My father's wife has abandoned him at the hospital without responding to any forms of communication in NYC. The social worker at the hospital was able to obtain Medicaid acceptance for my father as he would need to be placed in a long-term care facility. Although I’m not able to care for my father as the next of kin, the social worker indicated that Medicaid will pay for all his care and I will only be responsible for making a co-payment of $200 per month nor any potential upcharges in the future.
I don’t want this responsibility as we’ve been very distant and doing this I believe would then make me the caregiver. Not sure what other options my father would have as he has the onset of dementia and is being aggressive.
Please advise…
As I was called out of the blue, I will meet face-2-face with the hospital Social Worker and find out what’s going on. Hopefully they can place him in a facility he can afford with his benefits as I am not able to.
Your father's wife needs to see (hope she's done this already) a certified Elder Care attorney. In NYC, a spouse can refuse to provide funds for a spouse's care ("spousal refusal"), but it's nothing something I would try on my own.
You tell the SW that you do not have, nor to you want ANY responsibility financial or otherwise and that no funds will be forthcoming from you.
If s/he pulls the "you wouldn't want him to become a ward of the state, do you?" you say "YES, PLEASE".
"Medicaid copayment limit
As a New York Medicaid recipient, you will be asked to pay up to $200 in a copay year that runs from April 1st to March 31st. Once you have reached the maximum, you will receive a letter exempting you from Medicaid copayments until the next period.
Can I be refused services if I can’t pay a copayment?
Because Medicaid covers low-income and often very sick patients, health care services cannot be withheld for failure to pay. However, enrollees may still be held liable for unpaid copayments."
This applies to "Community Medicaid" which is likely what they were able to get him on an emergency basis.
What he needs now is "Long Term Care" Medicaid; he will most likely be placed in a facility "Medicaid Pending" while the NH goes after his wife for 5 years worth of financial records.
Do NOT pay anything and do not SIGN anything. Listen politely and give the SW the wife's contact information. This is her kettle of fish, not yours.
Would the hospital discharge him to the streets, homeless shelter or back to the Longterm Care facility he was initially sent?
Also could look into other programs is placement is a concern.
It is also not unheard of to release a dementia patient that is ambulatory and is aware enough of to know where they are to released. Normally those the difficult ones that require 1-to-1 to prevent unwanted wandering around, and risk a lock down
The hospital in required to make a "safe discharge". They may pressure you to take him.
The answer to that is a hard "no".
They might release him to a shelter if he is "chronic and stable" but it sounds like he is actively wandering and combative. The SWs will then work to get him into an Assisted Living or NH placement, depending upon his needs. Sometimes a person has to become homeless BEFORE they can get the help they need.
I just finished reading a book "Never Simple" about a mentally ill woman whose daughter TRIED desperately to help her mom (full disclosure, I know the daughter slightly). She was evicted for non-payment of rent, taken to a shelter, placed in a nice Medicaid paid Assisted Living place. She signed herself out.
The rest of the story doesn't end well, but it showed me that the NYC SW system DOES care and DOES find placements for folks, even those with no funds.
Is it possible his wife is in the hospital and that's why she's non-responsive?
IMO, I would not even go to the meeting. A SW will do anything to have you take over Dads care. You are not obligated to be his Caregiver. You are not Obligated to use any of your money. What you can do is not even get involved. Tell the SW you are estranged from your father. They need to locate the wife. Give them whatever info they can use to locate her. In the meantime, he can become a Ward of the State. A guardian will be assigned to his case and will get him placed faster than u can. Let the State locate the wife. 50% if the marital assets are Dads. Then tell the SW she is not to contact u again.
Sounds heartless I know but they will try to force you to take over his care. The State can work much quicker than you can. They WILL get him placed.
When my cousin needed to apply for Medicaid for his Mom, the Office of Aging told him not to allow a SW at the NH to do the applications. Knowing the rules of Medicaid takes studying it. An elder lawyer goes to classes to learn about Medicaid. I find the SWs attached to NHs and Hospitals no a little but not enough. Like with this $200. Something that you as a daughter would not have been responsible for but his wife have. Not quite false info but info that did not fit your situation. Always ask Medicaid. I found my Moms caseworker very helpful. I always took the info I learned here and verified it with Moms caseworker.
Appreciate the advise.
Just got home after a 2 1/2 ride from visiting the hospital where my father is being treated for water in his lungs. Both the Social Worker and Doctor had so many questions about his wife who has not responded to their calls. One medically the other surrounding Longterm Care. Apparently his dementia has progressed, but if stable the doctors would like permission to move forward with water removal procedure. I repeated the wife has full responsibility and I have no living will nor authority. I was told they would speak with the hospital directors to provide me the authority to provide permission as the wife appears unreachable. I have no problem in giving the permission as long as it doesn’t make me financially responsible since he has Medicare and supplemental insurance coverage. They said it won’t.
As far as the Social Worker, I stood my ground and provided all of the contact info I had for his wife. I asked if I should go to the local precinct and report a missing person and abandonment of an elderly person (dump-n-run). I was told not to and that they would do everything to find her.
How can she be married to my father for 15+ years and abandoned him, while all she needs to do is provide information for the Social Worker to assist in obtaining full Medicaid and not the Community Medicaid, which the used to place in a Longterm Care facility as a emergency. Made me tear as he also doesn’t look well (stares into space, frail, needs liquids to be made heavy in order for him to drink).
I was told they be keeping him in the hospital for the next two weeks (3 weeks total) and base on his condition back to the Longterm Care facility while they search for his wife ( I believe his current insurance solely provided short term care). I was vigilant in expressing he needs to be place in Longterm Care and Medicaid, but how will they be able to get any information if they could not find his wife. Again, I was advise they will work vigilantly to get in contact with his wife.
Sad very sad situation…