Wish me luck folks

[Grace Hopper]

1 hour ago, DawnM said:

He has literally never had a UTI.   They check every time.   He is always negative.  

I called 911 today.   He has been admitted.   He has Covid.   

Still working on a place, but if he stays in the hospital 3 days they can send him to rehab for 21 days and then to a facility, so I have a little time now.

I am sorry he’s not doing well. I do hope your dad recovers cognitively from this enough for you to have some quality time together. It’s possible he’s had a slight stroke which definitely can alter both behavior and physical strength. 

But, from the standpoint of getting him into assisted living, this should put you at an advantage. (TBH I imagine he is likely past assisted living and needs a SNF placement at this point.) If you haven’t already, ask for the social worker and/or patient advocate assigned to your dad (his case or his unit or whatever - the hospital should have someone on staff). They can help you navigate this. An admission directly from a hospitalization often is a higher priority. IME a SNF placement can go a fairly long time under Medicare if it comes on the heels of a hospitalization.
 

https://www.medicare.gov/Pubs/pdf/10153-Medicare-Skilled-Nursing-Facility-Care.pdf

Be sure to communicate to the hospital liaison that you and your family are no longer able to provide care!!!! Because if you don’t say it out loud many times, the assumption will be made that he has care enough to return home, especially if they see your presence at the hospital. And that’s often what seniors with dementia tell hospital staff. So get yourself heard!

 

 

[Harriet Vane]

Praying for you and your dad.

[Zoo Keeper]

Praying for your family as you navigate through this. 

[DawnM]

7 minutes ago, Grace Hopper said:

I am sorry he’s not doing well. I do hope your dad recovers cognitively from this enough for you to have some quality time together. It’s possible he’s had a slight stroke which definitely can alter both behavior and physical strength. 

But, from the standpoint of getting him into assisted living, this should put you at an advantage. (TBH I imagine he is likely past assisted living and needs a SNF placement at this point.) If you haven’t already, ask for the social worker and/or patient advocate assigned to your dad (his case or his unit or whatever - the hospital should have someone on staff). They can help you navigate this. An admission directly from a hospitalization often is a higher priority. IME a SNF placement can go a fairly long time under Medicare if it comes on the heels of a hospitalization.
 

https://www.medicare.gov/Pubs/pdf/10153-Medicare-Skilled-Nursing-Facility-Care.pdf

Be sure to communicate to the hospital liaison that you and your family are no longer able to provide care!!!! Because if you don’t say it out loud many times, the assumption will be made that he has care enough to return home, especially if they see your presence at the hospital. And that’s often what seniors with dementia tell hospital staff. So get yourself heard!

 

 

Thanks.

You should have heard me today.   I normally don't freak out but I was BEGGING the doctor to see that I can't care for him anymore and that he needed to be admitted and we needed to put him in a facility.   

I was told SN would only be 21 days after a hospital stay, can it be longer?

[mommyoffive]

1 hour ago, DawnM said:

He has literally never had a UTI.   They check every time.   He is always negative.  

I called 911 today.   He has been admitted.   He has Covid.   

Still working on a place, but if he stays in the hospital 3 days they can send him to rehab for 21 days and then to a facility, so I have a little time now.

I am so sorry.  I am sending lots of prayers his way that he has an easy time with Covid.

[Spryte]

I hope he gets good care and he feels better soon!

When he leaves the hospital and goes to rehab — if you can choose one that also does LTC, it can make the transition to LTC from rehab easier. Medicare pays for up to 3 mos of rehab, but most people don’t meet the requirements for rehab that long — they have to keep showing progress, so if he plateaus at some point he will not qualify to continue.

Are you and your family feeling better? Didn’t you (or some of you) have it recently? I hope you are all better, too.

So sorry this has been so hard. ((Hugs)) Hang in there.

[Catwoman]

I'm praying that he doesn't have a bad case of Covid and that the doctors at the hospital will be able to keep him comfortable and help him recover. The combination of his age and not being vaccinated is so scary! You must be a wreck. 😞 

I'm praying for you, too, Dawn. Sending lots of hugs.

[lmrich]

Oh I am so sorry! praying for you all!

[Grace Hopper]

1 hour ago, DawnM said:

Thanks.

