Dad won't see a doctor, which is required for admission to the facility. Has anyone else found a way around this requirement?

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Dad won't see a doctor, which is required for admission to the facility. Has anyone else found a way around this requirement?

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I am desperate to get my 98-yr-old dad into assisted living. He lives at home, alone, and is degrading in his ability to take care of himself. He won't allow a caregiver into his home and I, the only child, live 1,000 miles away. He refuses to go to the doctor as is required for admission to the facility. Has anyone else found a way around this requirement?

Assisted Living Care Decisions Geriatric Doctors Refusing Care

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These companies make house calls for elderly:
Central Texas - https://urgentcare2go.com/?gad_source=5&gclid=EAIaIQobChMI3cKDxt-ihgMVdDbUAR2U7gEoEAAYAiAAEgIXRPD_BwE

Phoenix - https://www.avcmed.com/service/house-calls

Who knows - https://www.redeemerhealth.org/Housecalls

Florida - https://www.housecallspecialist.com/

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In my case, the admission nurse came while I was at my Mom's place. My Mom refused to speak to her and got all huffy.

However, they were at least able to do their assessment.

Your next issue will be getting him to do what is needed to get him admitted, which might include a TB test.

Plan on being there personally through all of this. You will not be able to manage him remotely during this time.

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There are doctors who will make house calls. Insurance may or may not cover. Also you might be able to set up a telehealth appointment for him with his PCP. The PCP might want vitals, which could be provided by a home health RN that PCP office schedules.

Or he dies at home when he falls or has a stroke. He may have decided that’s what he wants.

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My father died 14 years ago this month. He was 91 and had Parkinson's. His much younger wife is a nurse. She allowed him to die in their home.

I have watched close friends go through the process of dealing with parents who are in their 90s. They tend to be a pretty stubborn bunch.

As many of the replies make clear, there is no way around the requirements of the system. You will need to work around your Dad and a number of suggestions have been offered.

I would like to make one additional recommendation: devices and apps.
I have not researched all of the devices and apps. However, they have been very helpful to my friends who are dealing with the iron wills of people in that generation.

I know that my friends use apps to
check compliance with medication
make sure the doors are locked
check the temperature (of the house and the person)
check other vital signs (fall signals are very popular).
order food
do live visual check ins
My friends use these devices even when their loved one has home a home health aid - One of my grandchildren offered to buy me a "granny cam" because I once bought him a "nanny cam."

If you Dad will allow, let technology help you.

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Have you asked the facility how they would handle?

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Wellness check by APS or local authorities. If they are concerned, they will take him to ER for evaluation by a doctor. Kind of an expensive way to get this taken care of. Better to set up an appointment and take your loved one - grumbling and complaining the whole time - to get the evaluation completed.

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Try using the Telecone Medical Zoon Doctor on your phone or iPad. See if this is authorized. If so once completed how are you planning to get father out of the house . Your main reason is for Father's safety. Living alone . Yes they all feel there independence is being taken away . As my seniors states a prisoner in these facilities. Can't get out on their own. Did you try respite care .

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There isn’t a way around this requirement . Like the others said call APS to check .
Otherwise if he lands in the hospital the social worker there can facilitate placement at a facility.
Do know that elderly die at home everyday . Sometimes it’s just how it is.

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Wordgirl: Assuming that your father is on Medicare, this issue can be brought up during his annual wellness visit.

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Another idea. Just let the whole train wreck unfold. You, like many of us, got called up late in the 8th inning to try to figure out a plan. I suspect he doesn't want to go to AL. Or anywhere else. Other than to stay at home, and carry on as usual. Hence, his resistance to any plan. Including doctor visits. Its messy, ugly, uncomfortable and inconvenient. No one tells you this. In my experience. If we were dead, or not available, what would happen? Consider letting That happen. Once push comes to shove, and IF you are willing to take this on, maybe hiring a caregiver to keep him at home will be more appealing to him. Given the options. No good answers. No good options. We did not cause this, nor can we fix it. I lived a 1000 miles away until 2 years ago when I chose to move to my hometown and handle everything. I would advise, do Not make the same mistake. In my experience, it does not go well and burdens you with everything. Let him choose to live however he wants. Get a local caregiver who can make it work for the next few years. AL is minimal support. He will likely need more support soon. MC or senior care private home or SNF. Tour and learn what is available in his area. Know, It will consume your life as long as this goes on. And you let it. Get as much help as you can. Going it alone is really hard. Take help, ask for help. Your dad is very old, older than mine, that is a good thing. It likely will be over soon. That is a good thing, in my opinion.

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Hi Wordgirl - two options are: you can call his medical insurance company and ask if they provide in-home health exams - many insurance companies do this. Or, you can research online doctor services that will come to the house for a health exam. Hopefully, this will make it easier for your father to accept.

And, I'd suggest doing the research first and once you come up with a solution, be firm with your dad and don't ask him - but let him know when someone will be coming to his house to take care of this for him. Let him know that he's really fortunate that it'll be an easy process for him!

