I'm hoping someone can help. My 86-year-old father lives alone in a regular apartment designed for senior citizens. He has been slowly declining over the past 10 years. Has had many TIA'S. 3 weeks ago he started talking strangely and 911 was called. On November 1st he was taken to the hospital he is still there as of today November 16th. I am the only living blood relative other than my two adult sons with families of Their Own. None of us live in the same town as he does I am about 20 mi away. He has been aggressive and angry to me specifically for the past 10 years and it's getting worse he did strike me although it was more shoving my arm away a few weeks ago as well but he talks to me with hate in his voice and has held me at arm's length with anything to do with his finances. Coincidentally in 2012 we lost my mother his wife after a 5-year battle with cancer in which he took care of her at home the entire time. They had been high school sweethearts so very difficult. I found him the apartment and it seemed to be working. Then we noticed the mental decline. He's been driving all this time an old junker car-- he has no money except for his Social Security. Fast forward to today. He has been in the hospital 15 days medically he is very healthy but mentally he has vascular dementia. He can't usually hold a normal conversation anymore he has good periods of time but for the most part I have to open his carton of milk and he thinks the cell phone is the TV remote it's definitely not good. But we had a bomb dropped on us, figuratively, he makes too much Social Security to qualify for Medicaid! Social Security is the only asset he has he has nothing else. Bluntly, after a meeting with social worker and doctor they are sending him back home to his apartment. Without Medicaid there is NO memory care facility, and NO nursing home, NOTHING, that will take him. I cannot take him in I have absolutely no room, the grandchildren cannot take him in, and that’s it that's the only people. I cannot believe that this happens in the United States but they tell me it's fairly common? I haven't slept in 3 weeks I cannot believe that I have to take this man and put him in the apartment and he's going to try and take care of himself? He is aggressive to me and agitated. I have reached out to just about every organization I can and he doesn't qualify for VA assistance as far as I have checked he was in the Army but never in combat. I have an association that tells me he's not been completely denied from Medicaid but the social workers are telling me he has. We have been abandoned. They told me that he could not be released from the hospital if he did not have a safe place to go. Believe me if we could take him in we would. I am absolutely sick knowing that this is going to happen on Monday they've given us hardly any time. The doctor coldly said "the hospital is not a glorified nursing home you know." That was his parting words. I work but I haven't been able to so my job is in desperation, but the hardest thing is my father's hatred of me and yet I am his medical POA and the only person that lives even remotely close. How can I drop him off in that apartment and go home and try and sleep at night? How can I be told that he will never qualify for Medicaid? We would love for his Social Security to just disappear but I'm told that they can't reduce it anybody have any advice for me? I am sitting here in the tears that I shed every single day and I am dreading Monday. Coincidentally, he had been driving right up until the day he went in the hospital and that was most important to him in the world. They've now taken his license of course that will mean nothing to him he would drive anyways but we did take his junker car and get rid of that and he is going to absolutely go crazy when he finds out the car is gone and it seems like I'm the one that's going to have to tell him.
You say it over and over again, refuse to take him and he will be made a ward of the state and they will find a place for him using his funds for his placement, the state will pick up the shortfall.
The social worker and hospital's goal is to release him although he will be unsafe, you have to keep saying NO.
That is IMO the only solution, he will vacate his apartment at the same time.
They must have care in place for someone diagnosed with dementia.
THEY want YOU to BE that care; don't do it.
When Social Workers say they are going home tell them.
A) "Dad is diagnosed as incompetent and unable to care for himself".
B) "I will not be assisting or caring for dad in any way."
C) "This constitutes an "UNSAFE DISCHARGE" (those EXACT words) , and I will report Dad's discharge IMMEDIATELY TO THE APS and the POLICE and the JCAHO.
I will report this hospital to APS. I will ask for state guardianship and placement for my father."
D) "I will then report this hospital to the Joint Commission on Accreditation which is responsible for your license. The JCAHO will be in here like the FBI on steroids. Prepare to lose your license to operate for Medicare patients."
That alone will take care of the social workers. They will say to one another "Oh, oh, this guy is informed, and he's not taking his dad off our hands; time to do our jobs".
Now onto this nonsense about no assets but SS too high for a demented person to be in nursing home care. I don't think there is ANY monthly SS that high. Your father needs placement. What EXACTLY is the limit in your state for Medicaid. What EXACTLY does your father receive in SS per month? THAT doesn't make sense on the face of it.
Were I you I would not become POA or Guardian and I would not handle this.
I would tell the social workers that your father is not competent anymore in his own behalf and you WILL NOT take on any responsibility for him, cannot handle him due to (make it up, physical or mental or a combo works). Tell them that he requires state guardianship.
NOW
If after all of THAT they do discharge your father home, then up to you to report him to APS, police, to call ambulances over and over again, and etc. Be on them so much they think you are family.
The other option? They send Dad home and he dies there. He is 86. Is another two weeks, two months, two years in the nursing home preferable?
All you can do at this point is try to
1. Stop discharge home in an unsafe manner
2. Call APS over and over and over reporting senior discharged unsafely at home and in grave danger.
3. Call ambulances.
Trust me, once they realize they CANNOT MANIPILATE YOU into collecting your father and taking him to YOUR HOME (which is what they want and ALL they want to get him off their own dance cards) they will function to do their jobs. They will get him placed. If you give over any rights to manage his care then THEY WILL DO IT ALL. Just remember you will have ZERO say in how he is placed, where he is placed; his home will be locked and they will eliminate it and car and anything else he has in terms of assets, and they will place him as near you as they are able in the circumstances. But again, you will have nothing to say in any of this.
