How do you handle a person who doesn't take his meds, might be incontinent, is extremely lethargic, and you have to buy food for?


Person does not hardly move, laying in bed and wanders very little. He was almost like a walking zombie. He does not take or forgets to take meds prescribed for Blood Pressure, Cholestrol, etc. We have to buy food for him since he does not leave his house. Recently, after a small stay in the hospital (against his wishes but a neighbor called to have him admitted) for uncontrolled Blood Pressure, the hospital no only refused to discharge him unless 24/7 care was provided. He was then transferred to a nursing facility at $10K/month out of pocket. Now that he is in the nursing facilty, he has become bedridden, doesn't eat 3 meals a day, has been zippered into a hosiptal bed to prevent him from leaving the bed, and has apparently become completely incontinent and no longer uses a bathroom/restroom. For the past 3 weeks he has become almost like an infant. He does nothing but eat occassionally, sleep or languish in the bed, and pees/craps himself, like an infant. However, he does need to take a few meds. The facility refuses to release him from their facilty until 24/7 care is provided to him. What type of arrangements can be made for him and what type of care is available that would basically do the samething at his home. It appears that home care would replicate the facility care he is currently receiving if (I am being blunt about this), someone changes his Depends in the morning after throwing him into the shower, puts a meal in front of him, and watch him take his meds 3 times a day. The rest of the time he will do what he has done for the last three weeks, which is staring off into space from his bed.

This might all sound cold hearted but the facility and the hospital have provided no information to suggest he is medically, emotional, or mentally incapacitated. As such, the Power of Attorney in place can not be used. It should be noted that the facility had him sign Medicaid and Medicare applications, indicating he has the legal capacity to sign documents. His financial resources are being drained very fast and if a solution or a course of action is not found soon, he will just wind up becoming a ward of the state.

As a layman, it seems to me there should be a way to provide services 3 times a day for roughly an hour or two and allow him to languish like he is doing in the current facility. He has received no medical attention in the past 3 weeks, meaning nothing after he was "transferred" (not discharged and admitted) to the nursing facility. Over $10K per month for what he is getting seems outrageous.

There has been no physical therapy (not sure if it is needed) and his joints are starting to atrophy. He walked into the hospital about a month ago, very little was done, we were not given any information concerning at medical/mental conditions beyond his high Blood Pressure, and now he is almost completely bed-ridden and unable to take care of his basic bodily functions.

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Rocknrobin is right - such a helpless person (whatever medical or mental problem they might or might not have) could not be safely cared for by someone coming in for just a few hours. Like leaving an infant to care for itself.
Helpful Answer (1)

You think a caregiver could come in 3 times a day to care for this person. What if there's a fire? Would you leave a baby in a crib and have someone come in 3 times a day for them? Whoever would put him in a situation like that could be held responsible for neglect. You don't know what's wrong with him. And I don't believe you have POA or you would know more. It sounds like this person is where he needs to be.
Helpful Answer (4)

Andrew, most of the time when someone walks into a hospital on their own, that person knows or feel that something is terribly wrong.

The ER will not admit someone to a bed in the hospital unless there are medical reasons for the admission. Medical tests are usually given and at that point in time the hospital probably found something wrong. As someone above had mentioned, maybe this gentleman had a stroke.

You can only demand answers if you have a medical power of attorney for this person, or if your name is on the admission application as an emergency contact and that you are allowed to received any medical information.
Helpful Answer (2)

I had a long response that was just lost. I would like to thank everyone for their inputs and I might try to resconstuction my response to all that was brought up. Not that something is amiss, but rather we are doing a few things wrong, questions are not being addressed or ansered by those in charge of him, and we really do not have clear information regarding his condition and needs.

To be blunt, I agree he needs an advocate but after walking into the hospital on his own, being told nothing dramatically was wrong with him other than his blood pressure, spending time in the hospital and now the NH, we are told he is completely debilitated and needs 24/7 indefinitely. To me, he walked in and now he is bedridden. Something is amiss.

Again, thank you for you inputs. You have made some interesting points and I guess I need to travel back East and just take the bull by the horns and demands answers, and try to find a direction that meets his needs Before he is bankrupted and becomes a ward of the state.
Helpful Answer (0)

Andrew, I really believe the best thing for this gentleman is to stay in the facility. If he does come home, someone will have to set up his home for a non-mobile person.... such as ordering a hospital bed, etc.

And since you live in Colorado.... in winter time, what if the Caregivers cannot drive to this gentleman's home when the weather is bad. At least at a facility, the facility knows exactly what to do in that situation, they can still have 3 shifts.... where at this gentleman's home if a Caregiver is snowed in, how will that person be able to work 24 to 48 hours straight?
Helpful Answer (3)

Did his uncontrolled blood pressure lead to a stroke?

I am so sorry that you are faced with this situation. Who has the medical power of attorney? I would hope that person would step forward and advocate for him. Also, if he is not incompetent he could easily sign HIIPA waivers to allow someone to have access to his medical information -- that does not require an active POA.

Is this person going to soon need Medicaid financial assistance?

Your question about what kind of in-home care might be satisfactory is a good one. If he is deemed to need 24/7 care, that does not mean someone coming in a few times a day. In the NH there are three shifts of trained personnel available to assist him at all times. I'm not saying they do that wonderfully -- I sure don't know -- but technically someone is always on call for his needs.

He is not incompetent, then he can decide that he won't accept 24/7 care, and that he won't (or will) stay in the NH. But what his legal rights are and what is best for him may not coincide. And even if he is not legally incompetent, it sounds like he may need considerable help even learning what his options are.

I sure hope someone can step up and be an advocate for him!
Helpful Answer (2)

Andrew, is this your brother (

If so, your other post infers that APS is already involved and will challenge for guardianship.

I agree with Jessie. Something's amiss here.

A zombie-like person, apparently immobile, incontinent, barely eating, and your position is that "there should be a way to provide services 3 times a day for roughly an hour or two and allow him to LANGUISH (my emphasis) like he is doing in the current facility."

If he was hospitalized, there had to be a diganosis which would allow the nursing home to accept him. They don't just take people without justification.

And someone obviously had to be told that he needed to have 24/7 care before he could be released. How did you know his joints have atrophied and that he's received "no medical attention in the past 3 weeks", no PT....

If there's blame to place, some of it has to be shared by whoever is responsible for this person.

But I still say something's missing from this story.

Whoever that person is presumably has HIPAA authority and should know what the issues are.

This "zippering up" doesn't make sense; if bed rails were used, I believe there has to be consent by someone in the family with authority to agree to that decision. It sounds more as if he was in a body bag.

Is he not old enough to have Medicare? That's the only reason I can think of that the nursing home stay would be entirely self-paid.
Helpful Answer (2)

$10K a month? Zippered into bed? Who is paying the bill? Isn't it illegal to restrain non-violent patients now? Something about this story is not adding up right.
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Andrew, I am curious how you found out that this gentleman has had no medical attention in the past 3 weeks? By law medical facilities cannot give out information except to a relative and whomever has a medical Power of Attorney. It could be his health was more dire than originally thought, thus the reason to keep him in the facility with a lot of employees instead of sending him home to three Caregivers, each taking an 8 hour shift.
Helpful Answer (2)

If you're not the responsible party for this person, the very best thing you can do is report his situation to an elder abuse organization. If you are the responsible party (have a healthcare power of attorney) you can get all the information you want or need. Without that? You can only report what you've observed to an organization designed to look out after seniors' welfare.
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