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Talk to the social worker in his rehab to determine what services he needs. If you have to be a pain in the backside until they talk to you - though without a POA they may not talk to you without your father's permission. Make sure wherever you go for any of your fathers medical appointments that you are listed as someone they can disclose information to.
Get your father's financial affairs in order. If he's competent have him appoint you as his DPOA (Durable Power of Attorney) for financial and medical decisions.
Contact the agency in your county that deals with seniors to help get him the services he needs.
You say your father is a veteran, check with VA for possibly getting Aid and Attendance benefits. Also even though my father had insurance and had a doctor, I applied to get him VA benefits - we didn't really use medical benefits, but I did get him hearing aids for a copay of $60 and lifetime free batteries.
Think carefully before taking on your father's day to day care - does your boyfriend agree with this decision. Your father's care will take up much of your time. If he has the assets look into placing him in a facility near you, maybe assisted living. You'd still be his advocate and caregiver, just in a different capacity. In MO AL facilities administer the meds. I'm not sure about FL, but they will make sure he has a better diet available to him. He'd also have the opportunity to make friend and have activities available to him.
My mom is in AL in MO, they administer her meds, do her laundry and clean her unit once a week (though not up to her standards). My job is to pay her bills, file her taxes and keep up with her care needs.
Please get your father vaccinated as soon as possible.
Good luck to you and your family.
Naturally, your father had trouble adjusting to his new situation. Plus, he has many issues to cope with. That’s a lot on your plate and his.
I feel grateful that my father died first because he would not have coped well if mom died first.
You will get through this one day at the time. Call his social worker at the hospital and allow them to walk you through the steps.
Social workers have been a big help to our family.
Best wishes to you and your dad.
He is a non compliant diabetic so he will need to be an environment, in MO or FL where he can be closely monitored and guided. If you can keep him in a rehab situation in MO for as long as possible while you set up a program for him it will be better.
A two bedroom apartment is tight quarters for 3 adults particularly when it is an intergenerational group and one person needs food education/guidance and possibly (based on the cobwebs you found in the tub/shower) some assistance with activities of daily living. Caregiving and monitoring is 36/9 (no, not a typo). And you will find that you have given up your life and may become depressed and resentful. Your boyfriend may be supportive but he may also tire (as will you particularly if you are working) so it will be best for all involved to find your Dad some type of monitored living situation (board and care home, assisted living, etc). Medicare is a health insurance program and will not pay for living expenses. Medicaid does pay for some living situations but as it is state administered you will need to apply for it for your Dad in the state he will be residing in, FL. I would call the Office on Aging in your county of residence to get more information on Medicaid and other programs your Dad may be eligible for as soon as possible.
Also make sure that you have Dad's Durable Power of Attorney, Will and Medical Proxy/ Advanced Directive up to date. These are vital documents and you will need them in the future. If you don't have them, make sure to ask the rep at the Office on Aging how you can find a low cost elder care attorney who also specializes in Medicaid as yes, the MO house will eventually need to be sold so the proceeds can be used to pay for Dad's care. Keep detailed records and receipts of everything you spend on Dad and try to only use his money for his upkeep. Also when you looking for FL living situations for Dad, keep in the back of your mind the knowledge that many assisted living facilities do not accept Medicaid.
Please come here often and keep us updated and ask questions. This is a wonderfully supportive group.
Peace and hugs to you.
With just this info I would make a list to just check on all - and make categories
From VA and SS to elder law.
Then make a medical care list - doctors and medications - health insurance - and dietary needs.
I live in south Florida (Palm Beach county). If ur in my local area - I agree with reaching out to elder services in your county - they can also connect you with a social worker that found me - a program that offers many services (which I’m sure he would qualify for) daily daycare centers and transportation or meals and aide care in home - supplies - they can also help you with local organizations that donate or for small fees can help you get any equipment you may need - specials beds - wheelchairs etc. I only use a small level of their services for an aide to help us travel to outpatient rehab in the beginning - but they also have me valuable advice and other resources.
I would call your county elder services as they may help guide you in getting him here as well as help find a local place if you find his needs are greater than expected. Breathe - we all felt like you did - I wish I had found this site long before I was a year in. This is an amazing place for guidance. Wishing you the best🌻
Start with those hear your neighborhood, then work outward. Chat with some on the phone, too.
