I've never heard of a doctor say he can't do testing cause Medicare won't pay while in a nursing home. Granted, I'm no expert, but I've worked in long term care for 12 years. I would strongly recommend another opinion.

Dementia is a disease that doesn't just occur. It could be that he was beginning to show signs, and the recent illness and hospitalization has worsened the dementia. It could also be delirium, which is common in older people who are ill, have infection, could be side effect of medication, etc. Its kind of like a temporary dementia. It may be worth having your dad see a neurologist. They can help determine if it is a true type of dementia, and if so, there are medications that don't cure dementia but can slow it down.

For the stepmom, have you asked her why she doesn't want him home? Maybe she would be willing to at least try it? She has been there daily, has she been able to observe his therapy sessions to see the progress he has made?

Would he qualify for Medicaid? The social worker at the nursing home should know the basics about the qualifications. Here in Arizona, there is a long term care part of Medicaid that for those who qualify medically, it covers home services as well as assisted living homes.

Medicare does typically cover short term home services. These are very limited. Your dad would have to be considered home bound; he can leave for doctor appointments, church, etc. Usually the nursing home would recommend home health therapy, so the home health agency can provide physical therapy a few times a week, occupational therapy few times a week, nurse and bathing aide. Typically these services are a few weeks, however there are circumstances that nursing is covered longer. Particularly if it is an extreme hardship for the patient to leave the home for catheter care and there is not anyone else able to help.

Per the Medicare website:

Home Health Services: Limited to medically-necessary part-time or intermittent skilled nursing care, or physical therapy, speech-language pathology, or a continuing need for occupational therapy. A doctor or other health care provider must order your care, and a Medicare-certified home health agency must provide it. Home health services may also include medical social services, part-time or intermittent home health aide services, and medical supplies for use at home. You must be homebound, which means that leaving home is a major effort.

If there are several home health agencies in your area, you can do a search on Medicare to find out what is available, how they rate, etc

http://www.medicare.gov/homehealthcompare/search.aspx

As for the smoking, I don't have any advice really. You won't be able to get her to change most likely. Maybe at the family meeting the social worker or nurse there can gently try to explain that it is healthier for everyone if she smoked outside? Otherwise, I would suggest purchasing a few air purifiers.

I've never heard of a doctor say he can't do testing cause Medicare won't pay while in a nursing home. Granted, I'm no expert, but I've worked in long term care for 12 years. I would strongly recommend another opinion.

Dementia is a disease that doesn't just occur. It could be that he was beginning to show signs, and the recent illness and hospitalization has worsened the dementia. It could also be delirium, which is common in older people who are ill, have infection, could be side effect of medication, etc. Its kind of like a temporary dementia. It may be worth having your dad see a neurologist. They can help determine if it is a true type of dementia, and if so, there are medications that don't cure dementia but can slow it down.

For the stepmom, have you asked her why she doesn't want him home? Maybe she would be willing to at least try it? She has been there daily, has she been able to observe his therapy sessions to see the progress he has made?

Would he qualify for Medicaid? The social worker at the nursing home should know the basics about the qualifications. Here in Arizona, there is a long term care part of Medicaid that for those who qualify medically, it covers home services as well as assisted living homes.

Medicare does typically cover short term home services. These are very limited. Your dad would have to be considered home bound; he can leave for doctor appointments, church, etc. Usually the nursing home would recommend home health therapy, so the home health agency can provide physical therapy a few times a week, occupational therapy few times a week, nurse and bathing aide. Typically these services are a few weeks, however there are circumstances that nursing is covered longer. Particularly if it is an extreme hardship for the patient to leave the home for catheter care and there is not anyone else able to help.

Per the Medicare website:

Home Health Services: Limited to medically-necessary part-time or intermittent skilled nursing care, or physical therapy, speech-language pathology, or a continuing need for occupational therapy. A doctor or other health care provider must order your care, and a Medicare-certified home health agency must provide it. Home health services may also include medical social services, part-time or intermittent home health aide services, and medical supplies for use at home. You must be homebound, which means that leaving home is a major effort.

