My husband had a stroke in 2009 and recently fell and broke his hip. I am 70 years old and I have health issues that make it difficult for me to care for him at home. Before the broken hip, he was living at home with me (helped by 4 hours per week from home health aides). He is wheel-chair bound and he is 74 years old.
When negotiating get the full name and title of the person yo are dealing with.
Sometimes it is worth mentioning this is needed should legal action become necessary....
Personally I am big on email confirmations because they provide written records
Quoting one of my favorite contributors to knowledge network groups
Attorney at law Kevin P. Keane:
"agreements not reduced to writing, are NOT worth the paper they ain't written on."
KISS
It is better to deal with friends than to make adversaries
Sometimes workers can make the spouse or family member feel terribly guilty, and can use extremely coercive, manipulative language to get the family to take the patient back home.
It's their job to get that patient OUT of the facility; sometimes they simply don't think before they speak, or, they might have too-few possibles to "go-to", so foist the task back onto family caregivers--never mind the circumstances.
Some of the Workers simply fail to consider the home circumstances appropriately...they can be over-worked, too.
Sometimes, it seems they don't care how/where the person goes, they just need to get the patient outta there.
It can be very tough, faced with social workers, hospital workers etc. who seem clueless about the level of care, or who have other agendas they don't mention.
It's also too common for in-home health care systems, to UNDER-assess a patient for in-home care assistance, resulting in not enough help in the home--this is where much in-home health care fails.
That gets worse, the lower one's available funds are; worst for welfare recipients.
It's up to you, to pressure those workers right back. As mentioned above, tell them he CANNOT come home; tell them that would be like expecting him to take full care of himself, "due to current circumstances preventing his getting adequate, appropriate, safe care at home, anymore".
You can tell them, "If you force him to return home, you [the Worker] will be directly complicit in the injury and/or death of both the patient being released, and the spouse left to care for him."
You can mention the terms: "Neglect" and "Abandonment" if you have to, as a last retort.
Sometimes they simply need to hear it distilled down to the dire brass-tacks.
Keep being firm.
Because, once they succeed in pushing a family member to accept the patient back to home, it will need another emergency room trip/hospitalization, to get him back into the facility, to try again to get them to move him to a facility to get the help he needs.
Key are: Safety + Appropriate level of care.
When you can't provide that at home, after they forced it back on you, they are then effectively forcing you to be negligent of his care, to get themselves off-the-hook.
Social workers and Hospital officials might wriggle every which-a-way to make it sound like anything else that's nicer, but that's what it boils down to.
Hang in there, be firm.
In the mean time, you can also search for a facility for him. Kinda like burning the candle from both ends...only this, might help find an open bed, faster...maybe.
If they still fail to do the right thing by getting him into a proper, appropriate facility, with proper, appropriate orders transferred with him, call APS, for sure, and report them and the facility.
DO watch out that the Doc writes appropriate orders for the person admitted to the facility----some are notorious for writing egregiously wrong orders; some accidentally, some to manipulate the facility the patient is sent to into taking a more complicated patient than they can handle, and some out of spite--they are human, too.
Keep us posted how it goes for you!
Please take care of yourself!
Participants here know to ask...
You should, however, be firm with the rehab social worker, in expressing your determination that you cannot care for him safely on your own, given his current needs.
I would recommend you put it in writing and give it to the rehab facility. Your local Area Agency on Aging can help direct you to the right agencies to help you appeal, or explore other options.
Now, if your husband does not return home, you will have to find a way to pay for his care elsewhere. That could be expensive and you may want to see if getting a lot of care at home ends up being less expensive.
Good luck, it's a difficult situation to be in.
Once you've made that clear, then the next step is how to get him into a situation (whether with home care or an assisted living or skilled nursing facility) where he can get the care he needs. Your financial resources will determine the first step. If you can afford (and he is appropriate for) assisted living, then start shopping. Problem solved. If finances are not sufficient for him to be in AL and you to continue to have enough money to live on, then it becomes more complicated and a lot depends upon which state you're in.
Get with the social worker quickly and hash all of this out.
Do not take on more care than you should try to handle! Sorry to be blunt, but it will kill you and your husband will keep on chugging along. I've seen it happen many, many times. The caregiver dies before the patient.
The ALF does not have to reveal this in this state.
They were actually very very rude ...so rude in fact I lodged a complaint and the social worker has been moved on from her cushy number to a more stressful role. She was used to telling people what they were going to have ...and that was an end to it. She had already bullied a neighbour who was in hospital at the same time and I just had had enough. the next social worker wanted to work with me during the transition phase and that may be all you need. I couldn't caregiver to begin with- all sorts of issues about personal hygiene and rubbing creams in places I didn't want to touch etc but eventually I came round to where I needed to be. no it still isn't breeze but it sure as hell is less stormy than it was
WARNING! The SW may try to pressure you into bring him back home. They may try to make you feel guilty for not complying with their request. Do not fall for it, you will need to stand firm. Call Adult Protective Services and the Area Agency on Aging for additional help!
Facilities that attempt to transfer residents in violation of the law or without providing them with the required advance written notice can be sued. The courts are authorized to issue injunctions to prevent transfers, to order facilities to reverse transfer, and to make nursing homes pay residents compensatory and punitive damages.
Why You Could Be on the Hook
Even if you don't live in a state with a filial support law, you could be on the hook. Nursing homes, rehab hospitals and other medical facilities can sue adult children or other family members (if there are no adult children) for unpaid healthcare debts using other types of legal justification. "If a bill is unpaid, it's very likely the facility will sue other family members to get it paid," says elder law attorney Robert Clofine of York, Pa.
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Grace + Peace,
Bob