The next phase after rehab - we're both scared. What do I do now?

Is he able to pay for an AL? Or would he be best served if he went to the Long Term Care unit of the same facility he's in, assuming that they even have one? Just a thought... And yes, Medicare will want what is owed to them after the number of coverage days run out. For my late mother, that was $144/per day. So money owed mounts up quickly. That was 5 years ago so the sum may be even higher now.

Hi,

I was in the EXACT situation in September, my 82 yr old dad had been hospitalized then rehab.... there was NO way he was going back to living alone, He like your dad is not very social, hes retired military and likes his privacy as well as calling the shots, but I realized it was time to "tell" him what he needed to do ,( nicely of course)

He is also a bit confused, as well as "old school".. ,we discussed moving him in with us 1300 miles from where he lives but we were going into winter where I live and he lives in Florida , so I felt it be best for him to "winter over" there before we make any big decisions.
the solution that worked.....
I found an assisted living facility that offers "respite" stay so instead of him jumping directly into a residential agreement he could "try" it out, he agreed because It was presented as "temporary"...and it worked.
Sadly we are 3 months in and he is back in rehab after another hospitalization, but this might be an option for you & dad.
Assisted living is very costly , and personally I don't agree with a lot of their policies, some are state mandated, some are per facility. I also viewed this as temporary , and as we near spring in the north I will revisit the idea of bringing him "home" but for now the ALF option seems to be a viable one.
If you have any questions that I may be able to answer feel free to ask, by no means do I profess to be knowledgeable but I have had a bit of personal experience, perhaps I can share.
This is an unchartered part of life, it does get inundating I know.
God Bless,
Moni

You haven't mentioned money as an issue. I would appeal the discharge date, and when Medicare likely denies your appeal, appeal again. That will buy you a little more time to figure out the next step with your dad and might give him more support (and therefore progress) in rehab before discharge. It seems like you are questioning his ability to do basic daily living skills. Is the rehab suggesting 24/7 care?

I know today is the day so this may not be too helpful but I hope you saw and took the advice to use the resources at his current rehab and or put some responsibility on them to find a placement for the time being at least. I remember having exactly the same reaction and panic when we were suddenly told mom would be discharged from rehab in a few days. She was not ready and we felt like we had just gotten her settled in and had a little breathing room when they slapped us with that! I wasn't alone though and can't imagine how much harder that makes it. Anyway wherever you are on this today I will say that the fewer moves the better for him and for you though I get that isn't all in your control. I also have to say that while he may not need as much help a month from now as he does now it sounds like he has (you both) have come to that pint where he isn't going to be able to go back to being totally independent or shouldn't. Even if he could it probably isn't safe enough and you will just end up right back where you are in the midst of an "emergency" medical event. I would urge you to reconsider one of the places that offer's various stages of elder living and care actually. I know the one place seems way too big but if you think of it as a community in it's self where there are people living independently, assisted and with more skilled level care in some ways that could be a big advantage. While he might move from one section of the community to another, say more of a skilled unit now and then to AL or IL once he's ready, it's all within the same facility and the people he gets to know will still be there as his actual living area changes. That said I get the "loner" part, my mom prefers being a hermit too but when taken into the world she gets along with everyone and enjoys herself she just dreads the thought ahead of time and sticks to herself at home if we let her. Even for loners though it's healthier for us as we age to have contact with others and the "outside" world, it's been studied and proven. He will have the ability to stick to his personal living area but maybe if that's easily a little broader, the way it is in rehab now, he will take advantage of the human contact. There are of course all kinds of options in-between but I will say for many (I don't know your fathers exact medical issues) transition is hard and the ability to stay in the same place even if they are moving their personal items is much easier than big moves and having to adjust to completely new surroundings. Making friends for instance with other community members means they can visit each other when a broken hip say necessitates the move to skilled care or better yet familiarity with the AL area when they need to move there from IL because they have been visiting friends there.

There is nothing easy about this and while you feel alone and will end up ultimately with many decisions you don't have to do it alone. Talk things out with people in your life you trust, if there aren't others around who care about your dad specifically turn to the people who care a bout you and let them help. Include your dad, talk things over with him get a feel for his wishes which will also help him come to the same difficult (or not) conclusions/decisions you do making it all easier on both of you. Use his doctor's (the ones he has had long term like his Primary), his care providers now, the social workers and coordinators there as well as any other organizations in the area for seniors as resources and ways to gather options and info and use this site for support. See if you can find the resources in your area for seniors and their caregivers, a geriatric specialist to help you navigate all of this, you don't have to do this by yourself.

