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I’m back AGAIN. Lol. Anyway, dad’s hospital chart is full of negative things. Not eating, not participating with therapy, being rude to hospital staff AND cussing them etc..... We have received NUMEROUS calls from the social worker complaining about dad not cooperating! We finally get him to do some things towards the last few days of his hospital stay.


The skilled nursing facility that we picked came to get him today from the hospital to start rehab for his hip. We were happy because we thought we were finally progressing to him getting the care he needs. They get there and see his chart full of all the negative things I mentioned above. They denied him and left him there! To say me and my sibling were angry and hurt is an understatement! I just don’t understand for the life of me why he acted so childish. And when confronted, he feels as if he’s done nothing wrong. He feels everyone is being mean to him! He cooperated for 2 measly days and thinks he did something so grand! They looked at his ENTIRE chart and saw how much hell he raised!! I’m exhausted! Now the social worker says that all we can do is start over and find another facility and hope they don’t reject him as well. Has anyone been through this or have any suggestions?

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If your father has always been difficult and he sees no reason to change HIS behavior, you need to change yours.

"Sorry dad, your uncooperative attitude is bolloxing up our attempts to get you the care you need. I'm going to be stepping away and letting the chips fall where they may. I hope the hospital can find you a place."

And mean it.

I don't recall your other posts. Have you been attempting to care for him at home?

I would not care for someone who didn't show some modicum of gratitude.
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You're understandably exhausted. You and your siblings need some respite from your father. Stop going to the hospital. Stop confronting him because it's not getting you the results you want. Rather, help him by working behind the scenes with the case manager on getting him a geriatric psych consult.

Talk to your siblings. What are you all willing and not willing to do? Openly and honestly discuss his living situation post skilled nursing facility if he gets accepted into one. Come to agreement about what's best for him and then stick to the plan.

Do not let yourselves be guilted into caring for your father in his home or in your own homes. Caregiving must work for everyone involved or it does not work.
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I agree with Barb. If he has always been difficult why do you keep expecting him to be somehow different now? Definitely do not take him into your home. Do get him a full neuro/psych/cognitive work-up so you know for sure if he is in control of his behaviors or not. If he is in control, let him know that since your efforts to help him are being undermined that you'd be willing to give up control and have the county take guardianship of him . His continued stupid behavior may make them decide to put him in MC and he won't have any choice. Roll him through the MC area of his rehab and see what he thinks. But don't make a threat you aren't willing and able to carry out. And do not take him into your home. I wish you success in helping him in a productive and healthy way!
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We did go through this. Care facilities are not interested in troublesome patients. There are so many people vying for the beds- they prefer to take the easy ones.

In our case a geriatric psychiatrist was consulted and medications were prescribed to help the issue which was dementia related. Barb's advice may be hard for you to follow, but it is good advice.

Best of luck! You can't help people who don't want help.
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If you go ahead and get the assessment by the geriatric psychiatrist, THOSE NOTES will be entered into his chart, making him more reasonable for acceptance in a center that has a vacancy.

Since you know his character traits are unappealing to many, you will be helping him and those of you who are responsible for his care by addressing his “stuff” head on. He obviously WILL NOT CHANGE because you and your siblings are “angry and hurt”, so doing something different may help.

The bottom line is HELPING HIM into a place that will be safe and willing to take him on. He NEEDS BEHAVIOR MODIFICATION and medication would appear to be the best place to start.

Ask the social worker to recommend someone if a Google search doesn’t give you what you need by way of resources.

GOOD LUCK!!
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Agree with NYDaughterinlaw, stop confronting him & start working behind the scenes. Oh yes - I had to learn this!

You can avocate for his care without taking on the responsibility for his behaviour. Find out the options, link in the professional services he needs (inc that Geri psyche).

Guilt should never be in charge of the care plan.
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NYDaughterInLaw Mar 2020
I love your insight, Beatty: "Guilt should never be in charge of the care plan."
That should be on a mug.
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About a year ago my mother fell and her senior facility called 911 to have her taken to the hospital to be checked out. She has severe dementia and cannot express herself in words. She didn't understand why she was in the hospital and why they were "bothering" her all of the time, she'd pull out the oxygen tubes, she bit the nurses when they did something she didn't like. At that point I realized she just wanted to be left alone. After she went back to her senior facility I consulted with her doctor and we changed her care to hospice-type care where they would just do things to make her comfortable, and changed her medical directives to "no hospitalization". I know you are going through a difficult time, but try to understand your father's wishes. This is also not easy for him.
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What does your dad want...........
Does he want to improve his quality of life?
Does he want to go to rehab?
Can he control his anger or if not would he agree to medication that would help him with anger and anxiety?
OR
Has he given up?
Does he want to die?
If the answer to the first few questions is YES then discuss this with his doctor to begin to find medication and rehab that will accept him under those conditions.

If the answers to the last 2 questions is YES then you should support him in his decision and ask the doctor if he thinks he is eligible for Hospice and then call a few and have him evaluated.
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If he refuses to cooperate Medicare will not pay for rehab therapy--there must be documented evidence of improvement. If he's on Medicaid, send him to a nursing home. If he's not on Medicaid get him on it and place him in a nursing home. There he can vegetate and do what he wants. But if he assaults the staff they can put him on the psych floor where he will be medicated. If he continues to assault staff, they will simply kick him out too. The only other alternative is be his full-time caregiver and take care of dead weight. Taking care of someone bedridden is not easy because you will be dealing with a lot of poop and urine...and if he can't go you have to use laxatives. Trust me if you are by yourself it's NOT easy. And if you don't keep his skin clean and protected he will get bedsores very quickly which can tunnel into deep infectious wounds. Urine is very acid and it will cause wounds if his skin is not kept clean.
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I just want to make sure that this insight from Beatty doesn't get lost in the replies:
"Guilt should never be in charge of the care plan."

I think that says it all. The mantra should be on a mug given to all caregivers when they sign the POA agreeing to take responsibility for a loved one.
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grlover Mar 2020
EXCELLENT mantra!!
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