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I have been dealing with my father who is diagnosed with dementia and Alzheimer's. Its getting worse. He has been living in my home in my living room. His bedroom is my living room. Small two bedroom house. Me, my wife and my daughter. I have been fighting with Medicaid since I brought him into my house in July when his second wife died. He only has SS, no savings. She died leaving him broke. Trailer had no working plumbing, no working water, no HVAC, trash everywhere, dirty clothes, mold on the furniture, and at least a years bed bug infestation. Getting the trailer condemned. Cannot get a title, state shows a lien on it. Medicaid has been giving the run around since July. Looking to get the full Medicaid to get the Aged and Disabled Waiver to get reduced rent in assisted living. No answer on why he has not approved. Medicaid basically told me to sit and spin. CICOA left me high and dry and refused to assist because he smoothed talked them into thinking he is fine. I have Blanket and Medical POA. I WILL NOT BE HIS GUARDIAN.


My wife took him to the grocery Friday 1/24/2020 and to get his smokes. Within 15 minutes of getting his smokes, he forgot that he had bought them. Wife showed them to him. 15 minutes after that he lost control of his bodily functions and deficated himself while in the store, did not know until he stated he felt it fill his pants. He walked himself to the rest room to do what he needed to do. He came home and took a shower, he refuses to bathe first shower in months (maybe, we heard water running but his smell was still there). We allowed him to go to sleep and planned to take him to the ER on 1/25/2020. My father woke up at around noon on 1/25/2020. We let him drink his coffee and eat breakfast and let him smoke. I told him that I was aware of what happened at the grocery (he could not recall) and we needed to get him checked at the hospital. He refused me but when my wife asked, he agreed. We drove to the ER. I checked him in stating that "My father has been having Cognitive Behavior Episodes and about the events of last night and needed to be seen. I stated all that had happened this week. I also stated that I was no longer able to care for him as he was a danger to himself and others. He was taken to the ER Room promptly. This was around 1pm. I talked with the nursing staff after he was settled. Told them the same information with the addition of him refusing to allow me to put together his meds and he admitted to missing 2 to three days of meds. During the check in, he could not tell the nurse what year it was. Said that they would relay this to the ER doc on call. The ER doc came in, talked directly asking him questions. I asked the ER doc to come outside. I asked him if he had read ANY notes prior to coming in. He stated he did not and would not till after he talked with my dad. I explained what was going on, stated the same stuff, I stated once again that he is a danger to himself and others, I can no longer care for him, he needs help I can no longer provide. I even said call the social worker, call APS, call the police, I can no longer care for him as he is a danger to himself and others. He walked away stating he would do what he needed to do. We were there from 1pm till 5pm. Staff Social Worker came him, told her the same info I had told the check in, the nurses, the doc. She kinda huffed and walked away. She came back later stating that there was nothing medically to keep him here, I WAS going to take him home and call the assisted living place back myself and tell them what they needed to do. I told her once again that he cannot and will not go home with me and that he was a danger to himself and others. I am not able to provide proper care anymore. I gathered my stuff and left the building. I was told by professionals to admit him with Cognative Behaviors and share I cannot care for him due to the danger to him and others. I did email the PCP today to make him aware. What happens to him & I?

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Am I correct there are filial responsibility laws in the OP's state?

Surely this cannot mean you have to financially support a parent in preference to providing for your immediate family (spouse & children)? Eg if it impovishes yourself to pay for AL?

So if the duty of care lies with the hospital (but only once admitted) that is why the pressure NOT to admit?

I'm thinking that pressure would encourage abandonment in the hospital carpark - instead of bringing the elder inside to actually inform of the situation in a caring & safer way?

Many on this forum have anticipated the scenario that the OP is going though - he is a fine example of holding to your boundaries under high pressure. I hope after the initial stress, the path forward is accomplished.
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worriedinCali Jan 2020
Filial laws are rarely ever enforced. Those laws are archaic and were enacted long before we had medicaid. And even when enforced, a family would never be impoverished by them because it has to be proven that the children can financially afford to support the parent.
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I totally agree with mstrbill about our healthcare system flaws. The OP had no other choice than to do what he did.

Does anyone feel sorry for those with ALZ or any other disease? Certainly, we all do BUT as the OP has stated, he has health problems himself. He counts just as much, so does his wife and daughter.

Abuse is abuse is abuse, no matter who is doing the abusing. After hearing the details of his circumstances I wholeheartedly support the decision that he made by making this choice for himself and his family.