My mother is in a GORGEOUS AL/MC. We are in Florida. It's only 3 years old. Communication is stellar.
Regardless of where dad goes the cats can no longer be considered safe in his care, therefore they need a new home.
Step one, if Dad is at all cognitively capable at this time is, when you get him home, to get that POA done. You will need it. Get it in a Lawyer's office and get it airtight so you can act in all ways for him.
You will be having to have his automatically deposited Social Security check put in banking where he is. I hope he has it going to a big bank and still has the cognitive capability to open an account, and have the monies transferred (the bank can do this automatically.)
If Dad is not cognitively aware it is TOO LATE for POA. You will need guardianship and will need to go with doctors letters to the Social Security office to be maid representative payee. They do not accept a POA of any kind.
You will have to change his ID. Take him to your local DMV to establish residency.
First thing to know about being POA is that you need to keep meticulous records against the day that he needs medicaid to have in facility care.
Don't suppose that any of this will "work". You will have to adapt as you go and handle your anxiety with your doctor. Don't be ashamed to see your Doc and tell him/her what you are going through and get yourself medication to help on crisis days.
That's enough to think about now on day one. Don't try to handle it all all at once. This will take a year at LEAST to get running smoothly. I did it for my brother.
To be frank, it is almost lucky, but you don't have time now to think about what you missed it the past. That water has not only gone under the bridge but is entering the ocean now; now is the time for concentration on the "now".
Again, welcome. Come to us with questions one at a time and we will try to help all we can one at a time. Get professional help for professional questions.
I am sorry, but here it is. And now you will deal the best you can. Forget about guilt. You are mourning what has come to your Dad AND TO YOU. That G word is GRIEF.Learn that well. You are a human being with limitations with intentions to do good. There is no room in that definition for guilt. Leave guilt to the felons in our land, those who do evil.
Hugs. You CAN do this. I did it a few years ago for my bro, who is now gone. It was a learning experience like few others, and I didn't even ATTEMPT in home care. I KNEW going in that I could never do that.
Last sentence is true. NO federal agencies accept POAs.
But you don't need a doctor's note to apply to be Rep Payee. I called MY local office, not mom's. It was closer and quicker response than calling the 800 number, which will likely just send you off to a local office.
They set up an appointment (pre virus, so this may be done by phone now, or perhaps they do something else) for me.
I brought all kinds of paperwork to show I had been managing mom's finances. I did NOT bring my mother with me. They did NOT ask to see ANY of the papers I had. Nothing. They ask the questions they have, you provide your ID, etc and they submit the request.
No doctor info. No test showing dementia. Nothing. It was one of the easiest things I had to do in the whole business! They will mail notice to you and the person you are applying for (gives you update and gives the person opportunity to dispute it - mom was already in MC. the nurse held anything not looking like a card or personal letter and handed it to me.)
Once approved, the first payment comes as a check. You can set up a special account (only you can access it and only SS funds go in it.) Make sure the bank you choose knows how to set this up. THIS was the nightmare for me. Once the account is set, call the local office with the routing and account number and have it deposited electronically.
At year end they mail an accounting, to report how you used the funds. It isn't difficult and can even be done online, through your own SS account. Just keep track how his money is used. They lump a lot together, like housing and food. It's only maybe 1 page, double sided, and a lot is confirming you, that you still manage the funds, etc.
We were incredibly blessed that my dad's insurance cancelled him because they didn't provide coverage where he was living. This opened the door for him to get any type of policy, without a physical and yes they do that with Medicare supplemental insurance and he didn't get dinged financially for preexisting conditions. Call a Medicare specialist insurance broker to determine what is the best route to take, either changing it or letting it get cancelled for no coverage.
My dads premiums were less than his annual co-pays and he could see any doctor that accepted Medicare, which isn't the case with Advantage plans.
Is dad a Veteran? If so the VA may be of great help. If he is a Veteran depending on where and when he served you/he may get a LOT of help or a little help. They are expanding the reasons a Veteran can be classified with what is called a "Service Connected Disability" and there are a lot of diagnoses that can be attributed to service. (diabetes happens to be one of them) If he is a Veteran contact your local Veterans Assistance Commission and they can help track down all the paperwork you need.
