How do you put parent in skilled nursing facility when they don’t want to go?

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Ambulence trips to hospital are weekly and my parent cannot care for himself at home. Suffering from siatica nerve pain. Family members work full time and are not able to assist with the kind of care he needs. Parent refuses to be admitted to a skilled facility, even though it would be temporary. What does the rest of the family do? Feeling frustrated. No money to help pay for this.

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Theschus, decades ago I had sciatica nerve pain that was so very painful. It was so difficult to do things around the house. Had to walk with a cane, and wear a device where I could zap the pain. Sitting down and standing up were the worse.

Chances are high that your Dad wouldn't be accepted into a nursing home because sciatica nerve pain can be controlled if not totally eliminated.

I tried physical therapy but that didn't work for me. What did work was TRACTION... oh my gosh, after two session the pain was completely gone and it rarely came back. If I feel a twinge, I would just sit down bend over as far as I can go trying to touch the floor. I realize that may or may not work for everyone. One would have to check with their doctor.

Long ago one would see old TV shows where a patient is hooked to traction with weights while in a hospital bed. No more. The session today is out patient.
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I would need to know where you live, if your parent lives with you, how much care they need and what kind of insurance you have to give the best advice. Because of my own caregiving, I'm not going to have much time to respond at length again. I wish you Godspeed (unless you are an atheist: then I wish you luck.) Do your homework and figure out your options. There is a steep learning curve but eventually you will grasp it.

The very first step is to call the PCP and get a referral for an occupational therapist (or sometimes a physical therapist) in to the home to do a safety assessment and to call the health insurance company and find out what services they are entitled to at home. It won't be enough, but it will be a start. If they don't have a PCP you can ask the hospital social worker how to set up the safety assessment.

If your loved one is truly unsafe, and you can't stay with them, the OT and the doctor have to act on it and your loved one will have to go to rehab. Some places offer adult daycare if you can be with them at night. It should be covered by insurance short term.

If your loved one is not unsafe, in this country we all have the constitutional right to make terrible decisions. Elders cannot be constrained physically or chemically without a court order. People can not be put in nursing homes without their consent unless you are their guardian or you have POA. On the surface this looks just, humane and honorable, but ultimately it may mean they get hurt.

The person with dementia who won't stay in a wheelchair gets up again and again, falls, breaks their hip, catches pneumonia in the hospital and dies. Their right to freedom has literally killed them. In facilities it is called "the right to fall." The elder has the right to decide to stand up! Other countries handle this differently. Your loved one, unless they are found to be incapacitated or in danger, has the right to make a terrible decision. If a loved one makes a bad decision, we are stuck with the consequences, but ultimately it was their choice and it is not our fault at all.

There are steps you can take and choices to make to get them care which I have outlined below. I want to emphasize it is a CHOICE on our part whether to help and how much. That I CHOSE to help my loved one and take her problems on is the only way I get through each day. If I become a martyr and say that I "had" to, I feel trapped and want to run away.

The advice to call in the hospital social worker when they are discharged from the ER and to say you can't care for them at home is sound. You want to get your loved one services as soon as possible because at some point if there are excessive ER visits, the state looks in to the matter. If the elder is not safe in their home, they may appoint a state guardian. This can go well, and get your loved one the services they need. This can go badly and there are horror stories such as when the elder was forced in to a nursing home, the state took their home to pay for the care and took their pet, even though her family was involved and wanted to handle those decisions. The family had to hire a lawyer and it took years to get back in charge of their loved one's care. They never got the house or pet back.

The routes that are apparent to me for you follow: 1. Home health aides (twice a week for 2 hours should be covered by insurance), PT and OT in the home, and neighbors and family to come to the house a couple of times a day while you work. There is also meals on wheels to deliver lunch, which provides a safety check, and sometimes there are volunteer organizations. But I don't know if your parent can be left alone and this would be leaving them unattended if there is a fall risk or they can't go to the bathroom unassisted. No one should do something they are uncomfortable with, for instance, changing a diaper. It will be your job to coordinate everything, and it is not a small task. People sometimes call in sick or cancel, leaving you in a bind. 2. You could take a leave of absence from work under the family leave act. 3. Another route is getting them to use their assets for a private aide in the home. 4. The 4th route is invoking a POA (power of attorney) if you have one and put them in rehab. Call it rehab, too. It's short term. They get to go back home. By doing a stint in rehab they are actually prolonging being able to stay at home. 5. If none of the above will work, consult a lawyer about getting guardianship of the physical person. (You only get financial guardianship if they are at risk of being scammed, stolen from, or are no longer handling money well.) Guardianship is granted based on capacity, and if they are oriented and rational, you probably won't be given guardianship. Again, your loved one has the right to make bad decisions.

I explained again and again to my loved one (who would have lucid periods) the risk of losing her to the state guardianship system because of her excessive ER visits and the family wanting to help her and find the best option for her. Because of her fierce independence and her impaired reasoning from her dementia she remains (usually) opposed to what happened to her, although she sometimes admits she needed a guardian. She does thank me for helping her, which helps me hang in. Her issues are different, including psychiatric symptoms caused by medications she must have for Parkinson's.

She had never appointed me health care proxy nor given me a POA (power of attorney) and I ended up having to shut my business. So far staying 2000 miles away from home for 9 months after what I thought would be a 10 day trip. (Luckily I had a free room at my 91 year old mother's house.) Once I became guardian, which cost my 91 year old Mom $6700, I had to put my sister in memory care. Soon we (the family) will be out of money so now I am looking in to Medicaid. I know WAY too much on this topic.

Hope this helps you and best of luck. Do something nice for yourself once or twice week (once a day is better) no matter what, even if it is just a walk or coffee with a friend.
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You think it would be temporary because the sciatica will improve? It probably will, but it may require physical therapy and pain medication until it does. Who is treating your parent for this now? What treatments are being used? What do they do in the emergency room? I'm not sure a skilled nursing facility is the appropriate route. What does the doctor think?
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Other posters might know more. hopefully some will chime in. A suggestion I have read is that next time he goes to the hospital, don't sign for his release, tell the social worker that he can't care for himself at home and that he lives alone, and no one is able to come and help him, then he will be forced to go to a nursing home.
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