NH says he may not qualify medically for memory ward. What do I do? - AgingCare.com

NH says he may not qualify medically for memory ward. What do I do?

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My dad has dementia and I have been living in his home for almost 3 years caring for him, but his smoking is putting us all at risk, affecting my health, my work is suffering and I just can't take his abuse any more.
I have been working with a nursing home for a couple of months and the admissions manager came out and did an evaluation. She said that he could go into general population, but that if he acted out, he'd end up in the locked memory care ward. She told me to get guardianship because he won't go to the home willingly and then we could move from there and it would take about a week after I got guardianship.
So I got guardianship - cost me $1600 in attorney and court fees. I called the NH the next day and found out the person I'd been working with didn't work there anymore!
The new admissions manager met with me and was very nice. We had to start a new file because the old one was gone (!). She came out to do an eval yesterday morning and at the end, took my aside and said that since he could still dress himself and bathe himself and could still use the microwave, she didn't think medicaid would pay for him to be in memory care. Basically, the people there need to have everything done for them and he doesn't, but she won't put him in general population because he won't be there willingly!
She did not yet have the doctor's records so said that would help her with the decision and about the only thing that would get him in is the fact that he's very unsteady on his feet.
I'm freaking out as I had assumed it was nearly a done deal once I got guardianship and she'd saying it might not happen at all - she doesn't want to admit him and have medicaid refuse and then have to discharge him.
I feel as though I'm an indentured servant - she said that because there's someone at home with him who can prompt him to take meds and eat, he probably won't meet the medicaid criteria.
Yes, he can still go to the bathroom by himself but he pees all over the floor and leaves "other stuff" everywhere. He can bathe himself, but probably shouldn't because of how unsteady he is. He does it because I won't. He wouldn't eat if I didn't make his meals. He's a heavy smoker and I keep finding him with cigarettes on the floor - the carpet in his room is covered with burn holes. The smoking is making me sick and he could burn us all down!
He has dementia and has been declared incompetent by the court! He cannot make a rational decision about going to a NH, yet because he won't go willingly he has to go into lock-down memory care, but doesn't meet the medical criteria? What a nightmare.
I'm so tired and depressed by this whole thing. I don't have a definite "no" from her yet, but it's hard to stay positive.
Has anyone experienced this? It's ridiculous that the acts of daily living are judged in this way (that's what medicaid bases it's decisions on) with no accommodation for the dementia aspect. Yes, he can bathe himself (atlhough probably shouldn't), but it's a fight every time and takes hours of prompting! Same with everything else really. So frustrated!

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SO . . . it turns out my dad DOES meet medical eligibility but the admissions manager said they don't have a bed right now and are concerned about his smoking and aggressive behavior. First of all, she told me on 9/26 that after her home visit he could be in within 24 hours. She came out to do her eval on 9/29 and then said he may not meet medical criteria. On 10/2 she said he does meet those criteria but they don't have a bed. They had a bed 6 days earlier! Also, they knew he smoked and said it would be fine. I asked if I moved him to e-cigs would they take him and she was very vague. For whatever reason, she or they don't want him. I talked to the Alzheimer's Association who said it was very common for SNF to say they don't have room when they just don't want to deal with someone. Since then, he'd developed bronchitis and yesterday fell down the steps, taking me with him. I can't believe they're so insensitive to his needs. I have switched him to e-cigs, which went very well - he was really calm. In fact, I haven't seen "aggression" in over 2 months.
I'm putting an application in with another facility, but they say it could be a month or 6 months, they don't know. The only other facility in the area has a 20 person waiting list for the dementia ward.
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Thanks. There are only 3 locally that take medicaid and only this one allows smoking, but I may need to revisit the others regardless.
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Contact more facilities for your husband, don't just deal with this one.
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No he does not drive.
I supply the cigarettes because it's easier to do that than deal with the fight that would happen if I didn't. He's been smoking for almost 60 years. He sulks and throws fits when he doesn't get his own way over a snack cake so over cigarettes? I can't imagine. Except I can. And yes, I know, how can I complain about this when I give them to him, but it's the lesser of two evils. Except it maybe isn't. Believe me, if they won't take him, he's done with cigarettes. He can throw a fit and I'll call 911 and have him in on a psych hold.

But thank you, I agree I need to give her more evidence and advocate for him.
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All I know is that one person's "evaluation" isn't the be-all-end-all. Become your dad's advocate with this woman and insist she try to get him covered.

It's apparent that he drives though, or can find his way to and from the store on foot, because . . . well, surely no one's buying him cigarettes??
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I should also add he has a history of stroke, has COPD, and a bunch of other medical issues. The guardianship I have right now is temporary while we wait for a hearing, but now that I have it I basically can't leave him alone! If he's not going to get into the home, I don't want guardianship.
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