I’m back AGAIN. Lol. Anyway, dad’s hospital chart is full of negative things. Not eating, not participating with therapy, being rude to hospital staff AND cussing them etc..... We have received NUMEROUS calls from the social worker complaining about dad not cooperating! We finally get him to do some things towards the last few days of his hospital stay.
The skilled nursing facility that we picked came to get him today from the hospital to start rehab for his hip. We were happy because we thought we were finally progressing to him getting the care he needs. They get there and see his chart full of all the negative things I mentioned above. They denied him and left him there! To say me and my sibling were angry and hurt is an understatement! I just don’t understand for the life of me why he acted so childish. And when confronted, he feels as if he’s done nothing wrong. He feels everyone is being mean to him! He cooperated for 2 measly days and thinks he did something so grand! They looked at his ENTIRE chart and saw how much hell he raised!! I’m exhausted! Now the social worker says that all we can do is start over and find another facility and hope they don’t reject him as well. Has anyone been through this or have any suggestions?
She was 93 and has always been strong-willed and independent. Having dementia has taken away her ability to do be self-sufficient in almost every aspect of her life and she resists it by being combative with anyone who tried to help her, including me.
During her last hospitalization I realized that she could not return to my house. After exhaustive research, I found a beautiful well-regarded memory care facility within walking distance of my home. Initially, the facility refused to accept her because of the notes in her chart. But after a few days of calmness due to medication by the hospital’s geriatric psychiatrist (and a lot of begging from me), the facility began the admissions process when I put down a large deposit. Sadly, my wonderful plans fell through when Mom refused to participate and became combative again. The facility bowed out and returned the deposit.
Like you, my family and I despaired about where Mom would go. In a turn of events that we didn’t expect, advice from A Place for Mom Representative and luck helped us find another facility. This facility didn’t have the same bells and whistles as the first one and was 30 minutes away, but the staff has worked with Mom in ways that I know the other place never would. Mom continues to have bad days, but I know that she also has had some good ones too.
The point I am making is that in looking for help, your family may need to be open to places and actions that you might not have considered at first. (For example, in addition to Assisted Living, Memory Care, and Nursing Homes, you might want to check out Group Homes. I have heard that their smaller size can provide more support for difficult elders.)
Good luck at this difficult time!
Consider that your dad may need a psych consult. He is acting out for a reason: fear, frustration, feeling lack of control.,. When you get the reason behind the behavior dealt with, your loved one should have more compliant behavior. Then he will be ready for rehab.
"Guilt should never be in charge of the care plan."
I think that says it all. The mantra should be on a mug given to all caregivers when they sign the POA agreeing to take responsibility for a loved one.
Your dad isn't trying to make you or anyone else unhappy. I suspect he is not able to control his behavior at this time. It doesn't matter why; it just needs to be addressed.
If he has an injury as well as behavior problems that is even more complicated.
Talk to a psychiatrist or social worker for help on how to proceed.
My 93 year old mom hated SNF and it was hard on my dad to have to go everyday. Last time she needed rehab, we denied SNF and got in home services. Mom loved the attention of the therapists and cooperated in the comfort of her familiar ALF.
Does he want to improve his quality of life?
Does he want to go to rehab?
Can he control his anger or if not would he agree to medication that would help him with anger and anxiety?
OR
Has he given up?
Does he want to die?
If the answer to the first few questions is YES then discuss this with his doctor to begin to find medication and rehab that will accept him under those conditions.
If the answers to the last 2 questions is YES then you should support him in his decision and ask the doctor if he thinks he is eligible for Hospice and then call a few and have him evaluated.
Maybe the "surprise" factor was a big driver in the rehab's last minute rejection. If the facility's DON had already agreed to a program for handling your father, the chart entries might not have had as much weight.
If it helps... Your story is so similar to a workmate. That man self-discharged last time from the rehab to home - only to fall within 12 hrs & start the cycle again. Currently recovering from broken hip, refusing to do the rehab & causing trouble. But family have wised up now. Refusing his wish for rehab-in-home & ensured a slow stream longer rehab was the path.
Sounds like your Dad just doesn't wants to be where he is & his behaviour is showing it!
You can avocate for his care without taking on the responsibility for his behaviour. Find out the options, link in the professional services he needs (inc that Geri psyche).
Guilt should never be in charge of the care plan.
That should be on a mug.
Talk to your siblings. What are you all willing and not willing to do? Openly and honestly discuss his living situation post skilled nursing facility if he gets accepted into one. Come to agreement about what's best for him and then stick to the plan.
Do not let yourselves be guilted into caring for your father in his home or in your own homes. Caregiving must work for everyone involved or it does not work.
Since you know his character traits are unappealing to many, you will be helping him and those of you who are responsible for his care by addressing his “stuff” head on. He obviously WILL NOT CHANGE because you and your siblings are “angry and hurt”, so doing something different may help.
The bottom line is HELPING HIM into a place that will be safe and willing to take him on. He NEEDS BEHAVIOR MODIFICATION and medication would appear to be the best place to start.
Ask the social worker to recommend someone if a Google search doesn’t give you what you need by way of resources.
GOOD LUCK!!
In our case a geriatric psychiatrist was consulted and medications were prescribed to help the issue which was dementia related. Barb's advice may be hard for you to follow, but it is good advice.
Best of luck! You can't help people who don't want help.
"Sorry dad, your uncooperative attitude is bolloxing up our attempts to get you the care you need. I'm going to be stepping away and letting the chips fall where they may. I hope the hospital can find you a place."
And mean it.
I don't recall your other posts. Have you been attempting to care for him at home?
I would not care for someone who didn't show some modicum of gratitude.
Has your father always had a difficult personality?