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Dad is in convalescent home recovering from getting pacemaker and sister and I are unable to provide care at this level. We have no idea how to find him a permanent home. He has good insurance, or so we keep being told, but no one will provide any information on getting help!


He's only 74 but much older health-wise. He's also a big guy - 6'4" (or used to be) and probably about 350lbs. So my sister and I are just not able to bring him home if he can't care for himself. He owns his home and has some savings and insurance so it makes no sense that none of the professionals can offer us any advice on what happens after he is discharged within the next month or so.


We're at a loss... Any information is appreciated!!

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"The doctors etc are insisting that my sister and I will have to do the caregiving."

?!?!?!?!?!?!!?!?!?!?!?!?!

Er, they can't.

You just say no.

Have you and your sister made it crystal, unmistakable, unequivocal, that you will not do this?
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Ah! I understand. Well done to you for supporting your sister in her decision to say "enough."

Does he need live-in care, actually? Or does he prefer to be waited on? It's not quite the same thing.

Next discussion that comes up: the aim of rehab has changed. Your father cannot be discharged home until he is able to function either alone, or with an agreed package of care. There is NO ONE else living in his home, they must amend whatever records they have that state otherwise. It would be an "unsafe" discharge (use that word). Make sure everyone has that written down.

I must sound very unsympathetic to your father, but I don't mean to be. I'm guessing that he was helpless when he lost your mother, that he's done nothing to address his bereavement, that he is not the best or most compliant cardiology patient ever?

The man needs and deserves a wide range of support; but that does not make you responsible for doing it. He's got good insurance - about time he started using it, eh.

I'm just curious - who *are* these health professionals who keep browbeating your sister and you about your duties?!
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CaliSisters Aug 2, 2019
Thanks so much for your advice... texting to my sister and think she's calming down because of this info!

Our father really is in bad shape, mostly due to his weight I believe. Plus he's always been a big baby. And it's literally been everyone who is telling us it's our duty to provide all his care! From his MD to cardiologist... as well as every member of the staff at this home! He was actually in here before and they forced us to take him home and he's been so bad he's been unable to go to any appointments and is only out of the house because he was having trouble breathing and my sister called an ambulance.
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Cali, CM has given you many good answers. Do you know if he has a LTC policy? You have to bottom line all of this. He has no family that can continue to care for him. No one can tell you that is your responsibility. They can say it but it is not the truth. You need to find a social worker overseeing his care and relay that strongly. If they are all so happy with his insurance then they can find the next plan. They would need to do it anyways regardless of his insurance. Are you being as emphatic with them as you are with your statements here? This might be a situation where you simply go MIA. It may seem cruel but so has his described behavior to you over the years. You just simply walk away and let him and those taking care of him presently deal with it. Consider the alternative. His care is way beyond your means and in engaging in it will feel as though your life is worthless most likely very quickly. Just read through this site and generally you will find so many others who are in that situation. You must stand tough and understand your rights.
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CaliSisters Aug 2, 2019
I wish he had a LTC policy! I thought he did since my mother was always overly cautious and always wanted my dad to have full coverage for everything. Actually, I've never looked into it, my sister takes care of that... but she did say he did not get it.
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I haven't read through all the answers, but what you need to do is inform the social worker at the nursing home that you and your sister are unable to provide care for him. Period. Or exclamation point if needed. It is upon them to find suitable placement. They cannot release him to an unsafe environment so it is up to them to find one. You then may want to contact an elder law attorney for him to help him with the finances. Paid for by him, not you. They will arrange for his finances to be structured for his care, and eventually qualify him for Medicaid if necessary. But make sure they do not release him to you expecting you to care for him. You do not have to, it is up to them to find a suitable care environment.
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rovana Aug 4, 2019
The thing is: the social worker finds a good placement for Dad BUT Dad refuses to use this placement. Since he has not been declared incompetent, he does have that right.  So...now what? I think that the social worker has met the placement requirement, Dad will not cooperate, the daughters refuse for good reason to undertake an impossible care burden.... So, legally speaking, who if anyone, is responsible and can be sued? Doesn't seem to me that you have negligence here, just a man who is determined to have his way no matter what.   What can daughters do here?
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Your father's health care team can't give you information or discuss his ongoing care plan with you without your father's permission. So it's him you need to talk to first. What has he said about what he would like to do?
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CaliSisters Aug 2, 2019
He wants to come home. No other option. Thinks my sister and I will abandon our lives and jobs and families and tend to him 24\7. We couldn't do that even if we wanted to. He's currently unable to walk because of weakness from heart disease. He lives alone and will basically sit in his feces and starve to death when they take him home.
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Sorry, forgot to ask -