**Ok, read through the comments and you did mention he is a Veteran. Contact the Veterans Assistance Commission. As I mentioned they have expanded the classifications and a Service person did not have to be "in combat" to have a "service connected disability"**
I suggest that you try to have him kept in rehab as long as possible to give you time to take care of what needs to be done before he gets home and faces a move.
Is your dad willing to move? Is he willing to sell the house? If the answer to these questions is NO you might have a bit of a tough go. Unless he is declared incompetent you can not force him to sell the house, you can not force him to move. This might also require you talking to an Eldercare Attorney.
Second on feeling that the rehab seems to be somewhat disinterested, you are probably correct. Your dad is a noncompliant diabetic. Rehab well they’ve seen this before and know that for a noncompliant diabetic it’s 5 steps forward then 10 steps back. That he is up and walking is terrific but if it means he’s up and walking to get a candy bar, he’s gonna be back at the NH but in a wheelchair after an amputation related to his diabetes.
Diabetes if it’s allowed to run wild so to speak really takes a toll on their whole body, from eyes to toes. Loosing toes really does happen for diabetes that insist on staying noncompliant. I’d try to get him to see an endocrinologist rather than initially seeing an internal medicine MD if at all possible. He needs to diabetic panel labs run to see how his whole system has been affected by his diabetes. He also should see an ophthalmologist that is a retina specialist to see if he has diabetic retinopathy, it’s really common and insidiously silent as it makes you blind.
If you are definitely moving him to FL, then I’d suggest that you find doc’s in FL and start to schedule his appointments now starting in May & thru the summer. Trying to find docs is a real mice maze. Probably the easiest is to try to get him as a patient in a Health science center affiliated with a medical school and their teaching hospitals. They will take MediCARE and will have set ups available for indigent. As well as a full slate of specialists and full lab with techs to do whatever blood work, X-rays, scans, etc needed within their system. Whatever you do, do NOT ever sign off to personally be responsible for any copays or payments for him.
That he has $ between his SS & Teamsters pension is great. Plus it lets you know that he will not need Medicaid. His place in Missouri will need to be sold. But for now, I’d put that on page 3 and deal with it after you’ve got him into a facility in FL. There’s only so much of you that can be there to do things. While you are there right. Ow, I’d suggest you drive around his neighborhood and take photos of houses up for sale and get the Realtors #. These are the ones you call to find an agent who can work with you.... like one that can find a cleaning crew to come in and clear it out and someone go to get the inside minimum market ready. A good Realtor will know folks who can do whatever and they place a workmans lien on the property to get paid, should your dad not have the $ to pay up front. I’m assuming he owns the house totally outright with no debt / mortgage on it. Most areas in the US right now, there’s no deep inventory on homes so it can probably be easily sold before EOY.
Bringing him into your apt will mean all 3 of you shift to a diabetic friendly diet. A ton of cookbooks out there for diabetes. A book I personally like is “Sugarbusters”, 2003 edition, it’s not technically on diabetes, it’s more on getting out of obesity but ties into diet to control ones diabetes; it’s not a cookbook with recipes per se but more the science as to how your body is affected by sugars and fats. The half price bookstore type of places seem to always have copies as it was a huge best seller a decade+ ago.
id suggest that you try to have his living with you life’s to be limited to the summer with the goal of having him in a facility before September. All this will be quite challenging. It’s basically a full time project. Going to be hard on your relationship with your BF so keep communication going & upfront with him.
Stage 1 - Denial - not seeing problem or admitting loss
Stage 2 - Anger - emotional acting out
Stage 3 - Bargaining - behavior to try to fix things or keep busy so don't feel
Stage 4 - Depression - the sadness and neglect when feelings of loss finally hit
Stage 5 - Acceptance - moving into healthy patterns of behavior that include acknowledging loss and allowing oneself to "feel" and process feelings.
Now onto caregiving for dad. He needs to be with others - being with you is a good decision. Making arrangements for his pets and his move are also good decisions. Grab all his financial paperwork and legal documents. Pack at least 2 weeks of clothes suitable for your part of Florida and his toiletries and medications. Clean out the kitchen and bathrooms thoroughly. Do a good housecleaning. Throw out the trash. File change of address for dad with post office. You might want to take detailed pictures of the cleaned home inside and outside for realtor/moving purposes (also helps with memories). Then go back to your home.
