Let me preface this by saying my FIL has some psychological issues and any hint of trouble, whether it's bills or something else stressful, sends him to the point of making himself sick. Vomiting, diarrea, you name it. He's been this way for years but he normally bounced back within a few days. Well, ever since he fell and hit his head on a window last November (went to the hospital and PT facility for it for nearly a month) and whenever he gets sick now, he becomes so frail and can't even take care of himself, can't wipe himself, etc. Right now, he's upstairs sick in his room (he convinced himself that the Tylenol he took made him sick) and it smells so bad, it's starting to permeate into the hallways and our kids' rooms. My husband is basically his primary caregiver, I help where I can, but it's quite a lot for us to deal with right now. He just lost his job and we are financially strapped so hiring a nurse right now isn't doable. And my FIL's hospital bills are insane, but he thinks going to the ER and getting hooked to an IV and cleaned up by nurses overnight is the only way he'll make it through but because he's been several times in the last year, his insurance won't cover it anymore, so it's just more bills he/we can't pay. We just don't know what to do and I don't want my husband to also suffer with this weight on his shoulders because he's already dealing with having no job and another thing I can't really get into, it's become too much. I just need advice or a place to vent and this was the one place I knew other people could relate.
Also, apparently, a nursing home or assisted facility is absolutely out of the question because my FIL's mom died in one and he, understandably, does not want to suffer that same fate.
We just need help or advice.
If he is not yet 65 years of age, but is disabled so that he can no longer work, then you help him apply for disability Social Security, and if that is approved, he will also be automatically enrolled in Medicare.
Medicaid covers medical expenses for people with low income.
You say that a nursing home is out of the question. For Him.
There will come a point when it is no longer his decision. If family (you and your husband) can't take care of him, and he can't afford a home health aide, then a nursing home is where he needs to be.
The next time he is in the hospital, Don't pick him up and take him home! The hospital has social workers who will work to find a suitable solution. They will likely transition him to a skilled nursing facility with a medicaid application pending. Keep in mind, a skilled nursing facility can be used short term. He doesn't have to spend the rest of his life there if his condition improves. Many young adults spend months in a nursing home to rehab after a hospital stay, before going home again.
Sorry, I am still stuck here. And I suspect the family is too..?
Who said that?
The OP? The Husband? FIL?
"Also, apparently, a nursing home or assisted facility is absolutely out of the question because my FIL's mom died in one and he, understandably, does not want to suffer that same fate."
ONE person he knows died in an AL/nursing home, so he won't go???
How many people does he know that died in a hospital? Many I'm sure - but he will still go there.
How many people does he know that died in their home? Probably not as many as you think, because ultimately, someone calls 911 and they die in the hospital, even though they "want" to die at home.
The harsh reality is this: We are all going to die. But are we going to let our loved ones take us down with them? Because that is what is happening. If our loved ones were in their "right minds", most would NEVER expect us to take care of them.
If I was you, I would seriously start checking out AL/nursing homes - and do NOT use your money for payment. Money needs to come from him, and if he does not have any put away, then sorry - it's a Medicaid situation.
My father was adamant about not going to an AL...we had MANY fights over a period of at least 3 years about it. However, we set boundaries - I visited once a week, my sister once a month (she is out of state)...that's it. No moving anyone into our home, no moving into their home. My sister and I resigned ourselves to waiting for the "tragedy" that would force our parents to move (mom has Alzheimers, Dad undiagnosed but we suspected vascular dementia). Dad still expected mom to do everything for him, mom couldn't...they were eating spoiled or uncooked food - except for the meals I made them on my once a week visit. Anyway, Dad got the flu, stopped eating/drinking for best guess 6ish days (it was between my once a week visits), I called 911 because neither of them could figure it out...went to the hospital, then a rehab facility. Rehab got him healthy enough to be discharged, my sister and I were adamant that it was an unsafe discharge, social worker convinced him to move to AL with my mom. He moved, but was so angry at us (and truth be told - we were angry at him as well). One of his last statements to us was, "I'm not going to die here (AL), I'm going to die at home". Well, he was half right - he had COPD and couldn't breathe, AL called the hospital and guess what - he died in the hospital. So all that nonsense about "dying in his home" didn't happen anyway and it usually doesn't. Inevitably, someone almost always calls 911 and they die at the hospital.
It sounds like you are at your breaking point, and unfortunately, it is time to move your dad out of your home.
My neighbour was found in a very bad way, at home, in her bed by a relative doing a welfare check. Apparently had a stroke but it was being unable to move & get help that did her in. Cause of death was dehydration. Tragic.
Mum died in a hospital bed in her own bedroom. It was what her husband and her son wanted, but being my mother's daughter, I knew that the place didn't matter - only the level of care.
I think it's sentimental to want to die in your own bed. I cherish sentiments offered from the heart, but I abhor sentimentality.
* He will continue to have thoughts that do not coincide with reality. You need to do what you need to do while compassionately supporting him to remain as calm as possible.
You need to make decisions for him. He cannot do himself.
