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He has no insurance. He has no way of paying for a nursing home or even to see a doctor. My brother and I cannot care for him as we are financially unable. What do we do? He’s only 58. Dementia is likely but has not been diagnosed. He has a history of heavy drinking.

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Fear not! No one will get into any trouble. We don't live under dictatorship in this country. The government can not tell us we have to care for other people. No way. Just like he can choose to be homeless, you can choose not to help.

However, you are helping.,.you are calling for help now. That's the best you can do. The reality is none of you, family nor friends, has the means or ablity to assume his care.

Don't let that stop you from calling. That would be selfish. It would mean your concern for yourself is greater then your concern for him.

No one will fault you nor judge you, for letting him do his own thing for all these years. Again, he has the right to make bad life choices.

Make the call, you will sleep so much better.
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Call Adult Protective Services in your city and tell them you know of someone at risk. They will be able to help you. You can also call your local area Agency on Aging to ask for help. You will need to apply for Medicaid for him. If you know of his whereabouts, you can wait until he passes out drunk and then call 911. If you can’t afford to or don’t want to apply for guardianship of him, he will become a ward of the state.
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He was admitted to the hospital. They found high levels of ammonia in his blood. They are trying to find out the cause and get that down. Dementia isn’t being ruled out but the high ammonia levels are certainly causing him to have delirium.
I’m happy he’s safe and getting treated.
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Ammonia most likely caused by drinking. There is liver damage that causes ammonia levels to increase to dangerous levels. Been there. It may eventually cause sepsis and dad may experience septic shock. This could likely put him in a coma that he may not come out of. He is very, very sick. This is where you need to step back and let state take responsibility for him. Do not let them guilt you into anything. Do not sign anything for him that could make you financially responsible.

My friend passed at the age of 54 after years of drinking and alcoholism. 

You need to take care of yourself first.
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The social work department at the hospital can explain.

Neither you nor your brother is legally responsible for your dad. Don't let anyone tell you otherwise. Most likely, the state will step in and appoint a public guardian. And apply for Medicaid for him. Don't sign yourself as financially responsible for his medical bills.

If the social worker dept tries to guilt you into signing something by saying " you don't want the state to take guardianship, do you?", you say "Yes, that's Exactly what I want to happen". Explain this to your brother as well.
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Bnb, some hospitals are what's known as Hill Burton Hospitals. They were constructed with funds pursuant to the Hill Burton Act. A condition of accepting those funds was a commitment to providing care for indigent people who couldn't otherwise pay their bills.

In my experience, some religious hospitals are Hill Burton hospitals.

As to the next placement, please heed the advice you've been given and don't participate in arrangements for your mother to care for him. At this stage of his life, with his medical complications from alcoholism, it would be too overwhelming for her, physically, and emotionally.

Your brother thinks your father needs to live with someone; has brother volunteered? If not, ask him why not.

And, in all fairness, it's inappropriate for your mother to have to care for someone who hasn't taken care of himself. I don't mean to be cruel, but that fact has to be considered.

Is your father still drinking, and if so, how would your mother adapt to this? It's unfair to her to burden her with the complications of lifelong self neglect. Her health would soon be at risk as well.

Let the state handle it. From the history you've written, no one else really is prepared to take on this monumental task.
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"...my brother keeps saying that this will be a process that takes time and that he will have to live with someone until he can get disability/Medicaid."

His usage of the term "someone" pretty well signaled it wasn't going to be with your brother.

"...my mom has decided that he can come stay with her if needed."

WRONG DECISION! And now you are going to have to help her? She could have refused.

I'm wondering if you ever would have just let the state take over. Were you the only one who would have accepted that? Or did you not really expect it would ever happen, either?

Yes, Barb is right that when (not if) he goes back to the hospital, no family member will pick him up. But if your brother wasn't the one to take him in this time, is he going to demand someone take him in again? And will your mother cave in again? WHO is really driving this train here?
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Bnb, NO,No, No. Do not let anyone take him, no one!

Just leave him there. THAT WILL EXPEDITE MEDICAID. Tell your brother he is wrong. Make sure Mom does NOT offer to take him. That will be a huge problem for everyone.

You yourself call the Social Services Dept of the hospital. Tell them you want his case worker. She will explain what's going on, stop listening to your brother!

You tell her, he has nowhere to live. She will put your mind at rest.
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Woe, wait a minute... YOU DO NOT SOUND STUPID!!!
Don't even think that.
How are you supposed to know if you've never done this before? The only reason I'm familiar with the process is because my Dad went through it.
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You wrote;
"Dad hasn’t had a drink in a long while according to him and his friends my brother knows. So I don’t think that’s a problem any more. By the sound of it, my dad doesn’t even acknowledge he was a drinker- like he forgot it."

Honey, you are in denial. So you believe your dad and his friends. Oh boy! We WANT to believe the alcoholic hasn't been drinking but they are ADDICTED to alcohol. You don't JUST STOP and say "Oh, I'm not going to do that anymore." It's a h*ll of a hard process to quit. Would a heroin addict JUST STOP?

From the sound of your dad's history, he will not be able to do that on his own. My dad never felt the need to hide it (and never quit either). My step-father hid it behind the headboard of the bed.

I never thought my dad would get any booze in the Board and Care Homes he was in .... but guess what? He did.

Your dad may be good at hiding it (brushing his teeth, mints, etc.) but please don't be fooled, unless HE wants to stop and gets treatment for it, he hasn't quit.

I'm not trying to depress you or bring your hopes down. It's just that a few of us have lived with alcoholics and know the trademark characteristics.

It's too bad your brother did not listen to the good advice offered here. Your mother may now be stuck with him. As we said, if she accepts him into her house, she has made a commitment for his care. She could be in trouble for throwing him out now. Do you really think your dad is going to leave her place when he's got it good? This was a homeless man-he's got it made now!

Tell your brother that he just imprisioned your mother. He would have been better off listening to us (those who have been through it), than putting your mother in a compromising position.

You may have a chance of talking with an elder law attorney if you contact the Senior Center in your town. They occasionally will work for free or donation or low cost. Find out legally what can happen. You will NOT ever be financially responsible for him. The state can NOT make you pay for any services for him.
You have also been estranged from him for years and that would be a factor also (proving no relationship).

Your husband is correct in not letting him into your home. And your first responsiblity is to hubby and your baby. Don't mess it up by pushing the issue. Regardless that you want to help your father, he's made his own choices and you and your family don't need to pay for them.

Take Dad to the hospital with any complaint he has (diarrhea, poor appetite, etc.,) then have EVERYONE refuse to take him home. You ALL need to be on the same page. Get the hospital Social Worker involved and REFUSE to bring him to anyone's home. This will force the state to place him somewhere.
The state will NOT throw him out in the street.
You will NOT have to pay for ANYTHING for him.

It will work IF you guys would quit letting your brother call all the shots when he doesn't know what he's doing.

Good luck
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