My dad (83) had a horrible fall in his apartment 10 days ago. He is in the hospital now and he tested positive for Covid-19. Dad has short-term memory loss /dementia.

Since the fall, he is very weak and cannot stand or walk on his own or do normal things like brush his own teeth or feed himself. The doctor says that they want to place him in a skilled nursing facility for rehabilitation.

I am very frightened for him going to a skilled nursing facility as I hear that most patients in his condition will not get better at all and parish in those places. I know this sounds morbid, but I’m mentally preparing for the worst.

It’s the first week of the month and I just paid his rent ($1,000+), so I’m wondering what to do with his unoccupied apartment. I have hired a cleaning service to come in and do a deep cleaning of the apartment.

I really want to make good use of the time that he is not there, but I do not know if there is something else that I should be doing at his place during the time that he is in the hospital and or skilled nursing home? I need advice.

Donte, it's sad to learn that what you've "heard" about some facilities is so negative.  That's not at all true of all of them.   There are some that are better, and some that are worse.   Finding a good one is one of the tasks of insuring good and proper rehab.   This is a link to several threads here on how to select good, reliable facilities:

My personal experience is that checklists. phone calls for discussion of issues of concern, and individual tours of the rehab facility are mandatory.    Read the threads listed in the link, make your own checklist, and start researching rehab centers in your area.   Ask for tours; good ones in my experience will offer tours to prospective clients.  If they won't, forget them. 

One thing to ask is the ratio of staff to patients.  That will give you an idea how many employees are available at various times during the day, especially at mealtimes.  

Another issue is whether the food is prepared on site, or trucked in.  The latter was our very negative experience at a facility owned and managed (?) by a joint venture with a hospital and another entity (for profit, I believe).  It was absolutely the worst place I've ever experienced.

Over the years, I've had experience with 6 different rehab companies and found that two were outstanding:  1)   the religious one provided better service, compassion, and support than any of the profit facilities., and 2) a health care chain in close proximity to the VA hospital and a teaching hospital provided the best and most professional support.  The latter rehab was a chain, and 3 of the  closer, more local facilities definitely weren't in the top notch category.

As to his potential return home, only a physician or NP or PA can offer insight on that.   Contacting one of them would be the first step to making any decisions.  If your father can rehab well, he may be back to his apartment in a month or so. 

Something else you can do while he's recovering is research home rehab companies.  There are a lot, and some are very good, some are okay, and some are not worth consideration.   This is a time consuming task, so you can start researching now.

The Alzheimers' Assn. used to publish lists of various types of facilities.  Before the pandemic they also were very prompt. I got e-mailed lists w/i 1/2  to 3/4 of an hour after calling.   Area Aging on Aging took a week.  I never bothered to contact the AAA after discovering how great the AA could be.
Helpful Answer (6)
Reply to GardenArtist

I would continue to keep the rent on dad's place current. If he recovers to the point he can go home, he needs to have a home to go to!

At this point, you really don't know what his health outcome will be. Having a clean, empty apartment should he need to be moved to long term care will be better to walk away from than if you broke his lease. packed all his stuff and then had to find ANOTHER apartment. There's a lot of fees included in moving, so paying that $1,000 is less painful than trying to re-home him.

Give it a month or two. Yes, it stings to have to pay for an unused apartment--but will, in the long run, cost less than finding a new place.

And to the question of how 'awful' you've heard about NH's or rehab facilities--do your homework and visit some. Yes, there's some bad ones, and sadly, that's about all we hear about. Why write about a NH where there are no or few issues? This is a site for solving problems, and so we hear about the 'bad' stuff.

Don't assume the worst!
Helpful Answer (6)
Reply to Midkid58

GA has given you some good info.

I need to be upfront with you. You mentioned in a previous post that Dad has Dementia. This "horrible" fall should be an eye opener, Dad cannot live alone. At his age COVID may do a number on him, meaning he will have some physical and mental decline. You may have no choice but to place him somewhere. Either u move in with him or him with you and you do the caring or hire caregivers. If he can afford it a nice Assited living or Memory care. If he can't afford it, a nice Longterm care facility with Medicaid paying.

These are decisions u need to make while he is in Rehab. Ask that he be evaluated for 24/7 care. If found he will need that, then u go from there. Where I live Rehab and SN are in the same building so easy to transfer. If u don't like the SNF then look for another one or an AL if he meets their criteria. Won't go into what happens after he goes to SN, if he goes. U can always come back and ask questions.
Helpful Answer (6)
Reply to JoAnn29

Just pay rent on his apartment until you know what's coming next. Rehab is generally 20 days, that's all. Once rehab is finished, you'll know if dad has to stay in the SNF long term or whether he can go back to his apartment with caregivers coming in or what. You've already paid his rent for November, and, in reality, $1K a month isn't horribly expensive, so I'd just take things one day at a time.

When my father lived independently with mom in senior IL and fell and broke his hip, he too went to rehab for 21 days. Rehab refused to release him back to IL even with mom who was willing to care for him; he was in too rough shape for such a thing. So I had to get him into Assisted Living, THEN figure out how to get their stuff out of their apartment, get mom moved into AL with him, meaning I had to maintain TWO places for them for a couple of months! When I knew dad was going into AL, THEN I let the senior apartment know they'd both be moving and not renewing their lease, etc. I had to give them 60 days notice anyway, so you may want to look into that matter NOW with your dad's apartment leasing office. I wound up having to purchase a new bed for dad to use at the AL, a nightstand, etc, then figuring out how to sell/dispose of their old bed at the apartment once mom moved out..........the whole thing was a huge undertaking.

