# Uncle in hospital AGAIN



## debodun (Jun 24, 2015)

I just received a call from a family friend that my uncle has been hospitalized with a severe infection in his leg. He has been in and out of facilities for the last several years. 

He has major social issues - agoraphobia being the major one. He lives alone in a senior housing facility and never voluntarily leaves his apartment. He gets meals-on-wheels and also has a woman do some shopping for him, so he can manage food. 

However, his personal hygiene is atrocious - he never bathes and has been wearing the same clothes for years. His apartment STINKS and there have been complaints from other tenants of the building because of this. Last year a resident called the police because they thought someone had died in the apartment. He was taken to the hospital then because his feet had turned black.

My issue is they get him fixed up and put him back in the apartment where he goes back to his old ways, then in a few months he's back in the hospital. 

After the last hospitalization, he was assigned a case worker, but she only made a few visits then stopped coming. I don't know the reason, but suspect it was a case of non-compliance on the part of my uncle or his refusal to admit her into his residence. I did receive a call from social services saying this was really MY responsibility and that I should be seeing to his needs, however, uncle thinks there is nothing wrong will not adhere to medical instruction. 

The friend I mentioned and I have been trying to convince social services that he should be placed in assisted care, but we have been met with deaf ears. Is there anything we can say to convince them to place him in assisted care?


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## imp (Jun 24, 2015)

Hello! A difficult situation, to say the least. Is your uncle otherwise of sound faculties? Such self-sacrificial tendencies must be difficult to treat medically, and the patient often will refuse medications. 

I am sorry to  say, in answer to your question, that I know of hardly any way you might intervene regarding assisted care. Hope for the best.   imp


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## debodun (Jun 24, 2015)

My uncle is brilliant in some ways - he has memorized the Bible! Yet his social skills are appalling; he never married or even had a job. He lived with my grandpartents until they passed, then alone for a while, then he went to live with his sister until she kicked him out, then he got the apartment where he lives now. I think social services thinks he is competent, so they won't do anything. I know people more competent that are in assisted care.


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## oldman (Jun 25, 2015)

It sounds like he may be a recluse and wants it that way, so I doubt if any changes are wanted or will ever happen, at least not if he has anything to do about it. It's nice that you care and you may continue to seek advice from others that may be able to help. Here in my county we have an association called the York County Area Agency On Aging that give great guidance and assistance with different issues. Perhaps there is an agency like this in your area. Otherwise, just keep looking and calling and hope for the best.

Good luck.


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## debodun (Jun 25, 2015)

I had a call from my uncle's case worker. I strongly urged that my uncle be placed in assisted care since he doesn't take care of himself in a hygienic fashion. She said "That's not the issue." When I asked for clarification, she went on to say that since he has no wife or children to make medical decisions and he's been deemed competent, he can make his own decisions. So if he doesn't want to go into assisted care, they can't force him. This seems like avoidance on their part. Since I deliver meals on wheels, I know of some people that were place in assisted care that I'd say were far more competent than my uncle, but then maybe other influences were going on (i.e. close family insistence). This was the same uncle that was scammed a few months ago and someone emptied out his checking account. I wonder what criteria they use to assess competency?


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## Glinda (Jun 25, 2015)

Debodun, I'm sorry you're having to endure this with your uncle.  He's lucky to have you and he probably doesn't even realize it.  I don't know what to say that hasn't already been said.  I hope everything turns out well for both you and your uncle.


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## SeaBreeze (Jun 25, 2015)

I'm sorry to hear about your uncle, but I can respect his choice not to go into a nursing home, I'd want to stay in my own home too.  IMO, nobody should force another to go to assisted living if they are in sound mind and can make those decisions on their own.  I wish him the best concerning his health, and I guess just checking in on him is all anyone can do right now.


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## debodun (Jun 25, 2015)

Now I received a call from another social worker saying there was a problem - Medicare will not cover his hospitalization since they deem it is not medically necessary. I said that I had been informed that he had an infection in his leg. The social worker said he had maggots on his leg which have now been removed and he did not require antibiotics, so it wasn't a true infection. It is not a medical issue now and as long as he stays in the hospital, he is running up a bill for which he (or someone acting in his behalf) is responsible. I think they just want him out.


