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Are social workers on staff at care facilities or part of a physicians staff? I'd love help in working through the challenges and emotions of moving my soon to be 95 year old Dad with increasing dementia out of his home of 50 years. We will need help in managing the conflicting emotions I feel and those of my siblings. How do we communicate to him what is happening or do we? There has to be tried and true methods for managing this enormous change for him and not lose our sense of balance as a family in the process.

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In general, best advice is to contact your own MD and say that you need therapeutic help working through these problems and would like to see a therapist, preferably a Social Worker therapist specially trained in life transitions.
Many of the insurance companies that cover therapy (including my own Kaiser) often now decide, based upon what therapy help you need, whether you should see a Social Worker therapist or an actual psychologist. Both can work with a psychiatrist if medications such as mild anti-depressants, anti-anxiety med are required. You can otherwise just look up therapist online. It will say if it is LCSW (Licensed Clinical Social Worker). Some have their own practice; many work within the medical system.
So start at your own MD and good luck.
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Social workers are not part of the physician's staff. They are part of the hospital or care facility staff. They are not available to help you or your family deal with the emotional distress moving your father into a care facility. That you will have to pursue outside help with a therapist for.
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drooney Jul 2021
Look for your local AOA (area agency on aging) . Your senior center should have contact information.
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If you're in the US try your local Area Agency on Aging. They have really variable services from state to state, but all of them should have some sort of services for the older adult and the family caregivers. That might be a social worker, case management, benefits coordinator, elder care clinician, or caregiver support specialist of some kind. Like someone else mentioned above they may be more or less overworked and overwhelmed, but you can always ask them to refer you to an outside source of help as well (private therapist, gerontologist, etc...). Type your Dad's zip code into the Administration for Community Living's finder: eldercare dot acl dot gov
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If your dad has a PCP that you like/trust, call the office and ask if they have a care manager on staff. If so, speak with him/her and go from there. They can usually at least steer you in the direction of the resources/people you might need.

My mom's PCP had a care manager who reached out to me when she got really ill - I had no idea there was one on staff- and she was a big help in giving me names and phone numbers of resources.

If your dad's doctor doesn't have a CM on staff, the next people I would reach out to would be the Area's County on Aging for some names.

Good luck.
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Social workers are part of the hospitals staff. Normally the doctor will send a referral to the social work department of the hospital he/she is affiliated with. ask your dad's physician or neurologist to refer a social worker. The social worker will follow through with you.
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The social worker I relied on most was through Catholic Charities Senior Services. They weren't religious, and they were connected to the local government branches of APS/Senior Services. I'm not sure they have locations in Idaho, I don't think so, but if you contacted your local Senior Services, I believe they could point you to someone, if not have social workers on staff available to the public.
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Some have suggested that we can ONLY get a Social Worker therapist through doctors, and that is likely the easiest way to get a recommend, but they do have their own offices in many case, just like a psychologist. They are listed as LCSW, clinical social worker, and would be available to find locations and numbers for in your local phone books or search engines on computer. They work with family therapy, life transitions therapy, and etc.
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We moved my mom into Assisted Living and also signed her up for Hospice care with a local care company. Anyone with Alzheimer’s qualifies for hospice care, even for years. It is paid for by Medicare and includes a social worker as well as lots of other benefits. They are a godsend, providing all supplies (disposables, medical equipment, Ensure drinks, etc.). A nurse checks on her 2-3 times weekly, takes blood & urine samples when needed, works with Mom’s doctor quickly and efficiently. The social worker helps me understand Alzheimer’s, provides me with support, and brings me peace of mind. It’s an awesome resource I highly recommend.
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disgustedtoo Jul 2021
"Anyone with Alzheimer’s qualifies for hospice care..."

I wouldn't make such a blanket statement. My mother had dementia and was into year 4 at a MC facility. We had not requested hospice as it wasn't necessary and likely wouldn't be approved. When she had a stroke around Labor Day last year, the MC nurse called hospice. She expected delay, due to the holiday. Nope, someone showed up Sunday evening, with the regular nursing staff off duty. She looked at mom's "records", which were out of date due to the virus and the big reason I was quoted after denial of service was she "hadn't lost weight in the previous 6 months." Seriously. She JUST had the stroke. Not only that, but this person didn't even make note of the fact that her records were over 1.5 years old!

The MC nurse made them come back. The initial denial was based on the old records. The second came because of no weight loss. AAAARGH! The stroke impacted mom's right/dominant side, so she had trouble feeding herself, couldn't assist with pivoting out of her wheelchair and had difficulty swallowing and speaking. THAT still wasn't enough for them. The MC nurse scheduled a TeleHealth with the doctor (we hadn't done that for her missed regular checkups due to dementia, hearing loss and generally confusion about "technical" stuff like that. I didn't even set her up with a TV or phone in her room, as she couldn't really manage them.

