Papa refusing permanent placement; what do we tell him now?

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Papa refusing permanent placement; what do we tell him now?

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I’ve posted before about Papa: he has Parkinson’s, is almost blind, very hard of hearing and has chronic back pain. Now we can add CHF to the list of things wrong.

He went into Rehab with the idea of permanent placement. We told him he had to stay. Of course, he had a fit. He yelled he was leaving (which earned him a WanderGuard lol). He was going to hire a lawyer (but he couldn’t remember any of their names). Then he was going to stop eating and drinking, rather than stay where he doesn’t belong. But he started to calm down a bit.

But there is a *itch in Physical Therapy that has become close to him. She told him that it was solely our decision that he had to stay, ignoring the fact that his three doctors all want him there. So she threw us under the bus. She also told him that he legally doesn’t have to stay there .

To say I am angry is an understatement. Now he says he’s leaving as soon as the swelling goes down in his legs. I doubt the swelling is going to go away, since it presented at 92 years old, but you never know.

So his mind is still pretty sharp. What do we tell him now?

Parkinson's Disease Refusing Care Skilled Nursing Facility

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Yay BeckyT! I'm so glad you are not in a situation where you might have to be tough on dad. It's so hard to see someone you love decline. Hang in there. This group has helped me so much over the last 8 years while I've been caring for mthr!

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Update: Learned something new today. Nursing neglected to tell us exactly how bad his new diagnosed CHF really is. His legs and feet are extremely swollen and they have TWO pair of compression hose on him and have increased his diuretic.

So the nurse said his talk of going home is a moot point. He is unable to walk, even with a walker, due to the swelling and pain. And she feels this is a permanent condition. He also has no memory of the CHF incident which was just last week, so that’s an issue too. So from now on we just change the subject and move on. Thanks for all of the advice from everyone! This group of people is amazing!!

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I'd be careful what he is reporting to you. Seniors get things confused or hear what they want to hear. He could have misinterpreted something she said that was innocent.

When you say that his mind is pretty sharp.....it makes me wonder, because, if he was thinking clearly, he would see that he needs care and that he can't get that by living alone. His threats to starve himself don't sound rational. Poor judgment and lack of insight into his condition could indicate cognitive decline. His doctors may recognize this. I'd stress my concern for his mental state.

If he decides to leave, then how would he do it? Call a cab? The nursing homes that I know require a home care plan. How would he arrange that? How feasible is it that he would be able to get his house handicap accessible, reserve around the clock caretakers, etc. without the family's assistance?

I'd explore keeping him happy, but, providing the protection. When the person is irrational and not capable of reasoning, our options are limited.

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Countrymouse is correct in pointing out he may be interpreting what he heard (or didn't hear it from her at all). Please do not report the PT until you can confirm from a different reliable source that this is in fact what she said to him. Or, you can have an informal discussion with the admin telling them you hope this is not something she is really saying and to make sure she is informed of this. You don't want to make enemies regarding his care. My LO with cognitive issues regularly say things/interpret things incorrectly (and conveniently in their favor).

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I would report the PT. Legal or not, its not her place to tell him that or who is keeping him there. I would mention it calmly. (Personally I have a problem doing that myself).

I would also wonder "how sharp" he actually is. Dementia and Parkinson's go hand in hand. You may ask for him to have a cognitive eval. You have 3 doctor's on your side. Dad needs to realize that he now needs help that you cannot provide. (Saw where u have some health problems too) He can no longer live safely on his own.

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Wow. No therapist should be saying anything like that. Since she's a therapist, I'd think she would have a pretty comprehensive view of why he needs to be there. And I'm also concerned that their relationship is "close." I mean, a relationship can be warm or even friendly but still needs to be professional above all else. Absolutely, this needs to be reported to management - just be ready for management and the therapist to both deny it or write it off as a misunderstanding. Were these comments something you actually heard or is your Papa relaying to you that this therapist said it? Did another staff member overhear it and let you know? In terms of what to tell your Papa, I'd say don't tell him anything right now and see if he settles a little bit.

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Why not just agree that he will be leaving once the swelling goes down in his legs = he is fit enough to return home?

Either you're right, and it doesn't happen, only in a way he sees the sense of; or he does get fit and well enough to return home. Can't see anyone losing out from this solution to the conflict.

The b1tch in PT is right, by the way: legally he doesn't have to stay there. But I, like you, am assuming that this is in fact what she told him and not merely his convenient interpretation of what she may have said in response to what he talks about to her.

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Yes, we talked to her today. She confirmed everything he told us. Said it is his right to know.

I would think this would fall under the social services dept., not physical therapy, for crying out loud.

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First you report the PT to management. She is to have no more contact with Dad. Management will not be happy that she has stirred up a patient who was finally calming down. She may be correct there may be no legal way to keep him there, but that it not the point.

Second, you tell Dad that unless the doctor signs off on his going home he is staying put.

Third you make it abundantly clear in writing that any discharge would be an unsafe discharge and there is nobody at home to provide any care.

Lastly, Stand firm in your resolve. If Dad brings up going home, tell him the doctors have to sign off, if he does not leave it alone, then end the conversation.

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1. Have you reported the PT to the place. I suspect she is looking for a man to take advantage of.

2. Is there a social worker who can talk to him?

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Papa refusing permanent placement; what do we tell him now?

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