My grandfather has recently been moved from a rehab unit to long term care. He has expressed to my family members that he wants to come home. He is vital and full of life. I'm concerned he is going to feel imprisoned and will mentally deteriorate being surrounded by people who REALLY do need to be in there. She states she cannot care for him and he needs 24/7 care which is not the case at all. I fear she is convincing the doctors that he has dementia. He is fully coherent when we speak and he has expressed he is ready to come home. My mother is moving across country for a job opportunity and I believe this is his wife's attempt to put him in a home since my mother will not be here. He recently had knee surgery which is why he was in rehab initially. It breaks my heart because my mother told him that his wife would do this to him and now its finally coming into fruition. She does have POA over him but she does not have the best track record with being honest and having his best interest in mind. Although a home health aide would be beneficial for bathing I do not believe he needs this 24/7 level of care. I have been a CNA for years and I know the type of environment he is in. He is going to go crazy being around people who can barely feed themselves and have full blown dementia. He is in his early 70's and I would hate to have him spend the rest of his time in prison. Please any information or resources I can utilize to bring him home would be greatly appreciated. I'm doing my part since my mother is in the process of a huge move and already has so much stress from the situation. Again any information would be helpful and greatly appreciated.
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Even without going that far a poa can not force a competent adult to live in a nursing home against their own desires, that can only be done if they have a guardianship and/or they have been deemed mentally incompetent. Something to consider though:
Those in the early (and even later) stages of dementia can seem perfectly fine to the casual visitor (as a CNA you should know all about showtiming)
Most nursing homes don't accept people who don't belong there
Doctors would definitely listen to the concerns of a spouse/caregiver, but probably would not make a diagnosis based on that alone
As Maggie and FF point out, his wife is not obligated to ruin her own health by trying to care for him, and although he may not need intensive 24 hour nursing care he probably needs more help than you could give him if you work full time.
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You can help your grandfather think this through. You can research alternative options for him. But you cannot force his wife to take on a caregiving burden that she is not prepared to accept. So, do you have a practical plan to propose?
You cannot force her to take care of him herself.
Anyhoo, an update.......
We had a family meeting (my mother, myself, my sister, my grandfather, his wife, his sister, and his niece) with the social worker, head nurse, and his nurse. Basically we were informed that he does not have dementia or any signs of dementia. Their biggest concern is he is a fall risk. He has fallen once since his knee surgery and that basically places him at an elevated level of risk. His wife gave concerns to his nurse about not being able to transfer him if he does fall again and thats when the whole long term facility placement came about. He does not need assistance with any of his ADL's. He dresses, showers, and feeds himself. They stated that they administer the medication in that facility so he does not take them himself. It seems the main issue is his wife being capable of his care which is monitoring his walking and limiting his activity. She feels that her own medical issues prevent her from doing such. It was suggested that his POA is changed since she feels she in incapable of making his medial decisions as her own health declines. She states she is about to lose her driving rights. A different POA has already been decided and we are going to start the process of recruiting someone to come by the house daily to assist with anything he may need help with. As soon as a home health aide is assigned he will be coming home. I thank all of your for your advice. Hopefully this will help others. When you feel as though someone shouldnt be in a long term care facility SPEAK UP. No matter how many people may tell you to just listen to the POA or "he must be there for a reason" JUST SPEAK UP. Ask for meetings. Ask for outside help. I reached out to the local Council of Aging and got great assistance from them. Now my grandfather knows he is not going to be staying in there forever and it gives him a piece of mind knowing we are doing what it takes to get him into his house with his dog so he cant enjoy his home. Thanks all again. God Bless!
As all the other posters have told you, he cannot be held against his will if he is competent. And his wife cannot be forced to care for him in their home. So all that needs to happen is to come up with a plan for release to a place where he will be safe and comfortable. If doctors have ordered "24 hour" care, then he really can not live alone. Other options include a group home, assisted living, independent living in a senior community, with round-the-clock in-home help. (Could he afford that?) or living with a relative and having in-home care.
This "very nice" long term care facility he is in now -- is it actually a skilled nursing facility, or what level of care to they offer? And there certainly may be people there who need help with feeding or who can't talk, or can't dress themselves, or are bedbound. But I'll bet there are many others who seem pretty capable and coherent whose company Grandfather might enjoy.
Please try to reserve judgement until you have a chance to spend time with Grandfather.
My husband, mid-seventies, was showering on this own, cutting the grass, cooking, driving, running errands, and suddenly, very suddenly, he was thrust deep into dementia. It wasn't even a month between the time he was seemingly self-sufficient and when he needed full-time supervision. And when my sisters came to give me a few hours respite they could not figure out what I was talking about. He seemed perfectly normal to them.
I managed to care for him in our home for the entire 10 year journey. One factor is that I was almost 20 years younger than he was. But I could not leave him alone in the house. I could not work outside the home (as you do). He had no mobility issues.
I can understand your heartbreak at seeing your formerly vital and coherent grandfather in a long-term care facility. But I urge you and the other relatives to try to spend a lot of time with him and to talk to the staff. The reason so many of us are suggesting there may be more to this than you currently see is because we have been there, done that, and have the scars to prove it.
Being your grandfather's advocate is an excellent role for you, as soon as you fully understand his needs and his options. I sincerely wish you every success.
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So what is your plan? Saying he should be in his own home is not a plan, it is a wish.
If he truly wants to leave the NH it is up to him to say so and act upon it. If he asks you for your help you can assist him. If you feel you have some practical advice about where he should live you and he can discuss it and plan a course of action. But I would be very careful about stepping in between him and his wife, that sound like a minefield you would be better off staying out of.
I know that my loved one would have a good day or a good morning and you could have a normal conversation with her for about an hour, but later she would keep repeating herself. She would describe her day, but it was all a delusion. And then there is the falling down, putting the cable box in the kitchen cupboard, eating spoiled food, not cleaning after toileting, etc. If you weren't there for the entire day, you might miss these things. So there was no way she could be left alone, even for a few minutes.
That is the issue with dementia, if that is what your grandfather has, he will require the same supervision that a toddler would. You may have to spend a lot of time with him to see the entire picture.
My Mom was an active until one day she had a serious fall a month ago. She's had been in rehab for a couple of weeks but she refused to do any physical therapy. Now she is in long term care due to quick onset dementia from a brain bleed caused by the fall.
My Dad is in denial, he really thinks that my Mom can come home. He hasn't seen her when she is in delirium, or when she is constantly picking at the clothes she is wearing or picking at the bedding, or when she is kicking her legs likes she is running a marathon, and when she doesn't make sense talking. He sees her when she is alert, talking, and smiling, or when she is sleeping.
When the family does visit your Grandfather, please let us know the results.
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