What are the steps we need to take now that we caregivers are facing a lawsuit?
from the man (father in law and dad) that we have been helping? Our patriarch-95 years old-is threatening to sue his children and spouses (5 of us) because we helped him to get into a nursing home. His wife of 74 years is in this home since May of 2016. Since her placement-from hospital to rehab to long care facility- he has been despondent, needy and failing. He had been living in a 2 story colonial, he has a stair chair lift, walkers, canes, grab bars, lifted toilet seats (all supplied and installed by one son-my husband). He has very bad knees, congestive heart failure, and had been eating poorly even though we had been fixing/getting his meals for him. Before his wife was taken to the hospital, he helped care for her-she slept most of the day on the couch, but he kept his eye on her, fixed meals, helped her dress, etc. 3 weeks ago, he decided he couldn't live without her. He needed someone to spend the night, and be with him all day. My husband called her nursing home, and finally arranged a bed for him. They suggested we take him to the hospital as a way of getting him placed there sooner. He was agreeable to all this. As was his general practitioner. He spent a week in the hospital- regaining his strength, being on anti-anxiety meds-eating well and being well taken care of. One of us visited him every day. This past Wednesday he and we were told he would be placed in the nursing home, for rehab. He was agreeable. The next day my husband and I showed up at the hospital. Waiting for Medical Motors Service, the 3 of us talked about getting his house ready to sell, selling the contents of the house, and putting all the proceeds into a trust FOR HIS AND HIS WIFE'S CARE. He agreed to it all and said thank you. Something happened on the way to the nursing home, for when we got there we were faced with a man in a rampage. He didn't even want to spend time with his wife. He thought he was going to be in a room with her (an eventuality, but not immediate since he was doing rehab-something he was well aware of) long sad story made short, my husband and I eventually left after 1.5 hours, hoping he would calm down. Instead he rolled himself to the lobby, called the local sheriff and said he was being held against his will, and had been abandoned. He refused meds, food, and care, and the nursing home called Medical Motor Services, who took him back to the hospital. That is where he is now. He calls my brother in law (the oldest) yells at him and hangs up (at 1:30 a.m.) They go to the hospital- he tells them we have all been disowned and he doesn't want to see any of us.And that includes grandchildren. Today he has told them that he is getting a lawyer to draw up a legal document to keep all of us off his property, and that if we step foot on his property we will be arrested. We do all the mowing, upkeep, get the mail, water his plants check on things for him. The hospital told my brother in law and wife that they found him to be incompetent, that he was unable to make his own decisions about his care. We live in New York State. Does this also mean that he cant engage in legal things as well? we don't need to go to his house, but this is such an abrupt change of heart, we are having a real hard time coming to terms with this. He is a WW2 Battle of the Bulge Lt. Colonel who has always put family first. He has also always known how to stand up for himself (and his family) when needed, He is a tough old man, Any suggestions? Any advice? We are quite literally at the end of our ropes.
If the doctors have said he is not competent then I doubt any law suit will get very far since you are acting in his best interest.
I also suggest you contact the VA to determine if they can help through a program called VA Aid and Attendance this can provide more money that will help offset some of the expenses of the nursing home or assisted living.
Shan, listen to Babalou - get a geriatrician involved. Too many doctors who don't have this experience and insight don't pursue options that might offer explanations. I still can't help thinking there's a medical reason behind the change in behavior, but non-geriatricians can easily miss that possibility.
I've had 4 different PCPs for my father and found that none of them were capable of dealing with elder issues. No more. Geriatrician or nothing.
It also might be the time for an "either/or" talk. It's easy to become frightened of growing old, especially when there are so many changes and life becomes unsettling. And that's an easy slippery slope to preoccupations with one's self and what he needs, not how it's affecting the family. There's a kind of panic that sets in with the realization that life can change precipitiously as one ages.
You might just have to take the "we have our own problems" approach a step farther and make it clear that (a) you can't jump every time he needs something (b) he's a rational (hopefully) person and needs to recognize that his behavior has to met certain standards or his options are going to be much more limited, and unpleasant, and (c) more is accomplished by everyone working together than him working against you (d) you can't help him if he's going to be unyielding and fault-finding, and (e) no caregiver is going to meet his stringent standards, but if he wants the care, he needs to be flexible.
Even in other aspects of life, no one person is going to meet someone else's standards 100% of the time.
That might be the hardest point - he's probably running scared now and it's hard to get perspective.
I truly understand the sense that your vistas have shrunk to the caregiving issue. Sometimes I'll read articles, or look at photos, of national park sites, of beautiful pristine forests, of quiet beaches with waves lapping along the shore. Or read the news - the thought of a Trump presidency, or the slaughters in Syria, help me realize that there are far worse problems than I deal with in caregiving.
