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My dad is 93 and a WWII veteran diabetic on insulin, who recently had to be hospitalized for a wound resulting from cellulitis in his legs. The hospital referred him to a SNF where he seems to have rapidly declined. He was using a walker when admitted to the hospital and could use it the first day at the facility. Then it seemed he just got worse, with symptoms of gout (later dismissed as arthritis) and recently nausea. He is unable to use his walker and doesn't want to go to PT, so they do his excercises while he is in bed. He is also fully incontinent.


Before being hospitalized, Dad refused to take a shower. He insisted that his military type washing was enough. He refused home health aid for showering, etc. And was adamant that his odor was just how old people smelled.


I am an only child and my mother/his wife died in 1975. I have no grid for the steps that I need to take to make sure that I get the best care for him, and no siblings on which I can depend. In this situation, my spouse is also no help. I am unable to provide the care he needs in my home. I work three days a week and have 90 minute RT commute.


Our resources are very limited, and the funds that Dad has are just enough to pay for funeral expenses, (whenever that day should come) and to pay off his bills.


I have been advised to get him qualified for a Medicaid bed. I do have power of attorney, so I plan to purchase a pre-paid funeral package. While he has received some VA benefits, he does not qualify for full VA services. He had both Medicare and Blue Cross supplemental, but neither will cover nursing home care, when the SNF benefit runs out.


In the meantime, especially since the lock down, he has stopped eating the food at the SNF. I haven't been able to see him, so we talk via cell every day. He tells me that he hates the food and won't eat it. He drinks milk and the rest of the food, he sends it back.


We are originally from KY and he goes in and out mentally, thinking that he still lives there and is just inpatient at the VA hospital in KY.


Any advice, references, and/or tips for any of this is greatly appreciated.


Running in place.

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Yes, get him qualified for Medicaid bed. My sister is in SNF and her dentures don't fit properly. She is on a pureed diet and will eat it. And they give her Ensure and fortified milk and pudding and ice cream. It's so hard not to be able to be there for her meals; but I'm thankful the caregivers at her SNF are so caring. One of the workers set up a Skype account so that we can see each other on the screen. That helps her to know that I am alive. God bless you and your dad.
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Reply to MaxineSue
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See if they will get him on Glucerna drink. It’s for Diabetics. Or you can purchase and drop it off for him. My heart breaks more everytime I hear these things.
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Reply to madison58
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Julibeads, sorry about the Hormels ice cream suggestion, I somehow missed that your dad is diabetic
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Reply to Rutabagagirl
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Hi Julibeads, I'm up in the middle of the night and saw your post. When dad was in the nursing home, he also refused to eat. He also drank milk a lot. I lived far away, so I ordered food on Amazon for him and had it shipped to the nursing home for the staff to give him. For a milk lover, the Hormels fortified ice cream variety pack was a hit. I had to nag the staff by phone to give it to him, but eventually they gave it when the tray was left untouched. Now that corona virus keeps family out of nursing homes, direct shipping of preferred foods with phone follow up might be an option
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Reply to Rutabagagirl
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Your father is a veteran and as such can be buried in a Military cemetery. This will help with some of his final expenses.
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Reply to Freudosa
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Perhaps he can get a food delivery service.
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Reply to Llamalover47
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Ask facility if they will allow delivery of prepared food. People in their homes are still getting no contact deliveries, so they may allow it, too. Might perk him up a bit to get something he really likes. Maybe something you cook or restaurant.
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To dogparkmama....it is not a requirement to have a body embalmed. It is only required if you are going to have an open casket..public viewing. I did not have my Husband embalmed and family only could view. (I live in Illinois)
I paid for funeral, I got a marker/headstone since he was a Veteran. VA did not pay funeral costs or any cost involved. I did get a pittance from Social Security (big whoop on that!...and they took back the last check since he died on the 26th!)
But again there is no need to pay for embalming so don't let them bully you into doing that if there is no need.
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Isthisrealyreal Apr 1, 2020
Grandma, if the body is going to cross state lines it is required to have it embalmed. Just an FYI.
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take him home. If you can't, hire a private carer.
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I'd confirm what he tells you, since you say that he has cognitive decline. He may be eating fine, but, just wanting favorite foods from you. I'd first get approval from the facility before sending any packages. I've read that they don't want to accept items from outside sources, since it could contain the virus. I know of one facility that is encouraging emails to the residents that they will deliver, instead of personal cards, to avoid the handling of outside items.
Also, if he is diabetic, they will ensure that he doesn't have too many carbs, which could cause his blood sugar to run too high. That might be why he is unhappy with their food, likely protein and not high in carbs. Of course, I support seniors eating what they want when they are of advanced age and terminally ill, but, maybe, the facility has their rules that must be followed with his diet.
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Reply to Sunnygirl1
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See if he will agree to drinking one of the high calorie supplements like boost, you might have to send them in if the facility won't supply one he likes. And what about little individually packaged treats like puddings or fruit cups, peanuts, energy bars or granola bars....
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Reply to cwillie
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If the facility has not contacted you about him not eating anything I would venture to say that he is probably eating. If not the facility is failing miserably and that can still be reported.