Home . You don't have to sell your childhood home right away. There are realtor companies, like OpenDoor, that will buy the property as-is and will give you a check on the spot. However, those companies do pay less than doing a little elbow grease to spiff up the place and list with a traditional realtor. Traditional realtors also have reliable tradespeople to fix problems for reasonable rates. Traditional realtors can also put you into contact with movers who can pack and move the contents of dad's home. There are companies that will evaluate contents of home and give you cash for everything in it.
Dad safety needs. Dad will be living with you for awhile until you establish permanent routines and/or new home for him, The primary goals are safety and health. If dad has mobility or safety issues with your home, brainstorm solutions together (you, dad, boyfriend).
Dad health needs. Health goals start with switching his insurance to Florida provider and then getting a doctor from their network for him. Once he has a doctor and insurance, make dad an appointment for an annual physical, Let doctor know in advance of loss of mom and dad's hospitalization. His new doctor may make referrals to a mental health specialist and/or other specialty doctors depending on the results of this physical. That will start getting all dad's health care needs met.
Financial needs. Take dad's banking information and help him to switch to a local branch, preferably, or a new bank. If dad has some beginning dementia (as determined by the doctor) talk with the banker about what are the best ways to help dad with his banking needs. Then, contact the utilities companies and services/creditors back in Missouri to cut off services and/or switch addresses to yours. It might be best to keep power, water, sewer and garbage until dad's place is sold or final decisions are made.
Legal needs. Find a lawyer who specializes in family law. Make an appointment to create legal documents. At least 2 weeks before your appointment have a series of discussions with dad about powers of attorney (medical and financial), wills (who gets what when he passes), advanced directive, and decisions if he is "terminal" - do not resuscitate orders and hospice. His funeral arrangements can wait. Look for legal documents in his papers. Some of these topics may seem a little morbid but try asking what would have made it easier when dealing with mom if there was time.
Day to day. Dad may need to have somebody with him all the time for awhile, Talk to family, friends, social circles, faith community, and paid help to cover times you and boyfriend are at work or going out. Eventually. you'll be able to determine if dad needs constant companionship, another living situation, or something more usual.
It does not sound like he is competent to live on his own. So your choices are stick him in some kind of home or have him live with you, but also realize just how difficult that will be and how this will impact your current living situation and relationships. It sounds like he requires 24/7 care and if you have to work a job that may pose an enormous problem.
If the doctors deem him competent (and don't be surprised they probably will) he can refuse nursing home/rehab and simply live on his own again.
I would contact the agency where he lives and where you plan on taking him, they can help you to plan the move. There are so many things that we don't know we don't know and it sucks when you are in the middle of a crisis to find out what you don't know effects everything you are doing and in my case, much of it was wrong. Like finding out the insurance, Medicare Advantage plan, didn't cross county lines, never mind state lines.
One way to get the rehabilitation facility to do their job is to make it clear that there is no money to pay after Medicare stops paying, even if it is not true, they don't want to get stiffed for the care and will do what is required to get him out the door. I also recommend that you follow your gut with his care and rehabilitation, I had my dad transferred to a different facility because the 1st one thought that him being able to transfer from bed to a wheelchair was as good as could be expected. Nope, not accepting that for one minute, he walked into the hospital and he needed therapy to regain his strength, that is what rehabilitation is about, not the lame job the first facility did.
If you don't already have Durable Power of Attorney, both general and medical, that is the 1st thing that you will want to get, believe me when I say that you will need the power that those documents provide to you. Make sure that you have a HIPAA release that states it is intended to be valid wherever, in any jurisdiction it is presented and that it has no expiration date, these are vital to ensure that you never lose the ability to advocate for his health care. www.nelf.org is a good resource to find a certified elder law attorney that can help you prepare these documents that will cross state lines.
You are at the beginning of an unknown journey, I recommend that you DO NOT make decisions based on emotions and that you research options before making decisions. You want to really know what you are getting into before you get in to it dealing with a parent, because he will still consider himself the dad, adult, alpha, etc and you want to protect yourself and your family from the wrath that could come because he is losing control of his own decisions. You have to prepare your heart for becoming the responsible, reasoning adult in the situation and that can be really hard depending on what kind of man your dad is and was.
