keep us posted.

OMG--an 87 yr old father and no one wants him. This is a fate worse than death.

To the point of the question, Medicare does pay for 100 days of rehab. Nursing homes/rehabs will ask family members to bring the elder home early after 30 or 60 days, because they benefit if they can get patients in the first 30 days. The home gets more payment from Medicare. However, you can get the 100 days of rehab if he needs it.

Too sad for words that no one wants to care for this elder or arrange a proper placement for him. The good book calls us to "honor they father and mother" I missed the verse that says it is proper to walk away from thy father and mother.
However in today's society some fathers fall short and many children fall short of caring for their elder. At 87 he will not live another 10 yrs in most cases --so getting him a proper placement if he needs one ---seems little enough to do.

Getting tired of folks who put themselves first always. Even if he was not a great dad, for god's sake find him a proper placement. Yes it takes some work, so what. Be the better person.

Bellas, I understand your sense of injustice about the system's assumptions. I think the system acts on those assumptions because most people think that most people would want to look after their parents. Then, like us, they try it; and suddenly they can understand how for many people looking after their parents, which isn't just a matter of smiling fondly on them and bringing them flowers, is too much to carry; and then suddenly they can completely understand how BlueRidge can decide that enough has been enough.

But, still, it's a reasonable assumption - as long as those who have good reasons to also feel free to correct it.

@Lizann… beating people up with God's Word goes against 99% of Scripture's teaching about how we are to treat others. Perhaps you have not had to walk in the same set of circumstances BlueRidge has been in all her life, I certainly hope not but if you have and you stand by your convictions, well, that works for you but not everyone is you. I believe we need to give grace to those who are hurting, come along side them w/o judging them and others here on the site, put our arms around them and accept them as they are, where they are and be thankful we were not raised by such an abusive man, if that is the case.

I agree with you Bellas, but I also agree (and I'm sure you do too) with Lizann that the idea on its own of an 87 year old person "having no one who wants him" is an extremely sad thought.

How that came about is a different question, and what to do about it is another question again. But the other really important point is that BlueRidge is sad about it too - not being able to provide home care for someone is not the same as not caring about him at all.

And it is crucial for elders' safety and wellbeing that we each of us recognise when we've got to the end of our rope, and admit it, and do something about it. Whited sepulchres in this context would be very dangerous indeed.

I really can't answer this question with much knowledge. I know I had my Mom in an ALF in NC for a while until they found out she was not eligible for MEDICAID and they gave me two weeks to get her out. I wanted to just leave her there and I was told that they would discharge her to my last know address (don't know if that was true). They sent me a bill for over $10,000 (not paying it). Good luck and I feel your pain. I have my Mom with me and would like to just take and leave her someplace. My Mom has dementia, COPD, hypertension, diabetes, CHF, and only God knows what else. Everyday...all day something hurts. To all of us dealing with elderly parents, may God bless us and give us the strength to make the long haul with our parents.

I have a mother who's a malignant narcisist, has dementia, and I stay Away. I applaud you Blueridge, for havin' the nerve to post this and take on all the MORONS. I totally support you as a lifelong abuse survivor, and I bless you. I remember as a child, no one believed me, but I believe you. Take care.

Thanks to all who wrote beautiful, thoughtful and thoutfilled notes of encouragement. Isn't there a saying about walking in someone else's shoes...Lets all continue to support and uplift each other. The world is difficult enough.

God Bless you all...and Big Hugs

Marylee

Honor thy parent dies NOT mean wait on them hand and foot!

Let the professionals take care of your Dad..

I don't have any sort of agenda. I'm just tired of him. Tired of him before he got old and more tired of him now that he is old. My other responsibilities rank higher - school-aged children, spouse, demanding job, mortgage, my own health etc. I don't have the time or energy to keep him company all day and cater to his needs. I only get 24 hours in my day and I have 30 hours worth of stuff to do even before you add him into the mix. It's time to pay others to do this I guess. Thanks all.

I completely understand what you are going through. My father has a softball sized meningioma brain tumor. His doctor told him that he would eventually become bedridden and a vegetable if he didnt have surgery. He chose not to have anything done. He has been very mean, mentally abusive and never satisfied with anything. I can't do anything right. He has a live in girlfriend who cant either. He hadnt bathed in months and wouldnt accept our help when we tried. He was constantly spitting everywhere and never washed his hands after using his urinal. I cant deal with this!! He was constantly calling 911, the FBI and the CIA. My brother and I put him in a nursing home because he was starting to require more care than we could handle, as we both work full time jobs. We thought we'd be nice and leave him with his cell phone. He has begun calling 911, the FBI and the CIA again so we had to take it away from him. I don't know what to do anymore. I've done all that I'm capable of doing. My stress level is extremely high and I don't sleep well. My brother thinks I don't care because I have distanced myself somewhat. I DO care but have to protect myself too. I only have this one body. I feel horrible for how I feel. Any advice?

Don't feel horrible. You've done all you can. The sad fact is that many people die sick and miserable.

@ fedup - as blueridge says - you have done all you can. Time to look after you and decrease your stress levels. Some people paint themselves into a corner. You watch it happening, try to prevent it but you can't. My mother has ended up in a geriatric psychiatric hospital totally isolated, by her choices. I am in the background and look after her finances, and see that she has what she needs - at arm's length. Eve that isn't easy.You can't do anything right for a narcissist, so you do what you think is the right thing and leave it at that. You probably have a life time to recover from. You are making the right decisions - protect yourself. I wish I had figured that out sooner. (((((((hugs)))))

Operative phrase "...I've done all that I'm capable of doing". Your brother will have to accept this. I think you would feel much less stressed if he accepted this fact about his sister. If he doesn't, is it possible you both could chip in to hire weekend help? Both of you need a physical and emotional respite.

I have the same going on except it's with a husband who's only 61 that I left 15 years ago. We were together since I was 15. We have 2 grown sons together. When I left he completely abandoned his kids. I raised them myself. I ran with the clothes on our backs due to his drinking. He had no one. Being foolish I left him the home we bought together which he did pay off. He is now in a nursing home with dementia brought on by drinking. I have gone to meeting to make sure he is getting proper care. They are applying for Medicaid but are giving me a problem with him signing the house over to me which is allowed or else Medicaid will take it. I don't have the resources to psy the taxes and insurance on it until whenever. I want the house or the money it brings for him. They're acting like I'm trying to steal my own home.

Blue Ridge I applaud your courage to know that you can longer take care of your father. Can he afford an Assisted Living Community ? They can help coordinate a smooth transition from the rehab facility to a community. Most of the Assisted Living Communities have meals, laundry and housekeeping so all of that will be taken off your hands. The Personal Care Homes are usually less expensive than the larger communities.

The assisted living are extremely expensive starting in NY at $1,500 a month for a studio. If they need to monitor their medication it's $700 more a month and so on. When they say assisted living you pay a high premium for everything they assist them with. Unfortunately this nature of care is a solution only for the wealthy.

I assist people with finding care so I am aware of the cost. To be honest there is no community in NY, that costs 1500 unless its in the Buffalo area. In the 5 boroughs the cost is at least 2700 just for the apartment that is without level of care charges. On Long Island its about 4000 per month.

Wait there are Adult Homes in NY that charge 1500 but that is for a shared room.