Am I legally responsible to take my husband home when he is released from rehab in a local nursing home?

The main question here is where else would be available for him. Would he qualify for care in a nursing facility? Can you afford assisted living for him? He will need to go somewhere. Talk to the social worker at rehab to see what might be available, since you are unable to care for him at home.

AgingWife, depending on your retirement fund, would it be possible to move to a retirement complex that has independent living, Assisted Living, and Continuing Care? That way you can either still be able to live together but the complex supplies the more difficult care that you just can't do any more. It's an option.

If retirement funds aren't available, then hubby can apply for Medicaid and move into a continuing care facility, and if there is a senior apartment complex in the same area where the rent charged depends on your income. That way you can go and visit hubby, have meals with him, etc.

Have you had a care plan with rehab staff to see what his needs will be and what level of assist you might have to provide? This is a key componant as you forward plan. This will help you make decisions about can you provide this at home with some paid help or what level of assisted living would be needed etc. You did not say what brought him into rehab this time. Another fall? Do you have family that can help you make some of these difficult decisions? All the best, not easy to be where you are.

I wish I could offer suggestions, but aside from the excellent comments so far, I do not have any. God bless you.

Grace + Peace,

Bob

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I totally relate to this question. My health is not good and getting worse with the added stress of wondering what is going to happen. My husband us in an assisted living senior care home. But over the last 4 months they suddenly started sending me outrageous bills that we can not afford. I am in the process of fighting them, but comming home is NOTan option. He would be falling, and his alzheimers has progressed to where he doesnt remember me. Please be strong! You are important, and you need to take care of yourself. It took me a very long time to realize this, i had to learn the hard way ((

Legal services organizations and the long-term care ombudsman can provide assistance with transfers and discharges.

Facilities that attempt to transfer residents in violation of the law or without providing them with the required advance written notice can be sued. The courts are authorized to issue injunctions to prevent transfers, to order facilities to reverse transfer, and to make nursing homes pay residents compensatory and punitive damages.

Why You Could Be on the Hook

Even if you don't live in a state with a filial support law, you could be on the hook. Nursing homes, rehab hospitals and other medical facilities can sue adult children or other family members (if there are no adult children) for unpaid healthcare debts using other types of legal justification. "If a bill is unpaid, it's very likely the facility will sue other family members to get it paid," says elder law attorney Robert Clofine of York, Pa.

In the UK we have a social service team that come out to the home to assess its suitability for a LO return. That includes a carer assessment. At this point they advise what is available what you are entitled to access or potentially could access in terms of support i.e. State funded stuff and charitable organisations that support in your locality. Now I don't have a clue as to whether you have that where you live but I am throwing it out there because others may know. PS Hospitals may not transfer vulnerable patients home in the UK UNTIL this has been done (well that's the theory)

If your husband is a Veteran you would be able to contact the Veteran Administration and apply for the Aid and Attendance program.....you can also apply for Medicaid and he can be placed in a facility that will take him...you can also contact an elder care attorney for advice.

I'll address the elephant in the room - I imagine that you found life a whole lot easier when he was in the hospital with that broken hip; maybe the first time since his stroke that you got to relax. Now, you don't WANT him back. I can understand why you are, maybe, dreading his home return, thinking that things will go back to what they were. I would follow the advice of the other posters - find a facility for him if you can afford it, contacting all the appropriate agencies you can. Don't feel guilty. Just do what you can. People change and caring for someone over a long period of time can wear a person down.

Aging, talk with the social worker at rehab. Tell them you are not able to care for him at home. SW will help you find an appropriate facility for him and yourself is you decide to move as well.

WARNING! The SW may try to pressure you into bring him back home. They may try to make you feel guilty for not complying with their request. Do not fall for it, you will need to stand firm. Call Adult Protective Services and the Area Agency on Aging for additional help!

Ah so you do have some sort of support system for home coming. i thought you would. You do have to be very very firm. They tried to bully me into having carers which Mum didn't want and tried to tell me ultimately that they would take the decision out of my hands. never ever going to happen while I live and breathe.

They were actually very very rude ...so rude in fact I lodged a complaint and the social worker has been moved on from her cushy number to a more stressful role. She was used to telling people what they were going to have ...and that was an end to it. She had already bullied a neighbour who was in hospital at the same time and I just had had enough. the next social worker wanted to work with me during the transition phase and that may be all you need. I couldn't caregiver to begin with- all sorts of issues about personal hygiene and rubbing creams in places I didn't want to touch etc but eventually I came round to where I needed to be. no it still isn't breeze but it sure as hell is less stormy than it was

Yes, he will be released to his legal residence (your home). But if you talk to the rehab center's social worker you can ask to apply for Medicare Hospice Care. He would be put on hospice in a memory care home, nursing home, or in your home. You would get much more help at home if you choose that route. For for information on Medicare Hospice, look here: https://www.agingcare.com/articles/Medicare-coverage-hospice-care-142914.htm

As per the first answer, Assisted Living Facilities (ALF) do not provide care other than monitoring, helping with medication management, in the state of WA. If care becomes too difficult or someone becomes seriously ill the individual has to transfer to a nursing home and may never return to their previous living arrangement.
The ALF does not have to reveal this in this state.