Take care of yourself by getting enough rest and nutrition (I highly recommend magnesium supplements and zinc, along with lots of vitamin C to help your body deal with the stress). This is a difficult time for everyone involved but, you need to take care of you to help anyone else.
I pray that you find great resources available for your dad at both ends of this. Great big warm hug for you!
If you cannot find him a nice place in Missouri, find him a nice place in Florida. You don't say what his age is, or if he was diagnosed with dementia or not. If he doesn't have dementia, an Assisted Living place would be perfect for him - otherwise, go the Nursing Home route. He needs the socialization and structure to maintain a happier and healthy lifestyle.
I believe Dad living with you must be a short term solution because being a care-giver is a 24 hour+ job. It will take it's toll on you and your partner quickly and your Dad's needs will escalate as time goes on. So make it clear to him that living with you is a short term solution, and if you can, take him with you to help pick out a suitable facility.
Wish you the best, and keep us posted on your progress - we've been there and we care!
I understand he was in the hospital and then in rehab; however, before you start packing bags, when was the last time, before the hospital, that he was under a doctor's care?
My mom was in and out of the hospital many, many times in the 2 years before she passed. The hospital treated the SYMPTOMS of why she was in - most of the time, because she had CHF and would swell up with fluid - but every time she was discharged, she was instructed to make follow up appointments with her cardiologist/PCP. They were the ones who kept her as healthy as she could be - not the hospital. I can't tell you how many times we left the hospital with a report/message in her discharge paperwork on other issues she was having - for example, I had a discharge report that her kidney functions were starting to fail - and no one ever discussed any of that with either her or me. They were there to treat the illness she was admitted for, and once that crisis was over, she was discharged. The responsibility for follow up was on her - and me.
You have gotten great advice about placing dad, and I agree with all of it; however, I will say that I think the first thing you need to do is get dad to a doctor and get him a COMPLETE physical. Diabetes is a terrible disease, but it can be managed; however, he has to take an active role in his own health. If he doesn't seem interested in doing that, then it might be time for him to see a psychiatrist, because it might be his worse health issue is depression. Moving him down to Florida with you won't change any of that. Having a PCP on your side to help you understand what health issues dad is having will be a great help when you have to decide whether to A) let dad live alone; B) move dad in with you or C)place dad in a facility to get the care he needs. I really think right now you need an objective opinion to help make this decision, because, frankly, it's possibly one of the biggest, most life-changing ones you will ever have to make.
Good luck.
He's alone and you have decided to move him in with you. Hope you find good homes for his cats.
Onice he gets relocated to Florida, you can hire Caregivers to help out but that will be your expense. You'll just have to find out what all is available to you in Florida and thru his Insurance. You can also get help thru the VA if your Dad was in the Service.
Prayers
Facilities fees can vary widely. Your dad may be a candidate for MC or LTC. Research faith-based non-profit facilities first. Many have been around for decades and are well-run. They are usually backed by a larger denominational support structure but see the care as a mission. You don't need to be their religion (or any religion) to be a resident. My MIL is in an awesome one. Sometimes facilities in more rural areas are less expensive.
Please don't feel guilty -- there was no way for you to really know what was going on from so far away. You did nothing wrong. What you probably are feeling is grief and just about everyone on this forum knows what that feels like. I wish you wisdom and peace in your heart as you move through this situation.
. We bought my mother an Echo Show that allows you to see each other without physically being present and she never complains about not seeing us. The Echo Show is less than 100.00 dollars.
While he is in rehab have him evaluated for 24/7 care. Where I live rehabs and NHs are in the same building. Have him transferred to the NH side if its found he needs 24/7 care. If he has money, you will need to use it for his care or apply for Medicaid. This will give you time to do a little research without being overwhelmed.
Medicare will go with him to Fla. His Medigap maybe not. Supplimentals are a State thing. States determine what insurances can write policies in their State. You need to call his Medigap plan and see if its offered in Fla. Medigap nor Medicare offer prescription plans so he is paying for a separate one. That will change too. Medicaid does not cross over State lines. If you think u may need it, check with FL to see about residency requirements.
POA needs to be assigned by Dad and he needs to be competent to do it. But its a great tool to have. Makes life a little easier. Otherwise its guardianship and thats expensive. Medicaid allows Dads money to be used, I think though u have to win.
