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The short of the long is my husband needs more care than what I can physically give him. He has been in the hospital since the beginning of October, first with high blood sugar, then low blood sugar followed by multiple other health issues. He is currently in rehab for therapy. While therapy has been beneficial to him, the plan is to discharge him to home. In the rehab center, it takes two to help him into or out of bed. Whenever I try to bring up the subject of not coming home, he is unwilling to discuss it.

You've brought the subject up. He cannot/will not discuss. He's not ready to.

Of course this does not make the issue disappear or solve itself.

Silence is communication of a sort too. It could be his defiance? Or maybe his way of trying to adjust. (It's a huge adjustment of loss for him to make). Or maybe his silence means You take over Dear.

He is the passenger now. You are in the driving seat. So drive where you need to.

If home is not an option for him right now, arrange the next best option.
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Reply to Beatty
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With the diagnosis of dementia YOU are the one that makes the decisions for him about his finances, health and safety.
Your first sentence is all that needs to be said.
Talk to the Social Worker or Discharge planner where he currently is. Tell them that you can not safely care for him at home any longer.
If there is a Memory Care facility that you have found now would be the time to get those papers in order.
But due to his other medical conditions it may be better if he were in Skilled Nursing.
As far as his refusal to discuss not coming home...do not discuss it. Tell him he has to remain in care until you can care for him yourself and it is not safe now.
I would also urge you to consider Hospice.
Many facilities will "find room" for a Hospice patient that might not have room for what they think may be a long term resident. (I hate to put it that way)
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Reply to Grandma1954
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When my husband was in the hospital after a broken hip, the doctor came in and announced he should be ready for discharge to go home soon. Knowing nothing about advocating at that time, I was shocked and this was our conversation...

Me: There is no way I can handle him at home by myself!
Dr: Would you like for him to be sent to rehab?
Me: Yes that would be very helpful.
Next thing I knew a social worker came in.
SW: Where would we like for him to go?
Me: I have no idea.
SW: Rattled off several suggestions and with very little insight, I had to choose a place and she made all the arrangements.

My suggestion is have a similar conversation with his doctor and I would hope the doctor could make it plain to your husband it is not safe for him to go home yet. He then would have to have the discussion and hopefully the doctor would stay for a little bit to back you. It should be handled by the facility from there... except you would have to be prepared with the financial arrangements. They are required to plan for a safe transition when discharging but you will have to select a facility... insist on what you think is best for y'all... for your finances and care. Also, you might can appeal his discharge to Medicare and possibly get an extension.

Unfortunately, the facility I chose was probably the worst for his needs. After he recovered, we began visiting facilities to try and be better prepared if we ever have a need again.

My message to anyone reading this... Hospitalization, Rehab and/or Nursing Facilities are often needed when you least expect it. If you have not done your homework, start visiting facilities NOW because it would probably be very difficult to have a loved one moved to a different one afterwards. Go unannounced and take a tour, if they offer a meal take it... it is during mealtimes you get a good look how the staff interacts with each other and the residents. If not an urgent decision, get on their mailing list and attend any open houses or activities when invited. We still don't have a preferred facility but I found places we definitely don't want to use.