Be very clear and adamant with the rehab's social worker. State very plainly that you are physically unable to provide care for his needs. Don't waffle around about what you can and cannot do. Don't go into excessive detail about your own capabilities.
Once you've made that clear, then the next step is how to get him into a situation (whether with home care or an assisted living or skilled nursing facility) where he can get the care he needs. Your financial resources will determine the first step. If you can afford (and he is appropriate for) assisted living, then start shopping. Problem solved. If finances are not sufficient for him to be in AL and you to continue to have enough money to live on, then it becomes more complicated and a lot depends upon which state you're in.
Get with the social worker quickly and hash all of this out.
Do not take on more care than you should try to handle! Sorry to be blunt, but it will kill you and your husband will keep on chugging along. I've seen it happen many, many times. The caregiver dies before the patient.

Facilities have an obligation to arrange for a safe discharge plan. If discharging him to home would require you to take on care responsibilities that you can't safely manage due your own health, then I don't think they can legally discharge him.

You should, however, be firm with the rehab social worker, in expressing your determination that you cannot care for him safely on your own, given his current needs.

I would recommend you put it in writing and give it to the rehab facility. Your local Area Agency on Aging can help direct you to the right agencies to help you appeal, or explore other options.

Now, if your husband does not return home, you will have to find a way to pay for his care elsewhere. That could be expensive and you may want to see if getting a lot of care at home ends up being less expensive.

Good luck, it's a difficult situation to be in.

Good luck. I just moved my Mom to AL. Lots of hidden things there too. Had to get a home health care for PT. Had to hire company to administer her meds. Hired another company to have a nurse practioner visit in case of illness. She hadn't seen her primary phy. in 6 months so they convinced me that would be a good solution to have access to NPract/ Doctor cause she would be hard to transport. Doable but a hassle. Oh, then a phar. company to dispense her medicines in single packet so the other company nurse would come 2 times per day to unlock cabinet & give her her meds. Rules & regulations just changed this year. She has 24/7 sitters since her 2nd broken leg. Can't trust her & still can't even though she seems better since leaving the Nursing Home. PT at NH after 2nd break was a waste of our time. Over medicated. Most people in PT worked & waited & slept. Its 3 hrs gruling PT per day according to Medicare & there has to be progress to continue PT or they will kick you out program if no progress or cooperation becomes difficult, as with short term memory did become a problem cause of over medication. Nursing Home folks will not listen & change anything if at all for in our case 3 wks to a month. Oh & after the medicare skilled nursing 100th day, you are on your own..you are dropped from medicare like a hot potato & private pay or make arrangements to go somewhere else. Even the facility we used was rated higher 6 months ago than now. Everybody has theirs hands out. Everyone is trying to cover themselves so their not liable. You sign papers that make you feel like you just bought a house instead of trying to do the right thing to take care of your person. So be careful. It is overwhelming & stressful. My Mom doesn't really understand but she is regaining some mobility since the move & reduction of medication. I just find in Louisiana from hearing some of you having such great luck finding all the resources you need that it is so different here than in other states. There seems to be no coordination between entities between NHms, hospitals, social workers, etc. It is very frustrating..I spend so much time trying to find all these resources I'm exhausted. I have people praying that somehow all these things will fall into place & somehow work out for the best. I haven't been to my real home in a year. One thing after another just keeps happening so I'm staying close by at my Moms so I can be sure she is taken care of. I lost my Dad this year cause she was sick & the people I entrusted my Dad to failed me. So be on guard, trust no one. Be available cause that is what it takes. When all the funds are gone & I have to sell her home, I will file for Medicad. Ya'll take care.

I am thinking the same thing SallySee....if my husband goes to a rehab facility, I don't think he could come back home nor would I want him too! He has Long term care ins for in facility care..so that's where he will go. People are living a long time so gotta plan for long term care. I also have it on myself.

Unless you can pay for his care in assisted living. Yes to be honest you are stuck w him. Many folks here are. All agencies do is give you someone else to contact. This whole caregiver thing is one big merry go round.

Aid and Assistance is not for all Vets. You have to have served during a war.

If the rehab is part of a nursing complex have him evaluated for the nursing care side. If excepted, Medicaid may help. This will give you time to research and get things together. Speak to the Social Worker. If you get nowhere with them try your Office of Aging. Some employers have a help program see if his does.

My mother has Aid and Assistance and it is a lifesaver for us. It helps us to be able to have a person come in and help with Mother.

You are not legally obligated to care for your husband at home. My mother's husband was responsible for my mother and her care since she had Alzheimers, but he was allowed to place her in a facility 400 miles away. He did not visit her, he did not pay for any of her care and wanted Medi-cal to pay for costs even though he has resources. Since my mother was so so far away and i could only visit one day a week, she died after only six weeks at the facility. I told hospital and facility that my mother's husband was legally and financially responsible for my mother, but they said they couldn't force him to pay for anything. So he didn't.

