Dementia is a condition that affects the brain and causes problems with memory, thinking, and behavior. People with dementia may have trouble remembering things, communicating, making decisions, or caring for themselves. They may also experience changes in their personality, mood, or emotions. Dementia is not a normal part of aging, and it can affect anyone at any age, but it is more common in older adults.
People with dementia need special care and support to help them cope with their symptoms and maintain their quality of life. They may need assistance with daily activities, such as bathing, dressing, eating, or taking medications. They may also require medical care, such as infection treatment, pain, or other health issues. They may also benefit from social and emotional support, such as counseling, activities, or companionship.
Finding a suitable care facility for your loved one with dementia can be a challenging and stressful task. You may have many questions and concerns, such as: What type of facility is best for my loved one? How much will it cost? How far is it from my home? How can I trust the staff and the quality of care? How will my loved one adjust to the unfamiliar environment? These questions can be even more challenging to answer if you live in a rural or remote area, where the options for dementia care may be limited, unavailable, or unaffordable.
If you are in this situation, you may feel desperate and hopeless. You may feel like you have no choice but to keep your loved one at home, even if you cannot provide the care they need. You may feel like you are neglecting your health, well-being, or responsibilities. You may feel like you are alone and unsupported. You may feel like you are running out of time and options.
But there may be one option that you have not considered: using the hospital system as a last resort to place your loved one in a care facility. This option involves admitting your loved one to the hospital for a medical reason, such as a fall, infection, or behavioral crisis. Then, you refuse to take your loved one home after they are discharged from the hospital. You tell the hospital staff that you are unable to care for your loved one at home and that you want them to find a care facility for them. This option may seem drastic, risky, or unethical, but it may be the only way to get your loved one the care they need and deserve.
This article will explain how this option works and what you must consider before choosing it. We will also provide some alternatives to this option if you want to explore other possibilities. We will also offer some resources and contacts for further information or assistance. We hope that this article will help you make an informed and compassionate decision for your loved one with dementia. We understand this situation is difficult and painful, and we want you to know that you are not alone. We are here to support you and your loved one.
The Hospital Option: How It Works and What to Consider
If you are unable to find a local care facility for your loved one with dementia, you may consider using the hospital system as a last resort. This option involves admitting your loved one to the hospital for a medical reason, such as a fall, infection, or behavioral crisis. Then, you refuse to take your loved one home after they are discharged from the hospital. You tell the hospital staff that you are unable to care for your loved one at home and that you want them to find a care facility for them.
This option may seem simple and quick to solve your problem, but it has risks and challenges. Before you choose this option, consider the following legal and ethical implications and possible outcomes and consequences.
Legal and Ethical Implications
Refusing to take your loved one home after they are discharged from the hospital may have legal and ethical consequences for both you and your loved one. Depending on the state laws and the hospital policies, you may be violating your legal duty or contractual agreement to care for your loved one. You may also violate your loved one’s autonomy, dignity, and self-determination rights. You may be accused of abandonment, neglect, or abuse of your loved one. You may face civil or criminal charges, fines, or lawsuits from the hospital or other parties. You may also lose your guardianship or decision-making authority over your loved one.
Moreover, refusing to take your loved one home may have moral and emotional consequences for you and your loved one. You may feel guilty, ashamed, or conflicted about your decision. You may feel like betraying your loved one’s trust or breaking your promise to them. You may feel like you are giving up on your loved one or failing them as a caregiver. You may also worry about how your loved one will react to your decision. They may feel hurt, angry, or confused by your refusal. They may feel abandoned, rejected, or unwanted by you. They may feel scared, anxious, or depressed about their future. They may also lose their sense of identity, belonging, or purpose.
Therefore, before you choose this option, you need to weigh the pros and cons carefully. You need to consult with your loved one’s doctor, lawyer, social worker, or other professionals who can advise you on your decision’s legal and ethical aspects. If possible, you must also communicate with your loved one and explain your reasons and intentions for your decision. You must reassure your loved ones that you still care for them and do this in their best interest. You also need to prepare yourself for the emotional impact of your decision and seek support from your family, friends, or other caregivers who can understand your situation.