You should have heard me today.   I normally don't freak out but I was BEGGING the doctor to see that I can't care for him anymore and that he needed to be admitted and we needed to put him in a facility.   

I was told SN would only be 21 days after a hospital stay, can it be longer?

I believe it depends on what his condition turns out to be, and what insurance will cover, whether he gets some time in rehab or gets referred for a SNF. In your shoes, I’d try to get his primary care doc in the loop, if possible, if you believe the PC would write orders for a SNF, and not leave it solely to the hospitalist.
 

You can also use his hospitalized time to gather all the documents and info necessary to complete an application for Medicaid for Long Term Care. Even if he has financial assets, many facilities want to see a prospective resident prepared to qualify for Medicaid in the event they outlast their assets to cover costs, that’s something to ask about when looking at residential facilities. 

Edited July 1, 2022 by Grace Hopper

[Storygirl]

Yes, the Medicaid application can be frustrating. My dad handled this for my mom's care, but I know it was really frustrating for him.

Expect for his long-term care to be paid out of pocket until all of his assets have been depleted. Until then, Medicaid will not kick in for skilled nursing. Of course, if he has long-term care insurance, that can help. But I know that Dad was upset during the whole Medicaid process, and it took a year before he got financial help through Medicaid (and they didn't have significant retirement savings).

Edited July 2, 2022 by Storygirl

[matrips]

4 hours ago, DawnM said:

I was told SN would only be 21 days after a hospital stay, can it be longer

It may be that Medicare pays 100% for 21 days, and then a declining percentage.  And at some point it goes to zero. I sort of remember having to pay the SNF for my mom to stay there and continue rehab longer.

[DawnM]

11 hours ago, Grace Hopper said:

I believe it depends on what his condition turns out to be, and what insurance will cover, whether he gets some time in rehab or gets referred for a SNF. In your shoes, I’d try to get his primary care doc in the loop, if possible, if you believe the PC would write orders for a SNF, and not leave it solely to the hospitalist.
 

You can also use his hospitalized time to gather all the documents and info necessary to complete an application for Medicaid for Long Term Care. Even if he has financial assets, many facilities want to see a prospective resident prepared to qualify for Medicaid in the event they outlast their assets to cover costs, that’s something to ask about when looking at residential facilities. 

Don't you have to go to a place that takes medicaid in order for that to even kick in?   Most of places I am looking don't take medicaid patients and I know that when another family needed to go into care and she had very few assets, they spent a lot of time trying to even find a place that would take medicaid.

But regardless, dad was a saver, and he is fine.   I can't imagine him outliving his assets at this point.   Some have estimated he may have 6 months left others have said not to count on more than a year.   Even if he lives a bit longer, he will not outlive his assets.

[LifeLovePassion]

3 minutes ago, DawnM said:

Don't you have to go to a place that takes medicaid in order for that to even kick in?   Most of places I am looking don't take medicaid patients and I know that when another family needed to go into care and she had very few assets, they spent a lot of time trying to even find a place that would take medicaid.

But regardless, dad was a saver, and he is fine.   I can't imagine him outliving his assets at this point.   Some have estimated he may have 6 months left others have said not to count on more than a year.   Even if he lives a bit longer, he will not outlive his assets.

I believe so, yes. 

When we looked at places for my mom that was one of the questions we had. Most places accepted Medicaid after you used up your assets. Those places had a staff member who said that they would help you with the application process when the time came. Since you have funds available, you can look to find a place with an open bed at his level of care. Between the time my mom entered an assisted living facility and when she passed away she never used up her assets so it was a non-issue. 

[Pawz4me]

1 hour ago, DawnM said:

 

But regardless, dad was a saver, and he is fine.   I can't imagine him outliving his assets at this point.   Some have estimated he may have 6 months left others have said not to count on more than a year.   Even if he lives a bit longer, he will not outlive his assets.

Since he has savings he won't qualify for Medicaid right now. So there's little/no use in worrying about that right this minute. If he lives long enough to spend down to the level where he would qualify--well, you'll know that's coming ahead of time and will have time to look for a different facility that accepts it.

