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Chronic hip pain prevents him from sitting up. Possibly a pinched nerve. He lays in bed all day (and will pee in a jar). When he is given OxyContin in hospital, he can walk about 10 feet. But that’s it. When sent home from hospital, they gave no pain meds… so he lays all day. This has resulted in returning to the ER. 3 visits to ER in 3 months, yet they keep sending him home to her.
My Mom has had 2 heart attacks and is very stressed out. He is verbally abusive and throws things at her. She would like to place him in assisted living or??? but is worried about finances and that he will resist. They have a modest amount of retirement funds. He is also a Vet and has used the VA for medical.
We are lost navigating how to proceed… I live five minutes away but don’t have the strength to lift him either.
I don’t consider his home situation safe for either of them!
What can my mom do if he refuses AL or a nursing home? He might need a nursing home… I’m not sure. He has COPD, lack of mobility; He had bladder + prostatectomy cancers, neck surgery, 2 bypass surgeries… but his mind is ok.
Guidance is appreciated… we don’t understand why he is sent home when she cannot care for him safely.
(we live in WI)
Thanks in advance!

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Your Dad is passed an Assisted Living. AL is just that, the assist. They do not do the kind of care Dad needs. He needs to be in Long Term Care.

For me ER is a bandage. You need to get Dad to his VA doctor and get him at least on a pain regiment and then tests to find out what is going on. Being in constant pain would make anyone not so nice if a person. (Can't use the "B" word on the forum) Maybe the doctor can have tests run at the hospital. If Dad is in over 3 days maybe Rehab. While at rehab have him evaluated for 24/7 care. If they say he is 24/7 care tell them then that Mom cannot care for him and have him transferred to the NH section if Rehab is connected to one or find a nice place.

Like said, in the meantime see an elder lawyer to have Moms part of the marital assets protected. If Dad does go to LTC, Mom will be a Community Spouse. Assets can be split with Dads split being spent down and then applying for Medicaid. Mom can remain in the home and have a car. She will be given some or all of their monthly income (Social Security and any pensions) to live on.
I am just giving u the basics. Each State is a little different.
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He may be a candidate for LTC, which would also make him a candidate for Medicaid if he financially qualifies.

I would discuss this with his physician. Then I would talk to a Medicaid Planner for his state of residence (Medicaid is run differently in each state). The planner can tell your mom how to prepare and manage their finances so that he doesn't get disqualified or delayed for the financial portion, if he is a medical candidate for LTC. In some states Medicaid will pay for AL but your dad seems like he would need more care than what would happen in AL. Some states' Medicaid programs have a 5-year look-back on the financial application. The Planner and a CELA would be able to counsel your mom so she has important knowledge and peace of mind regarding how it impacts her finances for her own future care.

I don't know anything about working through the VA, only know that it may not be the best experience or provide very good options for its vets...
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"What can my mom do if he refuses AL or a nursing home?"

He can refuse AL/NH.
BUT - your Mom can also refuse to look after him.

He can choose to come home. He may well need a full-time carer but he cannot make his wife provide the hands-on care. He can threaten, yell, whatever. No-one gets the right to insist someone else is at their beck & call, provides physical help. Even if their marriage vows including *obey*. If she cannot provide the care needed - then she can't. End of.

Make is clear & simple for him. You need care Dad. Mom can't do it. I can't do it. So you will move to where you can be cared for. That's how it is. If you have another solution, let us know.

Going forward, your role may be to help BOTH your parents - not to cater to one's wants at the expense of the other's health.
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KimberliMarie Mar 2022
Thank you! I asked her to just hop in the car when he is acting up. Letting him sit alone might help… or not. But I agree she needs to simply say “enough’… and so do I!
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That kind of pain and disability for your dad sounds awful. The first thing I would do having had debilitating disc/nerve damage myself is ensure he’s had an MRI and seen a specialist who may shed more light on the cause of disability and refer to a surgeon if needed. There is zero time to waste if he shows any muscle weakness (can’t left toes or heels when standing) or numbness. Prolonged pinched nerves sometimes don’t recover full function.

beyond that, I may be in a similar situation eventually with my folks who don’t want to leave their house and won’t move closer to their adult kids. It’s like they are both barely taking care of each other right now and one falls a lot. I’ve expressed to them my concerns and wishes.

I was able to convince my dad recently to do a trial run of in home therapy though so he didn’t “scary” drive to his old rehab place after last injury. I found a group willing to do this with the goal of switching to insurance covered treatment if he wanted to continue.

Mom is finally his driver now. But when he can no longer make it out the door and into the van, he’ll have to accept inhome help, move near my brother, or move to AL with or without my mom. I just don’t know what will happen. Those are the options I foresee. Good luck to you.
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KimberliMarie Mar 2022
Thank you. The pain is not letting up for him as far as we can tell. I’m not sure how this will all progress with them. The relationship is toxic for her… + he is narcissistic as it gets. It’s frustrating that he doesn’t see the help he is getting from her… or me! But he has always been like this… not gonna change now! Only gets worse. I’ve always had the ‘kill with kindness’ mindset… it seems to help at times. But he acts differently when it’s just my mom in the room.
I wish you the best on your journey navigating these times!
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Please get a certified elder law attorney to help your mom navigate getting him financial help. She doesn't have to lose everything but her home for him to get assistance.

www.nelf.org is where you can locate a CELA near you.

I would encourage her to call the police next time he starts yelling and throwing things, she doesn't deserve to be terrorized in her own home and they will transport him for a psych evaluation and that is when she says UNSAFE DISCHARGE, I can't care for him. This will get the social worker helping her place him in a facility.
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KimberliMarie Mar 2022
Thank you! I am talking to her about this today!
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Thank you for your reply. I honestly don’t think she ever said out loud that she cannot handle taking care of him in front of the social worker or the other healthcare workers. I think she has been afraid to voice her opinion in front of him because that would just make him more angry, leading to more abusive language and behavior on his part.
Her health is excellent at this point. But these last few months are taking it’s toll emotionally. She has been taking care of him and their condo for years. But the immobility is not in her wheelhouse. She wants to stay home. She has told me she is trapped and doesn’t get why they send him back when they know she can’t help him. I’m going to mention to her what you suggested. She needs to verbally state to a social worker that she cannot take care of him. And then maybe they can help her navigate the VA system if there is some assistance with a nursing home or whatever. She realizes that this will drain her finances but she will be able to keep the house or condo. She really likes her condo and it’s right down the road from me as well so it makes sense for her to live independently there.
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AnnReid Mar 2022
“…verbally state…” and MEMORIALIZE HER SITUATION IN A WRITTEN STATEMENT to be placed in his healthcare records.
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They usually send people home, especially from the ER. UNLESS someone from his home says "I can no longer care for him. It is unsafe, for both of us."

He will probably refuse, especially if she tries to get him to go from home to wherever. From the ER or maybe rehab, it will be much easier for him to be placed somewhere appropriate. I think the social worker at the hospital is used to helping place people and would know what type of facility would be best for him. I think he is way beyond AL. Sounds like he needs way too much care.

How about assisted living for your mom? Then he would have to go somewhere. Maybe go to AL together?
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sp19690 Mar 2022
I dont think the mom living in assisted living with dad is going to work. Didnt you read about his verbally abusive behavior and him throwing things at her? So mom should continue to live with him in assisted living. No. Since he is bed bound he would need a nursing home not assisted living.

Its nuts how some people's bodies can live with so many issues and others die from something like the flu. What a weird and insane world we live in.
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