If there are several home health agencies in your area, you can do a search on Medicare to find out what is available, how they rate, etc

http://www.medicare.gov/homehealthcompare/search.aspx

As for the smoking, I don't have any advice really. You won't be able to get her to change most likely. Maybe at the family meeting the social worker or nurse there can gently try to explain that it is healthier for everyone if she smoked outside? Otherwise, I would suggest purchasing a few air purifiers.

I agree that another opinion is warranted. Let us know how this works out.

I agree that another opinion is warranted. Let us know how this works out.

Wow. http://67.42.80.195

Wow. http://67.42.80.195

Thanks for your replies. Frankly I did not do much with this thread after I started it because immediately another poster attacked me for being money grubbing and told me to get a job which I didn't quite find helpful to my situation nor couldn't be further from the truth. Looks like the post disappeared so will give an update of where I'm at and see if anyone has some ideas for my sister and I. Catheter is now out and he is urinating so that is good. Has some incontinence which can be expected after 2 months with a cath in. Still no prostate test done but at this point we are willing to wait and see.
Found out his list of meds they had him on and feel he has been over served if you will. One of them was Benacar which I read should not be used for dementia however some docs use it for that. He was being weaned off of it last week and they also had him on a huge dose of Travacid (sp?) which they are backing down. They had also put him on aricept and just keeping that status quo for now. He has still never been assessed for alzheimers or dementia by a neuro. Supposedly this week a neuro will be in to see the patients at the home so crossing fingers we get to see him. He is walking better- still shuffles. 85% of the time he is there and then 15% of the time he will wander off somewhere else with his mind. Example: good all day Christmas and then when it was time to go he turned and asked me to take him back to the gas company for work-- he always knows us and no short term memory issue like that but the dementia usually involves him sometimes not remembering we were there the prior day or else involves him thinking he is at work or living where we lived 20 years ago. Step mom still visits him but still doesn't want him home. We got doctor approval starting last week to take him out for visits and have had him out 3 times including Christmas. She gets quite angry when we take him out and questions the home if we are allowed to do that. She chose to not spend Christmas with him even though we offered to bring him to her. It's very strange. We sense that she doesn't want him back ever which is difficult to broach. We have been trying to get a meeting set as we are near the release time in a matter of several weeks and no plans have been made at all. She made a comment the other day that he drools (side effect from aracept we believe), can't dress himself (not true), and only has half a brain. He has a long term care policy that I actually helped him purchase 20 years ago and have asked to see it several times but have yet to see it. We still believe he should be given 30 days at home to see how it affects his well being (we will stay the whole time as needed) but not thinking that will happen. My concern is that I don't really think our stepmom wants him back at all now or in the future and as his children we feel obligated to make sure he gets a fair shake at proper assessment, good medical care and a good environment for his future. If his wife no longer wants him we feel that perhaps we should take over the decisions for his care. Very tricky thing. Our first choice is for her to get involved as his advocate but if she isn't going to step up and do so then our choices are to either let her do what she wants with him and let it all be her problem or else step up and try to intercede to watch out for his best interest. What a mess !!