[Scarlett]

51 minutes ago, Pawz4me said:

Since he has savings he won't qualify for Medicaid right now. So there's little/no use in worrying about that right this minute. If he lives long enough to spend down to the level where he would qualify--well, you'll know that's coming ahead of time and will have time to look for a different facility that accepts it.

Yep. I agree. 

[Alicia64]

On 6/30/2022 at 1:47 PM, DawnM said:

I am not even going to explain it.   I am just going to say that we need him to get more care due to safety "for now" and then he will just stay.   He won't remember the conversation when/if he gets out of this, so.....

Smart. ♥♥♥

 

 

[DawnM]

4 hours ago, Pawz4me said:

Since he has savings he won't qualify for Medicaid right now. So there's little/no use in worrying about that right this minute. If he lives long enough to spend down to the level where he would qualify--well, you'll know that's coming ahead of time and will have time to look for a different facility that accepts it.

Yes, and it would years and years before he spent it......no way he will live that long.

[DawnM]

He had the nurse call me.   He got on the phone and told me that he wants to come home and get better at home.

Sigh......this is NOT going to be easy in any way.   He doesn't get it.

[mlktwins]

41 minutes ago, DawnM said:

He had the nurse call me.   He got on the phone and told me that he wants to come home and get better at home.

Sigh......this is NOT going to be easy in any way.   He doesn't get it.

Dawn, it isn’t going to be easy!  Stick to your guns as it really is the best thing for him.  It is also the best thing for you and your family.  It is a sad time.  You know my story and my dad is also 87.  I’ve been told maybe a year or 2 for him.  

Edited July 2, 2022 by mlktwins

[cintinative]

7 minutes ago, DawnM said:

He had the nurse call me.   He got on the phone and told me that he wants to come home and get better at home.

Sigh......this is NOT going to be easy in any way.   He doesn't get it.

Praying for you to have the words you need when you need them.

[DawnM]

1 hour ago, mlktwins said:

Dawn, it isn’t going to be easy!  Stick to your guns as it really is the best thing for him.  It is also the best thing for you and your family.  It is a sad time.  You know my story and my dad is also 87.  I’ve been told maybe a year or 2 for him.  

We don't have any other choice anymore.   He keeps falling and keeps having these episodes and we can't do it anymore.

[Grace Hopper]

7 hours ago, DawnM said:

Don't you have to go to a place that takes medicaid in order for that to even kick in?   Most of places I am looking don't take medicaid patients and I know that when another family needed to go into care and she had very few assets, they spent a lot of time trying to even find a place that would take medicaid.

But regardless, dad was a saver, and he is fine.   I can't imagine him outliving his assets at this point.   Some have estimated he may have 6 months left others have said not to count on more than a year.   Even if he lives a bit longer, he will not outlive his assets.

I can only speak from my experience, but even for people with assets, turning in a completed Medicaid application was part of the application package for the SNF. Just was suggesting that you shouldn’t be surprised if they ask you for that  

If you don’t have to deal with that, things should be easier. 

[Grace Hopper]

7 hours ago, DawnM said:

Don't you have to go to a place that takes medicaid in order for that to even kick in?   Most of places I am looking don't take medicaid patients and I know that when another family needed to go into care and she had very few assets, they spent a lot of time trying to even find a place that would take medicaid.

But regardless, dad was a saver, and he is fine.   I can't imagine him outliving his assets at this point.   Some have estimated he may have 6 months left others have said not to count on more than a year.   Even if he lives a bit longer, he will not outlive his assets.

Also, true that there are places that don’t take Medicaid and those will be top dollar private places. There are places that accept Medicaid after a resident’s funds are exhausted, which can happen quickly for a place that can run $8-9K monthly. And then there are places that will take a resident “Medicaid pending,” where they will admit someone and then, if Medicaid does not approve them, will give them 60 days to move out. 
 

 

Edited July 2, 2022 by Grace Hopper

[DawnM]

Sooooo, I am at the hospital and dad won't eat all of his lunch because he believes they are putting meds he doesn't want into his food.  😒

I just had a talk with his nurse and told her the goal is to get him to rehab and then to a nursing home.   She agreed that would be a good idea.  