A friend of mine recently died. He had colon cancer and suffered a stroke. He was supposed to show up for a dinner that we were having. This guy never misses a meal so we went to check on him. We knew something was off when he didn’t know who we were. We took him to the hospital and found out he had suffered a stroke. He had no wife or children. He wrecked his car due to his stroke. Poor guy did not even remember the wreck. Anyway, since he had no family, no other relatives, he had listed a couple of friends as his emergency contacts.

The hospital pressured us to take him home. They pressured us to become his POA. We had to refuse. The doctor clearly told us that he could never live alone again and needed 24/7 care. We had to leave our friend behind at the hospital.

I asked the doctor about his chemo treatments. My friend had given his doctor permission to discuss his medical records with us. The doctor told me, “No more chemo or anything else. He is too far gone. He will die soon.”

We told the doctor, social worker and hospital to find a place for him to die. The best that we could do was visit him. We got to see him in the nursing home which they found for him. He died two weeks after being placed.

The flip side is I have also known the hospital to put patients in a cab and send them home if there is a home to go to. The doctor knew my friend could not be alone in his home ever again.

We contacted the landlord. My friend had money in his apartment, enough for his rent and a cleaning service to clean the place. He didn’t own a whole lot. We gave it to charity.

His car was impounded after the wreck. The police wrote it up as a hit and run. I suppose technically it was but the wreck was caused by his stroke.

We had to call his insurance company for him and the police. It was a mess to straighten out. ,

Our friend listed us as an emergency contact but had no burial arrangements or anything. He was a mystery.

We had him cremated. He didn’t tell us any preferences so we had to do what we thought was best.
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Beatty Jan 2020
What a hard situation but you did well for your friend - at peace now.
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DrkKnt - you are doing a remarkably good job of dealing with your dad despite many adversities. You are doing the right thing even though it is not easy. Please take care of yourself and your family. Others can take care of your dad. Let us know how things work out.
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Oh my heart aches for you. You did the right thing, leaving your dad at the hospital. Please let us know what happens to your dad. Hugs!
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I’ve just read through your situation and update. What a hard road you’ve been down with your dad, I’m so sorry for it all. What you’ve done has been the advice I’ve seen given on this forum for others to do, but you’ve walked it. I hope it will get easier now. And I also hope you’ll continue to let us know how things progress for both you and your dad in this
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You are between a rock/hard place.
Does he have a GP? Does he have scaring from bed bugs? Have you or your wife recorded anything regarding what he does no matter what he's doing?
I don't know the State you reside, but when I had to become involved with my Mother's mental issue; she had not seen her GP for annual required Medicare physical.
RECORD EVERYTHING IN WRITING AND/OR YOUR PHONE.
Take him to his GP, inform the doctor's nurse about the situation so Dr is prepared.
Our daughter is an RN, which was very valuable for me said, 'Mom, when physicians examine or informed of the mental, physical issues by family and the exam; the Dr must report to Social Services. They will admit to the hospital WHILE they contact various facilities to find a room for the patient'.
I know doctors can do this. I took my Mom to her GP because my sister had not taken her for over a year.
Her GP told her she had 1 more chance as she only had 5 marbles left in her head. That she should be in assisted living NOW!
Mom told him she'd call the police because he can't make her go.
GP told her he could LEGALLY and would right then and there if she wanted to try him.
Mom used her last marble and ended up in the hospital in less than 2 weeks.
Me and my husband drove 16 hrs to get back to her. She was having major issues which required me to call EMTs. She wasn't going, you can't make me.
Yes I can Mom. If you don't get on that guerney I'm getting the safety belt and spank you (loved being able to say that to her). She let them take her to the hospital.
That's when me and my husband found an assisted living facility for her and stepfather.
Your Father's doctor CAN BY LAW, place him in a facility. It may not be the Ritz, not even close or even horrid, so be prepared for that.
Is your Father a Vet? There is a wait list for their facilities, but apply for the benefits. They will have a list of their ACCEPTED facilities as the benefits are paid directly to the facility. He will also have the benefit of medical, yes everyone has a story, but he'll have healthcare.
Talk with a reputable in-home care to request help for a caseworker to help. That person will go over everything as well as visually evaluate at the same time. They will take you to visit various facilities that have space. The caseworker will inform the facility manager/owner of the issue(s) about your Father.
I'd also demand a meeting with the Chief of Staff over the ER and/or the head of the hospital.
Illegals get better care/help than you. FYI, our daughter worked over 10 years in the ER of a County Hospital back home. She had to deal with it all, report situations just like this, and even the homeless men asking her to marry them.
You need to 1) take care of Dad 2) take care of you family 3) take care of yourself.
I'm blessed to have Mom's 2 brothers as my support system, you may need to find some type of support for yourself/family.
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https://www.agingcare.com/articles/medicaid-and-long-term-care-133719.htm

