I don't understand why we were told 89 y/o dad doesn't qualify for respite care...Somebody pls explain...

[msh789]

Dad is 89 years old and is rated 110% disabled. At his most recent VA visit with the nurse practitioner (he goes every 4 months, and I go with him to all his appt's),  the nurse practitioner suggested respite care,  in particular bc the VA suspended the adult day health care program due to the coronavirus. So somebody from the VA respite care called us. Now, I am my dad's 24/7 caregiver, I have been his 24/7 caregiver for over 10 years now. I get no help at all, 2 brothers refuse to help (claiming they can't, and no, it is not debatable with them, they refuse to help). I get groceries for dad, pick up his prescriptions, laundry, cook for him, clean for him, I even help him shave. I help him into and out of bed, and sometimes getting out of his chair (he has a mechanical chair that will help lift him, but he refuses, and if I try to do it, he gets very combative, to say the least...). Anyway, when this person from respite called, wouldn't you know she called on the time I was out getting groceries. I was gone barely half an hour (because dad has anxiety and borderline panic attack when left alone for an hour or so). She called and talked to dad, who told her I was simply "out"...making it sound almost like I was out partying or something...ugh...He asked her what the call was about (because he is paranoid and always been very nosy, to say the least..sorry, but I am so burned out..), and she told him it was about respite, having someone come to his house to help take care of him...OMG, I knew if he found out, her would say he doesn't need help....She still called me back about an hour later when I was home. She proceeded to tell me that dad doesn't want help, so basically too bad. She also said he doesn't need help with the ADL (like bathing, brushing his teeth and toileting...she picked all things he does pretty much on his own...) so she said he does not qualify for respite. The man cannot be by himself.  He breaks things, and him falling is a worry. Plus the panic attacks/anxiety. I really don't understand why she says he doesn't qualify. I would think him going to the adult day health care is also evident that he  can't be alone. Plus his nurse practitioner who sees him every 4 months recommended it. I have read on the va.gov site that it is also for caregivers who experience burden, and I am beyond burned out.  I guess she also said bc he refuses help, they won't come to his house. But isn't this to help the 24/7 burned out caregiver..? So then she suggested placing him in a CLC...really..?!?! I mean, she says he doesn't qualify for respite care, how would he be able to be placed in a CLC permanently..?!?! She told me to call the social worker about getting dad placed in a CLC, but I'm not sure he is 'that bad' yet...I was thinking/hoping we could get him respite care...Perhaps the respite care lady misunderstood...? Perhaps I misunderstood..??? Oh and his nurse practitioner also got him signed up to use the Wellness Center last week, so the respite care lady said 'looking at his chart, he is signed up to use the gym...'...suggesting him going to the VA gym would give me respite, but dad wants me there with him, waiting, the entire time (like everything else!!), so how is that me getting respite...?? But I feel like she must think 'if he can use a gym, he doesn't need respite'...I am so confused...Is there any way to have someone else look into this...?  Any suggestions..? The stress level is terrible...He is very combative and draining...I literally can't get away bc I worry about him falling or hurting himself (breaking things, I want to get plastic cups, but he borderline violently refuses, saying he wants to use regular glasses....insisting he can do certain things, and then he has already fallen a couple times bc he is so terribly stubborn and again borderline violently refuses refuses help...it is very sad and frustrating, to say the least...)

 

 

 

Edited March 13, 2020 by msh789

[broncovet]

I would recommend you "take charge" of your dad's care.  Call your brother, and explain that you can no longer care for your father "unless" he gives YOU the POA.  Tell him an "absentee" POA just does not work.  Tell him he is "welcome" to care for your Dad, all or some of the time, but you can not care for him if you can not make decisions in his behalf.  You have to set a boundary..and stick to it.  

Dont allow others to tell you "from afar" how to manage his care, if they have not seen your father in 3 months.  Tell your father your brother can not/will not take care of you and he has to sign a POA for YOU..medical care and medical care managent is not a "work from home" job.  You have to go where the sick people are if you want to treat or manage their treatment.  

