I am desperate to get my 98-yr-old dad into assisted living. He lives at home, alone, and is degrading in his ability to take care of himself. He won't allow a caregiver into his home and I, the only child, live 1,000 miles away. He refuses to go to the doctor as is required for admission to the facility. Has anyone else found a way around this requirement?
Central Texas - https://urgentcare2go.com/?gad_source=5&gclid=EAIaIQobChMI3cKDxt-ihgMVdDbUAR2U7gEoEAAYAiAAEgIXRPD_BwE
Phoenix - https://www.avcmed.com/service/house-calls
Who knows - https://www.redeemerhealth.org/Housecalls
Florida - https://www.housecallspecialist.com/
However, they were at least able to do their assessment.
Your next issue will be getting him to do what is needed to get him admitted, which might include a TB test.
Plan on being there personally through all of this. You will not be able to manage him remotely during this time.
Or he dies at home when he falls or has a stroke. He may have decided that’s what he wants.
I have watched close friends go through the process of dealing with parents who are in their 90s. They tend to be a pretty stubborn bunch.
As many of the replies make clear, there is no way around the requirements of the system. You will need to work around your Dad and a number of suggestions have been offered.
I would like to make one additional recommendation: devices and apps.
I have not researched all of the devices and apps. However, they have been very helpful to my friends who are dealing with the iron wills of people in that generation.
I know that my friends use apps to
check compliance with medication
make sure the doors are locked
check the temperature (of the house and the person)
check other vital signs (fall signals are very popular).
order food
do live visual check ins
My friends use these devices even when their loved one has home a home health aid - One of my grandchildren offered to buy me a "granny cam" because I once bought him a "nanny cam."
If you Dad will allow, let technology help you.
Otherwise if he lands in the hospital the social worker there can facilitate placement at a facility.
Do know that elderly die at home everyday . Sometimes it’s just how it is.
And, I'd suggest doing the research first and once you come up with a solution, be firm with your dad and don't ask him - but let him know when someone will be coming to his house to take care of this for him. Let him know that he's really fortunate that it'll be an easy process for him!
They need the doctor to evaluate your dad so they know exactly what level of care your dad needs. To try to skip this step can put your dad at risk if they are not equipped to care for his level of needs, and you don't want them to evict your dad when they realize he is beyond their ability to care for him—finding a decent AL facility is hard enough! It also puts the facility at risk of being fined or losing their licensing.
If you can't arrange to travel to your dad's to have a doctor do an evaluation at his home, I would take the advice of others, and have a wellness check done. They will evaluate him, and then you could use that for the AL facility.
Who is POA? Someone needs to manage all this, because what will happen "the day of" when he refuses to budge.
With this behavior in a 98 year old I am worried that ALF may not be a good fit, and that you may be looking at Memory Care.
Whomever is next of kin and POA is going to need to take charge here and let dad know that some of these things are no longer choices, for his own sake and safety.
If he is not suffering dementia, and is still on his feet, however, and push comes to shove, you may be unable to move him. This would lead to death in his own home in all likelihood, but that may be his wish at 98 in any case.
You could ask such a place whether they would admit him contingent on the assisted living's doctor being the admitting doctor. I'm not sure if this would work coming from home though. THere are some medical factors that can exclude someone from assisted living
The other way is that if/ when he is hospitalized, then the discharging doctor could maybe speak with assisted living based doctor and coordinate.
as others have mentioned, calling APS may be the best step
If you live so far away, how do you know he is "degrading in his ability to take care of himself"... have you visited him recently? If not, maybe a brief long-weekend to visit him might clarify what his needs are.
If you are not his PoA (and no one is) it will become a crisis when the day comes when he does need much more help. Although, at 98, a single crisis might be his last one. Not trying to be morbid or cause you to worry more, but sometimes dying in your own home is not as bad as the struggle of getting him into a facility, only to have him pass shortly thereafter -- which is a phenomenon that happens often.
I'm PoA for my 105-yr old Aunt who lives 1000 miles from me. She's in her own home overseen by 2 family caregivers. She has 95% of her mind and is mobile. She wants (and I have agreed) that if she has a fall or health incident, she will not go the the ER, but right into hospice care in her home. Her 100-yr old sister with advanced dementia who lived with her fell and broke her hip and died in the rehab facility as I was researching LTC for her (because she would not be able to withstand the surgery and she wasn't being compliant with the PT). It was merciful.
It is sad that your dad isn’t cooperative and that you live far away.
Wishing you and your dad all the best.
Be ready to make a trip.
If this doesn't come to a head now, it will soon enough with an ER calling you to tell you Dad is admitted. At 98, he may not even have the wherewithall to make that call to EMS, and if he doesn't do know that many of us elders (I am 81) do hope to die in our own home. We ARE at the ends of our lives.
Again, ask for wellness check.
Make the trip home.
I have no other suggestions really, other than daily calls a.m. and p.m.