Undiagnosed Gram - In need of 24hr care & I need to get back to my life

@supermomwife

I'm glad you found this board, many folks have walked this path before will offer you ideas, help & understanding.

First : No guilt- you didn't cause your Grandmother's health situation, and you didn't drop the ball as it seems your Father may have - as the DPOA to be he could have researched places near him , many have wait lists, gotten the Doctor's letter(s) if that is what triggers the DPOA to be active.

Is he managing her finances? If not who is?

As DPOA it would make sense to have your Grandmother be near him -one hour his way versus in her town or one hour near you. Has he thought of how he will coordinate her medical appointments, any future ER visits etc.? Most patients get sent alone to the ER from AL/MC which can be confusing and upsetting. Does he have any interest in actually handling her care,even when placed?

If his attitude is the AL/MC will handle all that , they don't- in which case he can explore hiring a professional case manager or even appointing a professional conservator to be paid by her funds to oversee her care. Then you and your family can visit as family members and not just do crisis visits.

Most folks say "yes" to being a DPOA thinking it is like being an executor but there are the care needs of a dependent adult that need to be coordinated and the time frame can be years.

The hospital isn't a holding zone for a bed in AL/MC , medicare rules bounce folks out to skilled nursing or home that don't need medical treatment versus care giving oversight . You can discuss options with her Doctor , maybe they can offer ideas to get some coverage.

Suggest you and your Dad discuss where it makes sense for your Grandmother to live and then start calling for available beds, the home will do their own evaluation for AL/MC. A case manager may be a good hire at this point to help sort the facilities or get a home health agency to staff quicker- since they are an ongoing client of the agencies vs one family. The first few days to weeks of staffing at home can be rocky until you get a steady crew- so someone would need to be around evaluating how things are going, secure valuables etc.

If your Father hasn't already consulted with an elder law attorney already about how best to fund AL/MC, how medicaid coverage in the state your Grandmother will be living in works etc. now would be a good time to consider that. The attorney will also probably have a list of case managers, prof conservators, maybe even home health agencies they've had experience with that they can recommend.

I'm sure others will also offer you ideas and support. Your Grandmother is fortunate to have a loving granddaughter to help her through this. Careful on the ladders!

Some facilities will take people for a temporary stay. If family needed a break for a week or two for vacation. So maybe you could make a temporary arrangement like this until a room is available at your preferred facility. 24/7 in home care is going to be a lot of work to set up. Then what do you do if someone is a no show. While your dad is the DPOA it’s sounds like you are going to end up doing a lot of the work. I would want her to move closer to you. I don’t think you need a diagnosis to place her. You said the DPOA needs to be activated. Have you seen it and read it or is this your dads interpretation? It’s my understanding that only a spring form DPOA would need to be activated. To activate it I believe you would need a letter signed by two doctors stating she is not capable of making decisions for herself. I’m not sure a specific diagnosis with all the testing would be required for that. If she is far enough along that should be clear with basic questions. It’s definitely important to see a lawyer. You may find it convenient to use the mc doctor. This will cut down on doctors appointments. I agree you should not feel guilty. It sounds like you are working very hard to take care of your family and your gram. We have our limits. Her local commission on aging may be able to give you some suggestions. I hope you can find a solution.

Here is a non-profit assoc website that explains about the field :

A social worker at a AL/MC or hospital can probably also offer leads on case managers they have worked with.

Just tacking on to this a bit. If your dad is older, it could be that your gram out lives him or he could develop dementia. You just never know. At the very least it would be good if you were listed as a secondary.