The examples you posted are great examples of why you have to be the POA.  Dont insult your brother.  Tell your Dad and brother you will "make sure" you have your brother handle "the legal" issues, since he is a lawyer, but YOU are the caregiver and must have the decision making ability to decide his care "in real time", that is, unless your brother wants to go to your house on a moments notice and do it himself.   (Your brother probably wont want to do that.  But..offer it.  Im sure he wants to be interrupted 3 times a day to make health care decisions for your dad (not), and drive to your Dad and make them.  

My wife is a retired nurse.  She "takes charge", and she must have the power to do so.  The patient either "accepts" the care given, or they can go elsewhere.  Health care isnt mandantory and we have choices, but, since the nurse is responsible (legally) she takes charge.  She tells the patients when to get up, when to go to bed, when to eat, when to take medicines, and what to eat, under the directions of the doctor.  

Explain to your Dad that a nursing home (the alternative) is much worse.  Tell him you can not do this any longer unless you have POA, and he will have to go to a nursing home.  Ask him if he wants to go to a nursing home.  (I dont know anyone who "wants" to go to a nursing home.)  The nursing home will take away his home, his possessions, his monthly income, his loved ones, his favorite foods, his pets, ...the list goes on.  

Tell him you dont want to do that, but it cant continue THIS way.  

I worked in a nursing home.  (nurses aid, years and years ago).  They explained that a nursing home resident loses their home, their family, their health, their money, their freedom, their possessions...all at once.  EVERYTHING they treasure is gone.  Even their privacy, for example.  Many different people probably have to change the diapers of residents, so privacy is pretty much out the window, along with everything else.    Its no wonder that most people die in nursing homes.  

     When I was a caretaker for my Dad, it got so I could no longer do it.  I had to put him in a nursing home.  He hated it.  He lasted less than a month.  

    Trust me, there are not many things worse than a nursing home.  Dont get me wrong.  There are many, many great people working at nursing homes, and many are excellent.  However, those are generally reserved for rich people, not people on VA disability or medicare.  In "public care facilities" who treat medicare or VA patients, there are way too many patients and way too few helpers.  Its all about money.  

Edited March 13, 2020 by broncovet

[msh789]

Wow, so much wonderful info..I did mention to dad to have me changed to the medical POA, and he refuses. I will go to the VAMC and ask to speak to the Care Management. He seems to think POA brother coming up to visit once a week is "good enough" and brother doesn't want to give it up. So I am really stuck. Dad is not considered mentally incompetent, so there isn't much to do there, either. But I agree, best to go see them in person. I am so annoyed that the respite care lady who called told dad why she was calling. He has been all the more unbearable since. He's always been very paranoid, his little wheels in his head always going, and me always being the "problem"...Sometimes I get so frustrated that I tell him he has 2 sons (both who have partners/wives who are nurses, no less...) who can take care of him, and that sets him off big time, raging...

[broncovet]

Well, I would tell your Dad that you are going to drop him off at your brothers..since he has POA, he will know "whats best for you".  Then put him in the car drive to your brothers and tell your brother:

"I cant make decisions any more for Dad, because I dont have the authority to do so.  (POA).   Im gonna leave him here until you have him sign POA over to me.  Catch ya later"  Then leave.  

Sometimes people push you around for ONE BIG REASON:  Because you let them.  Dont let them.  

You dont have to quarrel with them..no.  But you are not required to comply with your brothers wishes, AND, its not wise for you to do stuff for your dad when it does not make sense.  

My father had periods where he thought clearly and other times when it was "not so much".  You have to deal with all the time.  

You dont have to take my advice either.  But just remember, people often take advantage of people "when they can" and you let them.  Set boundaries.  Tell em both.  

DAD..I know you dont want to go to a nursing home.  To be able to take care of you, I have to have your POA.  I love you but that is the way it is.  

    I cant keep on like this.  

    People tend to do what they can get away with.  Dont let them get away with this.  You have more to say about this than you think.  Sometimes silence speaks louder than words.  

 

[GBArmy]

msh789 There is enough here to be close to whatever the accurate story is. Broncovet has put it right on the line for you. You are saying in words and actions that you CAN'T do this anymore. So Don't. Call your brother and say you and dad are going over your brothers house (pick a time.) Get there, and basically say it's is over unless things change big time. You put in the time and effort, etc., etc. No POA, all done. No argument. No negotiations, Just leave. If you don't, you're going to have a breakdown. It's called "responsibility without authority." Doesn't work. Pick up the phone and call. Today.