It is also very important you become aware of possible costs and your responsibilities financially. Will it be paid by LTC insurance, Private Pay, VA benefits, or Medicaid, etc.
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Reply to KPWCSC
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Cover999 Nov 13, 2022
All well and good but the good ones tend to have waiting lists and/or no openings compared to the not so good
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whenever my husband asked why he was in private care home … I said
because I can’t take care of you safely at home … after awhile he understood . I found the best private care home … was there everyday …brought him snacks and his favourite foods… on top of his care everyday … also FaceTimed with kids grandkids out town almost everyday… he was always happy see me … he’d say here’s my wife .. she signs off on everything!
I felt guilty but I knew I couldn’t do it
at home … no matter how much help … here he was safe and eyes on him
24/7 … and I hope he forgave me…but it did allow us to be together everyday and keep dignity till end
good luck … there are no good solutions ….
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Reply to Helenn
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Lymie61 Nov 14, 2022
Sounds to me like he was bragging and proud of how well you were taking care off him o I don’t think there was any forgiveness necessary just admiration, love and enjoyment. In fact he was probably very grateful you made the decision that enabled him to not feel guilty about the toll hands on caregiving would have been taking on you and your relationship.
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Your profile says he has dementia. With dementia he’s no longer capable of rationally discussing and making a decision about his best interests. It becomes your responsibility. As you feel it’s beyond your capabilities to care for him in a home setting, and you’re wise to realize your limits, please talk to the staff where your husband is now. Let them know very clearly that there is no one in the home that can take on the level of care he requires and that you need assistance in finding a safe place for him to live. Tell them you cannot take him home, it would be an unsafe discharge
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Reply to Daughterof1930
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In a perfect world, your DH would not need more help than you can give him alone at home. But this is not a perfect world, DH needs 2 people to help him in and out of bed, and you just can't manage his care at home. Any man that would insist on coming home to have his wife deal with THIS level of care just isn't taking his wife's health into consideration at ALL.

Let the discharge planner know you cannot manage DHs care at home, and that he needs to stay put where he's at.

Let DH know you cannot manage his care at home, that it will break you, you are only one human being, and that he has to stay put where he's at. It's not your fault he's as physically challenged as he is, and that he'll get much better care in the SNF. You'll be by frequently to visit him.

Life on life's terms is sometimes ugly and not as we'd like it to be. Sad but true.

Wishing you the best of luck with a difficult situation.
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Reply to lealonnie1
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Have him evaluated for 24/7 care while he is there. If found he needs it, then tell them that discharging him to home is "unsafe". That you are not capable of physically caring for him. Where I live, Rehab and LTC are in the same building. Easy transferring from one to the other.

I suggest seeing an elder lawyer to have ur assets split. DHs going towards his care. When its almost gone, applying for Medicaid. You then become the Community Spouse, remain in the home, have a car and get enough of your monthly income to live on.
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Reply to JoAnn29
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In a way you are in the perfect situation . Just tell the case manager he is Not Independent and you can Not Lift him . Ask to speak with a social worker and Have him transferred to a skilled Nursing Facility or Assisted living . Seek a Elder attorney to help you with documents and a care Plan . ( they should Know a lawyer at the rehab ) My Mother left the rehab a mess and was no way Independent - we waited almost 14 days for the VNA Nurse to arrive after her rehab stint which was about 80 days . She had a giant bed sore , was incontinent , could not stand , taste or smell and had diarrhea . I had to lift her in and out of bed and into a wheel chair and change her diapers . She was a big woman . We called 911 when the VNA Nurse arrived and she spent a week in the hospital and I found her a Nice Nursing home for 24 / 7 care . She lived another 3 months and 11 days . I never told her ' she was Not coming home " but rather she needed more rehab. I tell you that was the worst 2 weeks of my Life . I ended up at the chiropractors a few times . Don't put yourself thru that . I got tricked into Picking her up at the rehab . They knew she was Not independent .
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RedVanAnnie Nov 13, 2022
I don't think Assisted Living would be enough care if a person needed help even getting out of bed. Suggesting your mother "needed more rehab," was a good way of letting her know she was not coming home yet.
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Don't discuss, tell him he's not coming home. Back it up with recommendations from his doctors, physical therapists. Tell him you do not have the physical ability to take care of him. You can't do it, so he's not coming home.
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Reply to MaryNYC
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Cover999 Nov 13, 2022
I like how Docs, therapists and the like mention about NH and AL. Sure it's all well and good because they're not staying there.
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No convincing required if you are his caregiver you have final say. Not every decision you make will please everyone. That is just life.
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Reply to Sample
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Cover999 Nov 13, 2022
But he's the one staying there, she is not. So, if this is the choice, he should have a say.
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