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I am emotionally, physically, and financially depleted, and I honestly don’t know how much more I can carry.Caring for and managing everything for my father has consumed so much of my life. Along the way, I lost the career I had built for 20 years due to my now constant anxiety and nervous system being completely shot. My father lives 1,200 miles away in Florida because that’s where he has lived for 20 years and assisted-living facilities near me cost approximately three times as much, and neither of us could afford that. I travel to see him about every eight weeks, but the flights, transportation, missed work, and other expenses have reached the point where I simply cannot afford to keep doing it.Now we are facing another crisis. My father requires assistance with transfers, and during a recent transfer at his assisted-living facility, he fell and sustained an L2 compression fracture in his back. He was taken to the hospital and then discharged back to the same facility. I was not included in the discharge planning or even told by the hospital that he was being sent back. The facility had called only to say that he had fallen and was going to the hospital. They did not contact me afterward to tell me that he had a fractured back or that he had returned.Now the facility is saying that he needs a higher level of care, which he cannot afford. They told him this, not me. They have not contacted me since the fall two days ago and shamefully I haven’t had the emotional bandwidth to call them. I am working up the strength to do that tomorrow. I just know what lies ahead and am trying to prepare my life to be turned upside down again. I alone in a matter of 7 days flew down, found him a facility , moved him out out his apartment and into the alf two and a half years ago spending thousands of my own money. Now I am left with the task of trying to understand his medical needs, find appropriate care, obtain records, speak with an ombudsman and possibly an attorney, and figure out how any of this will be paid for—all from 1,200 miles away while still trying to work and maintain my own life.I love my father, but I have reached my limit. I feel guilty even saying that, but I am completely burned out. I mean completely burned out to the point it takes an extreme effort for me to even want to get out of bed and face what the day will bring. I don’t have unlimited money, energy, or emotional strength, and I cannot continue being the entire support system from another state. He is a veteran and already receives aid and attendance, has no savings and is over the income limit for Medicaid. I logistically and financially cannot get him here where I live. He also calls me demanding things from me up to 15 times a day to the point where I have had to block him while I’m at my part time job. I am in constant fear of him being in a nursing home so far away and alone without me there to check in on him. He is currently in an Alf with a standard license. If anyone has been through something similar—especially dealing with an assisted-living injury, a sudden need for a higher level of care, or long-distance caregiving—I would be so grateful for support, advice, resources, or even just reassurance that I’m not a terrible person for feeling like I cannot do this anymore. Thanks for listening

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If you are counting his Aid and Attendance as part of his income, that will stop if he goes on Medicaid. You can't have both A&A and Medicaid because both government programs. Looks like your only choice is a Longterm care facility with Medicaid and his Social Security paying. Floridas asset limit seems to be $2982. If Dad is under that, he qualifies for Medicaid.

Are you Dads POA? If so and its not immediate, you need to have a Dr. invoke it. Most are immediate. If you have not given a copy to the Assisted living, you need to do it. The hospital should have a copy too.

Is he competent to make decisions for himself, if yes than the Assisted Living nor the hospital has to deal with you. Assisted livings are not privy to his medical information either. So, the Hospital would not be giving them the info without Dads permission. Its a HIPAA thing.
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Brynway1819 51 min ago
Thank you for your response. Yes I am his POA and both the hospital and ALF have it on record. The hospital faxed the discharge care plan to the ALF upon his discharge. The hospital discharged him back to the facility without my knowledge. One of the biggest disadvantages of trying to manage someone’s care from 1200 miles away
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I am surprised that the facility agreed to take him back after the hospitalization if he needs help with transferring.

There are VA Medical Foster Homes.
These are peoples homes that have been approved by the VA.
The homeowners are trained, vetted by the VA
The Veteran moves into the home and the Veteran pays the homeowner.
the Veteran gets the care they need in a home setting. Far fewer people. More attention and the cost is less than a facility.
As far as I know there are not a lot of them, at least in my area, but that is changing.
You can call the Medical Foster Home Program Coordinator (224-610-3784) the email for this person is John.Zidek@va.gov
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Brynway1819 55 min ago
Thank you for this information!
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Thank you for your response, it is much appreciated. The facility that my father is in now is 4000 per month, care cost included. The least expensive one in my surrounding area is 10 thousand per month. That is a difference of 72 k per year. I have looked into doing a millers trust and him getting Medicaid and back here but as you said he cannot get Medicaid in my state because he has to reside here to be eligible.
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Geaton777 2 hours ago
Yes, so you tell him the current arrangement is unsustainable and if he wants to have you continue to manage and fund his care then he needs to do what I listed in my reply to you. Anything he says "no" to on that least means you will stop being involved in any way, shape or form. You will need to back completely away and the county social services will be able to step in and employ their own solution. He won't like it but that's too bad -- he's had it swell all this time at the cost of your precious well-being. If you don't understand you have to have very clear criteria and boundaries with him then you are asking for the continuing decomposition of your life, just to please someone who doesn't seem to give a damn. Wake up! A solution he doesn't like is still a solution.
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You didn't post this under "dementia" but he sure seems to have some of the symptoms, like: lack of empathy for people close to him; not caring that you tanked your career to care for him when he was totally able to do it himself, at least earlier on; calling you incessantly; stressing you out, etc. What is it about him that you love?