[msh789]

I agree, and I have actually thought about all of this...but Dad won't even get in the car...He says it is in his will that he can live where he wants until he dies (which methinks that is a reason brother has been him hawing about producing a copy of the will) and I have told brother that Dad is HIS responsibility, and brother doesn't say a word. I do feel on the verge of a nervous breakdown.  As Berta said, even doing simple tasks away from the person, you worry what they might get into. It's like a toddler, but the thing is, he is still considered mentally competent, so nothing can really be forced...Supposedly it is in his 'will' that he can live in this house until he dies...I tell a lot of people my age and those with parents approaching senior citizen age...see about getting nursing home insurance or make sure have your ducks all lined up for care bc you don't want to get stuck...we love our parents but even the sweetest ones can be terribly combative as they age. My mom was always sweet as pie but when Alzheimer's set in, she also could get violent. Getting stuck in the 'caregiver trap' is beyond exhausting. People say it's the hardest job they've ever done, and I agree. And when you are there 24/7, it can be beyond madness...Love them dearly but sometimes help is very much needed. I need to find a way to force this back to my brother, bc both refuse to sign POA over and dad says it is in his will that he can live here until he dies.  

I am going to call the attorney on Monday that was in charge of dad's POA and all..He and my mom signed the house over many years ago to me and my POA brother, so I need to consult that attorney, bc I totally remember he mentioned something about 'do you want a clause (or whatever the word was he used) saying that if mom or dad get to be too much, you can kick them out..?'..I honestly don't remember what the reply was...again, they let my brother do all the talking and I am always to keep quiet. But that attorney is an elder care law attorney, so he might have some suggestions, too. And I will also go to the VAMC to speak to someone from care management. Dad has an appointment for the LST later this month, so I will try and take the nurse practitioner aside and ask her what else can be done, he refuses to be evaluated, so I will see what she can suggest. 

[Carl the Engineer]

I can relate,

Here's the deal, if your parents signed the house over, it was probably done with a living trust, letting your parents live there until they die.  However, that doesn't mean they can actually live there till they die, it means they can live there as long as they can take care of themselves.  There is no place in a living will where the children have to take care of the parent until they die.

I have 5 brothers.  I am second to the youngest.  When old people get old, they give the POA or WILL all their stuff to the oldest or male child because that is what you do.  So, my parent's POA is my oldest brother who lives over 1000 miles away.  I live next door.  I my case, my wife was my parents caregiver, before my dad died and my mom went into the nursing home.  We cooked their meals for three years.  My dad was trouble, kind of like your's, but he fell and had to be treated at a hospital and my wife and I had social services send him to the nursing home from the hospital for rehab and he did not come back home.  I do not know how we would have gotten him to go any other way.  My mom on the other hand welcomed the move, and is the leader of the band at the nursing home, not that they have a band, LOL.  

My brother is still POA, however, I have threatened to kill him if I every see him again because of the pain he has caused my wife, which he dislikes because she goes the extra mile with my mother and makes him take her to the doctor when he, the POA, thinks its not necessary. My brother, "she is getting old, she is suppose to lose her vision". 

My brother does not come to the homestead anymore.  Good riddens.

You need to put your brother straight.  I would leave, if you can, for a couple weeks and tell your brother to take care of your dad.  Don't let him off the hook. A month would be better, it sounds like you could use a much needed break.

If your parents signed off the house to you years ago, you do not need to worry about not getting half as they can not change that now, no matter what you do.  I know that too, as my parents gave their home to me and my 5 brothers probably the same way.  I made them buy me out when my brother started giving my wife a hard time.  I threatened to sell my fifth to a realtor, or whoever I could find to make their lives miserable.  They had to go out and get a mortgage to pay me.  So, you can sell your half, even with your dad still alive.  

FWIW,

Hamslice

Oh, and never share lawyers, whether divorce or when money is involved.  That's a recipe for disaster. 

 

Edited March 13, 2020 by Hamslice
cause I can