Rules from state to state vary on qualifying for Medicaid long term care when income is over the limit. You need to talk with an elder law attorney, Medicaid or start with the Area Agency on Aging. It is possible.
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DrkKnt, this is such a stressful situation and I'm sorry you have to deal with it. I'm wondering why you stated you have blanket PoA but do not want to be your father's guardian? If you have the PoA you don't need to be his guardian if he has cognitive impairment. Is it not a durable PoA? If you resigned PoA you can let the county become his guardian and then they could deal with it all. Also, I think there is info missing: if his only income is SS and he has no other assets and is broke, how can he get rejected for Medicaid? I helped my MIL apply and she had $699 SS, no savings, no possessions and she qualified for Medicaid for LTC. Please fill in the missing details if possible. I hope this can get resolved for you and your family very soon.
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worriedinCali Jan 2020
He would be denied Medicaid if his social security income is over the limit. A lot of people receive over $1200 month social security. Or he was denied eligibility because of the look back period.
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i am a RN case manager and I’m sure to be flamed for this comment , but your father cannot be placed in a long term facility until he gets his Medicaid. We will not keep him in the hospital until that is issued, the hospital is not a place to hold patients. You need to go down to the Medicaid office and talk to them face to face, the hospital social worker may help you start it or look into it but it is your responsibility for your father to get that in place and it could take over 45 days. I am sorry this seems harsh but the hospital is for patients who need to be hospitalized and we need those beds for very sick patients we cannot keep patients there who have no need to be there. The hospital did the right thing by sending your father home with you .its not ideal but they couldn't take up a bed that they need for a person waiting in the ED that is ill that must be admitted .i wish you luck with your father and hope you get that Medicaid soon. You may want to look into adult day care or maybe a personal care assistant to help with his care. Please keep us posted on how your father is doing.
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mstrbill Jan 2020
I'm not going to flame you (moderately disagree) but will point out some errors. The hospital did not release the father, OP left without taking the father home. There are serious gaps in our healthcare system and this case highlights one of them. I experienced it and I still take an interest in trying to help others who may be going through similar experiences here. The fact is OP had no help from the outside and it is virtually impossible to place someone in a NH on your own with no money. That's just the way it is. You call on all the NH's in the area and the admissions person smiles and says "no, sorry", Meanwhile the patient and the rest of the family are left in in a state somewhere between extreme stress and imminent danger with no help. I do agree that it is somewhat unfair to put the burden on the hospital, but the fact is somehow the hospital is able to make things happen and quickly find a proper placement when the family cannot and there seems to be no available alternative. The OP did the right thing for both his family and his father by leaving him there and the hospital should/will do the right thing by finding a safe environment for the father.
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So sorry. It must have been so hard. Him living with you was not really the best scenario. Your Dad needs more care than an Assisted Living would have been able to provide. LTC will be better. Hopefully the state will take over his care. Then the responsibility will be off your shoulders. He will have everything he needs.
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ohmeowzer Jan 2020
Excellent idea thank you
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You did what you had to do. The hospital will try and make you responsible even if you are not capable. Hold your ground. Use the words "Unsafe environment".
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I agree with the others. You did what you had to do. Stay strong and if the hospital comes back to you say “I can’t keep him safe”.
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This is so hard! Stick to your guns. You have told the staff at the hospital all the right things. They will have to work it out. So many on this site have gotten to the point where you are and guilt often keeps them from following through.

Just always remember you have to take care of you and your family which is your top priority.
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You did the right thing, stay firm, he needs to be placed somewhere, and that somewhere is not in your home. The pressure will continue for awhile, just keep saying no.

I am sorry about this, keep posting it will help!
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You did the right thing, everything you needed to do. Good for you for not caving in , the SW needs to do her job. The hospital case manager needs to find a NH with an open bed that will take him as LTC Medicaid pending. Your job now is to assist in applying him for LTC. Meet with the SW at the hospital and help fill out the application. The hospital will work to find a bed for him, it may end up that nearest location is many miles away, so he may be moved far away from you. Once he's placed in a NH, the NH will likely ask you to fill out admission paperwork. Make sure you do not sign anything that says you will be financially responsible. If you're unsure, bring the paperwork to a credible lawyer and seek his advice before signing.

Also, it may take a while and hospital may continue to pressure you. Do Not Cave in! You cannot adequately take care of him and keep him and your family safe, make sure they are clear on that.
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I don't have the answers for you but wanted to say that I am sorry for your situation. Hugs!
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Crikey what a difficult pickle you are in. Sorry to hear about your situation
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