He has been kicked out of two bar/restaurant because he smell so bad. He drives, and still independent, with dementia becoming increasingly more pronounced. We want to get him into a nursing home, he’s reluctant, and we need to sell his house to help sustain the costs. Can’t sell the house with him there, as we need a professional company to thoroughly clean and sanitize. He lives in California, we live in Minnesota. Have tried working with his doctors, social workers, who are not making recommendations for senior living? He had a needed surgery cancelled because he couldn’t be in his home for aftercare, doctors were concerned about infection? Needless to say, we’re looking for suggestions:1. How to get him into a nursing home with limited income? Yes, he has Medicare 2. recommendations on quick sale of this house, with no out of pocket expenses?
Let him become a ward of the state .
This is a monumental task for a number of reasons . I honestly believe it’s best handled by the state.
You have no power to place him , he’s uncooperative . You have no easy way to sell his home to pay for his care either .
I would guess that the only thing you can do is to report him to APS.
The sad truth is that if he is competent, this being now a diagnosed mental condition, he will be allowed to stay and to die in his hoard. This is perhaps something that he would prefer to living a few more years in in-facility care?
You can consider reporting the squalor to the city. I wouldn't know what department you would contact, but calling the local council on aging in the area might get you the number.
This is so very sad, isn't it. I see you care. But there is quite honestly nothing I can imagine you can do to change this. Not everything can be fixed.
The follow up investigation should help.
If someone in the family has POA that person can begin the process of placing him and making arrangements to clean and sell the house.
If no one is POA you have 2 options.
With the APS investigation they will realize that a Guardian is needed. The Court can appoint a Guardian or a family member could be appointed.
(Ideally if he had had the surgery he could have gone to rehab then it might have been easier to "morph" that into Skilled Nursing or Long Term Care.
Does he have Medicaid? If not begin the process of getting him on Medicaid.
Is he a Veteran? If so contact the local Veterans Assistance Commission or his States Department of Veterans Affairs. You could also contact the VA and ask to talk to a Patient Advocate or a Social Worker.
All this to say that you won't be able to get much done from that distance. You or a family member will need to go spend at least 1 or 2 weeks there to help him. In the end, if no one is his PoA, then this situation won't be manageable because no one has legal authority to make him pay for his care, access his bank account, etc. You will need to report him to APS and keep reporting him.
Medicare doesn't pay for custodial care (no IL, AL or MC) -- only LTC -- which means he needs daily medical care, not just custodial care. And, he has to both financially and medically qualify. If he does, then Medicaid pays for his medical needs and his SS pays for his custodial care (room and board).
If he has no PoA and is not legally competent or willing to assign someone, then APS will put him on a track to get a court-assigned legal guardian who will then get him into a facility and sell his house. Family will no longer have any access to anything of his (not his assets, house, car, etc). But this is still a solution for him and peace of mind for your family, if you accept it as such.
"...recommendations on quick sale of this house, with no out of pocket expenses?"
No such a thing exists. No one will buy a hoarder's house "as is" or work to sell it for free. You should check to see if he owes back property taxes on it. It may be on its way to being a condemned property by the city. Does he own it outright? Or is there still a mortgage on it?
Please just call APS.
Hate to tell you, something else happened there with the surgery cancellation. He would have been placed in a SubAcute rehab facility, there was no need for him to return home for aftercare. His doctors must feel that he is of sound enough mind to legally refuse SubAcute admission, and he did.
His income would pay for a portion of his "rent" in an AL, Medicare, and after spend down, Medicaid will pay for his Healthcare services. If his doctors aren't recommending a nursing home, it's because he wouldn't be accepted in a nursing home until his level of care reaches that point. Basically, he has not to be able to ambulate on his own, toilet, bathe/shower, or feed himself. Not being willing to do these things is not the same as "can't." and these are what is required, in some combination of one or more, before acceptance to a Nursing home. Insurance won't pay for it, otherwise. I agree with Daughterof1930. Get Adult Protective Services involved. Unfortunately, you won't be able to sell the house without some out of pocket expense. No one will buy it unless you sell it at an incredibly reduced, below actual value price. If ADP services gets involved, it's possible that the city/town might just knock the building down since hoarder homes tend to be in very poor condition, structurally. The weight of the hoard is often too much and makes the structure unsalvageable. You will have to accept that YOU are not going to get any money out of this, and HE is unlikely to get any either.
It really sucks when that person with dementia is really very good at "show timing" for their doctors(hiding their dementia severity), and have done very little, if anything, to secure their finances to pay for their final years, and is VERY stubborn and Proud as it is, then add the inability to recognize that they even have a problem that comes with dementia. If he's still driving, you REALLY need to get on the phone with Adult Protective Services, before he kills someone. We got very lucky that my mom didn't kill the other driver. But, without POA, Or even a diagnosis, we couldn't take her keys away.
The "out of pocket expense" does not come from the OP's pocket. The father would be the one paying those expenses.