I don't think you're being 'morbid' here, I think you're being realistic as the person who will have to do all the legwork to get dad placed in AL or whatever comes next in his journey.

I feel your pain; the not knowing is the worst aspect of everything. Sometimes the fall and the illness signals the beginning of the end, which is a very difficult thing to witness and for us to handle, as daughters. That time was VERY stressful for me, to say the least. My father did well in the AL for 10 months (he got stronger after rehab & recovered from the fall/hip surgery at the AL) but wound up passing away with a brain tumor which grew during that time. The fall itself helped to diagnose the tumor which we knew nothing about until the CT Scan revealed it. He was 90 when he fell, 91 when he passed. All you can do is advocate for him, visit him at the SNF while he rehabs, and see what they tell you as to how he's progressing (or not progressing). Covid at an advanced age can be a difficult thing to recover from BUT, we have posters here on AgingCare who's 95 year old parents HAVE recovered from!

I am sending you prayers, positive vibes and hugs for a good outcome for your dear father in all of this.
Helpful Answer (6)
Reply to lealonnie1

If you are Dad's POA, gather all his documents and bank statements, his will, life insurance policies, burial plans, and health insurance policies. Take them into your possession, take them home.

If you are not Dad's POA, gather same, and find the name of his attorney-maybe the one who made his will.

Handle his mail. Open it. Current senior issues are "open enrollment" for health insurance. You might not want to change his health insurance provider at this time, but confirm he is still insured, and obtain his current insurance cards/I.D.

There also may be new debit or credit cards coming in the mail, guard and watch for that. Maybe for safety's sake, consider changing his address to a P.O. box in both your names. Or, to your home address. Obtain his credit reports from all 3 major agencies.

If he is not going to be coming home after rehab, plan to notify the apartment manager a.s.a.p., giving notice, 30 days, 60 days. Find a lease? If you find out by the end of November Dad will be moving, or not coming home, you can ask the apartment manager to apply the last month's deposit to his final rent. See if that is possible before you pay another $1,000.

You could plan to sublet the apartment until Dad comes home, if that is possible.

Sorry your Dad is ill.

Midkid is right, don't assume the worst. And trying to keep the apartment for him is a good idea.
Helpful Answer (5)
Reply to Sendhelp

I agree with what other posters have said already and that is keep the apartment until you are certain of what is next.
We had to do that with an uncle of mine that my mom, his sister, had POA over. He fell ill one year and with the help of one very dear friend he had, his rent and all bills were kept up until we were sure unfortunately that he was not coming home.
If your dad is released to come home, with or without home health care, having that apartment still at the ready will be one less thing for you to stress about. A bonus is that it will be nice and clean for his "welcome home"!
I pray everything goes well with your dad. The first time my mom was in a SNF, she was almost in the exact same condition your dad is in. After they kept working with her and with a lot of encouragement to keep doing as much as she could on her own, she was able to go home. She had about 6 weeks of home health visits after that and then she was able to live independently for one more year.
Helpful Answer (5)
Reply to ybd311

Donte1423: Imho, since you are really in a holding pattern in regard to your father's health, his apartment should remain static.
Helpful Answer (4)
Reply to Llamalover47

He is being admitted for rehab - a sensible option for somebody who is greatly weakened after a COVID infection. Depending on his progress over the next 2-3 months - his caregivers, physical therapists and doctor(s) will discuss with you his next best options. This options could be assisted living, memory care unit, coming home with home health aides, or hospice (in a residential facility or at home). You really need to consider that his best options are not going back to an independent apartment but into some facility with assistance or with 24/7 assistance at home (yours or his).

I suggest you talk to social work at the rehab facility to ask them which options he qualifies for in regards to his condition and finances. They can point you in the direction of facilities and resources he qualifies for. You will still need to do your own quality checks on each place. You will then be able to decide if you need to let his place go or hold onto it and keep paying the rent. In either case, consider securing his belongings.
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Reply to Taarna

Well, nursing homes are generally reluctant to 'approve' for anyone to be discharged to home. (The exceptions is relatively well younger elders - 60-70 who were admitted for rehabilitation after a surgery or illness, but are generally well.)
So see how he does with rehab, and ask about having skilled nursing and rehab care in his apartment when he goes home again. If he is still not able to manage, then hiring some in home care (NOT covered by health care insurance) will be the next step.
It's a long journey. Take care
Helpful Answer (1)
Reply to Clairesmum

If you choose home care, he will most likely need to live with someone. Evaluate who is going to be that person and if his apartment or another place is more suitable. Additional help may be provided by Medicare/Medicaid. When my Grands could not live alone, they moved to my house and sold their home. 20 years later, my mom can not live alone, she was here for a while but wanted assisted living. We have winterized her house. No need to sell at the moment as her ss and pension cover the cost of care. Each situation is different. Look at all the options, and follow your gut and what works $$ and for your family. A trusted family member could live there and pay 80% of the rent, a small discount for looking after the place.
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Reply to bowgirl

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