How do I know if it's time to move dad into my home or possibly nursing home?

Your State/County may have adopted the PACE program. This is Medicare funded caregiving at home. You should look into it. Program of All-Inclusive Care for the Elderly (PACE)

PACE is a program that combines Medicare and Medicaid benefits. PACE may pay for some or all of the long-term care needs of the person or those with Alzheimer's. It covers medical, social service, and long-term care costs for frail people. PACE permits most people who qualify to continue living at home instead of moving to a long-term care facility. PACE is available only in certain States and locations within those States. Also, there may be a monthly charge. You will need to find out if the person qualifies for PACE.

To find out more about PACE:
Phone: 1-800-772-1213
www.medicare.gov/your-medicare-costs/help-paying-costs/pace/pace.html

You also may want to consider Hospice. You'll need a doctor's order but from what it sounds like, this shouldn't be a problem. Here are some phone numbers you can call to learn more about what they can help you with:
◾American Hospice Foundation at 1-202-223-0204 or www.americanhospice.org
◾National Association for Home Care and Hospice at 1-202-547-7424 or www.nahc.org
◾Hospice Foundation of America at 1-800-854-3402 or www.hospicefoundation.org
◾National Hospice and Palliative Care Organization at 1-800-658-8898 or www.caringinfo.org


State Health Insurance Assistance Program (SHIP)
SHIP is a national program offered in each State that provides free counseling and advice about coverage and benefits to people with Medicare and their families. To contact a SHIP counselor in your State, visit www.shiptalk.org.

Department of Veterans Affairs
The U.S. Department of Veterans Affairs (VA) may provide long-term care for some veterans. There could be a waiting list for VA nursing homes. The VA also provides some at-home care.

To learn more about VA healthcare benefits:
Phone: 1-877-222-8387
www.va.gov/health

You can find more information about Medicare benefits on the Internet at www.medicare.gov, or call 1-800-633-4227, TTY: 1-877-486-2048.

Finally, there is this department: National Council on Aging

The National Council on Aging, a private group, has a free service called BenefitsCheckUp. This service can help you find Federal and State benefit programs that may help your family. These programs can help pay for prescription drugs, heating bills, housing, meal programs, and legal services.

BenefitsCheckUp also can help you find:
◾ Financial assistance
◾ Veteran's benefits
◾ Employment/volunteer work
◾ Helpful information and resources

To learn more about BenefitsCheckUp:
Phone: 1-202-479-1200
www.benefitscheckup.org

I got all this information from Alzheimer's.org. You father-in-law may not have Alzheimer's but these organizations can certainly advise you, nevertheless. Hope this helps.

jd - you know from your heart and mind that you can no longer care for your father like you did with your mother. You got burned out with your mom. And it also affected your family. Now you know the true reality of 24-hr care. You know your limitations. You are setting boundaries. People gave you several options. Before even allowing your conscience to overcome your decision, please look into all the options given above - well, except for the ones that said for you to take him into your home. Once you have researched and discussed it with your husband - objectively, not emotionally, then go from there. Know this, when a parent moves in and needs 24/hour care - it DOES affect the family dynamics. Yes, your daughter would learn some things. Question is - will she learn that grandpa comes first in everything? Unless you can afford Reliable caregivers to come when you need them (daughter's school programs, dance recitals, etc...), they will learn to resent you and grandpa. When you all decide you need time away from him and caregiving - like a weekend getaway - will you be able to find someone to come over and take over? I'm not against him moving in - I just know how very difficult it is to care for bedriddens 24-hrs a day/every day. The stress when cg on Saturday doesn't come and you have to be at work by 830am. The calls I had to make before I finally gave up, walked to my bro of next door - and told his grown up kids that bedridden grandparents need to be babysat until I get back home. I am just giving you a Word of Caution. I, too, strongly agree that you hop around this site and read other caregiver's who brought their parents to their homes. And those who took them to NH. There are all pros and cons of either decisions. But atleast you researched and know what will happen in either case. I wish you well in your decision making.

Hi JDF, I suggest you get case manager for him like social worker and start looking into options and what will work for you and him. It sounds like your dad is in need of help.