Are you even his PoA?

Why can't he go into a VA home? If he makes too much money to qualify for Medicaid, there's such a thing as a QIT (Qualified Income Trust) where his excess funds go into a trust reserved to pay back Medicaid upon his passing. He could even qualify for LTC + Medicaid. If he doesn't have friends or gets out and about then what difference does it make what state he resides in?

For you to continue his care I would have these criteria:

- You become his DPoA with full authority to do any and all transactions and decisions (and he has a Advanced Healthcare Directive and DNR)
- He takes a cognitive exam so that you know where he stands
- He moves to your zipcode (or as close as possible).
- He either starts paying you (with his "excess funds" or uses a QIT)

Anything less than this and I'd walk away and let him deal with things on his own.

For yourself: please see a therapist so that you can identify and defend clear boundaries with him (and I'm going to guess other people as well).

I wish you all the best as you get your own head on straight before sacrificing the rest of your life for his unappreciated care.
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Grandma1954 3 hours ago
In many cases a VA Home is for those that are 100% Service Connected Disability. (my guess due to mover Veterans that need care than there are homes)
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 "I am in constant fear of him being in a nursing home so far away and alone without me there to check in on him." Why? It solves both of your problems. Your dad get safe supervised 24/7 care and you can accept that he is where he needs to be, and focus on rebuilding your physical and mental health and your financial stability. Keep him blocked on your phone except for one or two phone calls a week that you make at your own convenience, limited to 15 minutes or whatever you want to set a timer for.
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Your dad is now beyond assisted living and needs skilled nursing care. He should qualify for a VA facility. In my area there are several that are quite nice and have good reputations. He will qualify for Medicaid after his assets are spent down. No more of your money going toward his expenses. That will only delay him qualifying. Don’t fear using Medicaid. My mother was in a nursing home and used it, her care was both competent and compassionate throughout. If dad cannot understand your need for limiting phone calls, there is likely cognitive decline, or at least a loss of consideration. Either way, protect yourself and answer only when it’s a good time for you. There is nothing to feel guilt about, you didn’t cause dad to have the issues of aging and you can’t fix them, Handle this one step at a time as you’re able. Dad is blessed to have you. I wish you peace
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Brynway1819 2 hours ago
Thank you for your kinds words☺️ I called his social worker at the VA and was told that since he is not service connected he doesn’t qualify for VA nursing homes. I definitely need to explore skilled nursing, I’m just trying to muster up enough strength to do that. Thank you again again
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You can hire a Geriatric Care Manager who will manage all of this for you.

Your father will need to be moved to a skilled nursing facility. It is his income that is used (and considered) to pay for it. If it is too expensive for him, then you help him apply for Medicaid assistance, which will make up the difference. That is, he pays everything he has, less about $20/month for spending money, toward the cost of skilled nursing, and Medicaid will pay the rest.

I have not done long distance caregiving. I cannot even imagine how you do that. If at all possible, (I know you said it is cost prohibitive for facilities near you) I would try and move him to a nursing home much closer to you.

You might be successful in getting Medicaid benefits for him in your community, but the catch is that he must already reside there before you can even apply.

You can just let go, and let the social worker at his current ALF figure out arrangements for him, or let Adult Protective Services make decisions for his care, but then you are left out of any of the decision making. I assume you are staying where you are, 1200 miles away from him because you have better income opportunity there. Perhaps it is worth spending some of that money toward getting your father situated in a good care facility, and ease some of your stress and worry. Having him closer to you has got to cost less in time and money and job security than travelling to see him every eight weeks. When the next major thing happens, how much time are you going to take off from work?
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Beedevil66 13 hours ago
I agree a Care Manager could be a big help to him and you.
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