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## Butterfly (Jun 25, 2015)

Well, YOU sure shouldn't be responsible.  His problem, not yours.  They can probably sue him all day long and not get the money.  They probably DO want him out, if he doesn't require hospitalization to recover.  Maggots -- YIKES!!!


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## debodun (Jun 26, 2015)

A friend who has been helping my uncle says the apartment house where my uncle has been living doesn't want him back. The hospital wants him out. He is not eligible for assisted care. Where can he go?


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## oldman (Jun 26, 2015)

Just curious, but why isn't he eligible for assisted care? If he has plenty of money, maybe he could have someone come in a couple of times a week and clean and perhaps, do a little light cooking for him. We have what is called assisted in home living here (or something like that). It closely resembles assisted living, but the individual stays in their own home and they come to you. Some pay and some are eligible for free service.


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## debodun (Jun 26, 2015)

oldman said:


> Just curious, but why isn't he eligible for assisted care? .



I am not familiar with his finances or what medical plans he has other than Medicare. I am just reporting what his case worker told me.


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## Phillygal (Jun 27, 2015)

You would need to have him declared incompetent. From what little you've said he MAY be an undiagnosed autistic (agoraphobia, poor social skills, poor hygiene, memorizing the Bible...) which if he were evaluated might get him more services. 

Hope that helps.


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## oldman (Jun 28, 2015)

Phillygal said:


> You would need to have him declared incompetent. From what little you've said he MAY be an undiagnosed autistic (agoraphobia, poor social skills, poor hygiene, memorizing the Bible...) which if he were evaluated might get him more services.
> 
> Hope that helps.



Hey, this sounds like it may be a ray of hope. Maybe it's worth looking into.


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## debodun (Jun 28, 2015)

He did have a psych exam. The report said he was fully competent. I wonder if the psychiatrist was?

BTW - I am totally confused now. I went to see uncle on Friday. He has not been discharged, yet Medicare says his hospitalization is "not medically necessary". If it wasn't, why hasn't the doctor discharged him? The appeal to have Medicare cover his hospitalization has been refused. I also learned that the apartment house where he lives will not be renewing his lease come October (because of his poor hygiene and housekeeping). A friend of his and I have pleaded with social services to get him into assisted care, but have been met with figuratively helpless shrugs. Uncle says nothing is wrong with him - he just wants to go home, live the way he was living and not be bothered with "all this fuss over nothing."


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## Phillygal (Jun 28, 2015)

You need a competency exam. It's different from a psych exam. 

I'd also look for a psychologist familiar with autism in adults. 

Those two things could help get him to a safe place.


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## debodun (Jun 29, 2015)

Second appeal for Medicare was denied. Uncle is now pulling out his IV and refusing to take any medicine.


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## oldman (Jun 29, 2015)

Can you call an attorney that deals with "Senior's" issues? I have one in my town for my wife's sister. The office was a big help with getting her into a facility. That may be your next move.


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## debodun (Jul 1, 2015)

It looks like the ball is finally rolling in getting my uncle into a skilled nursing facility. He is not happy that others are making decisions about his future, but we tried to reassure him we are acting in his best interest. I don't think he's convinced, though.


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## Warrigal (Jul 1, 2015)

What you are going through is not uncommon, debodun. It will be bumpy for awhile after he is admitted too but just grit your teeth and stand firm. If he is behaving badly when you visit make it a short one otherwise the behaviour will become set in.


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## Butterfly (Jul 3, 2015)

How old is your uncle?  Is he senile?


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## debodun (Jul 3, 2015)

Butterfly said:


> How old is your uncle?  Is he senile?



He's just turned 76 in May. He does have mental issues, but I'm not sure it's dementia.

Uncle was supposed to be transferred to the nursing home at 3 pm yesterday. A mutual friend went to see him around 6 pm. I talked to her this morning and she said that even when she got there, he still wasn't in his room and was sitting out in the hallway on a hard wooden chair. She asked around and found out he hadn't been admitted yet. It was like nobody at the hospital told the nursing home he was coming and they weren't ready. Is this any way to run a health care system?


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## Butterfly (Jul 3, 2015)

No, it isn't!

I hope he does OK -- very sad situation all around.


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