Cameras are great! Even though they will be found, they can still fall in a Nursing home,in fact most falls happen there. The only way to prevent a fall is to be with them 24/7 and even then they can fall right next to you quickly. I called my mom 5x daily before she moved in with me, if she didnt answer I left work and drove there right away. She was happy in her home, dementia and all and I wouldnt take that away from her,until I had to, but she thought my home was hers by then. She had a stroke at the daycare and they didnt even know it, when asked if she was ok they said shes just tired! I knew better and took her into the hospital and she had a cerebrel hemmorage. Know what they do for it at her age? Nothing! Good luck

I have just gone through this myself with my dad. I must tell you that it was the hardest decision I ever had to make in my life. But it know now that is was the right one! When your gut is telling you that they are unsafe, it usually is. Please follow your heart and let your dad know that you are doing it because you never want him to be alone again and someone will always be there to help him when he needs it. God forbid he falls and no one will know that. I have had two friends of mine who both lost their parents by them falling and they did not find them until they came home from work. They must have had a stroke and if you know anything about strokes the quicker you get medical attention the better your chances of survival. We installed cameras in our home to watch dad during the day while at work. If you think you cannot put him into Assisted living then get cameras at sams or costco and this will ease your mind tremendously. Also get meals on wheels as they will come every day and they can check on him. Hire a caregiver for just a couple hours each day to be sure he is fed and has his meds and is ok. My best advice after having to go through this is just to do what your heart and your gut tell you. I did after many tear filled days and I know now I made the right decision.

First I would recommend taking him to his physician for a thorough evaluation. Be sure to discuss your concerns honestly with him. He may admit him to the hospital and depending on your state this allows him to go to rehab under Medicare for a prescribed period of time. Here he will receive proper nutrition, physical therapy, occupational therapy, etc. They will hold care conferences which you should attend and determine his progress and if he is strong enough to return home safely. The important thing is his SAFETY.
Medicare will not pay for caregivers in the home. He may qualify for some veterans benefits which could offset the cost of assisted living if he is deemed safe enough for that setting. The safety net of assisted living is good nutrition, companionship, social activities, often physicians, podiatrists, and dentists make visits there. They generally have small apartments, but main gathering areas and dining room, living areas for activities, etc. many provide personal training and activities to keep him as string as possible . Of course bringing him home is an option with 24 /7 caregivers. I caution you to read other posts on this site regarding private caregivers vs. agency's. Buyer beware! You need to put safety net in place if hiring anyone to take care of a vulnerable person. Just do your due diligence before you proceed with that. Also take with an elder law attorney for all options available to him for now and in the future. A geriatric care manager can also help navigate eldercare roadmap. Good luck.
In Illinois there is supportive living similar to assisted living but for those with fewer assets, they accept lower monthly payments and some accept Medicaid or public aid. Again VA can offset costs if he qualifies in home, assisted living, and nursing home. Another option is long term care insurance if he has a policy.

jdh789,
Since your loved one is feeling so fragile from radiation therapy to the point of being unable to push the button on the emergency device and having two episodes where he couldn't move himself, and you're worried that he would be laying there helpless, he needs 24 hour care assistance. Rest assured that there are plenty of resources available to help and alleviate caregiver burnout. Agencies like VNSNY are fully equipped with all necessary resources and have of numerous programs that help the patient while allowing family members to continue working and fulfilling their primary family obligation needs. Programs range from Medicare Service Assistance, to Medicaid long term care (MLTC), to private pay, to hospice care, etc. There are many skilled personnel that are available to help no matter how complex the patient needs may be. But your loved one does need 24 hour care given the circumstances.
Regards,
Renata Gelman, ADON, RN, BSN

TerriM, I do not believe you. First of all you said before it you had one person with Down's syndrome now you have multiple people with Down's Syndrome ? And it is person first. Not Down Syndrome kids --it is kids with Down Syndrome. You should know that. And , when I asked you from another post how you did it , how you were able to watch that many people with a person with special needs-something I am trying to figure out because I have a teenager with special needs and am trying to take care of my Mom part time and it is very hard -you never answered me. I think you are full of it, lady!!! And it is not nice to come on here pretending to be someone you are not. Or on any other site. Just sayin'. Cut it out.

Um, not EVERY nursing home is a garbage can for the elderly!!!How can you say such a thing???!!!My mom is 100% Russian & VERY stubborn - we asked her constantly do you want this do you need help with that - answered with a big fat NO! I asked her because I wanted to respect her wishes, dignity, & I respected her enough to follow her wishes. I couldn't force anything on her! I really resent also the implication that I "forget" my mom's in that stupid nursing home - I SO wish she HAD accepted help so she could't ve stayed either in her home or at least assisted living, but that didn't happen & now she's "content" in the nursing home - my heart BREAKS EVERY time I think about her in their - I just got finished crying for the past 10 minutes - ugh - jdh789 I can't tell you what you should do - do what YOU think is best.

