My 90 year old dad has advanced dementia, and is presently in a local hospital after being treated for a UTI. He was sent to the hospital by his private pay memory care facility, but the facility will not be taking him back because his level of care is exceeding their ability to safely care for him. During his current stay at the hospital, they have restrained him to his bed because he tries to get out, and have been using sedative medicines to calm him. He has a history of combative and aggressive behaviors, and in the past we have had to move him out of other private pay units because of his behaviors. Over the last two years now, this will be the third facility that has either asked him to leave or would not take him back from a hospital stay. The social work department at the hospital has been sending out referrals to nursing homes. Four of them accepted him, many others declined him. I visited the four facilities that accepted him. One of them does not have a bed available in their memory care unit, so I don't know why they agreed to take him. Another facility has closed their memory unit for renovations and it won't be open for several more months, and so I don't know why they accepted him either. I visited and toured all four nursing homes, and also went online and read reviews about them. The two homes that have beds available in their memory care units, and without going into detail, were deplorable. Even the online reviews about them were consistently negative. In an effort to find a suitable facility, I did my own research using the Medicare.gov website, and identified about ten facilities with positive ratings and reviews. I submitted them to the social worker at the hospital who sent a referral to them. Every one of those facilities declined him. I do not want him in either of the two facilities that accepted him, and the social worker is pressing me to accept. I keep researching more and more nursing homes with positive ratings and reviews, even those farther and farther from my home, and when the social worker sends a referral to them, they all decline him. My concern is that if I continue to refuse a referral to a nursing home that will accept him, insurance will stop paying for his stay at the hospital, and we will get billed for his stay there. After five years of private pay facilities, my dad's money is running out in less than two months. If I accept his placement in one of these deplorable nursing homes, and use it as a temporary solution while I continue to look elsewhere, I may never find another one willing to take him. Bringing him to my home is not an option. At this point, should I stand my ground and refuse those placements? Do I have to accept one of them? And at what point might insurance stop paying for his stay at the hospital? What are my options, especially if every other nursing home with suitable reviews continue to decline him?
Insurance will press the hospital who in turn will press you to make a decision, since hospital stays are very expensive (one of the biggest cost being the room).
Good luck!
He cannot stay at the hospital for a great length of time or he WILL be billed after insurance is denied. You'll need to place him, let the meds do their job, and then see about a transfer to another SNF once he has a good behavior record to report.
I'm sorry you're going through this and wish you good luck and Godspeed with a difficult situation.
My daughter was telling me, RN in a NH, that they got the cutest little lady in that day, she is a "keeper". Then she explained what she meant by keeper, it means the facility can pick or choose who they keep. Your father is a danger to staff and residents that facilities have to protect. Not a problem these facilities want. You may have to take what you can at this point. As soon as he gets there, you need to start the Medicaid process if he only has a couple of months of money. You want Medicaid to take over ASAP. My Mom had 20k left which paid May and June in LTC. In those two months I was able to get together all info needed and Medicaid started in July.
IMO the hospital has gone over and above their responsibility. Medicare will cut Dad off. I suggest you take the best of the two facilities offered. Get his aggression under control and then look for a better facility. IMO, his aggression should have been addressed long ago by his Doctors. It takes a while to get the correct cocktail of Meds to stop the aggression. Thats why I suggest a Psychiatrict hospital.
You're going to have to choose one of the nursing homes that will accept him.
The two which do not have a bed available in a memory care unit - did you ask them how they would manage his exit-seeking behavior? Or how they would manage his behavior in general? I suspect at this point any nursing home that accepts your father will have to keep him heavily medicated, to keep him subdued so they can manage him safely.
It's unfortunate you found two of the facilities deplorable. That might just be his sad fate if his behavior has gotten him kicked out of better. Your only other option would be to bring him home and hire round-the-clock nursing care for him. His money is about to run out, leaving him with only Medicaid options.
I am sorry you are disappointed in the care facilities you have seen. You can make his stay a little better by visiting often, helping him out a bit yourself, bringing him treats, and advocating for him by getting to know the nurse in charge and the staff of CNA's - who will be interacting with him the most.
The one that accepted him but at this moment does not have a bed, do they anticipate having a bed available by the time your dad is ready to be discharged?
And a "shot in the dark" here...would a rehab facility accept him on a temporary basis until one of the beds opens?
Or as someone mentioned...Place him on Hospice, the Hospice can admit him to the "In Patient Unit" until a bed opens where you feel comfortable placing him. A Hospice In Patient Unit can be in a free standing Hospice facility or many Hospice have agreements with other facilities where they place patients for Respite or for symptom and pain management.