What can the family do about grandmother who wants to bring grandfather home?

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He really needs to be in a nursing facility. My grandmother is 86, grandfather is 94. He had a stroke in April and she has done everything opposite of what doctors and other medical professionals have told her since day one. The acute care hospital he was in was making great progress with him, but when the time came that medicaid was not going to pay for a longer acute care stay, she refused to go see any rehab facilities, so he ended up in the ONE she looked, then she wasn't happy with the care there. She also tells him everyday that she's going to take him home. Because of her last minute decisions, or lack thereof, he's been to sub-rate facilities and hasn't gotten the care he needed. Now, the time has come that the insurance will no longer cover rehab care. The only way to get him into a nursing home would be for her to apply for medicaid, which she refuses to do, and she won't agree to sign her property over. We've explained that medicaid won't take her house (I know they will put a lien on her house and that it will have to be sold to pay that off when he passes), but she seems to pretend that we have not. I don't know if she's just selfish (she's been a selfish person her whole life, but as she ages, it's getting worse). My grandfather is not a veteran (he was born with a hole in his heart). I cannot move to where they are, I'm just a school teacher, so I can't afford to travel 5 hours every weekend. My brother is an 8 hour drive away and has a home and family with small children to care for, and my parents are elderly themselves (70 and 71), my uncle is 65 and had a heart attack recently, his wife still works full time to support them, as his social security isn't enough. Even if I did live there, I'm 50 and NOT a medical professional. She just won't listen to us, not even to my brother who IS a medical professional. I don't know if we need to take power of attorney or what. Besides, that will take a lot of time and money that I don't have, and meanwhile he's going to be at home being cared for by my 86 yr. old grandma and my 70 year old mother! They can't move him. I'm 50 and a pretty strong person, and I can't move him. I'm at a total loss in this situation.

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Nasmir, you have a very good point!Yes, she's been asked. Her answer is that SHE wants him home. "I will do what I want to do." I understand that they are old, and that this must be scary for her. After all, they've been married 75 years! However, I've known her for 50 years, and she has always been very stubborn, selfish, and has had the need to control everything and everyone around her. It's never been an issue before, for me anyway, because it was easy just to tell her "no" I won't do something or "yes" I will. But now that it involves my granddad, it's a little harder to deny her what she asks. So, now I'll spend my last $199 dollars making a 10 hour round trip to do the stuff she wants me to do, as all my family is either elderly themselves, or live much farther than I do (the $$ is grocery and gas money until my first paycheck, I'm a teacher - and a very good budget shopper, but not if I spend in traveling). BUT, you make a very good point, and I'll suggest that to my mother so she can bring it up from that angle (she didn't take it well from me!). Thank you for your very thoughtful suggestion!
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Thank you everyone for your advice and suggestions. Of course, it's all stuff I already, or should already, have known. I grew up in a catholic family, so guilt has been a way of life. I just need to find a way to get around that. You all are right, my mom is the one to worry about here, she's working herself into the ground right now. Thank you again. I will be taking this advice and do what I can. Thankfully, the one bright spot in all of this is that my son, husband, and I sat down last night and made a pact that will ensure that my son will NOT be going through what my mother is going through right now. May you all be blessed. I can't thank you enough for your words of support and advice.
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Can all of you persuade your mother to back out of this plan? She is the one who will suffer the consequences. And with her in the picture the plan to bring Grandpa home may look feasible to the discharge planners. It is your mother's decisions that are key here, I would think. She is the one you need to convince.

Do your best. And also accept that this isn't ultimately your responsibility or your decision to make. Of course you are concerned and I don't mean you should butt out -- just that after you do your best you should NOT take on any guilt for the outcome. This is Not Your Fault.
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Rena, one more thing. Medicaid will lien the house, but they won't take it when GRANDPA passes. Grandma, as the "community spouse" will be able to keep the house until HER death.
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Absolutely! What Rainmom says is correct; perhaps your mom can contact the discharge planning folks at the current rehab and talk to them about the lack of a viable plan for care at home. It MUST be made clear to the facility that family members will not be available to care for grampa at home and that grandma (who sounds like perhaps is developing dementia, or perhaps has a prior history of mental illness?) will be the only game in town, so to speak.

A good facility will send an OT to the home to see if it's safe discharge. If this doesn't happen, or if the facility seems intent on sending him "home" no matter what the care plan, your or your mom should contact APS yourselves to report what will undoubtedly be an unsafe situation.

What you need to remember, above all, is that grandma's stubbornness/mental illness/dementia or plain stupidity DO NOT add up to you having to discommode yourself and your family to care for grandfather.
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Although there seem to be plenty of 70+ year-olds who are doing caregiving (which doesn't seem right to me), the real person to be concerned about here is your mother. If your grandmother bullies her (seems like she does, along with with everyone else), your mother is going to age before your eyes if she becomes your grandmother's slave. Your grandmother may very well outlive her (especially since there is only a 16-17 year difference in their ages). Is that what you want? You (ideally your brothers, too) should all come to the care conference. Your mother may not have the will to openly defy her mother, so you and your siblings should go to protect her.

Please keep us updated!
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Usually before someone is released from a rehab facility there is a care planning meeting with the family and the team of professionals who have been working with the patient - there is usually a facility social worker at this meeting. At this time the team will advise as to what level of care will be needed for the individual upon release. I suggest you attend and even though it will likely make granny mad as hell, lay it out for the team as to what home care will look like for your grandpa if he is released into your grandmothers care. If that is too daunting, contact the social worker prior to the meeting and talk with her about grandmas inability to properly care for your grandpa - along with grandmas denial in facing the facts. The outcome could be hard to face - I have heard of facilities contacting APS and the agency then filing for emergency guardianship in order for the patient to recieve proper care. However, I also know that APS will work with the family and if an appropriate plan can be worked out, APS will back off. I know this all sounds extream but for everyone's mental and physical health and safety - grandparents, your mom and you - drastic times my call for drastic measures. Good luck to you.
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