Possible Outcomes and Consequences
Refusing to take your loved one home after they are discharged from the hospital may have different outcomes and consequences, depending on the response of the hospital and the availability of care facilities. Here are some of the possible scenarios that may happen:
The hospital may find a care facility for your loved one in the same area. This may be the best-case scenario, as it may solve your problem and provide your loved one with the necessary care. However, this scenario may not be guaranteed, as it depends on the availability and affordability of care facilities, as well as the cooperation and coordination of the hospital staff. You may also have to accept the facility that the hospital chooses for your loved one, which may not be your preferred choice or meet your expectations. You may also have to deal with the coordination and costs of transferring your loved one to the facility, especially if it is far from your home. You may also have to adjust to the changes and challenges of visiting your loved one in the facility, such as the distance, the schedule, the rules, or the staff.
The hospital may involve social services or the court system to determine the best interest of your loved one. This may be a neutral scenario, as it may provide a fair and objective assessment of your loved one’s situation and needs. However, this scenario may also be stressful and time-consuming, involving a lot of paperwork, interviews, evaluations, hearings, or rulings. You may also have to abide by the decision of the social services or the court, which may not be in your favor or in line with your wishes. You may also have to deal with the legal and financial implications of the decision, such as the fees, the fines, or the penalties. You may also have to deal with the emotional and relational consequences of the decision, such as conflict, resentment, or estrangement.
The hospital may charge you for the cost of your loved one’s stay or sue you for abandonment. This may be the worst-case scenario, as it may cause you financial and legal trouble. The hospital may claim that you are responsible for paying for your loved one’s hospital bills, which may be extremely expensive and beyond your budget. The hospital may also claim that you are liable for abandoning your loved one, which may be a severe offense and subject to prosecution. You may have to defend yourself in court, which may be costly and complicated. You may also have to deal with the reputational and social implications of the lawsuit, such as the shame, the blame, or the isolation.
Therefore, before you choose this option, you must be aware of the possible outcomes and consequences. It would help if you were prepared for the situation’s uncertainty and complexity. It would help if you were realistic and flexible about your expectations and options. It would help to cooperate proactively with the hospital and other parties involved. It would help if you were resilient and hopeful about your and your loved one’s future.
Alternatives to the Hospital Option
Using the hospital system as a last resort to place your loved one in a care facility may not be the best or the only option for you and your loved one. There may be other ways to find a suitable care facility for your loved one with dementia without risking the legal, ethical, or emotional consequences of refusing to take your loved one home. Here are some suggestions for other ways to find a care facility for your loved one:
Contacting Local or National Organizations
Many local or national organizations, such as the Alzheimer’s Association or the Mayo Clinic, offer information and support for dementia caregivers. These organizations can help you find and compare care facilities in your area or other locations based on your loved one’s needs, preferences, and budget. They can also provide you with resources and guidance on choosing a care facility, preparing your loved one for the transition, and coping with the changes and challenges of dementia care. They can also connect you with other caregivers who can share their experiences and advice.
You can contact these organizations by phone, email, or online. You can also visit their websites or social media pages to access their online tools, databases, articles, videos, podcasts, or webinars. You can also join their online or in-person support groups, forums, or events to interact with other caregivers and experts.
Exploring Different Types of Facilities
Several types of facilities provide various levels of care for people with dementia, such as adult day centers, long-term care, respite care, or memory care. Each type of facility has its advantages and disadvantages, depending on your loved one’s condition, stage, and prognosis. Here is a brief overview of each type of facility:
Adult day centers offer daytime care and activities for people with dementia while allowing them to stay at home with their families at night. They can provide social stimulation, cognitive stimulation, physical exercise, health monitoring, medication management, personal care, meals, and transportation for your loved one. They can also provide respite, education, counseling, and support for you and your family. Adult day centers can be a good option for people with mild to moderate dementia who can still benefit from staying at home but need some supervision and assistance during the day.
