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FIL has been in hospital about a week. He calls and said he is being released tomorrow with a pic line for IV antibiotics until the end of January, he needs physical therapy, but refuses. His wife had neck surgery a few months ago. Part of her neck fusion didn't fuse. She is on strict restrictions!!! She can't care for him and he can't take care of himself. He has stomach ulcers and has been taken off all nsaids. He has called repeatedly during the night asking us to bring Excedrin in the morning. The doctors are giving him meds for his headaches. His can't be in charge of any of his medications because of not remembering things. This is just a little part of issues. He has aphasia from 2 back to back emergency brain surgeries. He has been hospitalized several times for infection. Bedsore.... cut on finger... he will not say he is sick or has a fever. As he doesn't want to go to doc. Therefore he starts tapping on deaths door and is forced to be hospitalized. He has seizures often. The last one sent him to hospital as he didn't know his age. Thankfully it did. He has mrsa/ecoli and was septic. He is really good (when he is clear headed) about telling hospital staff everything they want to hear so he can go home. He refuses to go to physical therapy. He goes home lays in bed only goes to the bathroom when he can, goes downstairs for a shower etc
He has explosive diarrhea and can't clean himself or the mess. He can't cook or do other things because he's too weak/ in pain to get up most days.
This is just a tiny peak into his illnesses.



If he is released tomorrow without pt, and no one to care for him and he can't care for himself..... what should we do? What should be done to get help he needs. There is no one right now that can care for him.
Thank you in advance for your help. We appreciate your time. I'm sure some of this is sporadic information as we're freaking out trying to find away around him not going home until he is able to care for himself.

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The sign of any problems, tell them to get him to ER and don't pick him up. They did not send him to Rehab because Rehab would have sent him back. He has to be able to do PT or Medicare will not pay.
He was an unsafe discharge.

Now the family should call the PCP and ask for "in home" care. That the wife is not in the position to care for a pick line and a catheter. This man needs Skilled nursing care. MIL needs to see and Elder Lawyer to have their assets split, FILs going towards his care. When his split gets spent down, then Medicaid is applied for. This man could have been transferred from the hospital to a SNF, if MIL could afford to do it.
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If FIL lives in NE OH, sorry but🙂. You may not know but it's pretty competitive here for bodies living or not. I'm surprised the hospital didn't "push" to go to at least rehab if nothing else (hospitals get a cut for referring patients to care places).

Since it is mentioned he's home, Good luck!!
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FamilyMatters2
I hope you will periodically update us. I am very concerned, especially for your FIL's wife and her cervical surgery.
I hope things are going well.
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So, FM, elderly parents are now at home in their home?

Have you called APS in their county?
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OP, this makes me sick to my stomach. FIL should never have been released to home. Your relatives who are responsible are now going to flounder around having no idea what they are doing. FIL and MIL are going to get worse. And eventually everyone will be angry with each other.

You and husband would be well advised to stay out of the way while this train wrecks. You know nothing, do nothing and mind your own business. Retreat and heal from the trauma you’ve endured while the rest of them take care of those two.

This is (trust me) one of those situations where it’s best to retreat. Good luck.
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FM, this isn't "cold-hearted". This is common sense.

He needs more and more specialized care than can be given at home.

No clue why they were talking to a doctor. Discharge planning is who makes arrangements for care after hospitalization.
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cover9339 Dec 28, 2023
Doctor on the floor signs off on it, though.
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FamilyMatters:
I see that all capitulated and took this gentleman home.
This could well spell disaster for someone with a poorly healing cervical spine surgery.
Dad needs placement.
You aren't there and aren't able to do it.
After you read them the riot act I hope you will simply stay away.
This is a disaster coming, and you can do nothing about it.
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FIL now home (per below).
It's on the adults that collected him & offered to stay now.
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Speak with head nurse or case manager say " This is a unsafe discharge and he needs rehab till we can make a care Plan " then ask for the social worker On the hospital floor and explain the circumstances as why he can not go Home . be adamant and firm .
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cover9339 Dec 28, 2023
😆. Something similar happened at facility. Bed bound resident's family came to pick her up after she was discharged. Family had to call EMS to get her in the car in the parking lot
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FM, PLEASE tell local family to notify APS about "vulnerable seniors living alone". And have everyone call 911 at the least sign of an emergency.
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Total sh*t show. They argued with Dr for a little bit. With the phrases I told them to say. Doc said he could walk he could go home. I'd say needing help from a nurse to go from bed to bathroom which is only a few steps... how does that make him able to care for himself.... they folded like wet paper bags went and picked him up. One grown child going to stay with them for a bit. I've been telling them for over a year to video him trying to walk, when he has confusion, everything!!!! So we can get POA here we are again and nothing is any different. I probably seem cold hearted. I'm not. Frustrating no one listens after doing research over and over and getting no where.😔
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Beatty Dec 27, 2023
I reckon I often appear cold-hearted too - but I call it Common Sense.

