Uncle refuses to follow plan to get him into SNH. He went behind my back and made appt. with old VA PCP after we got a better one. Advice?

I got fed up with being given runaround by the PCP and Social Workers at the VA, who refused to honor their agreements to help us transfer my uncle into a CA run Veteran Skilled Nursing Facility. After I spent over a week gathering the paperwork for the application, all that was needed was the small section to be completed by the PCP. I submitted to him nearly 3 months ago. He returned it to me, 2 months later--COMPLETELY BLANK--without a letter or note of explanation of any kind! I resubmitted it to him, of course, placed a phone call to his social worker (as close to talking directly to him as permitted), explained what had happened, why I was returning it, and asked why the doctor had not filled it out.

The SW was extremely rude to me, told me SHE didn't know what was going on in other people's brains, and she was NOT responsible for them not doing their jobs. She advised me to call a lawyer if I didn't like it. I had already spent over 4 hours in the business office trying to speak with a Service Representative only to be passed around to 3 different guys who each said it wasn't their job.

I am fed up with the Veterans Affairs after 5 years of this kind of poor service. Half of the time, the notes from the office visit don't even reflect what really happened! But my uncle feels a loyalty to his doctor because he's been with him for over 20 years (and I have seen him try to manipulate him.) During visits, the PCP tells me my uncle has alzheimer's but refuses to write it up in his notes, and when I pushed him for a written diagnosis, he waffled and would only commit to MCI. He said "dementia is tricky to diagnose and you would have to go to Palo Alto for an 8 hour appointment." He knows that is practically impossible for us. It is so far it means staying overnight in a motel, which I cannot do, logistically! He also reminded me my uncle would have to agree. I only want to help my uncle get the best care and stay safe. The doctor made it sound like I was trying to do something evil to him!

I told my uncle I will not go back to the VA again. I do not believe he is getting proper or even adequate care there. He agreed to see a new doctor after I got advice from an elder care attorney to find one who accepted Medicare. The new doctor committed to help get my uncle into a SNF because he needs a higher level of care than he is currently receiving now at the AL. It is proving quite a difficult feat, however, because there are not a lot of beds available for Medicare patients and he cannot afford to pay privately. As it stands now, he gets a highly discounted rate and only has $20 left over each month.

I am working with a great social worker, now, with this new doctor. We discovered any PCP can complete the medical portion of the VA housing admissions application, so we have an appointment next Monday to do just that.

However, my uncle is going crazy with his delusion about walking again. He believes when he gets into a new facility, he can con them into letting him out of the wheelchair (where he has been confined due to his extreme fall risk) 10 falls this year). He is totally non-compliant with his restrictions and walks as soon as anyone is not looking.

So, my uncle convinced the in-home caregiver to help him make an appointment at the VA with his former PCP. Then my uncle called me and said "he HAS to get this `thing' fixed", meaning he needs to get the housing situation going-he's told me he believes if he talks face to face with his PCP he'll get what he wants. He won't, of course. But, he's a stubborn old fool and he's impatient. Fine. But I'm sticking to my guns on this- he's on his own.

I asked how he plans to get there. He says he will work it out. I have had him take the special bus before, so he can do that. He won't know how to use the computer system--someone can help him. It might be good to let the doctor see him struggle without me.

Sorry this is so long.