The things you describe when going thru his home are things I see happening with a person who is not treating his diabetes correctly. He would have been confused, almost Dementia like. I am surprised he didn't collapse before. I hope that once he is stable and eating correctly, he goes back to normal. But then this could have all been brought on by Dementia.
I would not have Dad live with you permanently. If he has the funds, I would place him in an Assisted Living near you. Move him right in when u get to FL. He is used to being on his own. Check to see if FL Medicaid pays for AL care in anyway.
Your County Social Service office can give you info on Medicaid and maybe help with other resources. Your county Office of Aging maybe able to help with insurances.
If daily assistance is required for a short term - ok, try your home. But if his needs are ongoing, already high, or increasing - I'd consider an assisted living residence instead. The bottom line is that if he needs help, he needs help & your place will become his Assisted Living anyway - staffed by you. Or maybe managed by you & a team of aides.
It's all going to be a big adjustment & time of change. Many here have been through it. Keep reaching out & remember you can't fix it all for him. It's just rotten old age 🙁.
Then take in the information the hospital gave you, assuming that someone did speak with you, as well as what assessments were made while he was in rehab (regarding health issues that are in play on top of the known diabetes along with where his current and projected self-functioning baselines are at).
You’ll also most likely have some follow-up appointments that are established with his primary care physician and whatnot shortly after his discharge. I’d try to get those changed to Telehealth ones that can be accomplished in the comfort of his home/familiar surroundings with you sitting right beside him on the couch. At 82-years-old your dad may be in the early stages of dementia, Alzheimer’s, suffering from depression or a combo of any of those at the very least. Then again, he might not and it was all a matter of him not monitoring his blood sugar, taking his meds appropriately and eating right (obviously) that he merely spiraled downhill without actually knowing it re: diabetic confusion.
The time for concrete answers should come from that discussion with your dad’s doctor in terms of what is and isn’t in play and how you’ll need to address those issues. I’d press the doctor for bluntness on his or her part as to what level of care your dad needs based upon X, Y, Z medical issues. And sadly with his: age, glucose level upon ER admission, condition of his home/clothes, hospital and subsequent rehab stints I’d brace yourself for some measure of delirium to be still in play even now—that’s been pretty normal for me to see in my parents during medical emergencies/rehabs though it’s still disconcerting whenever it happens. I mention this so you’re aware that it may take him awhile to adjust to where he used to be mentally or you may find yourself having to adjust to his “new” normal as some never revert to exactly where they were before the event(s).
Once you have these facts in mind you can move forward. Only you can know how much time you’ll be able to provide overseeing the care of your dad with the answers you receive from his doctor(s). If it’s financially possible, I’d hire caregivers to help you for a few hours a day so you have time to step back both for your own needs as well as to observe him from a distance for the first month or two. Let him adjust and yourself adjust to this new scenario. Reassess every couple of months and plan accordingly when possible. I wish in retrospect I had done that with my parents. Instead I jumped in headfirst and thought I could do it all...7 years later I find myself questioning why I thought I could do it all and handle everything. I should’ve reassessed things every few months and made changes when and where I could.
No matter what lies ahead for you, I wish you and your dad the absolute best and hope this helped in some small way.
I moved them to be nearer to me and his brother, who isn't so fit anymore himself. Anyway, I made the decision to move them in June 2020...it took me until Oct to get them a place and set it all up. The paperwork took me four months. Then the drama of the health care issues set in. It's been SO hard on my life, my relationship, my personal time, my physical and mental health.
I wish someone had told me before I made this big decision. They'd have been better off, frankly, in an assisted living kind of place in MO, even if that meant they rarely saw me...and it would have been better for me too by far. I am just warning you that this level of self-disregard he's showing indicates that you can't make him happy all on your lonesome. I'm an only child too, and it's gruesome to see an old person circling the drain.
All I can say is that I've learned to set aside a certain number of hours per week and that's that. I'm down to abotu 15/week right now, which feels like heaven after what I had been going through. Most important thing? Setting up in-home care workers. In IL, that's through the county's senior services. They've literally saved me from a complete meltdown.
Not trying to discourage you at all. I get the feelings that are driving you. But remember: life is for the living, and he's already spent most of his life energy, whereas you've still got a long way to go with yours.
Self care isn't selfish. xoxo Best wishes.