Well the Duty of Care has now been passed from the hospital to the adult child/children who collected FIL & then onto the one who will be staying with him.

A friend's family has been though this for YEARS now. One offsping moved interstate, the other limping on alone. Say can't can't but then folds (just as you said), collects the elder & stays o/n too.

It's their choice to do so.

You are not alone. Check out Mid's thread called DH has to finally step up.
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THIS IS NOT A TEST. THIS IS AN EMERGENCY. CALL SOCIAL WORKERS IN AT ONCE!
Who is POA here?
That's the important question.
If it is wife then you need to assist her in going AT ONCE NOW to the Social Services to explain that this unsafe discharge, cannot be done for the safety of the patient and the wife.
He needs 24/7 care she cannot do. A bad cervical spine surgery can result in complete PARALYSIS. How can this have come so far without intervention???

Stop this discharge NOW.
He needs placement. Were he to accept PT he could perhaps get rehab to delay this and give you time but right now you don't have that time. This is an emergency.

DO NOT GIVE PAIN MEDs such as excedrin to someone with a stomach ulcer or he will bleed out.
Someone needs to be responsible for knowing this.
Who would that be?
I see a crisis coming in all of this from every front.

This gentleman needs PLACEMENT IN-FACILITY NOW and at once, and emergently and he isn't going to be an easy placement. Talk to Social Services right away WITH THE PERSON WHO IS POA. Or with the wife. And let the hospital know he cannot return home now.

Once Social Services understands he has no one at home, and he is slated for home care with that Picc line, trust me, as an RN will have to come in for the antibiotic.

Has he had c-diff check? He is on antibiotics and now has explosive diarrhea and that almost certainly means c-difficile.

You have to stop this discharge. If they do it anyway then call EMS and have him transported RIGHT BACK TO THE HOSPITAL.
This is an emergency.
I REPEAT. THIS IS AN EMERGENCY. You need all hands on deck or this is moving to crisis.
Please update us. I am very worried for you.
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Familymatters2 Dec 27, 2023
I certainly agree with everything you are saying. I told them last night what to say, and write down all of her restrictions and his needs. After arguing with hospital social worker and the doctors, they folded and went later and picked him up. 😡 No one has POA over him. I told them over a year ago to record his daily life in bed around the clock almost everyday, his confusion with aphasia, explosive diarrhea and the mess he can't clean up or himself. He never tells anyone when he isn't feeling very well ( because he doesn't want to go to Dr) then he is so ill and has been septic every time he has been to the ER. The Dr. said again this time he was close to death. If he hadn't had a horrible seizure and didn't know his age he wouldn't have gone in the ambulance and wouldn't be here right now. He is good at lying to staff so he can go home. Every single time! He refuses to do rehab, and won't let pt come to the house. He will certainly be really upset when he finds out there are no nsaids at the house, nor will there be!
His wife has been taking care of him for years running herself in the ground to care for him. I finally go her to go to Dr because of her pain. (As I previously have had neck surgery I know a few things) of course I was right. She had surgery, we found out a month ago part didn't fuse. If it doesn't fuse she will need another surgery. She knows her restrictions and knows she has to use caution at all times so she isn't paralyzed. Everything will be the same as it is now. I can give them all the information available... As my parents always say " you can lead a horse to water but can't make them drink. One of their kids is staying again to help out. It's definitely frustrating for rest of family they all have kids and don't see, hear and remember everything over the years. Our kids are grown and is just us, I will always do what I can, I also have health issues and have to care for myself as well. I promise I'm not cold hearted, even though it may sound like it. I'm the one that looks for answers and solutions, I'm the one to get up in middle of the night to take people to the hospital, take to run errands when I can.
Not only did he come home with a pic line but a Foley catheter as well. He will go to hospital several times a week for his antibiotic fusion for a month!!
Im just spent.
Thank you all for your answers and suggestions. Most of it is everything I've been spewing for several years.
Hugs, love and prayers to you all
Have a blessed, safe and prosperous new year
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Coming home with a pic line would be the least of my worries. But the coming home at all should be a HUGE worry!!!
Call the social worker at the hospital and tell them in no uncertain terms that he CANNOT come home as there is no-one there to care for him and that it would be an unsafe discharge.
And don't listen to their BS about what they will provide should he come home as that will never happen. So stand your ground and be firm, and let them find placement for your FIL.
And if for some reason he still is sent home, just call APS and report 2 vulnerable adults living alone who shouldn't be.
Sadly with all the issues your FIL has, he more than likely should never return home.
Perhaps it's time for the family to have a heart to heart conversation about both your FIL and MIL moving into an assisted living facility.
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FM, how are things this morning? Has your spouse gotten in touch with the hospital?
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Familymatters2 Dec 27, 2023
No word on anything yet. Did call hospital last night left message for his caseworker. We have told everyone to not pick him up. Hurry up and wait. Thank you
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I would raise holy hell with the hospital right now as to how this is an unsafe discharge,
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Ensure the hospital discharge peson knows the level of care FIL currently has at home.

