Is Father a candidate for home care? - AgingCare.com

Is Father a candidate for home care?

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Father (92) has PEG tube from stroke, wheelchair confined, incontinent (both), but cognitive and alert. Dad was in hospital for a week where they determined he could not swallow without aspirating. So he elected to have a peg tube. Went to rehab, now is still in therapy, but in a LTC bed. We are self-pay. But it is exorbitant. Seeing an attorney tomorrow. He is a veteran, but monthly pension too high for VA benefits. My question is--is he a candidate to move back to his one story condo (where he lived pre-stroke) and get home caregivers? His feeding tube is an issue in that caregivers will not feed so I would have to go to his house every 3 hours for tube feeding. Will a paid caregiver deal with his bowel incontinence (diarrhea) issues? I know Medicare will pay for intermittent skilled nursing and continuance of his physical and speech therapies. Could I get away with a caregiver for 5+ hrs/day and hope he would stay in bed and use the urinal at night? I just don't know what type of care he needs. And am concerned about paying $7500-8000 a month for nursing home. Living with me is not an option. He is a difficult, bossy, stubborn man and would send me to an early grave after my husband divorces me. Please advise. Suggestions on how to make this work are appreciated!

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"I just don't know what type of care he needs." I think his current facility can explain that to you. Have there been any care conferences to attend? As soloinny suggests, I'd start with the social worker who can arrange appointments to the other professionals you need to talk to.

Be very clear about what you are and aren't willing to do. Since Dad is alert and competent it may be his decision whether to go home, but if his plan includes relying on you for things you are not willing to commit to, then he needs to make other plans. You cannot tell him "you can't go home" but you can say "I won't be there except for feeding."

In general, the cost of in-home care comparable to nursing home is higher than for a nursing home. If Dad doesn't need all the care provided in an nh, the cost at home may be less. So finding out exactly what care he needs is important.

For example, can he safely be left alone overnight? If not, paying someone to stay overnight with him needs to be taken into consideration. I doubt he can clean his condo, so that is an expense. I assume he'll need bath aides. If he only has an aide there 5 hours a day, what about his toileting needs outside of those hours? Surely you don't want him to sit without being changed.

Yes, care centers are extremely expensive. In-home care is extremely expensive. I am glad to hear you are seeing a lawyer soon. I hope it is a specialist in Elder Law!
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He is self pay, but I hate seeing the money go down the drain so quickly. Also, just got first bill and they are charging incontinence fee (diapers?), antifungal powder and cream extra $12 per day! If they are going to nickel and dime me like that, I should ask for a credit for the baths they were supposed to have given him, but didn't. Sorry, now I am venting. Just so tired. I know in home care would require more of my time and sanity. He won't like anyone they send and he definitely won't want to just have someone there to be a "companion". Tried that and he would tell her to go home after 2 hrs, but would have to pay for 4. If he didn't have the PEG tube, he might be able to go to assisted living. (Do they deal with incontinence issues?)
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If he's competent, I'd let him set up his care with the proper professionals. If not, then I'd handle it differently.

It sounds like a lot for in-home care. I can't imagine going by every day to ensure things are going well, supervise aids, maintain his household, etc. It sounds like those who have gone through this found it extremely challenging. Do you have the costs of the in-home care versus the cost of the NH?
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If your father is competent and alert, it's actually for him to discuss this with the ltc people and decide for himself if he could cope with whatever support structure could be made available to him. Which in a way is nice because it means it's his problem, not yours! But on the other hand...

Phew, you know? I don't think you should be factoring in your attending him every three hours for feeding - what if you can't? What if you twist your ankle? What if you get flu, or measles, or food poisoning?

And leaving him unattended overnight. Again, I'm wincing. What if there's a fire? What if...

When you say "we are self pay" what's this 'we' bit? Are you funding your Dad's care?
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