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Hi, my dad is 88 years old and is having much more accidents (fecal incontinence), inability to stand up from the couch and fell down today. He’s been in my care since January 2019 and we have a care provider (provided by the state) for about 4 hours a day five days a week who helps my dad take showers, cleans up after my dad, cooks and is good company for him. I am a disabled veteran myself who deals with cervical spine/back issues and cannot pick him up off the floor amongst other things. My dad is receiving social security, has a tiny pension and is receiving state benefits…has no property and is living with me. What will start the process of him getting admitted to a nursery home? I have a very nice one that is not private that is close to my home, but I’m thinking that he has to have a accident that will require us going to the emergency room and the doctor deeming him unable to care for himself, is this true? Or his primary physician deeming him unable to care for himself? Thank you in advance.

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If your father requires 24/7 care and/or help with 3 or more Activities of Daily Living (ADLs), then he is qualified for Skilled Nursing Care in a nursing home. If he's currently on Medicaid, then you'll need to find a SNF in your area that is accepting new residents who are on Medicaid, get him evaluated, and then accepted into care in their facility. If he has a social worker or case manager currently who's assisting with the care needs that you mention, call that person and express your desire to get him placed in Skilled Nursing care asap. Take it from there. Hopefully dad is agreeable to being placed....?

Best of luck!
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Cinot7me Dec 2022
Thank you so much. I have POA....my dad most likely will do whatever I choose to do and can handle. I'm going to keep him with me as long as I can though!
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It does not matter if Dad has cognitive ability, it sounds like he is becoming 24/7 care which you cannot provide. Nor will you get 24/7 care provided by the State.

Call your Office of Aging and explain your situation. They can evaluate and help you get him placed probably with Medicaid paying for his care. Be aware, that his SS and any other income he has will be needed to offset the cost of his care.
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Cinot7me Dec 2022
Thanks so much! Yes I'm aware of the SS being used to offset the LTC living. I
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Are you his PoA? Does he have a medical diagnosis of cognitive/memory problems? If he still has mental capacity, then, even if you are his PoA, you may not be able to transition him to a care facility without his consent and cooperation.

Sounds like you should consult with a Medicaid Planner for his state since he is getting income beyond his SS and may have difficulty qualifying.
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Cinot7me Dec 2022
Thanks for responding. I do have POA, but I think that if he's in need of care that I can't provide then that may be suffice to his being admitted in a LTC facility. He receives a monthly pension under $200 along with his SS, and he still qualified for state benefits so I think he'll qualify for a skilled nursing facility. I actually found one close to my home and they are checking if he qualifies ...for when that time comes. Nevertheless, I'm going to keep him with me for as long as I can.
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The next time he falls, call 911 and have him transported to the hospital. Once there, tell the case manager and SW he is not safe at home anymore and you cannot take care of him sufficiently. The SW will help prepare the LTC Medicaid application. Or you can contact your care provider's boss and tell them your father needs a NH now, that the in-home care is not enough anymore. They likely have a department that can help you with this.
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Cinot7me Dec 2022
Thanks so much! What you answered is correct...I confirmed with the NH that I'm in talks with. The hospital has a case or social worker that will help when that time comes. It helps to know which NH I prefer my dad to be placed as well and that the NH already has knowledge of my dad's situation and benefits beforehand so the process is almost seamless between them and the hospital. Thanks again!
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I’d suggest going back to the source where you were directed in how to get in home help and asking for help with his increasing needs.

Any fall can be source of concern for a frail elder. If you call and ask for advice: “My 88 year old father fell, what should I do?” You are likely to work your way into an ER trip, with an offer of an ambulance. Is he on blood thinners, did he hit his head, has he been checked for osteoporosis, etc.?

Once at the ER there is a process through the unsafe discharge conversation to the nursing home.
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Cinot7me Dec 2022
Thanks so much! Your answer was Very helpful as he is on blood thinners and God forbid the next fall take place.
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Cinot7,

I am so sorry that you are in this difficult situation.

Is your dad on Medicaid? If so, I would speak with a Medicaid specialist to find out the next step in your situation.

There are knowledgeable posters on this forum that will be able to help you further.

Best wishes to you and your father. Wishing you peace as you continue on your caregiving journey with your father.
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Cinot7me Dec 2022
Thank you so much. I have received the help I needed....everyone is so kind and knowledgeable. I'm working with a NH now to check his benefits so when that time does actually come it'll be almost seamless to get him in, until then dad will be with me as long as possible.
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