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

[msh789]

Thanks so much, everyone, for all the wonderful advice...I wish I could 'heart' each and every reply..I think it is a good idea as hamslice suggests, to consult a different elder law attorney (I know one I dealt with previously for a different matter).  As they say, knowledge is power... Thanks all, again...

[Berta]

You said:

" Forgot to mention, we need to get copies of dad's living will and POA to the VA...the respite lady basically said nothing can be done otherwise...which, really, every vet in CLC or getting respite has a living will and POA...???? "

I will try to check out that info-I have a friend who just retired from VA and worked in the CLC. Bath NY VAMC.

He might know the right person I could ask--and I can search the main VA we site-

 

I do believe the CLC must have a Health Care Proxy-( a DNR) to be admitted, and I think when my doctor ask me for a copy of mine, it was part of the annual Medicare check up---but I am a civilian.

 

"I am going to call the attorney on Monday that was in charge of dad's POA and all

 he is still considered mentally competent, so nothing can really be forced..."

That too would need a medical assessment- my husband was declared competent by the VA, but incompetent by the SSA,due to his SSDI award for PTSD. 

Before my father died, my brother tried to get the Hospital to declare him incompetent= my brother thought that would give him right to POA-of course it doesn't and my father was far from incompetent.After  dad died, he produced a phony will and threatened me if I challenged it.I said I would challenge it and the Estate was properly divided .

Death brings out the best and the worst in people- I am so glad you are seeking an attorney's help.

You mentioned that there were situations where you did not speak up- or maybe your brother's tried to talk over you  etc etc...

I REGRET all of the times I was told what I could say and what  I better not  say- to my husband's VA shrink.

We become victims of our situation.

 I had to ask my Congressman to intervene in his VA medical care 3 times,,and that is the only way I got the VA to admit him to the psyche ward at some point.I was the loving wife and caretaker but sick and tired of his  threats to kill me. A neighbor was willing to keep his weapons under lock and he was angry about that when he got of the Hospital,, but at least that threat was gone.

 

My point is that I fear your dad could become aggressive with you to the point of physical harm.

If that happens  call the Police.

On the other hand the VA is unwilling to deal with any vet who could cause harm to others.

But often vets, as VA patients, are only focused on their spouses or other family members, as their blame targets or victims they can control.

Sorry for my honesty here-Dont be offended anyone-

I am sure none of our members have  aggressiveness to that level.

The only thing that really helped  my husband ( PTSD, brain damage  dementia) was the 21 day inhouse program in Buffalo.(That was a battle . I had to get him to the real PTSD shrink*-  It changed him radically. He asked if he could go into the program for 11 more months, because his anger stemmed from his year in HELL (Vietnam) . But he died 3 weeks later.

* (his VA MH care had come from the Employee Psychologist for 7 years- because he had been a former VA employee.)

(A wonderful man- however he didnt have a clue on PTSD)His medical care was due to his VA employee status.

That was the motive I found in Title 38 for why he died.(FTCA/1151 death)

 

 

Edited March 14, 2020 by Berta

[broncovet]

I like what hamslice had to say.  He suggested:

Quote

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.

I like that idea.  Its real easy to criticize the way others do things..until you try doing yourself what you were criticizing others for.   In other words, wait until you walk a mile in your brothers shoes to criticize him.  If your brother was the caregiver for your father for a couple weeks, then you  would get a much needed break, and he would likely have an attitude change toward your dad's caregivers!  

I have been a caregiver..it takes a special person to do that.  I could not do it for as long as you did.  Not even close.  

[Berta]

MSH 789

Can you tell me what VAMC you are dealing with?

I sent an email to my CLC friend, but do not think he can answer my questions.

Do you have a phone # for their CLC- I am trying to obtain their administrative handbook-on line and cant find it at VA.gov site.

I will try the locale VA CLC as well----

I think they require a DNR and the POA, and maybe the will- but not sure.

Did you say they are not admitting PTs to the CLC due to the Coronavirus?

Maybe I got that wrong.

The VA is taking steps all private doctors are doing, to screen every new Patient for Corona.

What is his Service connected disability (ies)

edited--- I have all of the CLC numbers-I just need city and state.

 

 

 

 

Edited March 14, 2020 by Berta

[broncovet]

Berta posted:

Quote

I think they require a DNR and the POA, and maybe the will- but not sure.

I would be furious if they require a DNR.  That takes away people's LIFE.  I do understand why some people choose DNR.  But to have it forced on you?  I draw the line there.  

(The VA nursing home) is telling you:  Ok you can stay here but our goal is for you to die, so you can not be ressucicated when you stop breathing if you come here.  

[Berta]

They might require a Health Care proxy and not a DNR.

It is not unusual for seniors to have both.

I thought it was a Medicare requirement.not sure.

Also it might be a good idea to have a "File of Life" form filled out and posted on your refrigerator.

EMS, most Fire Departments and any County Office of Aging would have the form.

EMS here in NY looks for the form on the refrigerator when they get an ambulance call.

Mine contains Drs names, next of kin, the only med I take, but list them all for your father and list any known allergies.

The "File For Life" can save lives!

It can be found here:

https://www.folife.org/

I disagree with your comments. Everyone should have a Health Care Proxy and DNR.

I even have a heart on my driver's license as I am an organ donor, as my deceased husband was.So, in case of a fatal accident, or something, the EMS  knows what to do.

I called the CLC locally as to their admissions criteria - which should go for every VAMC CLC but the person I needed to speak to was not working today-

I have nothing else to offer.