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My dad is in a skilled care facility that is wildly expensive (self-pay). He hates it there and he can't even go outside without someone visiting him and taking him out. We are over 1,000 miles away and get to visit him once a month, which is also very costly. He doesn't want to move away from sunny Florida and would love to return home. He can't get into an assisted living place because he can't stand on his own. He doesn't seem to want to do physical therapy and is very difficult in that way. We are trying everything to get him to do it because that is his ticket out of there. On top of all this he is a big man at over 215lbs. That doesn't help. I tried to get him out of his wheelchair and he didn't want to stand all the way up because he got afraid. I am not a professional. The professionals there are using a machine (Hoyer lift) to get him up and in the wheelchair or the shower. There is one assisted living place in Venice that would take someone that needs two people to get him to transfer from bed to wheelchair, but I just don't think he has the strength to do that long term.
Are there any options for him to live at home or a better place? He is in Venice, FL. Are there any other options for a care place that is more like an assisted living area that he could come and go outside as he pleases? Are there any help numbers to call that would help me find 24 hour care at home?
Oh and since he wasn't progressing with physical therapy his medicare help ended. The price per month is incredibly expensive, but he wouldn't qualify for any help. Lets just say his bills will be around $120K a year for him to stay where he is.
There really isn’t that I can think of. However a nursing home should still allow him to go out to their court yard unattended as long as he’s not a fall risk. Has he had any falls while in the facility? Do you know if he’s actually able to push his own wheelchair out to the door? When you say come and go as he pleases, what exactly do you mean?
There really isn’t that I can think of. However a nursing home should still allow him to go out to their court yard unattended as long as he’s not a fall risk. Has he had any falls while in the facility? Do you know if he’s actually able to push his own wheelchair out to the door? When you say come and go as he pleases, what exactly do you mean?
There is no courtyard really, but there is areas he could be. He can't come and go outside unless he has someone with him. Now in an assisted living place they can come and go, but not a skilled nursing facility. At least that is how it is in Florida where he is. He has slid off his chair, but they strapped him in now. He wears some device to alert the staff if he gets to the door now. This is nothing like assisted living.
Could you hire shifts of caregivers to let him stay at home? Does he own a home or have a place to which he could return? It probably would not cost $120K/year either.
My FIL did that, but he had had a major stroke and only lived for a few months afterward. My husband hired a caregiver (plus a part time one to give breaks), which worked out great for that short amount of time. The caregiver even used a Hoyer lift in my FIL's home.
Firstly he can get cheaper home care then the corporate run medical facilities. He is ripe for having a mobile chair to aide him. He can even get support devices to move him from chair to bed or open shower area.
I know as I had a parent with weight concerns. Her Doctors advocated for home care as patients faired better in a home environment setup to meet their needs.
215 lbs is not to much given I am 110 sopping wet and my parent was 260lbs. I found ways to work with her limited strength. She knew how to roll...scoot and had active upper arm strength. Granted I was there as a live in...but even a part time care aide can get him up and ready then allow him his independent tI'm. .til night arrives...6 hrs a day for help beats rotting away in a home that doesn't inspire him...
My advice...start the ball rolling on looking into those devices...some are covered by Medicare and other house modified devices can be gotten at reduce cost thru the VA hospital and rehabs looking to upgrade themselves. We got a shower slide for 35$..the rehab was more helpful in guiding us.
You need to talk to whomever the Social Workers are, in that State. If he requires 2 people to just transfer from his bed to a wheelchair, w/Hoyer lift, and he is unable to perform ADL's/activities of daily living.....there is NO way a Dr would sign off on his living at home by himself.
Even some limited physical therapy might have given him back some level of freedom, but I doubt at 86 yrs old, and unable to even transfer himself t a wheelchair, living by himself would even be an option.
Are you POA? Are you allowed the legal access to his health information and speaking with his health care providers?
I suggest doing as much online research as possible, and speaking by phone to the health care professionals that are able to make any kind of decision like that.
There is no courtyard really, but there is areas he could be. He can't come and go outside unless he has someone with him. Now in an assisted living place they can come and go, but not a skilled nursing facility. At least that is how it is in Florida where he is. He has slid off his chair, but they strapped him in now. He wears some device to alert the staff if he gets to the door now. This is nothing like assisted living.
Thanks for your reply.
That is why he can’t go outside alone, because he is a fall risk. There are no laws or rules preventing people in a nursing home from coming or going in any state. At the nursing homes I work in there are people who drive their scooters up to the corner store and many in wheelchairs who go out to smoke alone. Others are not allowed to because they are a safety risk. Your relative fell out of his chair so they can’t let him do that. It has nothing to do with it being a nursing home. If he went to PT and cooperated and improved, they could remove his restriction of needing supervision though. If they are actually using a seat belt restraint though I guarantee he fell more than once. All states require a lot of documentation of falls as well as a doctors order before they will okay physical restraints.
No assisted living facility is going to take a fall risk who needs alarms and restraints except a specialty place for dementia, but they wouldn’t let him outside either.
There is no courtyard really, but there is areas he could be. He can't come and go outside unless he has someone with him. Now in an assisted living place they can come and go, but not a skilled nursing facility. At least that is how it is in Florida where he is. He has slid off his chair, but they strapped him in now. He wears some device to alert the staff if he gets to the door now. This is nothing like assisted living.
Thanks for your reply.
If he has slid off his chair in the past, it sounds like he shouldn't be going anywhere alone whether he is "allowed to" or not. The primary focus shouldn't be on whether he has freedom to come and go as he pleases, but rather making sure he is in a safe situation. Unless he doesn't care about falling and injury (which can be devastating for an elderly person).
Home care is an option but beware that 24/7 home care is much more expensive than the $120K you quoted for a facility. Figure about $15-16 an hour for one person at a minimum. Then on top of that there is still the household expense of electricity, heat/air, food, etc. which would be included in a facility cost. People will tell you you can get one for less money but would you want to entrust him to the care of someone making less than that?
He can't get into an assisted living place because he can't stand on his own. He doesn't seem to want to do physical therapy and is very difficult in that way. We are trying everything to get him to do it because that is his ticket out of there.
Went through something similar with my dad starting at about 85. He was still living at home but kept being hospitalized more and more frequently because he didn't keep himself mobile, wouldn't care for himself (dehydration because he hated getting out of his chair or up at night to pee...so he refused to drink enough), wouldn't pay attention to diet or medications (so had recurring bowel problems and anemia as a result), refused to make any modest safety modifications around his house so he could avoid falling or self-rescue, etc etc etc. Of course each time he was discharged from the hospital he'd go into skilled nursing as part of rehab and then have home PT to get his strength back but he didn't cooperate. His MD, the physical therapist, friends, everyone around him kept trying to motivate him to accept and do the PT in order to stay independent at home, but he dismissed all of it and just wouldn't. Eventually he lost his independence completely and was furious over it. Fought assisted living with a passion and was asked to leave, blamed or resented everyone else and never could admit he was his own worst enemy.
Last edited by Parnassia; 10-17-2018 at 12:53 PM..
Not trying to be a Negative Nelly, but have you read what you've written? He's unable to walk or transfer, lacks upper body strength, falls, refuses to do anything to help himself and requires a Hoyer lift. How on earth do you think this man is going to be able to do ANYTHING by himself, especially go outside? There is a reason the meanies at the nursing home have to take him. And I'm sorry, but moving him to a place with lower levels of care isn't safe for him. I admire your desire to improve his quality of life and save money, but it's not going to happen. Sorry, but I think it's unrealistic.
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