You claim "unsafe discharge" to the SW. There is no one to care for Dad and he has no money to hire someone. Even if Dad could get VA assistance it may take a while to get into one of their homes. You need one now.
If he doesn't have a financial PoA you may have to ask the courts for a conservator (legal guardian) to manage his finances. You can pursue it but it is expensive and time-consuming to do so.
When my cousin with ALZ became combative, refusing meds for her agitation, she was admitted into the hospital's psych wing for a full month until they got her more stabilized on meds. This may be something that happens to your Dad, but my cousin has PoAs managing all her affairs.
I think for anyone to manage another's SS payments they need to become a Representative Payee through the local SS admin office, but again... a FPoA or legal guardian probably needs to pursue this if your Father doesn't voluntarily assign it (if he's even cognitively able to).
Good advice has been give to you below. You will need to work through it, eating the elephant one bite at a time. You do not need to go get him from the hospital. I have read on this forum where staff has called taxis to get discharged patients back to their homes so be prepared.
As others have responded, "unsafe discharge" needs to be said over and over, and that you are not will or able to be his caregiver due to his anger and aggression. See Alva's post to you.
I wish you all the best on Monday and that your Dad will go into appropriate care.
Him being violent with you once was one time too many. Don’t make excuses or try to rationalize that.
I feel for you....the stress of it all, the not sleeping, dealing with an angry mentally unstable parent...it is a lot!
That doesn't make any sense to me that your dad would not qualify for VA benefits because he didn't experience combat. Again, I think an Elder Lawyer could help with all of this.
A person needs to read the fine print and/or find an attorney who specializes in this area. (I had called and spoke to a representative who didn't know ... he referred me to go to google to do my research).
If he is considered unable to care for himself living alone and needs to be in a nursing home (or other facility), discuss making these arrangements with the staff. If an MD talked to me like he spoke to you, I would report him/her to the hospital's administrator, their board of directors and the licensing board. Write a letter and cc everyone. It is inexcusable.
- From what I've read on this site previously, a hospital or medical facility cannot LEGALLY release a person if that person doesn't have care available upon release, if they are unable to care for themselves. I see below that it is called: UNSAFE DISCHARGE
Based on the feelings you have for him or the relationship (his hatred of you), it would be advantageous for you to find another person to take legal responsibility for him. You are not obligated to be legally responsible. If you need to, make him a ward of the state. I know this sounds cruel and is difficult - however, you need to do what you can, depending on who is available to help.
While it can be convoluted, see if you can find a live-in if you think that might be enough. The problem with that is caregivers living on site are considered employees and legally protected to have all benefits that any other employee receives. It can be a major headache.
He will continue to be more resistant and angry as he is losing more of his perceived independence. Expect this (response / behavior).
Do whatever you need to do to extricate yourself for this situation - for your own mental and physical health.
Take your name off his hospital papers IF you signed as the responsible person for his welfare.
Get medical authorization that he has dementia and/or is unable to care for himself.
Gena / Touch Matters
1. Non-Medical Homecare, since your father is being discharged back to his apartment, non-medical homecare services can provide assistance with daily activities such as meal preparation, bathing, medication reminders, and light housekeeping. While this doesn’t cover memory care or medical needs, it can relieve some of your stress by ensuring he isn’t left entirely on his own. Non-medical homecare is often more affordable than medical care, and some agencies may offer payment plans or sliding scale fees based on income. You can start small, even with just a few hours a day, to provide him with necessary support.
2. Maximizing Social Security, though your father may not qualify for Medicaid, it’s possible to explore programs such as Supplemental Security Income (SSI) or other local elder care services that could assist with his living expenses. Social workers or elder law attorneys may help guide you through managing his financials and ensuring his Social Security is being used effectively for his care.
3. Veterans Assistance, for veterans and spouse this is an option many seniors don't realize is there for them to use. The VA Aid and Attendance benefit, for instance, could help with costs related to his care, even if he only served during wartime without being in combat. I would recommend speaking to a Veterans Service Officer to review his eligibility further.
4. Medical Power of Attorney as his medical POA, you can discuss the situation with his primary care physician (PCP). They may be able to recommend additional local resources or even re-evaluate his eligibility for Medicaid based on his deteriorating mental health.
5. Community Resources, contact local non-profits, aging agencies, or churches that often provide free or low-cost respite services, support groups, and caregiving assistance. Many communities have services specifically tailored to seniors who live alone but require help. This could offer a stop-gap until longer-term solutions are available.
6. Memory Care Alternatives If private memory care facilities are financially out of reach, consider if adult day care services or in-home memory care could provide some level of oversight during critical times of the day, which could help with safety and mitigate some risks without requiring him to leave his apartment.
Lastly, while it’s difficult to think about, you may need to take legal action to ensure your father’s safety if his behavior becomes dangerous to himself or others. While you’re doing your very best to respect his autonomy, his mental health needs might require additional support from medical professionals or legal intervention.
Remember, you don’t have to carry this stress alone. Reaching out for help from organizations and legal professionals might provide the relief you need in this situation.
l wish the best!
There should be a social worker available at the hospital to talk with you and help you navigate the next step.
As POA, you will need to make that decision. But it does not mean you need to take care of him at home.
Do Not pick him up and take him home! Tell the hospital that he has no one to care for him at home.
If the worst happens, and he is released and sent home - by taxi, presumably - then you call 911 when an emergency arises. He may well die at home. Which is the way he wants it. You cannot fix this situation.
Your only responsibility is to provide the best care you can within his budget.
Spend time with him. Make your peace with him. Do only what you are able, and don't fret over the things you can not do.
I'm glad you got rid of the car! Don't feel guilty about that either! And don't bother trying to explain it to him - he won't understand.