They do not have cancer or a disease where a doctor is saying they only have six months to live. My father has Alzeimer's and my mother has vascular dementia. They have help during the day but not over night. Hospice has been hinting that they should have overnight care but my parents can’t afford it.
My question is, can hospice force them into a nursing home? They do not wish to move to one and want to age in place.
Hospice can call APS .
If your parents can not afford in home caregivers they will need to be placed in a facility . Your parents are no longer capable of determining where they can live safely .
Whoever has POA should start looking for a facility .
Hospice and EMT workers can report your parents to APS. Are you their POA? Think about what is best for them in the future.
Dementia affects everyone differently. Just because they seem fine now doesn’t mean they will continue to be able to function well.
Get a head start on looking at facilities. You’ll have more peace of mind if you are prepared for the next step.
And the fact that both your parents brains are broken and are left alone overnight is beyond scary to me.
Vascular dementia is the most aggressive of all the dementias with a life expectancy of just 5 years, whereas Alzheimer's can go on for 20+ years, so your mother will more than likely die before your father. However they both now require 24/7 care and if that means placing them in the appropriate facility where they will be safe and looked after around the clock, then that is what should be done.
No one wants to leave their home and move into a nursing facility, and everyone would like to "age in place," however that is not always what is best for those involved. It's now about making sure that your parents are kept safe around the clock and not just during the day. Have you thought about staying with them every night, and being their nighttime caregiver? That would solve the issue now wouldn't it?
And if you can't for some reason and if money is an issue with having your parents placed, you can apply for Medicaid for your them before they get placed in a facility.
Someone now has to step up and make some tough decisions for your parents as they can no longer do that.
Bottom line it has to come down to what is best for all involved.
I am sure one of the papers that was in the Admission pack was a Caregiver Agreement and I think that would be spelled out as to the policy.
Honestly I am in agreement with Hospice.
I do not think a person or in this case 2 people with dementia should be living alone.
Would Hospice be satisfied with cameras placed to monitor them?
You do know that them remaining alone, in their home is not a realistic goal. They both will need more and more help. They both will / are at risk of wandering off at any time. there is the risk of one or the other turning on the stove and walking away, or leaving a towel on a burner, turning on water and forgetting it, fiddling with the thermostat, trying to "fix" the furnace ...I could go on and on. The reality is at some point they are going to need full time help. And unless their house is adaptable getting around with equipment that is needed will be difficult. Wheelchairs, Sit to Stand, Hoyer Lift....oh, wait none of that can be used unless they have caregivers.
You need to look ahead. What they want is not possible.
What I do NOT understand here is that you say these two have hospice care when they do not fulfill the governmental REQUIRED diagnosis and prognosis. I understand that Hospice, a massive money maker now and a darling of all the Hedge Funds, DOES fudge needs a bit, but this seems out of the sphere.
You say they want to "age in place". What they WANT at this point isn't what will HAPPEN if you involve agencies such as Hospice in their care. Agencies such as Hospice are mandated reporters and when the judge a situation as unsafe that is that. Were they not on the scene the family would have some control. But family needs also to understand the risks they are taking in allowing fragile unsafe elders to make this decision.