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My husband of 50 yrs has always been a stubborn, stoic and emotionally unavailable person. John Wayne type personality. Two years ago he developed dementia. I am the sole caregiver, other than a home health aide that comes for 1 hr 3x week. Lately he is refusing to let me help him wash, only a sponge bath, or change his Depends. Every day it's a battle no matter how I try to sweet talk him or bribe him. If I wait till he goes to the bathroom I can pull down his pants and rip the Depends off, but with great resistance and yelling. My neighbors must think he's being abused! Then, after they are off he refuses to put on the clean ones. Yesterday I spent 6 hrs before he finally put on Depends, but not before it left a distinct odor or urine on the couch. I then had to use the upholstery cleaner and put protective pads underneath the cover of the seats for next time.
Anyway, I'm totally burned out physically, I'm 73 with health issues , and emotionally on the verge of a nervous breakdown. I don't want to do this anymore and I am not equipped to do it anymore.
Question, I can't afford a memory care facility and am not sure if a diagnosis of Dementia qualifies him to enter into a skilled nursing home facility. I believe he'd have to be in the hospital for 3 days first then transferred. But as a hospice patient, he can't go to the hospital or rehab.


Although he's on Hospice, you'd never know it as he's mobile and his health is stable, and he has no pain, mainly stage 4 kidney disease, no dialysis.
We only have Medicare but will probably qualify for Medicaid once limited funds are spent down. Any information on nursing home admissions would greatly be appreciated.

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If you are on hospice, you can go to the hospital and discharge from hospice while you are in the hospital, then get readmitted to hospice after you leave the hospital and return home. Your health insurance that covered hospice also covers the hospitalization, then the hospice again.

We did this with my mother when she came down with pneumonia - we weren't sure until she was tested and diagnosed in the hospital that it was pneumonia, and it was important to know that it was pneumonia and not Covid.
So the hospitalization was worth it in her case, her fever went away and she was rehydrated and became more coherent. But it was clear she wasn't going to get better, she no longer had the capacity to do so, so everyone agreed to discharge her back onto hospice. And the hospice nurses then had the benefit of the info from all the testing that was done in the hospital. She passed away ten days after leaving the hospital - but it was in her own home, in her sleep, and peacefully without pain or discomfort due to the hospice medications.
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Hospices are not all the same. Check out some others and see if they offer more time with a home health aide. I agree with speaking to an elder law attorney.

please discuss your husband’s behavior with the hospice nurse and see what can be done.
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His recent change of behavior may be an indication of UTI. There often are no other symptoms. You could take him to ER to be checked. if he does have one and is admitted, that will help. Otherwise the rest of the advice about getting him on Medicaid and then to nursing home is helpful and the path you will have to take.
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You are going to need a Dr's recommendation for Nursing home placement. Talk to his neurologist and see if he can sign off on him needing a nursing home. That is needed for the LTC Medicaid approval process. I would also consider contacting the state and getting a social worker involved. Tell the social worker everything you've said here. Your health is at risk and you can not adequately take care of him by yourself anymore. You are in a tough position. It is very difficult to get him into a NH by yourself. The easiest way is through the hospital, but obviously he's going to need to get there for a good reason first. You could also try to have the state take guardianship, but I think in your case I'd see an attorney first to make sure you can do it and have the best outcome for you. But first start with area on aging and also contacting a state social worker. If they can't help to your satisfaction, see a good elder attorney.
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Caring41
Since you will be what’s known as a community spouse, you will not be left indigent. Please contact a certified elder attorney, well versed in Medicaid for your state. He or she can guide you through the maze and make sure your assets and income are protected.
If you haven’t already, contact your Area Agency on Aging for an assessment and information on what services are available for you and your husband. Each states Medicaid program is slightly different. I’m sorry you and your husband are going through this difficult time.
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Dear "caring41,"

On the teal banner at the top, right hand corner of the "AgingCare" page you can click on "Find Care" and it explains each type of facility and who they are for. Also, you can click on "Care Topics" and search for each subject you are interested in such as "bathing issues" like what you are dealing with along with a whole host of other topics which is a good place to start. All are by alphabetical order!
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