My mothers best friend was in the same predicament several years ago. Her final solution was to become legally separated from her husband. It's an extreme route to take but it did solve the problem.

Don't think u need to go that far but I have heardthis being done. I know seniors who have had to put spouses in longterm care. Its hard enough for anyone to take care of someone longterm but for someone with their own heath problems its really impossible. It will only make their problems worse. Just talk to the SocialWorker.

"You don't ask - you don't get ~ help"

Participants here know to ask...

Aging, how is it going? Would like to hear how it went and what was decided.

Some good answers here.
Sometimes workers can make the spouse or family member feel terribly guilty, and can use extremely coercive, manipulative language to get the family to take the patient back home.
It's their job to get that patient OUT of the facility; sometimes they simply don't think before they speak, or, they might have too-few possibles to "go-to", so foist the task back onto family caregivers--never mind the circumstances.
Some of the Workers simply fail to consider the home circumstances appropriately...they can be over-worked, too.
Sometimes, it seems they don't care how/where the person goes, they just need to get the patient outta there.
It can be very tough, faced with social workers, hospital workers etc. who seem clueless about the level of care, or who have other agendas they don't mention.

It's also too common for in-home health care systems, to UNDER-assess a patient for in-home care assistance, resulting in not enough help in the home--this is where much in-home health care fails.
That gets worse, the lower one's available funds are; worst for welfare recipients.

It's up to you, to pressure those workers right back. As mentioned above, tell them he CANNOT come home; tell them that would be like expecting him to take full care of himself, "due to current circumstances preventing his getting adequate, appropriate, safe care at home, anymore".

You can tell them, "If you force him to return home, you [the Worker] will be directly complicit in the injury and/or death of both the patient being released, and the spouse left to care for him."
You can mention the terms: "Neglect" and "Abandonment" if you have to, as a last retort.
Sometimes they simply need to hear it distilled down to the dire brass-tacks.
Keep being firm.
Because, once they succeed in pushing a family member to accept the patient back to home, it will need another emergency room trip/hospitalization, to get him back into the facility, to try again to get them to move him to a facility to get the help he needs.

Key are: Safety + Appropriate level of care.
When you can't provide that at home, after they forced it back on you, they are then effectively forcing you to be negligent of his care, to get themselves off-the-hook.
Social workers and Hospital officials might wriggle every which-a-way to make it sound like anything else that's nicer, but that's what it boils down to.
Hang in there, be firm.
In the mean time, you can also search for a facility for him. Kinda like burning the candle from both ends...only this, might help find an open bed, faster...maybe.

If they still fail to do the right thing by getting him into a proper, appropriate facility, with proper, appropriate orders transferred with him, call APS, for sure, and report them and the facility.
DO watch out that the Doc writes appropriate orders for the person admitted to the facility----some are notorious for writing egregiously wrong orders; some accidentally, some to manipulate the facility the patient is sent to into taking a more complicated patient than they can handle, and some out of spite--they are human, too.

Keep us posted how it goes for you!
Please take care of yourself!

NO you are not legally responsible for bringing him home. IF you desire him to be there, but you cannot care for him, then you need some agencies to help you with a plan...home caregivers, home hospice assistance, Medicaid for in home care, or VA aid and attendance if hubby qualifies etc. Other options would to find a full service Assisted Living facility, and move in together. Sell your home if you own it, to get some money to pay for private pay until he can qualify for Medicaid and your half of the money can protect you and your future. You may benefit from a consultation with an Elder Care attorney to plan what the next steps should be and how to get there from where you are now. But if you have your own health issues, do NOT feel stuck by what anyone tells you. You have a legal right to take care of yourself first. You are no good to your husband if you are dead....and your basic legal responsibility to him is to assure he is safe where ever he is, since he is no longer able to care for himself. Safety first for both of you; happiness comes second. I say these things having learned the hard way, being responsible for both my parents for almost 4 years now. My Dad had dementia, and eventually had to be removed from the home due to agitation and wandering. Was able to keep Mom in her home, with out caregivers, by installing an upgraded alarm system with cameras because no family is in her town and I am 5 hours away...Then, after hospitalization last spring, and her own worsening Alzheimers, she's had part time caregivers, and still able to be home. Dad died in August. Running out of cash money from investments, so now, next week, Mom is moving into AL close to me, and her house is being sold. She is devastated, and not happy at all, and keeps wanting to know what happened to all their money because Dad always said he had enough invested to last them the rest of their lives. Well, he didn't figure on dementia for him, and private pay to the tune of $75,000 before Medicaid approval, and living to be 93 yrs old, and now Mom at 90, with lots of health problems...physical as well as Alzheimers. None of that was figured in....and I cannot keep her happy. Could not keep him happy until his memory got so bad he thought he'd always lived in Memory Care....but I had to learn...I had to keep them safe...especially being the POA and Trustee of their Trust.. safety first, happiness second. Say it over and over daily!! And may GOD bless you as you fight for your husband to get the right stuff.

I think we have been hacked.