I can only tell you what I did and why. My father is 82 and his health suddenly failed, he was fine one week and the next week he had turned gray, was shaking, lost all of his strength and could barely walk. It was so scary. He was falling down and hurting himself a lot and not telling us, his neighbors rated him out as soon as they could. We literally only had a day or two to make a decision of what to do.
My father has very little money and after talking to him we decided to move him in with us. It is hard and an adjustment and we have been taking it day by day and it is getting better, but I have many advantages that you do/did not have. I have no children, unless you count my little dogs. I did not have to go through what you did with your mother (I am so sorry you and your family had to go through that) and we are very quiet people that live a very quiet life so it is easier for us. You need to look at what is best for your family first and your father second.
There is nothing wrong with putting your father in assisted living where he can still have independence and you are not the one that has to worry about his well being 24/7. There are many here that have given excellent advice on how to assist him in getting into this type of home. Do not let anyone tell you that you have not done enough or you should have taken him in or mock any other decisions that you make. You first have to take care of yourself before you can take care of anyone else. My family life allowed me to take my father in and live with us; you have to make your decision on what is best for your family.

I would move him on in right now. That way you can know he is safer. I don't recommend throwing one's parents into nursing homes. That is just me but I have taken in my grandparents and parents as well as friends and Down syndrome kids. A nursing home is a garbage can for the elderly. I have a husband, family, work and have 4 people here currently we care for. I feel sad reading some of these responses. People seem to forget that they once were a hassle for their parents who had to clean crap off of them, listen to screaming , and more. This would be a wonderful lesson in compassion, kindness, and family support for your 8 year old daughter. What you do for dad now is what she'll do to you one day when you are in his place. Just do for him what you want her to do to you. I wish you the best.

I had the same concerns with my mother and she is now living in an Adult Foster Care Home. She had falls at home and didn't hurt herself, but shortly after moving into the AFC home she had another fall and the doctor prescribed Physical Therapy which has helped very much. She hasn't fallen since. I personally think that when she was at home, she only watched TV for entertainment and became weak. Now at the AFC home, she has three square meals per day, activities, CENA's to assist with her hygiene and is safe as well as monitored. The facility she is at specializes in Memory Care as she is in the moderate stage of Alzheimer's. Now my only problem is the guilt that I feel after visiting her when she begs to go home. The staff assures me that after I have gone she interacts with the others and participates in the activities, especially if they are singing old songs. She loves music. I know that I did the right thing, but sometimes feeling guilty is unavoidable...especially when they know how to push your buttons.

jdh789- as a nurse, no you are not overreacting. You have pretty much answered your own question in that you cannot do this anymore. Someone that frail will fall and break a hip, get a concussion, etc., so it is better for your father to be in a safe environment than find him lying in his bed or chair dead. Your small child and your brother's small child are not going to understand this part of aging and you do not weigh enough to pick him up if he falls. Get him into a healthcare facility ASAP and all of you can rely on medical staff to keep him hydrated, fed, and safe. Best wishes.

After reading your comments, I agree that it is time to move your father into a home where he will be assisted with his meds, daily needs and some socializing. The sooner he gets used to a new environment, the better. This will allow you peace of mind and freedom to concentrate on your family and work. I am also concern about his meals, I am taking care of an 80 yr. old with beg. Alzheimer's and her appetite is not good, she waits for me to fix her food. Is this an issue with your father? Does he fixes his own meals? Can he really keep up with his basic daily hygiene etc? Hope this helps.

jdh, you need to think in your fathers shoes, what would you want if you were him, thats how I think. Talk to him, sounds like he sure has his mind. Moving into your house might be like pulling teeth but he will have an accident in his home for sure which will put you in this dilema "immediately" as to where he goes after that so plan "now!" My Mom was as stubborn as can be, I called her 5x daily and went over 2 days a week, yet it only took a second for her to fall and break her hip. After that, even with dementia I sat and talked and talked to her. I told her it was my home or a nursing home and she had to understand the Doctor said she cannot go home alone, she agreed and is with me now. I have a medicare paid hoyer lift and hospital bed. She is $25 over the monthly limit for medicaid help. Yes its hard, but its my Mom and she was he best mom ever to me and I have such a good feeling inside when I tuck her in safe at night and I can watch over her. I lost my fil to prostate cancer and its a horrible death if it goes into his bones as did my fil. Enjoy him now while you can, his bone cancer was so bad the sheets hurt. I am not trying to scare you, this is reality. Talk to him and do what he wants. If you have to, set up cameras in his house and you can watch him as easily as on your computer or cell phone, they are worth their weight in gold! Best of luck, its so difficult, I know, first hand.
RR

