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About a month ago my dad (88) fell and broke his femur. He was in the hospital for a week, then went in to rehab. He has refused treatment and the rehab has known he refused. They sent him home to mom (87) yesterday, with no help, not anything. They have known about sending him home for a week if not more. He has dementia, not clear of his decisions though he thinks he is. My daughter was with my mom when they brought him home. Its not good. He is not mobile though rehab said he was. He sat in his depends since the ambulance dropped him off, in is hospital gown. We couldn't get him up and all he wanted to do was just sit there. His mind frame for years is he wants to die but he knows it's a sin to kill yourself. He was taken back to hospital last night for he just would do a thing and my daughter made the decision with grandmas understanding that he's going back to the hospital. I need help and at a loss with this mess. Any advice would be greatly appreciated. Will be going through their finances and paperwork to see what actually was done. Supposedly I'm POA. First thing I'm looking for today. Anything please, I'm getting desperate especially for my mom. Thank you..... Robin

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The two times my Mom has been in the hospital, she has been able to get home health care for a set period of time and this service as covered by Medicare. I am a bit surprise that the hospital did not make you aware of this service. The case manager should have talked to you before discharge. While it is not a solution to your situation, it can be helpful while you are searching for a solution. You may want to follow up with the hospital or directly with a home health care agency that is approved by Medicare. We used Kindred Care and Adventist Home Health Care.
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I would complain to the State Ombudsman in the way Dad was sent home. In home therapy should have been set up. He should have been sent home in his clothes. Also, I see this as an "unsafe discharge" since he needs 24/7 care and no one at home capable of giving it.

You could have him evaluated for 24/7 care. If found that he needed it, you could have had him transferred from rehab to a Longterm care facility. Where I live, rehab and LTC are in the same building. So transferring from one to the other is easy.

When it comes to ur parents finances, Mom will be considered the Community Spouse. Medicaid allows for assets to be split. Dads split would be used for his care and when spent down Medicaid applied for. The house is an exempt asset and Mom can remain in it and have one car. Their monthly income of SS and pensions will be looked at and she will get some or all of it to live on.

I suggest you get all your parents assets together. Some maybe exempt. Then consult with an elder lawyer. You may need him to split the assets.

In the meantime, try to get him into a LTC facility.
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In situations like this sometimes it is just best to laugh, before getting down to business.

That being said, sadly it is time for placement. Make sure you have Doctor's orders as well.
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You have done well & all survived this round. Hold strong & pull together for the next round.

Follow Barb's steps & beware of strong arm tactics such as Geaton faced (just so wrong!)

You know your Mom. Can she stand up to Hospital Staff if need be? Or will you or another family be the spokesperson?

A friend's MIL keeps allowing her Husband to be brought home from rehab (or even collects him in a taxi). She knows his care needs are getting too high for her but he insists on leaving rehab early & she gives in. He has lack of insight/denial of his own needs & also his wife's serious health issues. Each round brings another crises.

So check in with your Mom & be aware of the grief & guilt she will be feeling. It can come in big waves.
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If you find the PoA paperwork, make sure to read it to see when the authority is activated (some are "springing" and require an actual diagnosis of dementia from a doctor; others are "durable" and do not require a diagnosis). If you can't find the paperwork ask your mom if she remembers who the attorney was that helped create the doc. FYI being assigned as PoA means you had to sign that paperwork and it was notarized in your presence. If you didn't participate in this, then there most likely isn't any document, and your dad just meant that he wanted you to manage his affairs -- but without actual PoA authority you won't be able to legally do it.

If you can't find the paperwork/are not his PoA then I would call his regular doctor to see if he was ever given a cognitive/memory exam (and assuming he didn't score well) you could use this diagnosis to prevent him from discharging himself back home.

If you can't prove he has cognitive impairment I'm not sure you can prevent him from going back home except to strongly insist to the discharge nurse that he is an "unsafe discharge" and do not give in to their relentless hounding (because that's what they'll do).

My own personal experience was that my step-FIL gave the hospital my number (because my MIL was in rehab and SFIL didn't have the car at the hospital because he went there by ambulance after he called 911 to come pick him up off the floor of his house because he had Parkinsons and Lewy Body, they took him to the ER even though he had no signs of injury) and then at discharge hounded be to come get him in the middle of my work day, me being over 20 miles away. I refused because I ran my own business and had no subs. But then they (the hospital) had the *Sheriff* drop him off at SFIL's house (sFIL didn't have a key) and the Sheriff called me and said I better come and find a way to get him into his house since it was getting dark or he was going to leave him there on the stoop!!! It was a shocking (and eye-opening) experience. I can't make this stuff up. FYI SFIL was a jerk who tried to manipulate my husband and I as his unwilling care plan.

Just want you to understand what lengths some hospitals (and counties) will go to in order to discharge patients. Also, please understand that "stubbornness" is often a symptom of dementia.
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Cover99 Oct 2021
Lol to hospital and Sheriff, though interesting that sheriff did not take him back to the station to wait for pick up
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1. Make sure he is admitted to the hospital, not just under observation.

2. Find the discharge planning office at the hospital and tell them that is no one at home to care for dad. Mom is too old to be able to care for him herself.

3. He needs placement. The social workers at the hispital need to find him a rehab where he can be admitted (after he refuses rehab) as a Long Term Care patient.

4. Look at your parents financial resources. If dad will need Medicaid for Long Term Care, find an eldercare attorney so that mom can get protection as the "community spouse". If she needs dad's income to live on, she will get it.

5. Instruct mom NOT to sign for discharge, no matter what, until they find him a placement
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