Family Matters
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*sweetdreamz*

are you around?  I'm a hospital social worker and had some questions/suggestions for you on your dad!  
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Gretchen Evie, born 7/8/2012 at 35w5d

Re: *sweetdreamz*

  • I'm still here.....been MIA for a few days. My dad went back in the hospital on Monday morning, which sucked. He fell 3 times during the middle of the night. Luckily I heard him each time, but I could barely get him up.

     I actually got somewhere in regards to long term 24hr care for my dad (yay!). But it took a lot of pushing and strong words on my part to make it happen. Doctors consented to 24hr care and/or Hospice as needed. And required that may dad go into a nursing home upon being discharged. Knowing it wasn't an option and that this could potentially be temporary he agreed and is actually looking forward to it.

    Tomorrow he'll be moved into a nursing home to attempt PT to see if he can get stronger, and if not, stay long term w/ the aide of Hospice when the need arises.

    Any advice or recommendations are welcome. Its been a battle and anything you have to offer is greatly appriciated!

    *Sept. 2013 March Siggy Challenge-Hair Inspiration* Image and video hosting by TinyPic Wedding Countdown Ticker
  • image sweetdreamz6700:

    I'm still here.....been MIA for a few days. My dad went back in the hospital on Monday morning, which sucked. He fell 3 times during the middle of the night. Luckily I heard him each time, but I could barely get him up.

    I actually got somewhere in regards to long term 24hr care for my dad (yay!). But it took a lot of pushing and strong words on my part to make it happen. Doctors consented to 24hr care and/or Hospice as needed. And required that may dad go into a nursing home upon being discharged. Knowing it wasn't an option and that this could potentially be temporary he agreed and is actually looking forward to it.

    Tomorrow he'll be moved into a nursing home to attempt PT to see if he can get stronger, and if not, stay long term w/ the aide of Hospice when the need arises.

    Any advice or recommendations are welcome. Its been a battle and anything you have to offer is greatly appriciated!

    I am sorry he is in the hospital but I am glad too!  I was going to say that getting hospitalized would be the best route to getting him placed in a safe environment.  With those 3 midnights under his belt (you mentioned this before so I assume he has Medicare) he can get 20 days in a medicare facility at 100% coverage and 80 more days at 80% after that (plus there are 100 lifetime reserve days on top of all of that).  The doctors could have him classified incompetent to make decisions if he were insisting on returning home w/o 24 hour care at discharge.  If declared incompetent you could apply for guardianship and have the power to place him.  

    The social worker at the nursing home will help you with discharge planning from their rehab.  It sounds like with his level of care he has three options (unless he improves enough in therapy to take care of himself at home with only supplemental help from home health/hospice): move into assisted living (will need to be able to ambulate or transfer to/from a wheelchair) or long term nursing care (if he can't ambulate/care for himself at all), or go home with private duty care.  You have essentially been acting as his private duty caregiver and it doesn't sound like it is doing either of you any good.  It is just not sustainable and I think it's time you relinquish that role.

    Financially, private duty is the most expensive, which I'm sure you know.  Can be upwards of $700 a day for 24 hr care in the home.  If he cannot afford that or assisted living then long term care at a nursing home is his other option and he can apply for Medicaid.  Age is not a factor for Medicaid really, it's about financial/medical need.  If he needs 24/7 nursing care and can't pay for it himself he should qualify.  They will take any savings/pension/social security and then pay the rest of his care expenses at a Medicaid facility.  He won't be required to sell his house/property.  

    I think he is on the right path now and hopefully will better realize his limitations once he is working with a therapist daily and under the care of the doctor at the nursing home.  You should sit down with the social worker and therapists soon after he gets situated and explain to them what you are hoping for discharge. Explain the financial barriers, his desires, and the reality of the situation he is in.  You need to get back to your life, so you are not available to be his 24/7 caregiver anymore.  Set a discharge plan in motion (placement!) and then make arrangements to leave town.  If you aren't there for him to pressure to take him home he will come to terms with his situation more quickly.  Sure he can walk out of the nursing home and go home against medical advice, but he'll probably fall and end up back in the hospital and repeat the whole thing.  And maybe that's what it will take for him to realize the severity of his situation.

     I'm not trying to be mean or insensitive at all, just realistic.  I see patients in similar situations all the time and it is so hard for the family, but ultimately you have to keep him safe and you sound strong and extremely capable of helping him make the transition he needs to a sustainable long term living situation.  Book your plane ticket home and let the social worker and your dad know when you are leaving.  It hurts but it is so important to set healthy boundaries, even when you feel like maybe you should be giving up everything (your health, job, insurance, relationships) because he's your dad and you love him and you're all he's got.  You can help him and love him without shouldering it all.  

    sorry to write a novel, I just saw your posts and it really stuck with me and I hope I offered some helpful info!   Feel free to PM me with any questions!

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    Gretchen Evie, born 7/8/2012 at 35w5d
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