Long-term care facilities are facilities that offer 24/7 care and supervision for people with dementia who can no longer live at home safely or independently. They can provide medical care, nursing care, personal care, medication management, meals, and laundry for your loved one. They can also provide your loved one with social, recreational, and therapeutic activities. Long-term care facilities can be a good option for people with moderate to severe dementia who need constant care and attention but still have some quality of life and comfort.
Respite care facilities offer temporary care and relief for people with dementia and their caregivers. Depending on your needs and availability, they can provide short-term or occasional care for your loved one, ranging from a few hours to a few weeks. They can offer the same services and amenities as long-term care facilities flexibly and conveniently. Respite care facilities can be a good option for people with any stage of dementia and their caregivers who need a break, a vacation, an emergency, or a trial period before moving to a long-term care facility.
Memory care facilities are facilities that specialize in caring for people with dementia, especially those with advanced or severe dementia. They can provide a safe, secure, and stimulating environment for your loved one with locked doors, alarms, cameras, or GPS trackers. They can also provide staff who are trained and experienced in dementia care and can handle the behavioral and psychological symptoms of dementia, such as agitation, aggression, wandering, or hallucinations. They can also provide personalized and individualized care for your loved one based on their history, preferences, and abilities. Memory care facilities can be a good option for people with advanced or severe dementia who need specialized and intensive care but who may not qualify for or benefit from hospice care.
Finding a care facility for your loved one with dementia can be very expensive and unaffordable for many families. However, there may be ways to reduce the cost or get some financial assistance or subsidies for dementia care, such as Medicare, Medicaid, veterans benefits, or private insurance. Here are some examples of how these programs can help you pay for dementia care:
Medicare is a federal health insurance program for people who are 65 or older, disabled, or have certain diseases. Medicare can cover some of the costs of dementia care, such as doctor visits, hospital stays, lab tests, medications, medical equipment, or hospice care. However, Medicare does not cover most long-term or personal care costs, such as nursing home care, assisted living, or home health aides. You may need to pay for these services out of pocket or use other funding sources, such as Medicaid, veterans’ benefits, or private insurance.
Medicaid is a joint federal and state health insurance program for people who have low income and limited resources. Medicaid can cover most long-term care or personal care costs for people with dementia who qualify for the program, such as nursing home care, assisted living, home health aides, or adult day care. However, Medicaid eligibility and benefits may vary by state, and you may have to meet certain income and asset limits or spend down your assets to qualify for the program. Depending on the state rules and regulations, you may also have to share the cost of care with the state or pay back some of the benefits after your death.
Veterans’ benefits are benefits and services the Department of Veterans Affairs (VA) provides for veterans and their families. Veterans’ benefits can cover some of the costs of dementia care for veterans who have a service-connected disability, a low income, or a special need, such as nursing home care, assisted living, home health care, adult day care, or hospice care. However, veterans’ benefits eligibility and benefits may depend on the veteran’s service history, disability rating, income level, or other factors, and you may have to apply for and prove your eligibility for the program. You may also have to use other funding sources, such as Medicare, Medicaid, or private insurance, to cover the rest of the costs of dementia care.
Private insurance is insurance from a private company or employer to cover some health care or long-term care costs. Private insurance can cover some of the costs of dementia care, depending on the type and level of coverage you have, such as health insurance, long-term care insurance, life insurance, or annuities. However, private insurance may not cover all the costs of dementia care, and you may have to pay for deductibles, co-payments, premiums, or exclusions. To qualify for or use the insurance, you may also have to meet certain criteria or conditions, such as age, health status, or pre-existing conditions.
Considering Hospice Care
Hospice care is a service that offers end-of-life care and comfort for people with dementia who have a terminal illness or a life expectancy of less than six months. Hospice care can be provided at home, in a hospital, or in another facility, depending on your preference and situation. Hospice care can provide palliative care, pain management, symptom relief, emotional support, spiritual support, and bereavement support for your loved one and your family. Hospice care can be a good option for people with advanced dementia who have no hope of recovery or improvement and who want to die with dignity and peace.