My dad was always telling me garbage to make me worry and feel bad. He was fine, eating, active and social. To hear him tell it, he was in living hell not being fed, unable to do anything and no one to help him. Just a heads up for you that he may be manipulating you.

Call the facility and ask for his weight, ask if he is eating and how he is doing overall. This should be recorded, be sure and note date, time and whom you spoke with, so you have a record of the weight and what that is doing. Losing weight and not eating can be a cause for hospice.

Does your dad understand what is happening, why you can't be there? He may be trying to get you to visit if he doesn't completely get quarantined.
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cetude Apr 1, 2020
don't count on them saying anything
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This is a tough situation given the lockdown. Have you contacted the dietician to discuss the situation? Maybe she could work with you and your Dad regarding food preferences. Nursing home food can be bland because they need to meet so many specialized diets. I would ask about his current diet order. Maybe, hopefully it's an easy fix such as added salt if it won't affect any of his medical issues. Good luck.
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Reply to Peanuts56
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Talk with the social worker at the facility as soon as you can, if you have not already done so, to advise that he cannot safely go home and you are not able to take him in. They should begin the process of finding him a place to go and can help with the Medicaid process. The SNF may have Medicaid beds that he could qualify for once the Medicare benefit ends. He may qualify for VA death benefits; they pay for funeral and plot if he is to be buried in military cemetery. but they don't pay for everything. I don't think they pay for much if he is to be buried in a private cemetery but at least see what is covered.
Check with the staff to see if he really is not eating any of his food. If he is truly sending back his tray untouched, the staff should have taken action by now. So he may be eating more than he is telling you. Especially if he is on insulin, his food intake should be monitor and insulin adjusted. If he is not eating, then have whoever is in charge of meal service meet with him to find him food he likes.
I hesitate to ask this but as POA, does he have a designated DNR status? Is he considered competent to make that decision or would they be leaving it to you?
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worriedinCali Apr 1, 2020
The VA doesn’t pay for funerals. Burial is free yes but only in specific cemeteries. It’s the plot and burial that are free. Some
thing are provided at no charge but the VA doesn’t actually pay much when it comes to funerals. VA doesn’t pay for anything else. They reimburse some costs but you have to pay out of pocket first and seek reimbursement.
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Seems he is very much in control of his own health - for better or worse.

See if the facility will try supplements like Glucerna, which is better for diabetics. Ask him what he likes as far as flavors go- maybe he prefers highly seasoned food or hot pepper flavors. You could send him Mrs. Dash or hot pepper sauces to try on his food.

You will need to apply for Medicad for him so he will have a bed after his rehab days are through. Check with VA about burial. Since he served he can probably get a military funeral which the military pays for.
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dogparkmomma Apr 1, 2020
The military will pay for the cost of the funeral if the person is going into a military cemetery but they don't pay for embalming or transportation of the body. If there is no space in military cemetery, they don't pay for plot. For my FIL, who is still living in memory care, we had to apply for space in military cemetery; he lives in IL so we applied for Abraham Lincoln cemetery. We have his discharge papers so application was easy. It took several weeks but they can do it faster if the person has already died. However, we paid for transport of body from the memory care facility (which is literally across the street from the funeral home but that part was still $300), and for cremation costs and urn. When the time comes, they will deliver/send the cremated remains to the cemetery and they will schedule burial. There will be a service if we want to attend. He wants to have ashes put in the ground so that is the part the military pays for. so it is in no way free.
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The facility should have a product like "Magic Cup" or some similar name. It is a supplement product that should be better than the milk he is having. The product can be served frozen or as it thaws it can be drunk like a shake, then as you would milk when it is fully thawed.
Products like Boost, Ensure and others like it might be an option.
If he is drinking his milk and not eating solid foods there might be another problem. Dental problems would be a guess. Sores in his mouth might also cause pain if he were to try eating solid food.
Would he eat pudding, applesauce, ice cream, oatmeal? If he does then it probably is the hard solid food that is bothering him.
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Reply to Grandma1954
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You describe a very difficult and, I believe, typical situation, really mediocre food that residents don't like and won't eat, other patient considerations that would require close attention the SNLs don't have the staff resources to provide and, in your case, limited family resources. I look forward to anyone's solution. I don't have one.
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Reply to amoeba
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Can you have a care package of healthy snacks delivered to him?
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Reply to againx100
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I’m so sorry for this. My husband is in rehab for mobility therapy and when he tells me about the food he’s served, it makes me cringe. When I was still able to visit him, I’d bring him food.

Your father sounds very stubborn and set in his ways. Whatever he says goes, right? And with the situation in facilities today, the staff doesn’t have time to cajole and coddle their patients. I’m sure that with his issues, he’s on a strict diet. Only the resort type facilities have actual chefs. Most facility kitchens do the best they can with their budgets.

First of all, apply for Medicaid ASAP. You never know how long it will take. Secondly,,speak with his nurse and the facility doctor, via FaceTime or Skype is you need to. There are meds to increase appetite, for depression and for anxiety. Some of them may help. I’m also sorry you’re in this alone. I know how you feel. I was in the same boat with my mom and now with my husband.
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Reply to Ahmijoy
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Perhaps you can call and see if he can get any different food?
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