Hello all,
I have written here before about my 86 yo FIL. He was in an ALF for about 6 months, then caught Covid at that facility. He went to the hospital, where he recovered with no real issues (!!!). He has been diagnosed with dementia and has been bipolar for a long time. He now seems as though his meds for the latter are doing okay.
The problem is that he had some issues when at the ALF. These included angry outbursts, and possibly some threats to the staff (we are not 100% sure what exactly).
After he left the hospital, he was sent to a rehab facility. His original ALF will not accept him back, and the family is really struggling to find any place that will accept him. It certainly appears as though he is being blackballed in some way.
They are working with the ombudsman (this is NC) who has tried to help, but so far it has been a couple of weeks, and he has no where to go. I should add that he is a Medicaid patient.
I read a few other threads here that sounded similar, but I was wondering what else the family can do. Is it really possible that these places can all simply refuse him, even if he had some anger issues? I do not believe he has actually harmed anyone, nor do I think he would. He is angry, but this seems to be common for people in his position.
Any thought or advice about what his family might be able to do would be welcomed.
I had a toxic father with a lifetime of personality disorders that got worse as he aged. From the time I got both parents into a beautiful ALF, I worried that he would get himself evicted. When people first met him, he was always on his best behavior, then after a while his true self would emerge. When on his second stint in rehab after a hospitalization, they diagnosed him with MDD and anger issues, but not dementia. The staff was amazingly patient with him, though he was stubborn, verbally abusive, and non-compliant. Towards the end, they even brought in Hospice rather than transfer him to a nursing home.
Make sure rehab or whoever are held responsible for placement. With mental illness issues, he may even be held in inpatient geriatric psychiatric hold for evaluation. Look into Baker Act laws in your state. Anything is better than an "unsafe discharge." Do not let them talk you into taking him home. That is not an option and not safe for anyone. Best of luck.
He’s slid down my legs a few times now then had to lay on pillows until help came to pick him up. My shoulders and back are ruined . I’ve had a lot of neck and back surgery I fell with him one day at the VA and it messed up
all of my neck surgery so I’m never out of pain. I really thought the VA had facilities. I need to go to another state to gather papers I need for court regarding his house he’s let his dead beat sister live in free. It needs to be sold and she’s fighting me doing it. I thought the VA could take him a week or so.
They will have to find a place for him but if you take him home, they don't have to worry about it.
ALs in general are looking for residents who have the least issues and who will present the least amount of care problems and/or behavioral issues so ALL the residents will be happy and content living there.
SNFs, on the other hand, are less picky about who they take and have a tendency to accept a wider variety of people with behavioral issues.
Good luck!
Just so you know, even LTCs (aka Nursing Homes) have a right to refuse a resident if they can not meet that resident's needs/ requirements. And a new facility that does accept him may not be close to you or what you would normally chose for him but at this point you don't have a lot of options (might be the reason you have not heard a lot from the Ombudsman at this point). FIL definitely sounds like he needs an eval by a geriatric psychologist and a careful (possibly ongoing) adjustment of meds. This might lead to a stay in a psychiatric unit so they can carefully monitor the meds.
I wish you and your family peace and good luck in this difficult journey.
He is angry, aggressive physically and verbally. I’ve had meetings at the facility three or four times over the last 12 months where they were on the brink of discharging him, and were recommending he go to locked skilled nursing. We were not able to find a locked skilled nursing for him in our area and all involved agree that isn’t the best solution as he is physically healthy and agile. It’s just that he is a harm to himself and others when he goes into a rage. He also refuses to take his meds regularly. The place he is at is licensed as an AFC home and they can not force him to take meds or give him something in a pinch when he starts winding up for a blow-up.
He spent 10 weeks in two different psychiatric hospitals over the last six months. The main objective is to get his meds right so he will calm down. He is now getting a monthly injection of invega sustena that helps some but not the best. ECT electroshock treatment has been recommended also.
His dementia has not affected his memory much yet. What has been destroyed is his reasoning, executive functions, impulse control, and knowing the difference between what is real or imaginary.
There isn’t an “answer” for us but we are thinking outside the box and it has helped for the moment. A maintenance worker at the facility has “hired” my step-dad to help him out. This gives him some purpose and feeling of accomplishment. Also-we are very fortunate that my mom worked for the county prosecutors office until her death last year. She was well liked by all and local police stop in to visit step-dad regularly with coffee or sandwich and have a chat with him.
I, too, would recommend not accepting a discharge from rehab unless another facility is lined up to take him. There is no good place with long term care for our elderly dementia patients with consistent anger issues.
Has rehab applied pressure for family to take him in 'just until this is worked out'?
Is he still legally responsible for himself?
Sounds like at this point, he needs memory care not ALF....
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