Seeing such magnificent sites as our national parks also helps clear my mind, and helps me realize that I'm but one person in a vast and complicated world, and that my problems and concerns are certainly serious, but not as difficult as those created by people who abandon and abuse this beautiful planet.
At this point, tell him that you all have your own medical problems and that he needs to hire round the clock aides. With his money, of course. Staying at the NH for rehab short term and being cooperative would be much more economical for him, but if he's got dementia, the logic of this is gone.
You have a right to choose your own home care agency. If you have a trusted doctor, ask one of his staff - I got recommendations from one of the best doctors we've had.
I also made some decisions based on interviews with home care reps; the last one was probably not a good choice; only the PT'ist and speech therapist were any good.
Babalou raises an excellent point on the hospital's incompetency Dx but now they're pushing him out the door. That inconsistency is unexplainable and inexcusable. Use that to your advantage.
Hospital staff often can be hard to reach, so add a touch of emergency to your voice mail message, something to the effect that you're trying to work the situation out in a manner that's best suited for FIL without having to bring in outside sources (hint, hint) to intervene.
Temind them if they take him home (if they "sign for delivery" they are then responsible for keeping him safe, full time, from now on (probably not true, but it might give them pause....
I think perhaps you could ask for a 72 hour psych hold, perhaps in a specialized geripsych facility. They could get his meds stabilized there.
Ask for an assessmebt of his need for home care. Medication management. Ask for an OT to assess the home environment for safety. Ask about rehab.
What did the psych assessment show? Get the head of psychiatry on the phone and make sure they read the suicidal gesture in the record.
YOU DO HAVE OPTIONS, but act quickly.
1. You should have received a Medicare notice of rights, something like that, on the first day. It advises of your rights to challenge a discharge. You have to call ASAP to preserve that right.
If you didn't get that notice, politely demand it now, even if you have to go beyond the nurse (it isn't often her responsibility). Hospitals are obligated to provide that notice of right to challenge a discharge.
2. Start moving up the chain of command. Go past the social worker, ask to speak immediately to the attending physician. If you don't get satisfactory answers, keep going, to the hospital administrator if you have to.
3. Ask the discharge planner specifically what their recommendations are. Is there any discussion of rehab, or is it assumed that the family will provide all the home care necessary?
4. Another source is to contact an attorney who has familiarity with this type of premature discharge, but you'll have to do a lot of calling. Another option is an ombudsperson, especially if the hospital has one.
5. And start documenting every contact in the hospital and make sure they see you documenting. If you have to bring in a laptop, make sure you get names, times, etc. That tends to send "liability" chills up the staff's individual and collective spines.
6. DO NOT sign the discharge instructions and if necessary write on them that you specifically disagree with the discharge decision.
7. You can also put them on the spot by asking them if they're short on beds and need to discharge him b/c they have new patients who need the beds. This will really put them on the spot, and I know for a fact it can be a consideration of discharge.
I had to do this last year when the now fired PCP recommended my father be discharged with pneumonia, too weak to walk, and on 6 liters of oxygen. I called my niece who's a nurse; she said the hospital at which she worked would NEVER discharge someone on 6 liters of oxygen and agreed I should challenge the decision.
I advised one of the nurse staff I would be challenging the discharge decision and wanted the attending physician replaced immediately, but before I even had a chance to call pursuant to the discharge rights notice, someone else became involved. It might have been a charge nurse - I don't recall w/o checking my notes.
The then fired PCP called me several times at home, backpedaling, blaming a nurse for misstatingi the situation, blah, blah, blah, but the bottom line was that he was more concerned about losing a patient and specifically asked if we would be continuing with his care post discharge. Obviously not!
I did manage to keep Dad in the hospital until he was more stabilized, but it was an unsetling experience.
Good luck, and don't take this crap from the social worker.
Babalou, excellent suggestion. I had completely forgotten about hospital psychosis.
I recall when my father was in ICU during his long odyssey over a decade ago, one of the treating physicians or nurses (don't remember which) told us there also was a syndrome called ICU psychosis. I had commented on the number of machines beeping and bleating and jokingly queried if it didn't affect patients in some way.
Shan, given all the changes in your FIL's life recently, it might be overwhelming, and the complication of the beeping machines, hospital control, drastic change in daily activity, could be contributing to his current state of mind.
I think it would be a harmless "therapeutic fib" to raise the issue with him and suggest that perhaps his current hospitalization is contributing to unsettling him.
Babalou, you raise an interesting point as well. We've probably both read here on this forum that older people often suffer confusion after leaving a hospital. And generally, there's some discussion of dementia, with it having been complicated after anesthesia or hospitalization. Perhaps the real issue is hospital psychosis.
I recall that when I had an emergency appendectomy a few years ago, by the 3rd or 4th day I was so unsettled that I couldn't sleep. Most of it was b/c of the dry air and the miserably uncomfortable hospital bed, or so I thought at the time.