My dad has resided at the Armed Forces Retirement Home (formerly The Soldier's Home) in Washington DC for 20 years. He was diagnosed with metastatic prostate cancer 18 months ago and Congestive Heart Failure a year ago. He also maintains a permanent Foley cath and recently -due to a poorly administered IV has lost use of his left arm and hand.
Prior to the IV incident he was living fully independently. He was very active, walking 3 miles daily, taking care of himself.
Now he's been moved to an Assisted Living quarters but has significantly declined in mental and physical health and has requested to be moved to Long Term Care quarters. His request has been denied by the Home because he remains fairly self sufficient. He is tired of keeping up the pace but feels he must because it is what the Home expects of him.
I'm just asking opinion if he's being unreasonable in his request to go to Long Term Care where he can have more care and be more comfortable to face the inevitable undeniable end of a beautiful life.
I feel at his age, with his diagnosis and prognosis, he deserves and should have what he wants in order to die with dignity.
And what about adding in hospice care?
We had an excellent meeting today at AFRH in which he was really listened to. I'm pretty sure they "got it". Now the issue is that there are no beds in LTC. While we wait for one, we have requested Hospice. My Dad doesn't understand palliative care.-Oh and did I mention he's hard of hearing? He has very excellent hearing aids but also a type of hearing loss (from the flight line) that is hard to aid. But I will continue to be his ears and his advocate. The HoH aspect adds to the issues and causes a new level of frustration.
However, we today are feeling hopeful that he will be where he wants to be.
Thank you for your support.
Philosophy of Care
Person-centered Care
The AFRH staff will focus on your individual needs, develop proactive plans of care, and deliver meaningful services to help you thrive. In fact, you will be an active participant in guiding your life and happiness. Also, each staff and family member will work very hard to identify and understand your personal needs, listen carefully to your wishes, and offer smart solutions for consideration.
So, without waiting to hear how formally his application was made, I think you have plenty of scope for advocating increased support.
It also sounds as if insufficient weight has been given to the impact on morale of his diagnoses, and that besides the inevitable physical toll.
Argue!
Best of luck, I hope your father is soon feeling much better supported and comforted. Please let us know of any developments.
Thank you so much.
Tell him I said, "Thank you for your service Sir, I live in a free country because of men like him and I appreciate his sacrifices!" Big hugs!
I only asked for an opinion if a move to LTC seemed appropriate.
A lot has happened in a week due to advocating and pressure on facility to look into the situation and give us reasons for their decisions. We are confident that they are now doing what they can to make my dad comfortable until a room is available in LTC.
I did my due diligence and things are looking up.
Thank you !
I will see that as well as I am able, those gaps are closed.
My father (98 and on Hospice since June 2018) receives VA Home & Community Based Care at home in Michigan (6 til 10 p.m.) He also receives daytime non-VA care. We could not afford for him to be taken care of at home without the VA Aid & Attendance benefit. His savings are now zero so my sister and I kick in and have taken a home equity line of credit to hopefully keep him happy and in peace per his wishes. It was not easy to extract this from the VA, but we did find out that if Dad reaches what's called "skilled nursing" requirements, he could potentially be transferred to a VA facility or a VA-contracting facility. Skilled nursing, as explained to me by both Hospice and the VA Social Worker, is not required for Dad just because he is bedridden, cannot communicate (but is highly aware when awake), has dementia, protein deficiency (though fed very well and appropriately, not forced) and is no longer a fall risk. He does not use oxygen nor requires any IVs. He does not need advanced medication management (injections, infusions or the like). He does require 4-5 Albuterol treatments each day, and gets frequent pneumonia. But the VA does not recognize this as requiring "skilled nursing" because CNAs can administer his RXs at home.
The VA social worker said that the Detroit VA Medical Center does reserve a limited number of beds for Hospice vets, but does NOT provide Hospice services. They cooperate with other Hospice agencies in the area. If the Detroit VA Medical Center Hospice beds are full, the VA social worker has told me that they contract with a number of other skilled nursing facilities in the Detroit metro area. It was like pulling teeth to get the names of these facilities, but I did because I wanted to visit these places before I had to agreed to any sudden potential transfer. Also very difficult to extract, but in 2018 when I was investigating VA skilled nursing, I learned that the VA Medical Center hospice bed and hospital services would be free. But costs may be dependent upon the VA priority rating of a veteran, and my Dad was disabled during WWII. Finally, only a VA physician can certify VA skilled nursing requirements. They would cooperate with Dad's non-VA-Hospice doc, but ultimately any VA placement would require a VA physician signature.
Separately, Dad's Hospice service also contracts with local facilities, but transfer would be for respite only such as during a severe blizzard when caregivers couldn't get through. Not sure about co-pay for that.
Thank you for watching out for your Dad. He sounds like the kind of person my own Dad is. Unassuming, upright, dutiful and a living example to others. My heart goes out to both of you.