My FIL's health has deteriorated quickly. Apparently he has made no plans for this and my wife is wanting to know what to do?

I would ask for assistance from the social worker at the Rehab Center to apply for Medicaid, as it sounds as though he would qualify.

While you're working on that, you might want to talk with the PT and OT staff to determine whether or not the physical issues for which he's getting rehab will be improved sufficiently to return home, factoring in the mental deterioration.

Do you know if anyone has done any tests to determine if he does have dementia?

Assuming a worst case scenario, and after speaking with the rehab staff, you might want to consider where he'll live if he is discharged from rehab. Could he go home, with home care to help? Is he a veteran and if so has he applied for assistance? Would you want him to live with you, and are your homes physically close?

There are a lot of factors to consider so I would try to get clarification on his mental and physical status, then consider options based on that.

If it gets confusing, as it often does since there are so many "if this, then that and if not this, then that" options, like a geometry problem, then draw a decision tree to help identify which options might be available for which conditions.

The social worker should be able to help you consider these options and provide a list of various facilities that might meet his needs.

If, for example, he returns home, you might want to consider not only in home assistance but meals on wheels. You also might want to investigate any senior center in your community to find out what services they offer, including recommendations or referrrals for someone to help keep up the house, yard, etc.

If he'll be needing transportation, check with the local public transit agency, if any, to find out if it has point to point service for medical appointments. These services are generally much cheaper than commercial services which transport people who need assistance.

In the meantime, do you know if he's executed estate planning documents? If not, it's time to consider that if he's still sufficiently cognizant to execute documents. If family relations are cordial, forward planning might be something to discuss with your wife's relatives.

But do get started on the Medicaid application, and good luck. I'm sure this must be overwhelming to see so much change so quickly.

I would quickly determine if he has signed a Durable Power of Attorney, Healthcare POA, and Living Will. If he is still competent enough to sign them, get them signed quickly. She will need them in order to act on his behalf. Once she has the ability to act on his behalf, she can obtain documents, statements, financial records, etc. Then, I would consult with an Elder Law attorney, who is familiar with Medicaid rules. They should be able to explain how and why he may qualify.

Each state's rules vary on Medicaid, so it will depend on what state is he is. For example, in NC (I'm in NC too.) which you have on your profile, they have what is described as Special Assistance for those who need Memory Care or Assisted Living, by referral of a doctor. Most Medicaid qualifications apply, except they have a 3 year look back period, not 5. For Nursing homes, it's straight Medicaid. An Attorney can explain all of that in more detail. Depending on his assets and income, you apply for Medicaid through your county social services. HOWEVER, I would research it all first, before completing the application by reading and consulting with an attorney.

Thank you. I thought about Social Services but was not aware they may have a social worker at the Rehab Center. I will check with them. I'm sure his estate planning is non existent. I also doubt he will return home. Family is good. Just a stubborn older man who never trusted anyone and now he needs help. Thanks again.

Brad, if it's a very small rehab center, it might not have a social worker, but in my experience, economies of scale apply to rehab centers so they're generally large enough to afford social workers on staff.

The Area Agencies on Aging are also good sources of information.

Since this man is stubborn (and boy can a lot of us relate to that!), you may find that he'll insist on going home even though it's not realistic, and that he isn't able to recognize that he can't manage on his own. Sometimes this is the biggest battle.

There are designated workers to process Medicaid, but I will strongly encourage you to obtain as much information as possible on the requirements BEFORE you apply for Medicaid.

You will also need a Form completed by his doctor that designates what he needs help with. It used to be called a FL-2. The facility he is in, may be able to complete that for him, so potentially, he could be transferred directly to another facility. Also, some Rehab facilities have Assisted Living on the same premises. Some facilities have Assisted Living, Nursing Home and Memory Care on one campus.

Since dementia is his primary ailment, I would make sure whoever completes the FL2, really spends time watching your FIL. It may take time to see just how much assistance he needs, such as with bathing, eating, medication, etc. I would encourage them to explore if the facility he is placed is set up for dementia. If it's not a dementia unit, they may not be a good fit. It definitely depends on the stage of dementia.

Thank you so much. I am making a good list of questions and notes.