I question why he is in a situation 'now' where he can't clean himself / is soiling himself - and no help? Why has this situation escalated to this point?
- Get him assessed with medical provider for dementia; get documentation that you have legal authority to make decisions in his best interest (since he cannot).
* Call Adult Protective Services (APS) and ask them for support / make a home visit.
* If he can't pay bills, it seems to me that he qualifies for Medi-caid or some government assistance.
From my experience, when a person is hospitalized and has no one at home to care for that person, they go to a nursing home. He doesn't have the luxury of making this decision for himself. Of course, he doesn't want to suffer the same fate - no one does. Yet, YOU NEED TO DO what you need to do - for him.
See if City Hall / Senior Services can refer you to a med soc worker or anyone to help you manage all this (not using your finances. Ask hospital social worker if they can help you.
Gena / Touch Matters
The person being sent to one also has to want to go and has to be able to afford it.
The ER *might* be able to help locate one, assuming the patient consents to going to the ER (EMS will not kidnap your loved one for you). They will suggest where the beds are available but still leave it up to you to contact the "facility."
AJRW89, I wish you luck. There are resources out there that may help. I would reach out to the aging and social services resources in your area for advice.
A lot of elderly who need placement end up getting placed in LTC at the level appropriate for their care needs either when discharged from the hospital or rehab . They aren’t all volunteering to leave home and be placed .
Sometimes getting an elder into the hospital first is the only answer to get an elder the care they need , and the family the relief they need . It’s sad that it is that way . It has worked for many of us though . So yeah , it is the answer we think it is .
Sometimes it takes more than one try , having to fight off hospital social workers who try to force families to provide care at home .
Yes , there are different levels of care and financials do play a role . Some families are stuck waiting for their elder to be declined enough for SNF on Medicaid .
I recently installed a bidet for a patient of ours who had taken to calling 911 when he had soiled himself and was unable to clean himself. The county paid for it because it was cheaper for the taxpayer than sending an ambulance. Doing this also gave me the pretext to make regular home visits to check on him and his housemate and connect them both with other resources.
Check with your FiL's primary care provider/physician and let them know the situation. There are medications that might help with his apparent anxiety.
Let us know any updates.
Hopefully they will find a way to have this man get care in a facility and not live with them . It’s not always easy to get someone placed , but that is the best solution to this complicated problem .
Seriously, if all of you lived in Northeast Oh, these issues would not be a problem. Anything involving medical is very competitive here.
As an example, the roads around the many medical facilities resemble rush hour from downtown, it's made even worse if there is construction (which currently there is)
Saying that, can't really blame FIL's reluctance in going into a facility. He may be onto something,
Another example, a facility underwent a name and management change, with the complaints about bad service increasing as well.
Refuse to take him home.
Done.
I don’t understand what about this is a “dead end”.
Unsafe Discharge.
Period.
But, yes, he certainly does suffer from that. To be quite honest, I feel like he's too far gone for meds to even help him. He would probably claim they made him sick. The mind is pretty powerful and he can convince himself of just about anything. He once got sick because I bought him the store brand version of yogurt instead of name brand.
It's understandable that insurance is not going to pay for your FIL to go to the ER for basically a spa-day to get him cleaned up and hydrated. That's not what the ER is for. You also say he has a mountain of bills and cannot afford homecare either.
So here's where he is. Unless there's a family member or friend willing to give up their life to move in and become an unpaid care slave his only real option is a nursing home or psych facility. Or your FIL is going to have to seriously work hard to get psychological problems under control. Or it will be a nursing home or psych facility. If there's dementia, he has to be placed.
First step is getting a full medical work up including psych evaluation and dementia testing from his doctor.
When you know what you're dealing with then you can start making realistic plans for him.
Medicare and Medicaid is not going to pay for hour after hour of babysitter companions to keep him company or for CNA aides to come several times a day to keep him clean. That's not going to happen. I was a homecare CNA for 25 years and have my own agency now. Medicare and Medicaid do not pay for this level of care.
Your state may participate in a paid family caregiver program through its Medicaid program. The stipend they pay the family caregiver is low and they have to also live in the house.
It's just a suggestion.
I don't think if you've got kids living at home that you should keep your FIL with you. Your kids deserve better than to grow up with a crazy person who falls to pieces at the drop of a hat and in a house that smells like sh*t all the time. You and your husband deserve a better life than this too.
Get him to his doctor for testing. Then look for a facility.
When in the ER you need to speak with a social worker to determine a sound discharge plan that entails your FIL going to rehab and in the future at home care or a long term facility that has Medicaid beds. How old is your FIL. Is he receiving Social Security? If so, he should be paying for his home care from now on.
Wishing you the best!
And the reality is that he WILL suffer the same fate - regardless of where he is.
My grandmother and great grandmother died in nursing homes. My dad died at home. Neither of the LOCATIONS was the cause of death.
People of a certain age likely have very specific images of what a nursing home is. And since they almost always know someone who died in one - they automatically relate the death to being in the nursing home. I know plenty of people who have died in a nursing home, in fact - in most cases people in a nursing home do die there. But it isn't the reason they died.
