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Lookin4hlp Asked June 2018

SNF wont take my dad because he is physically healthy?

My dad has LBD and Parkinsons. My mom can no longer take care of him due to her health issues. My dad is always confused and thinks people are in the house and hitting him. He has left the house walking the streets many times and we had to call the police. He has Medicare and MediCal but I cant get a SNF to accept him. Some say no one will because he is physically healthy. They say he needs assisted living. Assisted Living said they cant medicate him and if he acts up they will call us for him to leave... even their memory care side. What do I do? He is endangered on his own. I can't get his Dr. to send him to the hospital for the 3 days for Medicare to kick in... I need a facility to take him initially on his Blue Shield then Medicare and then Medicaid/Cal. Anyone experience insurance saying he needs to leave based on his physical health? His mind is far from healthy? Help

Shane1124 Jun 2018
Jeanne, you are so correct. We shut down “insane asylums” years ago ( remember Geraldo Rivera & Willowbrook” days) but had no plans nor options in place for those types of patients needing care & follow up. Sure they set up “community based” clinics but no one can guarantee to get those patients in for treatment.
Another huge quagmire. Very sad indeed.
For the OP SNF’s won’t take your dad as he poses a safety risk to others & do not have the capability to provide 1:1 supervision. While at home now, does he have a 1:1? I would consider that until he gets placed.
As said above, nurses don’t “restrain” people nor take the chance your father refuses to takes medications that may calm him down while being “in the moment” of a crisis if your father exhibits out of control behavior.
Such a difficult situation. I wish you luck.

Isthisrealyreal Jun 2018
Unfortunately an aggressive person is a huge risk to staff and other residents. That is the reason you are having difficulty.

SNF typically do not have enough staff and to add a known risk is low priority, perhaps a non-profit facility will be a greater help.

I hope you find some place that will give your dad the care he needs.

Hugs 2 u in this hard trial.

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Lookin4hlp Jun 2018
This is about my dad. When I say “restraint” i mean to do what my mom has to do when he gets aggressive and give him a little more medicine. That is what the dr said to do. He is seeing a neurologist but very few doctors are decent , unfortunately.
Today i got his primary care dr to write an order regarding him needing 24 hour care and that my mom can no longer take care of him due to her health issues. The dr will sens this to blue shield and get authorization and then we will see if a SNF will take him. The dr says he needs to be in a safe, locked facility like a SNF for Dementia. Hopefully this will all come to fruition.

jeannegibbs Jun 2018
This is another gaping hole in our health care structure. We used to recognize that some people could not live within the mainstream of society by having "insane asylums." I don't think any of us would want to bring those back! But when we closed them we still had a need to protect and care for these people and to protect others from them, but we did not come up with wide-spread viable alternatives. And with people living longer and so many more developing dementia we have a great need for this kind of care. A very frustrating situation for all concerned.

Is your husband seeing a specialist in LBD? If not, I think it would be worthwhile to make an appointment with the nearest clinic that has such a specialty, even if it is some distance away. (I have a cyber friend with LBD who comes from Tennessee to Minnesota's Mayo Clinic once a year for their specialists.) They may be able to come up with treatments that will be more effective at calming your husband and they certainly should be able to suggest some long-term care alternatives.

baskethill1 Jun 2018
In the mean time get a male nurses aid in and put an alarm bracelet/ watch on him that alarms if he goes past the sensors on the door.

DeeAnna Jun 2018
What do you mean by "He would need to be given more medicine sometimes... meaning restraint which a nurse should determine"?
Are you saying that your Dad should be in a facility where the nurse can administer medications as needed when your Dad is aggressive? Or are you implying that you want your Dad in a facility when the nurses can physically restrain him with belts and straps and "straight jacket" devices?
Physical restraints CAN NOT be used any more in nursing homes and medication restraints (medication used to control a person's behavior) are monitored to ensure that the person receives the lowest dosage possible that controls that person's symptoms. There are some nursing home facilities that overmedicate their residents--but they are NOT going to tell you that. ;)

shad250 Jun 2018
Liability SNF does not want to do something that could bite them in the behind later, hence getting the report and making their decision. 

Lookin4hlp Jun 2018
My dads medical report says he is healthy and his inability to take care of himself is a result of LBD and Parkinsons. His dr even said he gets aggressive in the report. Why dont they consider this illness in need of skilled nursing? He would need to be given more medicine sometimes... meaning restraint which a nurse should determine

jjariz Jun 2018
Mobile men with dementia are notoriously difficult to place because facilities are worried about physical aggression. The typical route is when a patient becomes violent toward a caregiver, police are called, patient goes to ER, ER transfers patient to geriatric Psychiatric facility for med stabilization, and then to a LTC facility that accepts this type of patient. The key for this to work if that the family must REFUSE to accept him back in their home due to fear for their own safety.   It then becomes the work of the social worker to place him.Good luck

bicycler Jun 2018
Lookin4hlp, try calling the Orange County Social Services Agency at 714-825-3000. If they can't help or at least point you in the right direction, then I suppose you could call Orange County's Adult Protective Services at 1-800-451-5155. Here's the website: www.ocagingservicescollaborative.org/our-members/county-of-orange-adult-services 

Your family is in a tough situation, I hope the OCSSA is able to help.

shad250 Jun 2018
Ahmijoy. Exactly why the medical report should be looked at. SNF always look out for themselves first and foremost. That is how the industry is.

Ahmijoy Jun 2018
Have you tried more than one SNF? In my mom’s facility, there was a very large man who could completely lose control. I don’t believe he was a danger to the patients, but the RN told me he had hit her. He also played Motown music at top volume. When he was in one of his episodes, his yelling and cursing shook the pictures on the walls. And, my own mom smacked people on two occasions that I heard of and tried to trip the aides when they walked past. Nothing was ever said about removing this man or my mom.

Try investigating another skilled nursing facility and see if they would accept him.

shad250 Jun 2018
SNF is looking out for themselves first and foremost. If there is any indication that your dad would be a harm to himself or others, then, they would not hesitate to decline his admission to their facility. Do you/can you get a copy of his medical report if possible? These facilities use these reports to determine admission of patients to their facility and care.

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