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Inlaws refuse change

Posted by inlawgrief (My Page) on
Wed, Mar 11, 09 at 9:59

My first post to this forum. 91-year-old FIL and 87 1/2 year old MIL. He had severe stroke 3 years ago. Mental condition very poor. MIL is almost totally wheelchair bound due to stroke/osteoporosis. 250 miles from us. Refuse to move closer. FIL is presently in "skilled nursing facility" after VA Hospital discharged him saying nothing more could be done for him but the 20 days are going to be up the end of this week and MIL says they will "put him out," and she says she is going to bring him home. He is in diapers and catheter and has feeding tube.

MIL is very secretive and we cannot get the truth from her on anything. No one has medical POA over either one of them. She took out reverse mortage on their home for most of its value and says it is all gone, but we don't know any details or whether she's telling the truth.

They are in Houston. The state revoked their driver's license because they couldn't pass test. When DH called her yesterday, MIL was leaving to drive herself to the grocery store. She cannot even walk by herself.

There is no possible way MIL can care for FIL or even herself properly but she gets extremely hostile and nasty when my husband tries to discuss making changes or questions her about applying for medicaid or other VA benefits. FIL served for 2 years during WW II. They have been getting home health aide for 3 hours 5 days a week but she won't tell us anything about how that is paid for.

Please suggest further options for their care. We are not financially in a position to pay for legal proceeding to get guardianship over them. They have absolutely no assets nor friends, family, etc, near them. I'm hoping to still be able to reason with MIL if I can present her with some options for their care.

Follow-Up Postings:

RE: Inlaws refuse change

I'm not 100% sure of what they all are, but it sounds like it's time to call in one of the social service agencies dealing with vulnerable adults. Search out Texas Social Services for vulnerable adults or Lutheran Social Services of the South, Inc. They could advise how to start and what actually can or has to be done. You would not necessarily have to take on the responsibility of looking after their care or finances.

Resistance to change is symptomatic of growing older. But it would seem that your MIL has absolutely no chance of being able to care for your FIL - and the skilled nursing facility he's currently in shouldn't even consider releasing him to your MIL's care. An hha for 3 hrs/ 5 days a week is not sufficient but possibly what is allowed and paid for by insurance. Any chance you could deal with one of the social workers at the facility he's currently in?

RE: Inlaws refuse change

Contact the Council of Aging in Housten, Social Services, or Elder Abuse, explain the situation and even the VA. You cannot reason with a person like this. Someone must take charge. Remember us oldies are like kids when we get old and cranky. But without their signatures on file and the HEPA laws, you and your spouse cannot do anything or contact anyone for information until you get legal authority to do so.

RE: Inlaws refuse change

You said you are 250 miles away - are you in Texas? I live in Houston - please let me know if there is something I can do for you. Carolyn

RE: Inlaws refuse change

You should be able to find out if they took out the reverse mortgage or not. Many large cities and counties have their property records on line. You could start there. Otherwise, you could go to the county property assessor's office when you are visiting and look it up. Those kind of records are public. You could possibly get the information over the phone.

RE: Inlaws refuse change

Thanks for the responses. Confirmed the reverse mortgage filing date through on-line search of real property records. MIL is finding every excuse to not complete the Medicaid paperwork for the nursing home that FIL has been in since dismissed from VA Hospital that was paid for by Medicare supplement insurance but only a couple days left. Nursing home staff cannot discuss with family members because no one has POA or on approved list. I believe only option is to contact Adult Protective Services and hope they aren't too backlogged and will act quickly if MIL decides to move FIL to home. Without being able to talk to other family, nursing home has no way to know there will be no one nor any equipment to care for FIL. Last week one son visited NH, it required 3 people to move FIL in the bed, etc., but MIL insists he's getting better and she can bring him home. Is there any legal responsibility for the NH to confirm the conditions of where a bedfast patient is going?