If you bring him to your home, it will be even more difficult to get him into a nursing home. He won't want to go. I would, in your situation, put him in a NH while he recovers and regains strength from the prostate situation. Then if he can return home, let him. Otherwise keep him in the nursing home. I know from experience how hard it is to do all the care at home. It disrupts your life and if you have a little girl at home, it will be really difficult for her. Yes if he is a veteran with a good discharge, he can get into a VA home for just his pension and his Social Security. That is what they take. I have my brother in law in a VA home. I do have to pay for meds and health insurance from his savings.

I still say it's completely up to you. You have to decide what is best for YOU & YOUR family. The emotional ramifications can be devastating for some of us - I know they were/are for me - I STILL have to remind myself where mom is!!!BUT it is what it is - AND I also know I couldn't take care of her either in her home nor ours!!! So really you have to make some kind of decision for Dad's care.

Put my Husband in a full care facility. He was falling and I have my own issues. He had dementia. There is a very small aid working there and it is amazing to see her taking care of residents. Hire someone who can take care of your Dad while you are at work and try having him stay at your home for awhile while he is staying at your home. If it doesn't work at work you will know you gave it your best! Norma

My husband had the same fear w/mom - regarding me finding her on the floor possibley, well, dead BUT she agreed to get Phillips Lifeline's button where you don't HAVE to push the button - it could tell when you fell & needed help - what a relief for me!!!My mom's in a n.h. because eveyone in the family knew she would NOT accept home health care - she said "I don't want it" so I couldn't FORCE it on her! JDH789, if YOU don't want to take care of your Dad long-term, that's OK!!!!!!!!!!!!!!!!!! I weigh about 90 lbs & I couldn't do hands on either for myi Dad. But you also don't want to on call 24/7? If Dad moves in w/you, you WILL be on call 24/7. JDH789 it seems like you're going back & forth on this one - I don't kow what else to tell you - a rehab ctr could be a temporary solution like 1500miles said - it seems like you have an internal battle going on. Well, you probably already know the "answer" right? It's really up to you - if it were ME I'd probably place your Dad in a rehabe center until he regains his strength, etc. THEN decide where/who will care for him after. This is a tough one...

You need to talk to his doctor and get him to order care so Medicare or Medicaid or the VA or someone will help with the cost. From the sounds of things, this is a tragedy waiting to happen. Call your local area agency on aging or whatever it might be called in your state. Go to your state's website and look around. There is help out there, but you have to find it yourself. They won't knock on your door. Please do this for your Dad's safety! Good luck and God bless.

He may not need 24/7. It sounds like his situation is due to medical treatment, and therefore might be temporary. He can go into a nursing home while the condition lasts, Medicare cost, and then come out again. In-home support services like home health aides, physical therapy, and occupational therapy can also be called in on a relatively short term basis, bus can be renewed if he declines. You really need to talk to his doctor about the situation, as either service requires a doctor's order.
I had in-home nursing, PT, and home health care for my Dad when his situation first turned difficult. This was followed up by private-pay companion care for four hours/day, seven days/week for over two years. Recently this changed to live-in care on a private arrangement rather than through an agency, which was going to be more affordable for him.
If he is a veteran and has less than $80,000 in funds, the VA has some benefits that will help pay for assisted living. They will more readily pay for this in an Assisted Living Facility than at home for some reason, but you might be able to get some help there as well.

In Vegas where we live , we had 24/7 care for my daddy ,it cost 9 grand a month.

24/7 live in care is not covered by Medicare. You have to pay out of pocket. Now if your Dad served his country V.A. will pick up some but hardly live in help 24/7.

It takes some time for a parent to adjust but after awhile he will come to get used to the live-in help he would get.

Maybe a 24/7 live-in home health aide would work for your dad. Medicare might help pay a portion of the cost.