But at a certain point - what someone WANTS has to take backseat to what they NEED.
Without a diagnosis you cannot know.
It is time for a medical team to assess whether or not FIL is capable of remaining at home.
To be brutally honest and frank with you, it no longer matters what FIL wants in terms of placement. It is now a matter of who will be his guardian to see that he is safely placed in care. Will that be you, his family, or the state.
I would call APS if FIL remains uncooperative. This should have been done some time ago and it cannot be avoided anymore.
Begin the application process for Medicaid.
Has he been tested for C Diff? Some of the indications you mentioned are
Diarrhea
Belly cramping
nausea
particularly bad odor
It is HIGHLY contagious
If you do take him to the ER or Urgent care he should be tested for this.
You do not have to hire a "nurse" a caregiver will do what needs to be done, the only time an agency would require a Nurse is if medications have to be administered. If the person can take the medications then a caregiver can hand the pills in a container for a person to take themselves.
Hate to tell you but FIL's mom probably would have died at home, in a hospital or anywhere else cuz people die. It was not the Skilled Nursing facility that killed her. She was there because she needed care that could not be given at home.
He has had stomach issues and ulcers for years, since childhood. He has severe psychological issues though, as mentioned. He convinces himself that something he eats will make him sick because it's not the brand he normally eats, or if he can't pay a bill on time, it makes him sick. So basically a very nervous stomach. He's been to the doctor and has had tons of tests done but nothing stomach wise is wrong with him. It's just his mind working against him. When he's up and about, he is capable of going to the bathroom on his own, wiping himself, he does need assistance getting to the shower but can wash himself. However, when he goes down like this, he becomes incontinent, frail, can't do anything for himself. Note that this version of him only came to be after he fell last year. Before then, he'd vomit for a day or two and then be back to normal. I think that's why my husband is so hesitant to actually place him somewhere, he thinks it'll get better.
It's just so frustrating because I know it'll be better for him to go somewhere to get care but sometimes I feel like it's not my place to make these decisions because he's not my parent, but I know I need to convince my husband that this is best.
Your FIL needs a nursing home .
You , your husband , and your kids should not have to live in a nursing home , which is what YOUR home has turned into with his ‘smells permeating to your children’s rooms ‘ .
None of this is fair to your family .
Call 911 to take him to the ER for his vomiting and diarrhea . You ask to speak to a social worker and you tell him/her that you and your husband can not take care of him . Tell the social worker that you both work . You lie and say you both work and that your father in-law can not be home alone .
You tell them your father in law needs a facilty on Medicaid . You do not take your father in law home under any circumstances . They will try to send him home with the promise of help coming to the home but it’s not enough . Or they will say he has to go home first until you get him on Medicaid. Don’t agree to that .
You refuse to take him home . You say it’s an “ unsafe discharge “ Use those words . The social worker will have to find a nursing home to place him in . Never use your own money to pay for any of his bills .
Have your husband read this thread . Finally , don’t let him die in your house for the sake of the children . Get him out to the hospital today and never to return .
You're right to suggest the 'Social Admit' through the hospital ER.
You know they will make all kinds of promises of unlimited homecare and resources if the family will just let the person return home. I hope the OP and her husband see through it because social workers are trained and instructed to lie in these situations. They will in reality get little to nothing if they agree to take him back with them.
Right now your FIL's situation is as good as it is ever going to be, it will not improve. It will continue to get worse. He needs more help than you and your husband can provide. You might need to reconsider a facility. I wished I didn't have to place my 95 yo parents but their situation was beyond my ability or my sisters' to handle anymore. There was no choice. Kept hoping they'd finally die at home but their needs just steadily increased and our ability to handle it did not.
What is most important is raising your children in a healthy environment and not sure what you describe is it.
Wishing you the strength to handle this situation.
I would call 911 and have him taken to the ER for his latest "sickness"( the hospital cannot turn him away)and once there you let the hospital social worker and doctor know that your FIL is an "unsafe discharge" and that you and your husband can no longer care for him at home.
They will then have to find the appropriate facility to place him in, and you will get your home and life back, and get back to just being his family and advocates and not his burned out caregivers, and he will get the care he requires.
It will be a win win for all involved.
And of course since your FIL has no money he'll have to apply for Medicaid.
You and your husband must now do what is best for you both, your marriage and your children. *And please note that I didn't mention your FIL anywhere on that list.
I wish you the very best in getting your FIL placed sooner than later.
1-put your fil in a facility.
2- your husbands physical and mental health will deteriorate.
Seems like a no brainer to me
I'm truly sorry you are going through this, it's got to be horrible.
I would also say , don't help your husband, it's his dad not yours, and helping your husband enables him to keep your fil in your home
Yes, unfortunately, my husband is already dealing with A LOT in terms of his own mental health so it's hard to see him carry this burden, that's why I try to help as best as I can. As far as cleaning him up and truly caring for him, that falls on him. I do simple things for him like cooking and going to the store for him, I don't think my husband would expect me to or even let me care for his dad in other ways.