There is always a Social Worker at these Hospitals and Places of this Nature who can Best Assist you and wil Sit sdown with you and Come up with a Game plan. They cannot By law discharge him, This would be Endangering the Welfare of a vulnerable Elderly Person, and if Today is the Day, Go In right now and Speak your Mind. He can Go back into the Hospital until Someone is Best to help him Find a Skilled Nursing facility.

First thing I would do is get him on the list for the new facility
You can do a tour when you can.
If he can afford to stay where he is that would be great. Otherwise the one you like best of the ones that are available would be the best option.
When the new facility opens determine how well your Dad has adjusted, ask him if he would like to move to the newer location. Take him for a tour as well.

As for another option....
You could take him to your home but there are a lot of problems with that. Is your house safe for him? Can you be there with him or will you have to hire caregivers to be there when you can not?

Depending on his situation if he is not on Medicaid you should begin the application process now. It is possible that one of the Social Workers at the rehab facility he is in now can help.

And one final thought
Is your Dad a Veteran? If so contact the VA. Depending on where and when he served and his other medical conditions you or rather he could get a little help from the VA or a LOT of help from the VA. So please check into that.

Dear Annabox: The answer from againx100 below is spot on. Hubby and I have been primary caregiver and POA for his mother for the past 7 years. The move to Assisted Living became an emergency as did her move to a nursing home last year after Assisted Living sent her to hospital and refused to allow her return due to her changed state and needs.

It sure does create panic and anxiety. Good luck today. Be sure to pace yourself for a marathon. Nurture yourself. Get rest. Get exercise. Trust yourself. And reread againx100 over--what she/he said is absolutely true.

You'll be amazed how things work out.

The place where my mom rehabbed was old and dated and cramped but the STAFF was amazing.
In your situation I’d choose the place closest to you, ask if you could have lunch there yourself before you decide, and pick up as much of the vibe as possible.
A second relative is now in AL in the same complex, and we are equally pleased with the MC unit there.
In our experience, a positive relationship with the care staff means everything. Good luck, and see for yourself what you think when you visit!

Annabox, only child here, too.... my Dad moved to Independent Living at 94 as he realized he no longer wanted to live in his house, and didn't want the responsibilities of being a home owner at his age. Smart move on his part.

My Dad sold the house and used the equity to finance his stay in a senior community. He really liked the place, especially the food. Plus he received physical therapy on a regular basis. He wasn't much on joining people, was happy as a clam sitting in his recliner reading. He felt he had MORE freedom than living in his house.

When you tour senior living facilities, ask for an appointment around lunch time and if you could stay for lunch. My Dad was with me on the first place we toured and he said the food was excellent. He liked everything about the place. he wanted to sign up immediately. Whew.

Try to find a facility that also has Memory Care, just in case your Dad starts on that journey. That happened with my Dad, and Dad would only move to Memory Care if the chef was the same person. And the chef was, so Dad happily moved to his "college dorm" size studio apartment.

I agree not to do respite since it sounds like this will be an ongoing situation. Unless they're expecting him to make a full recovery?

It's tough to make these big decisions, but the time has clearly come for you to become that decision maker. So, take a deep breath, you CAN do this. It may not be easy but it's got to be done. Make the best decision you can, given the info you currently have, and don't beat yourself up about it. Others may second guess your decision, but try to stand firm and know that you're trying to do your best for your dad. There are no perfect solutions.

I would look at places that offer more than respite care. You can always choose to leave but if you have only respite care, you are insuring that your dad will have to move again- like it or not. It's hard on them to move frequently. It does sound like your dad is open to living in a facility (Why can't I just stay here?). The AL next to the rehab sounds like the easiest option. But it depends on your dad's needs.

We moved our bachelor, loner uncle into an assisted living facility (after two strokes) and he really liked it. He had his own room, aides came daily to dress and undress him, and bi weekly to help with showers. He had meals available to him regularly and even though he didn't really need or want it, there were other people to speak to and activities. But how much he interacted with people or ate was up to him. It suited him fine.