However, hospice care may also have some challenges, such as:
Being difficult and emotional to accept or choose, as it may mean giving up on curative or aggressive treatments or acknowledging the imminent death of your loved one.
Being limited and restricted by certain criteria or conditions, such as the diagnosis, the prognosis, the consent, or the availability of hospice care providers
This is misunderstood and stigmatized by some people, who may think that hospice care is giving up, abandoning, or hastening death rather than enhancing life and comfort.
Therefore, before you choose hospice care, you must understand what it is and is not. You need to talk to your loved one’s doctor, hospice care provider, or palliative care specialist, who can explain the benefits and limitations of hospice care and help you determine if your loved one is eligible and ready for hospice care. You also need to talk to your loved one, family, friends, or faith leader, who can support you and your loved one emotionally and spiritually and help you cope with the grief and loss.
Considering a Life Plan Facility or a Continuing Care Community
A life plan facility or a continuing care community offers multiple levels of care in one location, such as independent living, assisted living, memory care, skilled nursing, or hospice care. A life plan facility or a continuing care community can be a good option for people with dementia and their families who want continuity, stability, and convenience in their care. By choosing a life plan facility or a continuing care community, you and your loved one can:
Stay in the same facility or community as your loved one’s condition changes and progresses without moving to a different location or facility.
Have access to various services and amenities, such as health care, personal care, social activities, recreational facilities, transportation, or security.
Have a sense of belonging and connection with other residents and staff, who can provide support, friendship, and companionship.
Have more control and flexibility over your care and lifestyle, such as choosing your living space, your care plan, your activities, or your payment options
However, a life plan facility or a continuing care community may also have some drawbacks, such as:
Being extremely expensive and unaffordable for many families, as they may require a hefty entrance fee, a monthly fee, or a long-term contract
Being limited and unavailable in some areas, as they may have a high demand, a long waiting list, or a strict admission policy
Being inconsistent and unpredictable in their quality and availability of care, as they may have staff turnover, financial problems, or regulatory issues
Therefore, before choosing a life plan facility or continuing care community, you must carefully research and compare your options. You must visit the facility or community, talk to the residents and staff, review the contract and the fees, and ask for references and recommendations. You must also consult with your loved one, family, lawyer, financial planner, or care manager to ensure this option is suitable and feasible for you and your loved one.
Conclusion
Finding a care facility for your loved one with dementia can be one of the most challenging and important decisions you will ever make. You may face many challenges and obstacles, especially if you live in a rural or remote area, where the options for dementia care may be limited, unavailable, or unaffordable. You may feel desperate and hopeless, and you may consider using the hospital system as a last resort to place your loved one in a care facility.
However, this option may not be the best or the only option for you and your loved one. It may have legal, ethical, and emotional consequences for both of you, and it may not guarantee a positive outcome or a satisfactory solution. There may be other ways to find a suitable care facility for your loved one, such as contacting local or national organizations, exploring several facilities, seeking financial assistance or subsidies, or considering hospice care. These alternatives may offer more benefits and fewer risks and help you find the best care option for your loved one and family.
We hope this article has provided useful information and guidance on finding a care facility for your loved one with dementia when local options are unavailable. We also hope that this article has helped you understand the pros and cons of using the hospital system as a last resort to place your loved one in a care facility. We encourage you to research, compare your options, consult with professionals, and communicate with your loved one and family before making your final decision.
If you need more information or assistance, you can contact the following resources or contacts:
The Alzheimer’s Association: A national organization that offers information, support, and advocacy for people with Alzheimer’s disease and other dementias, as well as their caregivers.
The Mayo Clinic: A leading medical center that provides comprehensive and compassionate care for people with dementia and their families.
The Eldercare Locator: A public service that connects older adults and their families to local aging and disability resources.
We understand this situation is difficult and painful, and we want you to know that you are not alone. We are here to support you and your loved one with dementia. We respect your decision and dignity and wish you and your loved one the best possible care and comfort.