Inserting a pacemaker is normally a straightforward minor procedure, and doesn't take much in the way of convalescence beyond a few simple precautions until it's firmly embedded - e.g. no contact sport! Are you sure this is all they were doing?
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CaliSisters Aug 2, 2019
He's at the home for PT because he can barely use arms and can't get up without help. They have him walking a few steps but he's in extreme pain from a knee that's bone-on-bone.
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Unless there is any question about your father's mental function, the choice is entirely his. If he wants to return home, he can return home.

What he can't decide is that you and your sister must be his primary caregivers, or, indeed, that you are involved in his care at all. That choice is entirely yours.

His healthcare team need to be made aware that you and your sister are not able to provide hands-on support. Ideally, one or both of you should be included in discussions of his discharge plan. Will your father agree to that?

The only immediate problem I can spot is that your father may airily tell the discharge planners that his daughters will be helping him, so no worries about his returning home. Now the NH *ought* to verify that statement! - but I wouldn't chance it.

Who keeps telling you that your father has good insurance? Your father or somebody else?
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CaliSisters Aug 2, 2019
We've been at his care meetings. The doctors etc are insisting that my sister and I will have to do the caregiving. Everyone else for all other medical procedures always says he can have whatever he wants due to his insurance, yet no information on a permanent home for him. With his insurance and pension, he can afford care... we just can't find how to get it. It's so frustrating and my sister and I are having health issues due to all this stress.
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CS, at the moment:

Your father won't hear of any plan except his going home.
You and your sister are focused entirely on placing him in a permanent home.

This means that your views are diametrically opposed, and conflict is inevitable, and constructive discussion becomes next to impossible.

It will reduce your stress dramatically if you and your sister *start* *out* from your father's point of view and work on possible ways for him to live at home. It may not be possible, and then he'll have to think again, but the decision is his to make.

Is your sister completely in agreement with you, or are you anxious that she might give way and become a caregiver and drag you into it with her?
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CaliSisters Aug 2, 2019
She moved 500 miles to help him after our mom died... that was two years ago and the level of care he needs has become too great. She is packing and moving back home tonight! I will not be dragged into that role and I'm the only relative nearby. If he won't make permanent plans, I won't see him at all. He's always been mean and abusive and, to me, this is just more of the same. If he makes arrangements I will see him.

Also, we can't even get information on finding him live-in care in his own home. Again, when my sister would take him to his appointments, she was told repeatedly that it's her job to do this! She just can't take it anymore and is leaving. So I'm trying to find a solution for all of our sakes.
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It's such a shame.

As you say, the guy is only 74. He's young enough for his life to be turn-aroundable.

Have you considered finding a different kind of rehab for him? Supposing he lost a hundred pounds, had his knee(s) sorted out, and underwent therapy - just say.

Pin down those health insurance details and find out what's possible.

He's not a veteran by any chance, is he?
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We went through the same thing and I don't know why it's a big secret to find the answers. The social workers were worthless. Research the assisted living/nursing homes in your area and visit them. You will want to choose somewhere that has all levels of care, as once they decline they will need more care and it's best not to have to research again and move them. Make sure it's a place that has "Medicare" beds. Here's how it works, at least in the Chicago area. You need to show he has at least 200,000 - 300,000 in assets, which may need to include their home that can be sold. This cost is per person. They will then be "accepted" and that money will be used for their care. Once the money runs out, they can put him in a "medicare" bed, which is most likely the same one he will be in from the beginning and medicare will take over the payments. Bottom line you need that amount of money for them to take him. They need to make a profit aside from Medicare. Getting the information is like pulling teeth and the research will fall on you. Once he is there, make sure you visit at different times and you need to be sure he is getting the care he is paying for. None of the places are great but some are better than others. Ask what the nurse/assistant to patient ratio is. Also helps if they have visiting doctors, so you don't have to worry about taking him out to appointments. Also you will need to have POA for their medical and finances. You will need to consult with an elder attorney for that which will cost about $600.00. Good Luck and God bless.
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rovana Aug 4, 2019
Good advice and details, but here the problem seems to be that this man, who is competent legally, is refusing to go anywhere but back home.  Now obviously the daughters cannot care for dad at home - no point in even trying.  So what next do they do?
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