#SoHard

[Kassia]

15 minutes ago, DawnM said:

Sooooo, I am at the hospital and dad won't eat all of his lunch because he believes they are putting meds he doesn't want into his food.  😒

I just had a talk with his nurse and told her the goal is to get him to rehab and then to a nursing home.   She agreed that would be a good idea.  

#SoHard

I'm so sorry Dawn.  I wish I had something better to day.  Sending hugs.  😞 

[Halftime Hope]

On 7/1/2022 at 4:13 PM, DawnM said:

He has literally never had a UTI.   They check every time.   He is always negative.  

I called 911 today.   He has been admitted.   He has Covid.   

Still working on a place, but if he stays in the hospital 3 days they can send him to rehab for 21 days and then to a facility, so I have a little time now.

Oh, Dawn! I'm so sorry, but I'm glad that so much more is known now about treating covid. God bless you and him as you traverse this new and difficult landscape.  Hugs for you all from one who has been there. 

[Hilltopmom]

I’m sorry. Thinking of you.

[Halftime Hope]

4 hours ago, DawnM said:

Yes, and it would years and years before he spent it......no way he will live that long.

Dawn, one other option. Forgive me if you've already considered it.  What about smaller group nursing care homes, like a residential home with only a handful of residents? Anything like that near you?  When caring for my dad got to be too much--after having in-home caregivers coming for months to help--we moved Dad to a small group home. Fortunately for my brother who directed Mom and Dad's care, one of our beloved caregivers who had been caring for Dad applied for work at that group home, was hired immediately, and so Dad moved "with her."  It truly was the best of all worlds.  (The home had a staffer who could do medical treatments that the caregiver was not qualified to do, so that's why Dad needed to move.)   

Edited July 2, 2022 by Halftime Hope

[Carrie12345]

3 hours ago, DawnM said:

He had the nurse call me.   He got on the phone and told me that he wants to come home and get better at home.

Sigh......this is NOT going to be easy in any way.   He doesn't get it.

I’m so sorry, Dawn. 
From what you’ve shared, I think you may be able to use some truths to appease him, or close. 
“I know you do. We miss you. We’re working with the doctors to come up with the best plan for you.”

[Kassia]

33 minutes ago, Carrie12345 said:

“I know you do. We miss you. We’re working with the doctors to come up with the best plan for you.”

This may not work but I really like this.  Thank you.

[Harriet Vane]

33 minutes ago, Carrie12345 said:

I’m so sorry, Dawn. 
From what you’ve shared, I think you may be able to use some truths to appease him, or close. 
“I know you do. We miss you. We’re working with the doctors to come up with the best plan for you.”

This.

I used a version of this with my aunt, when she had to live in a nursing home due to severe dementia from a brain tumor. She missed her kids and her husband terribly. We said things like, "The doctors feel you need a little more time to heal here" or "You're in the hospital to heal." She'd ask for steps she could take to heal more quickly so she could get home, and we would tell her things like: Make sure you're hydrated and drinking plenty. Practice walking. Play the piano to help your brain heal. These were conversations to help her manage a couple days more. Eventually she was used to being in her facility, though she spoke of missing her kids almost the whole time until she was finally totally nonverbal.

[LifeLovePassion]

Can you bring him food that is not "tainted" or order Uber eats? Focus on good fats if possible as they are helpful for maintaining weight and good for brain health. 

Huge hugs, it's so hard. 

[cuckoomamma]

I’m so sorry. It’s so hard.

[DawnM]

1 hour ago, LifeLovePassion said:

Can you bring him food that is not "tainted" or order Uber eats? Focus on good fats if possible as they are helpful for maintaining weight and good for brain health. 

Huge hugs, it's so hard. 

😁 Yeah, I thought of taking him a milkshake from across the street at the Cookout, but a burger and shake would be good.   

I did take him a couple of Boost drinks.   He likes those.

But I can't be there for every meal.

[LifeLovePassion]

Tell the nurses what he will drink and eat. 

At one point they made a milkshake for my mom with two of the little cups of chocolate ice cream and some boost. A special treat from the nurses. 

[Laura Corin]

Thinking of you. I know how hard this is.

[DawnM]

4 hours ago, LifeLovePassion said:

Tell the nurses what he will drink and eat. 

At one point they made a milkshake for my mom with two of the little cups of chocolate ice cream and some boost. A special treat from the nurses. 