The hospital may push FIL to have home support/nursing services in place to allow safe discharge.

Once home, advise MIL & FIL
1. To be in close contact with their primary Doctor
2. To keep any support services they need
3. To call 911 for any medical emergency.

Some people distort the truth to get home, even when not safe to do so. Some will cancel support services, even when they need them. Some will find out the hard way: That while home is great, it is not a magic cure-all.
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If he does manage to get himself home, call APS about both of them – immediately! Don’t try to sort it out yourselves. This is one for 'the system'.
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He's probably going to tell the people at the hospital that when he goes home, his wife will take care of him. Obviously, she can't.

What does she say about this? I hope she doesn't think she can do it! But your dad may be released on his own say-so, and if she picks him up, the hospital is through.

Does anyone have POA? If not, this needs to be addressed and executed ASAP. Right now your husband, their son, should be calling the hospital nonstop until he finds someone there to enlighten about the situation. No one is at their home to care for these two. You can't get there now, and FIL needs to be released to rehab or a nursing home. No other plan will work.

As for other ideas you might have, DO NOT proceed toward taking them into your home in Ohio. That multigenerational thing almost never works out, and in this instance, you wouldn't want it to (explosive feces, seizures, neck fusions gone bad).

Hiring and maintaining people to look after them in their home is a huge job, and you don't want to get started with that either. It takes time, management, and hands-on care from you as well. You'd need at least three caregivers and probably more to handle FIL and MIL at home. And don't move in with them at their home. Clearly the job (explosive feces, seizures, neck fusions gone bad) is beyond what you and/or husband can do, even in the short term.

Placement only. That's the rule for explosive feces, seizures, and neck fusions gone bad whether they like it or not.

Good luck, and let us know how it works out.
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You need to tell all of this to the social workers and discharge team at the hospital. They cannot send him home, he must go to a SNF. There is no other option. Period. Do not pick him up from the hospital.
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You need to call the discharge department first thing in the AM and tell them that there is no one in the who can provide care for him, and that this an "unsafe discharge" (use those words).

Do not show up. Do not fall for any promises that they will find you help.

However, if they judge him competent to make his own decisions, they can release him as able to care for himself.

If he calls YOU with an emergency, call 911 and have him send back to the hospital.

Does anyone have Durable POA?
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Maybe call the hospital and ask to speak to the social worker there and explain the situation and that discharging him would be unsafe as he has no one to take care of him?

I don't understand why seniors do this. Why they can't just accept their decline and move to where they can get help. Instead they make everyone's lives miserable until the issue has to be forced on them and even then they make sure they let family know how much they hate being in a facility. It is just messed up.

I feel really bad for his wife because she will have to bear the burden of trying to do the impossible in taking care of him and herself. Neither should be living independently at this point. Both need to be in assisted living or a nursing home.
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