My father is elderly but was 100 percent independent. He drove, cares for himself, cooked, lived alone. He contracted covid.
After 60 days so far of icu on a vent, a trach, and now off of the vent, trach is removed he is in acute rehab.
He will need to learn to walk, he is having trouble swallowing, he currently has a catheter and a feeding tube.
We are 1/2 a week in at acute rehab and they are telling us he will only be there a total of 2 weeks. They are already talking about when he comes home and what we (myself and my two siblings) will need to be able to care for him.
I do not want to have to help him shower, clean up messes if he can’t make it to the bathroom and that type of care. I don’t think he would want us doing that either. I also have some health issues that would make lifting him an issue.
my one sibling will be insistent that he should come home.
How do I handle this? I have a week to figure it all out.

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"No, my father cannot possibly be discharged to my home".

That, my dear lady, is a complete sentence.
Helpful Answer (16)
AlvaDeer Aug 2020
Barb is so right. Say it. When they come up with all their hoopla, say it again. Say it. Rewind. Repeat. Barb knows how to cut this down to the essentials.
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Tell them you will not be taking him into your home.
First question is that you say your Dad was completely competent. Was he living with you? What was your understanding moving forward? Or was he in his own home.
Know that SNF is covered for at least 21 days especially after Covid. But in almost all cases in which patient is on medicare.
Let them know NOW, at once, that your father was self care, and that you will not be caring for him. That, if he requires care then he requires placement. This is much easier, esp in these times, for the Social Worker there to handle than for you. The important thing to tell them is that you are neither mentally nor physically able to accept him into your care; they will try EVERYTHING. I have been there as a nurse seeing it. They will tell you that they will get you help and together you will all make it work. They won't and and it won't work and then you are stuck, having no answer but an ER dump to get him back into care. It will be almost impossible for you to find.
Your Dad will require four negative tests (in most CA facilities, at least) to get into care; they know that. It is a pain for them and they want him in your home.
TOMORROW, ask to speak to the Social Worker. Tell her that you will not be accepting your father into (or BACK into) your home, and that he was self care, and you are not prepared mentally or physically to care for him. Tell them that he will require placement, and they will need to find placement for him, as you cannot go in "covid-19 times" to check out facilities. They will then ask you for his assets, and you should be ready, if you can, to tell them as approximately as you are able.
Good luck. You are going to have to STAND STRONG against them to accomplish this. It is no time to be a shrinking violet. The truth is that your Dad may never fully recover from this; many younger than him have been unable to, and there may still be complications of blood vessels, strokes, no lung capacity on the horizon.
I am so sorry this happened to your Dad, but do not allow them now to use you and make it clear it will not happen. They cannot do a discharge to someone not accepting a patient and they cannot do an "unsafe discharge".
Time to kick it into high gear tomorrow, and I am so very sorry your family is going through this.
Helpful Answer (15)

If you father is not showing improvement they WILL discharge him. You should have been telling your father to work HARD on rehab, or he will be going to a nursing home. Medicare does NOT pay for nursing home care other than rehab up to 100 days, and they have to show improvement--they can eject them, called "no progress" discharge.

Your choices are either learn how to do basic care and get over your reluctance to "clean up his mess" -- or straight to the nursing home he goes. I took care of my mom with end-stage Alzheimer's for decades and in the end I had to bathe, clean and even make certain she has a bowel movement a few times a week, which often involved enemas and lactulose. If you really love someone you do what you have to do.

If you can't, or won't--then you can't--then get him placed in a nursing home, and you better tell your father that. GET WITH A SOCIAL WORKER.
Helpful Answer (6)
Isthisrealyreal Aug 2020
If you really love someone you do what you have to do. Seriously! Could you possibly say anything more judgemental and guilt inducing? I am sure you could if you tried. That is just wrong and not everyone wants to do what you did for your mom nor are they equipped to do it. It doesn't mean they don't love their parent.

You weren't faced with doing this for your dad, so pull your rocks back until you walk in those shoes.
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Tell the discharge planner they have it wrong. You are a long haul truck driver who lives in Alaska.

I joke right? But what if you were? What if there were no adult children?

Alvadeer is correct. They will try anything to 'close case' & move on to the next case. They are crazy busy I know. But Dad is in their care so the *duty of care* is theirs.

Tell them you are your Dad's advocate to enable him to receive the care he needs. But his care is beyond what you (as one person, or as one of three sibs) can do.

Stand firm, be polite & professional. Stay strong.
Helpful Answer (5)

Tell the one sibling that  you think dad belongs in an institution, but if he/she wants to take dad home, go for it, but you are not going to help.
Helpful Answer (5)

Granted, it sounds like your family has been stressed of late. But, if it feels wrong to become his in-home caregiver..... then it's probably wrong. I'm glad the staff is giving you some idea of what care your dad needs. However, for every one thing they are telling you about, there are probably TWO things they are not telling you about in terms of things your dad will need or things you must be willing/able to do for him. Rehab staff will smile and ask if you have any questions prior to releasing your dad to go home. They will say you can call if you have questions once you're home and you realize the magnitude of what you've agreed to, but don't be surprised if you have trouble reaching them.... Just my experience talking.
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Please listen to Barb and Alva. Do not listen to those who imply that it is your duty to take on his care. You know what your limits are as far as what you can do. Make sure all of the others , siblings and health care workers, are fully aware of those limits too. Be firm.
Helpful Answer (5)

If you can not do the level of care your father needs, please let your siblings know this now in very direct and simple terms. Maybe one of them can take dad in while he recovers. If none of you can handle this level of care, he may need placement in a residential facility that will provide daily rehab. Discuss with the social worker a placement for him. Then, discuss with your siblings and the facility the level of independence dad will need to come back home. Consider that your father needs extended rehab not permanent nursing home placement.
Helpful Answer (5)

My uncle was doing rehab in a nursing home and was all set to go back to his apartment with care from an agency set up for him. While final arrangements were being made he contracted covid-19. He spent a month in the hospital and went from walking, talking, eating, and using the bathroom on his own to being bedridden (need to use a hoyer lift to get him into a chair), unable to swallow, and on a feeding tube. They say he will never return to his baseline prior to getting the virus. The virus often causes delirium in the elderly damaging the brain thus the inability to swallow. His level of care is too much for the care agency and he can not go home with a feeding tube. He is now in diapers because the liquid feeding results in diarrhea. He will be in the nursing home until he dies. They will not release him so Medicaid is the only option. This really stinks if you have a home or other assets to deal with. They will start charging and the bill will add up fast if he does not qualify for title 19. It's a no win situation and tough spot to be in for you and your siblings. Find out what his prognosis is. Usually if they are going to get better it happens sooner rather than later. Im not sure you could get aides because usually you would need a nurse because they can still choke and get pneumonia with a tube. It's expensive and will consume your life caring for someone so sick. On the other hand if you don't take him in you will lose any inheritance and he will have no life to go back to if he does happen to get better. I'm sorry you are dealing with this. I've been through these tough decisions with my dad and it's not easy but at least you have siblings to share the burden with. I wish you well.
Helpful Answer (5)

You are NOT cut out to be a caretaker and it will destroy you and your w ay of life if you bring him home. He needs the type of care that is best handled by a facility. Simply be strong and do NOT allow him to come home with you. Tell your sibling no and that the sibling should care for him. But YOU DO NOT BRING HIM HOME.
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