Thanks for your replies. Frankly I did not do much with this thread after I started it because immediately another poster attacked me for being money grubbing and told me to get a job which I didn't quite find helpful to my situation nor couldn't be further from the truth. Looks like the post disappeared so will give an update of where I'm at and see if anyone has some ideas for my sister and I. Catheter is now out and he is urinating so that is good. Has some incontinence which can be expected after 2 months with a cath in. Still no prostate test done but at this point we are willing to wait and see.
Found out his list of meds they had him on and feel he has been over served if you will. One of them was Benacar which I read should not be used for dementia however some docs use it for that. He was being weaned off of it last week and they also had him on a huge dose of Travacid (sp?) which they are backing down. They had also put him on aricept and just keeping that status quo for now. He has still never been assessed for alzheimers or dementia by a neuro. Supposedly this week a neuro will be in to see the patients at the home so crossing fingers we get to see him. He is walking better- still shuffles. 85% of the time he is there and then 15% of the time he will wander off somewhere else with his mind. Example: good all day Christmas and then when it was time to go he turned and asked me to take him back to the gas company for work-- he always knows us and no short term memory issue like that but the dementia usually involves him sometimes not remembering we were there the prior day or else involves him thinking he is at work or living where we lived 20 years ago. Step mom still visits him but still doesn't want him home. We got doctor approval starting last week to take him out for visits and have had him out 3 times including Christmas. She gets quite angry when we take him out and questions the home if we are allowed to do that. She chose to not spend Christmas with him even though we offered to bring him to her. It's very strange. We sense that she doesn't want him back ever which is difficult to broach. We have been trying to get a meeting set as we are near the release time in a matter of several weeks and no plans have been made at all. She made a comment the other day that he drools (side effect from aracept we believe), can't dress himself (not true), and only has half a brain. He has a long term care policy that I actually helped him purchase 20 years ago and have asked to see it several times but have yet to see it. We still believe he should be given 30 days at home to see how it affects his well being (we will stay the whole time as needed) but not thinking that will happen. My concern is that I don't really think our stepmom wants him back at all now or in the future and as his children we feel obligated to make sure he gets a fair shake at proper assessment, good medical care and a good environment for his future. If his wife no longer wants him we feel that perhaps we should take over the decisions for his care. Very tricky thing. Our first choice is for her to get involved as his advocate but if she isn't going to step up and do so then our choices are to either let her do what she wants with him and let it all be her problem or else step up and try to intercede to watch out for his best interest. What a mess !!

Wow, how sad for your dad. It sounds like your stepmom is looking for a reason to not have him at home. It could be due to lots of reasons, including her own fear, but its strange that she would then question you taking him out for a few hours. But even if all of a sudden she did agree to allow him at home, considering how she has responded so far, it may not be the best thing for your dad. I would worry how she would be with him.

It can be a tricky thing when asking about "taking over" someone's care, but in my experience it can also sometimes be a relief to a spouse. Maybe if you are able to approach it as a "we know having to make decisions for dad can be very stressful" and not a "you aren't doing anything so we want to take over", she would be more willing to allow it.

A neuro exam is a good 1st step. When your dad is doing well, does he ever mention what he wants? Does he ask to go home? I would even ask the neurologist if your dad is competent enough to complete a new healthcare POA, signing you and/or your siblings as the person to make decisions for him. With that you would hopefully also be able to get information on the long term care policy.

Has the nursing home gotten any information on the long term care insurance? They might be able to also get some information about it.

If your dad is doing better and not needing a nursing home, but for whatever reason is not able to return home, an option may be assisted living. But that's something down the road. Right now, its important to have the neurologist exam and hopefully get some cooperation from your stepmom.

Please do keep us updated!! 99% of the people here are here for the right reason and really do care.

Wow, how sad for your dad. It sounds like your stepmom is looking for a reason to not have him at home. It could be due to lots of reasons, including her own fear, but its strange that she would then question you taking him out for a few hours. But even if all of a sudden she did agree to allow him at home, considering how she has responded so far, it may not be the best thing for your dad. I would worry how she would be with him.

It can be a tricky thing when asking about "taking over" someone's care, but in my experience it can also sometimes be a relief to a spouse. Maybe if you are able to approach it as a "we know having to make decisions for dad can be very stressful" and not a "you aren't doing anything so we want to take over", she would be more willing to allow it.

A neuro exam is a good 1st step. When your dad is doing well, does he ever mention what he wants? Does he ask to go home? I would even ask the neurologist if your dad is competent enough to complete a new healthcare POA, signing you and/or your siblings as the person to make decisions for him. With that you would hopefully also be able to get information on the long term care policy.

Has the nursing home gotten any information on the long term care insurance? They might be able to also get some information about it.

If your dad is doing better and not needing a nursing home, but for whatever reason is not able to return home, an option may be assisted living. But that's something down the road. Right now, its important to have the neurologist exam and hopefully get some cooperation from your stepmom.

Please do keep us updated!! 99% of the people here are here for the right reason and really do care.