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My husband has been in MC since 03/01/2022. Everything was going well until 2 days before Thanksgiving when the director said they can no longer take care of him and needs to be relocated somewhere else NOW! She said that it is taking 3 staff members to handle him because he is resisting. He is not combative or verbally abusive, quite the opposite. They say this has just become an issue over the last month or so. They come in to shower him three times a week and it is just one person who handles him. So, I am getting mixed messages. I feel that his resistance is pain related and have requested pain management from hospice. As of now, MC has agreed to have hospice come in daily to relieve their staff and to give me time to find another facility and to obtain additional funds from my IRA to cover the cost of a long-term “rehab facility” (their words). Suffice to say this was a gut punch. Is any MC facility allowed to basically kick someone out without prior notice or at least a thirty-day notice to prepare for a new facility and/or financial planning? Their demeanor was heartless.

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It's an unfortunate and painful issue for you, but his behavior may be endangering other residents or taking too many caregivers away from the other residents and thus endangering them. They have to look out for the greater good when there are many vulnerable people involved.

There was a resident at my mother's place who started walking around punching walls. He'd been fine and dandy until then, but all of a sudden he was in danger of putting his fist through a window or through another resident. He was big and very strong and the caregivers were all fairly petite women, so yeah, he was gone the next day.

Unless you know the reason behind his behavior is pain-related, I don't think you can expect the facility to put their employees and the residents in danger. This isn't a rental like an apartment, so a 30-day notice isn't a thing.
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Kaycoocam1972 Nov 2022
Thank you for your input. Other than resisting standing up…..he is quite docile. In fact the staff have always mentioned how sweet he is.
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I would get the Hospice Nurse and the ED of the MC facility on the phone TOGETHER and ask what exactly is going on and if he needs to be checked for a UTI or his psych and or pain meds adjusted. What are they asking him to do that he is resisting?

One of the good things about Hospice is that they are an extra set of eyes and ears. Use them, and good luck!
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Kaycoocam1972 Nov 2022
Usually just to stand him up to get him into shower or commode. That is the only thing he resists. He is not a heavy man (6’ & 180 lbs) but he is as strong as an ox! The resistance is pretty much prying his fingers from the arm of his wheelchair. He is starting to lean to the right lately and they treated him for UTI. Other than his advanced dementia, he is otherwise very healthy.
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Long term rehab?

Ask them what they mean by that. Are they saying he needs a skilled nursing facility? For what medical issue?
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If he is on Hospice if he goes to rehab Hospice will be discontinued.
Tall to the Hospice nurse and possibly the social worker. It is possible that medication adjustment might help. If necessary a stay in the Hospice In Patient unit for symptom and medication management might help. If that does not work it is possible that the Hospice social worker can locate a Skilled Nursing facility that will be able to manage him.
BUT the Memory Care facility has to give you time to locate another facility and arrange transfer. The facility social worker should be able to help and they should also be aware of the legality asking a resident to relocate.
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Kaycoo, make sure someone checks for broken bones. My mom was "resisting" PT. Fortunately the PT ordered a mobile xray.

Mom had a broken hip.
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If he has been on hospice how can a rehab facility be suggested? That sort of facility implies improvement which is not the case with hospice. That would be my first question.
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RedVanAnnie Dec 2022
Exactly what I was going to say. Something seems "off" about the facility's suggesting "rehab."
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Once a resident is on hospice, they should be kept until death. This facility is wrong to give you no notice and to further suggest "rehab" while he's on hospice which is ludicrous. I'd be livid and demanding a sit down with the ED STAT.

You mention dad is leaning to the right......he may have had a stroke and that's what's causing the leaning which my father was doing too. Their balance is thrown off, and he might be having an issue knowing where he is in space, which causes a feeling of vertigo and that is scary. That may be why he's resistant to standing up and unable to express himself and his fears due to advanced dementia.

Talk to hospice about this leaning matter and what I mentioned. And this memory care is shirking their DUTY to you and dad by trying to kick him out now that he's having more issues,which is their job to help him with! Get hospice on board with you and see if they think calming meds would help dad relax or if he should be seen in the ER.

I'm sorry you're dealing with such a thing and I hope you can reach an agreement with the memory care admin about keeping dad.
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Read the original contract about your husband's care arrangement. I don't think he can be asked to leave on such short notice unless his condition is dangerous to the staff.

Those IRA funds are Your Money, not your husband's. Please use what his funds have available for his care.
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Read your contract for the facility he is in.

Confer with the hospice team; that is attend either by phone or in person the next scheduled interdisciplinary meeting that hospice has when your husband's case will be reviewed; these are held either weekly or every 2 weeks. You can of course speak with the case manager for his hospice care or call the Director of the Hospice for assistance prior to the interdisciplinary meeting. ( the advantage of attending the meeting is that the Hospice medical director and all disciplines involved in his care are present.

Now, the facility that he is in sounds like they may seriously need continuing education on how to cope with and best care for a patient such as your husband.

Changing the place of care may or may not address your husband's care needs. Speak with the administration at the facility and have hospice team present.
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He can’t do hospice and rehabilitation. A sit down is in order. My moms hospice nurse was a great advocate for my mom. When she was found soaked by hospice CNA , the RN intervened with the director…talk with the RN for her thoughts , recommendations
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When they give you written notice, there should also be a form telling you have right to appeal their decision. Send that notice by certified mail to Medicare immediately.

Evidently, the MC does not provide the level of care your husband needs. You can contact Ombudsman's office to ask them if this is true. (Read your contract as well. There should be information that describes the level of care they provide or what happens should his needs increase after initial admit)
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No facility can kick a resident out. By law they have to give both written and verbal 30 day notice to the resident and one family member. They can not kick a resident out just because they want to or do not have enough staff. You need to call your Ombudsman. If you do not know the number ask the MC director or DON, director of nursing, or the a facility administrator. If you are not comfortable asking the staff for the information they are required to post the Ombudsman information via poster in the facility. Look for the poster and it will have the 800# on it. This information should have also been provided to you in your move-in paperwork. You can also look on line for your state Health and Senior Services as they will be able to help you too. Moving a loved one into a facility does not mean you give up your rights!
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Kaycoocam1972: Imho, since your father is on hospice, the facility was in error in saying that he can't stay there. Speak to the executive director.
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