The answer is, "He will eat nothing FROM you guys, he thinks you are trying to slip meds into the food."

[ScoutTN]

6 hours ago, DawnM said:

The answer is, "He will eat nothing FROM you guys, he thinks you are trying to slip meds into the food."

Can you take him a stash of boost drinks and healthy snacks that he knows came from you, that he can eat whenever he wants?

[Katy]

Tell the nurses about the paranoia, they can give him something for it. 

[LifeLovePassion]

6 hours ago, DawnM said:

The answer is, "He will eat nothing FROM you guys, he thinks you are trying to slip meds into the food."

Oh boo. Another vote for bringing him a stash of snacks. I'm sorry you have one more thing to worry about. 

[TravelingChris]

I  think people are giving really good ideas.   Continuing to pray for you and this situation.

Many hugs too.

 

[Annie G]

Will they give him anything for anxiety? MIL had paranoia and fear with dementia and it was anxiety driven. 

[DawnM]

1 hour ago, Annie G said:

Will they give him anything for anxiety? MIL had paranoia and fear with dementia and it was anxiety driven. 

Maybe they can slip it into his food! 🤣

[DawnM]

2 hours ago, Katy said:

Tell the nurses about the paranoia, they can give him something for it. 

I think the confusion came when they told him that he needed to take blood thinners and some blood pressure meds.   He refused both.   They finally got him to agree to some blood pressure meds but he was very reluctant, and the nurse said that when he reluctantly agreed, she quickly put it in his IV before he would change his mind again.

Then all night he was trying to take out his IV.

[Halftime Hope]

14 hours ago, DawnM said:

😁 Yeah, I thought of taking him a milkshake from across the street at the Cookout, but a burger and shake would be good.   

I did take him a couple of Boost drinks.   He likes those.

But I can't be there for every meal.

This is what worked for my mom when she was in a nursing home for post-surgical rehab for 2 weeks. She was beside herself at the nursing home food, because as a very healthy eater, close to being vegetarian and a lot of raw, she was convinced the food in the nursing home would not help her heal. (I can't say I blame her.)  Instead of fighting it, I brought leftovers from home a lot. 

[DawnM]

I got a call from the hospital, not sure the title of the person, but she said that he is being recommended for 28 days of skilled nursing/rehab, so that bides us a little more time!   YAY!

She asked if she should talk to my dad about it and I said NO!   We will take everything one step at a time and since he thinks he can just come and recover at home with us, it is not a good idea to talk to him about it right now.

[ScoutTN]

15 minutes ago, DawnM said:

I got a call from the hospital, not sure the title of the person, but she said that he is being recommended for 28 days of skilled nursing/rehab, so that bides us a little more time!   YAY!

She asked if she should talk to my dad about it and I said NO!   We will take everything one step at a time and since he thinks he can just come and recover at home with us, it is not a good idea to talk to him about it right now.

Glad for this. Time for you to get things sorted a bit. Do you know how long they think he’ll be in the hospital? 

[DawnM]

Just now, ScoutTN said:

Glad for this. Time for you to get things sorted a bit. Do you know how long they think he’ll be in the hospital? 

Originally they said until Tuesday.   Today she said they won't be able to find out where the beds are in rehab until Tuesday so she thought Wed or Thur.

[Kassia]

What a relief, @DawnM  Hope it all works out and that he handles the transition well when it's time.

We had this happen with MIL and it fell through the day she was being discharged when they told us she was going home instead of rehab.  Even that morning, DH had to go to her house to get her Covid vaccination card to show the rehab place she was vaccinated and then...nope.  We were completely unprepared for her to go home.  It was awful but I think this is HIGHLY unusual.  

[DawnM]

2 minutes ago, Kassia said:

What a relief, @DawnM  Hope it all works out and that he handles the transition well when it's time.

We had this happen with MIL and it fell through the day she was being discharged when they told us she was going home instead of rehab.  Even that morning, DH had to go to her house to get her Covid vaccination card to show the rehab place she was vaccinated and then...nope.  We were completely unprepared for her to go home.  It was awful but I think this is HIGHLY unusual.  

Oh my gosh!   WHY did they do that?

And do you have to be vaccinated to go to a rehab facility?