He has been kicked out of two bar/restaurant because he smell so bad. He drives, and still independent, with dementia becoming increasingly more pronounced. We want to get him into a nursing home, he’s reluctant, and we need to sell his house to help sustain the costs. Can’t sell the house with him there, as we need a professional company to thoroughly clean and sanitize. He lives in California, we live in Minnesota. Have tried working with his doctors, social workers, who are not making recommendations for senior living? He had a needed surgery cancelled because he couldn’t be in his home for aftercare, doctors were concerned about infection? Needless to say, we’re looking for suggestions:1. How to get him into a nursing home with limited income? Yes, he has Medicare 2. recommendations on quick sale of this house, with no out of pocket expenses?
Paying cash for a nursing home always always depletes personal funds, which means that everyone inside a nursing home eventually becomes a Medicaid patient/resident.
With that in mind, it might be best to choose a nursing home that accepts BOTH private pay + Medicaid, that has 3 separate wings (Dementia/Memory Care, Long term Care and Assisted Living).
1. Choosing a nursing home that accepts both private pay + Medicaid, will stop the need to switch nursing homes, when his private pay switches over to Medicaid.
2. That combination facility will have federal standards that a private pay only facility is not required to meet, so you'll have the best if both worlds. Federal standards + private pay higher priced expectations.
3. A 3 wing facility (AL, LTC, MC) will meet all present and future needs
Hopefully, you won't be too overwhelmed with everything
As for dad's dementia and care. He needs to be declared mentally incompetent so you can take over his healthcare and financial decisions. Contact a lawyer that deals with elder law near where he lives for the best advice since laws are a little different in each state - and sometimes county too.
This is a legal and personal safety matter.
someone will need to hire an elder care attorney and petition the court to get legal control over his living situation. You don’t mention other family or who, if anyone, has POA. If no one has POA, then that needs to be addressed. If he goes in the hospital again, and is admitted for at least three days, his son (your husband) has the opportunity to tell the hospital he cannot be safely released back home. That will buy you time and Medicare will pay something like the first 20 days in full. After that Medicare pays 80% for a short period and then stops paying. He will have to pay for a permanent facility with any assets he has and then apply for Medicaid. If he tells the hospital that he wishes to go home, his son will have to be firm and try to override his wishes by telling the hospital he is not able to make sound decisions and it would be an unsafe discharge. If it were me, while he is still in the hospital, I would request APS to visit his house and, if necessary, I would demand that the hospital order a neurologist to evaluate his competency before going along with his wishes. Since this is a legal and medical fight, you will need evidence to back up your position that he can’t go home and needs to be in a facility. That is where the pictures and other documentation comes in.
The alternative is to back away - let whatever happens happen (and it will), and go on with your life knowing that this is a situation out of your control. In for a penny - in for a pound….
If you can get him to resign and let you assist him and once he has signed over everything to you then you can go ahead and sell his items/home.
I had to have my daddy resign and enact the power of attorney so I could get him in a group home and get his assets together.
With his dementia he forgot that I had Power of Attorney but with his signature and the letter I had from his doctor I was in charge.
Hate to tell you, something else happened there with the surgery cancellation. He would have been placed in a SubAcute rehab facility, there was no need for him to return home for aftercare. His doctors must feel that he is of sound enough mind to legally refuse SubAcute admission, and he did.
His income would pay for a portion of his "rent" in an AL, Medicare, and after spend down, Medicaid will pay for his Healthcare services. If his doctors aren't recommending a nursing home, it's because he wouldn't be accepted in a nursing home until his level of care reaches that point. Basically, he has not to be able to ambulate on his own, toilet, bathe/shower, or feed himself. Not being willing to do these things is not the same as "can't." and these are what is required, in some combination of one or more, before acceptance to a Nursing home. Insurance won't pay for it, otherwise. I agree with Daughterof1930. Get Adult Protective Services involved. Unfortunately, you won't be able to sell the house without some out of pocket expense. No one will buy it unless you sell it at an incredibly reduced, below actual value price. If ADP services gets involved, it's possible that the city/town might just knock the building down since hoarder homes tend to be in very poor condition, structurally. The weight of the hoard is often too much and makes the structure unsalvageable. You will have to accept that YOU are not going to get any money out of this, and HE is unlikely to get any either.
It really sucks when that person with dementia is really very good at "show timing" for their doctors(hiding their dementia severity), and have done very little, if anything, to secure their finances to pay for their final years, and is VERY stubborn and Proud as it is, then add the inability to recognize that they even have a problem that comes with dementia. If he's still driving, you REALLY need to get on the phone with Adult Protective Services, before he kills someone. We got very lucky that my mom didn't kill the other driver. But, without POA, Or even a diagnosis, we couldn't take her keys away.
The "out of pocket expense" does not come from the OP's pocket. The father would be the one paying those expenses.
The follow up investigation should help.
If someone in the family has POA that person can begin the process of placing him and making arrangements to clean and sell the house.
If no one is POA you have 2 options.
With the APS investigation they will realize that a Guardian is needed. The Court can appoint a Guardian or a family member could be appointed.
(Ideally if he had had the surgery he could have gone to rehab then it might have been easier to "morph" that into Skilled Nursing or Long Term Care.
Does he have Medicaid? If not begin the process of getting him on Medicaid.
Is he a Veteran? If so contact the local Veterans Assistance Commission or his States Department of Veterans Affairs. You could also contact the VA and ask to talk to a Patient Advocate or a Social Worker.
Let him become a ward of the state .
This is a monumental task for a number of reasons . I honestly believe it’s best handled by the state.
You have no power to place him , he’s uncooperative . You have no easy way to sell his home to pay for his care either .
I would guess that the only thing you can do is to report him to APS.
The sad truth is that if he is competent, this being now a diagnosed mental condition, he will be allowed to stay and to die in his hoard. This is perhaps something that he would prefer to living a few more years in in-facility care?
You can consider reporting the squalor to the city. I wouldn't know what department you would contact, but calling the local council on aging in the area might get you the number.
This is so very sad, isn't it. I see you care. But there is quite honestly nothing I can imagine you can do to change this. Not everything can be fixed.