RE: Inlaws refuse change

Is there any legal responsibility for the NH to confirm the conditions of where a bedfast patient is going?

Any care facility I've come into contact with - and I admit not all that many - the staff (RN's, Aides, Nutritionists, Physical Therapists, Social Workers, etc) has routine care meetings about patients. If your MIL visits the facility/attends these care conferences and is known to any of the staff, they should be aware she's not physically capable and would not release your FIL without 24 hr. care, etc. The facility might have more of an ethical responsibilty about the release of your FIL rather than a legal one. They probably also have the capacity to transfer a patient to another space available facility - which may or may not be a place you'd want someone to be.

It gets murky with no POA, etc. You have no legal standing and you certainly want to avoid signing anything that makes you a "responsible party". A contact person - yes; responsible - no. Being the responsible party could put you on the hook for all the finances your FIL incurs.

Adult Protective Services seems to be your best option, and something for you to look into soon.

RE: Inlaws refuse change

Protective Services for Adults will be your worst nightmare. Don't do it!

People who work there are uneducated and not sympathetic to the problem. They make mistakes with their cases all day long. The workers are the lowest paid of any government agency. They answer to the government not the loved ones or the patient.

Find out if Houston offers a self directed care program for senior citizens.

You hire who you want as long as the person is over 18 years of age.
Medicaid pays for it.

The idea is to keep the patient at home directing his own care. If the patient is unable to do it he can appoint a surrogate of his choice to assist. People with alziemers have been known to be accepted on this program.

The surrogate does not have to be there to assist. Just keeping in touch with the workers and patient is sufficient by medicaid rules.

Call Medicad or an elder care attorney to inquire. Don't speak to anyone else. They might not know. By all means don't call any home care agency. This self directed program has nothing to do with home care agencies.

The program will give more hours because it is a couple but you have to be on medicaid to join the program.

RE: Inlaws refuse change

Texas participates in the Medicaid Waiver program - this lets folks who don't quite need a nursing home bring in outside help (they won't let you pay a family member) to assist someone - the cost must be less than a nursing home. Since your in-laws do not have any equity in the house any longer, they basically do not have any assets other than any cash, stocks/bonds, etc.

The Medicaid waiver eliminates a person having to go to a nursing home IF IN HOME HELP IS AN OPTION. You might want to check into that program - you can get info about it from the State of Texas website. They would not give the money to your MIL - it would go directly to the care providers. Perhaps they could get enough help so your FIL could remain at home a while longer.

If they have no assets, Medicare/Medicaid will pay for a nursing home for your FIL.


RE: Inlaws refuse change

After repeated phone conversations, I have been able to get a little more information from MIL. She took $50K reverse mortgage three-and-a-half years ago and has less than $10K of that money remaining in bank account. I believe that is why she has been dragging her feet on filling out the Medicaid paperwork. She thinks that cash will be taken by "the government," as she puts it. That is all she has left in this world. It takes 3 people to move FIL at the NH to just change linen. He weighs about 230 pounds and is totally helpless. But MIL thinks the only way to keep her reverse mortgage cash is to bring FIL home, which just cannot happen. MIL has severe osteoporosis and multiple fractures and one leg useless from stroke. I told her I thought the reverse mortgage money was not considered an asset or income because it is a loan but if she doesn't get Medicaid approved, then the NH can treat FIL as private pay and can eventually get a judgment on the cash she has left from reverse mortgage and it sure wouldn't take long to use up $10K. Am I correct on that?

RE: Inlaws refuse change

I would suggest you make a trip to where they live, and get the necessary papers signed so you can legally get information. Get information from Texas web sites and see if AARP has legal help for you in that area. It is my understanding that the VA CANNOT just release someone unless they have a place to go, like a nursing home, but they will try anything to get people out of the VA. IT happened to SIL in AZ. Is there a council on aging in the area? There are all sorts of free help available, just check any senior citizen origination in the area or county agencies.

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