So, once the nurse could prove weight loss, they accepted mom into hospice. Dementia certainly was NOT enough. If that were the case, every resident in MC would be on it. Perhaps once they are farther into the progression or depending on the type of dementia, it might help, but all the online hits show something like this:

"To qualify for hospice care, a hospice doctor and your doctor (if you have one) must certify that you're terminally ill, meaning you have a life expectancy of 6 months or less. When you agree to hospice care, you're agreeing to comfort care (palliative care) instead of care to cure your illness."
Source: Medicare.gov

Despite this, yes, there are many who live longer than 6 months, some actually live for years, but as long as doctor approves and certain criteria are met, a person may remain on hospice longer than 6 months. The point is dementia alone is NOT going to be sufficient to get on hospice (if that were true, my mother would have been on hospice for about 7 years!)
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If your Dad is in a hospital you would have immediate access to a social worker there to help you plan a safe discharge but they generally will not be available to help you work through the family's response to his health situation. I recommend you Google "geriatric case management" in your area. You can also try your local Office on Aging for a referral. In NJ we have access to excellent services from Jewish Family Services and Catholic Charities (you don't have to be Jewish or Catholic to use them). Also be advised that while social work services secured when your Dad is in a hospital or a memory related facility will probably fall under the payment of Medicare, it is very likely that Medicare may not pay for social work service revolving around the family response.
Wishing you peace and good fortune in helping your Dad and family through this phase of the journey.
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"I'd love help in working through the challenges and emotions of moving my soon to be 95 year old Dad with increasing dementia out of his home of 50 years."

This sounds more like you need counseling with a family therapist. The next sentence says "We will need help in managing the conflicting emotions I feel and those of my siblings.", so this may be much more in the balliwick of a family therapist or mediator than a social worker.

Are you and your siblings in sync, aka not fighting over whether to keep dad at home or find a facility or is that the dissention? It sounds like you yourself are fluctuating between these two options, and if your siblings are in the same or similar boat, you all need to take stock and decide what's best for DAD, not what makes any of you happy.

Is he safe in his home? Does someone live with him? Who is providing his care and/or oversight, hired help or family? Does he wander? Does he fall or need a lot of help getting around, toileting, bathing? Are those assisting running into burnout? Then hiring help or a facility would be the choices. Does anyone have POA? NOTE: POAs are not sufficient for making someone move to a facility, however they ARE important when the move happens so that you can sign as POA, not yourself, otherwise the signer can be accepting financial responsibility. If no one has POA, guardianship should be the next step.

Y'all need to resolve and agree on how to handle dad's situation first. If there's no agreement, life will be hell no matter what anyone does! This is where some family therapy or a mediator might help. If no agreement can be settled on, someone needs to take the bull by the horns and make a decision, which will require applying for guardianship. Once approved, that will override any POAs that might exist. Family therapy may need to continue, if all parties are willing. Dissention in the ranks cause more problems than they will ever solve!

Dealing with the family, coming to agreement, the decision, and determining "who's in charge" has to come first. Once that is resolved, then the move can be planned and "discussed" with dad.

"How do we communicate to him what is happening or do we? There has to be tried and true methods for managing this enormous change for him and not lose our sense of balance as a family in the process."

Personally I would have to say there are no "tried and true methods" for managing anything to do with dementia. Each person's journey is unique, although many share similar symptoms and/or behaviors. Different types of dementia present different challenges and even different progressions and manifestations. It may not be easy, but the change will need to happen. It might work with fibs, it might take some medication to tone down his anxiety, and it will take a lot of cooperation between siblings.

How you handle it depends a lot on where he is on this "journey" and what you feel you all can manage. Some people have a very difficult time with fibs, aka little white lies, and insist on the truth. But often these fibs can facilitate what needs to be done. Bending the truth sometimes works as well. The truth can very often be unreal to the person as well. They either won't accept it or will forget it shortly after the "discussion." We were advised by the EC atty that we couldn't force mom to move to MC (she was refusing to consider any move.) He suggested guardianship, but 1) I don't think she was far enough down the dementia path to get that granted and 2) the facility chosen didn't accept "committals." So, fibs it was. YB wrote a letter from 'Elder Services' at the hospital that treated her cellulitis, stating she moves to a place we choose or they will place her. Madder than a wet hen but she went with my brothers (I did all the up front work.)

So, family therapy unless you can all agree on what's best for Dad and is least negative for everyone. The facility chosen can also assist with the move. Often it's best to stay away for a week+.
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