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I would think your dad is on some sort of medication. Refills can only be given so long before a refill can't be issued without him being seen in the office. You can tell him that he has to see the doctor in order to continue on his prescriptions, the insurance company requires it. Total truth.

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Will he go to his own doctor for an annual wellness visit, and follow-ups? If so, maybe you can give the form to his doctor to fill out. Make sure your father's paperwork is up to date. He needs to set up powers of attorney (POA) for financial matters (called a 'durable power of attorney' and healthcare matters also called 'healthcare proxy', he needs a will if he has assets (such as a house, investment accounts, etc.), he needs a living will with his advance medical directives. Are you his POA? You also need to be on file with Social Security and Medicare to be able to speak on his behalf. You can do this with a conference call. Financial institutions, such as his bank and credit cards, also have their own POA forms. This needs to be done while he is mentally capable of signing legal papers. He may need an attorney to help with these legal papers. It's something that may be easier to do the next time you visit him, if it's not already done. Will he agree to making you joint owner on his financial accounts? If so, this will make things much easier later on. Setting all of this up is something every adult should do, not just your father. Speak with his doctor about the medical form, and also speak with the assisted living staff who you are in contact with. They may have some suggestions. Regarding the AL facility. Would he be moving to a facility near you? If he did, it would be much easier for you to visit him and oversee his care. Good luck and all the best to you and your father.

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Just so you understand, the requirement is a legal requirement. There are different levels of care that an Assisted Living facility, and their staff, is licensed for and/or is willing to take on based on their current residents needs (i.e. there needs to be a balance between how many residents need special care and the level of staffing the facility is willing to provide—many are now run by investment companies, and thus must make a profit).

They need the doctor to evaluate your dad so they know exactly what level of care your dad needs. To try to skip this step can put your dad at risk if they are not equipped to care for his level of needs, and you don't want them to evict your dad when they realize he is beyond their ability to care for him—finding a decent AL facility is hard enough! It also puts the facility at risk of being fined or losing their licensing.

If you can't arrange to travel to your dad's to have a doctor do an evaluation at his home, I would take the advice of others, and have a wellness check done. They will evaluate him, and then you could use that for the AL facility.

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Read what our other forum has to say. Call the APS for a wellness check. If he gets injured or sick and winds up in the hospital ER, he will be forced into assisted living since no hospital will send him back home alone.

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You are going to need to arrange in home visit when you are there.
Who is POA? Someone needs to manage all this, because what will happen "the day of" when he refuses to budge.
With this behavior in a 98 year old I am worried that ALF may not be a good fit, and that you may be looking at Memory Care.

Whomever is next of kin and POA is going to need to take charge here and let dad know that some of these things are no longer choices, for his own sake and safety.

If he is not suffering dementia, and is still on his feet, however, and push comes to shove, you may be unable to move him. This would lead to death in his own home in all likelihood, but that may be his wish at 98 in any case.

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in addition to what the others have said - another idea - some assisted living facilities have their own medical directors or 1-2 doctors considered official doctors who cover patients there.

You could ask such a place whether they would admit him contingent on the assisted living's doctor being the admitting doctor. I'm not sure if this would work coming from home though. THere are some medical factors that can exclude someone from assisted living
The other way is that if/ when he is hospitalized, then the discharging doctor could maybe speak with assisted living based doctor and coordinate.
as others have mentioned, calling APS may be the best step

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Agree with wellness check by APS. If you live so far away, how do you know he is "degrading in his ability to take care of himself"... have you visited him recently? If not, maybe a brief long-weekend to visit him might clarify what his needs are. If you are not his PoA (and no one is) it will become a crisis when the day comes when he does need much more help. Although, at 98, a single crisis might be his last one. Not trying to be morbid or cause you to worry more, but sometimes dying in your own home is not as bad as the struggle of getting him into a facility, only to have him pass shortly thereafter -- which is a phenomenon that happens often. I'm PoA for my 105-yr old Aunt who lives 1000 miles from me. She's in her own home overseen by 2 family caregivers. She has 95% of her mind and is mobile. She wants (and I have agreed) that if she has a fall or health incident, she will not go the the ER, but right into hospice care in her home. Her 100-yr old sister with advanced dementia who lived with her fell and broke her hip and died in the rehab facility as I was researching LTC for her (because she would not be able to withstand the surgery and she wasn't being compliant with the PT). It was merciful.

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Call police for a wellness check or report him to APS as a vulnerable adult.

It is sad that your dad isn’t cooperative and that you live far away.

Wishing you and your dad all the best.

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Is dad of sound mind? Have you visited in person recently? I don’t believe you’ll find a way around the requirement.

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Ask APS to check on dad for wellness check and to assess his living conditions and mentation.
Be ready to make a trip.

If this doesn't come to a head now, it will soon enough with an ER calling you to tell you Dad is admitted. At 98, he may not even have the wherewithall to make that call to EMS, and if he doesn't do know that many of us elders (I am 81) do hope to die in our own home. We ARE at the ends of our lives.

Again, ask for wellness check.
Make the trip home.
I have no other suggestions really, other than daily calls a.m. and p.m.

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Dad won't see a doctor, which is required for admission to the facility. Has anyone else found a way around this requirement?

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