Worried about my sick father in another state...
July 12, 2018 10:10 AM Subscribe
I sought out and connected with my birth father about a year ago. We corresponded for a while. At 80 he was living alone in an apartment in San Francisco, and dealing with a few health issues, but in general very alert, active, and independent at that time.
He told me he took a daily mile walk and was a vegetarian. We worked together on one of his creative projects. I was pleased he was doing so well. I live 1000 miles north of him and couldn't afford to travel to meet him, but he had a neighbor who told me on Facebook that she was keeping an eye on him.
Fast forward a year, and he developed a serious urinary tract infection requiring hospitalization. Since then he has had another infection with another hospital stay, and two bouts of post-op treatment at different nursing centers.
The complication in all of this is that it turns out my father is a hoarder. His last care worker (who isn't on the case anymore, not sure why) said his place is also a biohazard, full of human feces and mice droppings. If I didn't know better I would think he was immobilized, but in our conversations he said he often took walks to his favorite restaurant for take-out, and he was always befriending people on the street.
So to find out that for some time--maybe years--he has been either incontinent, or unable to change his clothes, or unable to get to the toilet, or unwilling to deal with self-care for some other reason (Diogenes Syndrome?), has been a shock to me. Never having met him, I had no idea all of this was going on. He always behaved as if he was on top of the world in our phone conversations.
His last care worker said one thing that troubled her in particular was his habit of removing his soiled pants, spreading them on the bed and sleeping on them. He's got layers and layers of soiled clothing all over the bed, and this is where he sleeps. I believe this is why he continues to get UTIs. She told me they were delivering diapers, but since his surgery he was so tired he couldn't dispose of them outside. So the aparment keeps getting worse.
I got upset and arranged to have a sterilization company go to his place. He initially agreed, but when they got there he flew into a rage, screamed at them and drove them off.
Four days ago I got a call from a nurse at Pacific Nursing Center where my father was staying, saying they were going to release him. As far as I know, he got a ride from a staff driver and has been in his apartment since then. I assumed he was at least mobile, or they wouldn't have let him sign out.
An agency called Helping Hands Home Health Care called me trying to get in touch with him. Apparently his phone is dead. I don't know why this is, but he's spent most of the last three months in either a hospital or a care center, so he probably didn't pay his bill. I begged them to go to his apartment and knock on the door, but they refused to do it! The woman on the phone said, "We can't work with him if he doesn't have a working phone." "You really can't go over and knock?" "No." I was in disbelief. Also couldn't believe the snarky attitude. Just amazed and horrified at this point.
So now it's been four days that my father has been home from the care center, and no one has checked on him as far as I know. I'm frantic because I can't get in touch with him. I just messaged one of his neighbors who she said she's going to knock on his door today, so we'll see.
If he doesn't answer, I'm thinking I should call the landlord and have them open the place. Or I could call the police and ask them to do a welfare check or break in.
I left a message for one of his old case workers, but she's working other cases now and I don't know when she'll get back to me.
Is there any other agency I can contact before I call the police? I know my father doesn't have AC. My fear is he is so exhausted from surgery (his former case worker mentioned this) that he might be unable to reach water or food. I just don't know what to do.
I'd appreciate it if anyone in San Francisco could steer me toward an agency that might help. Helping Hands is more like Helpless Hands at this point.
He told me he took a daily mile walk and was a vegetarian. We worked together on one of his creative projects. I was pleased he was doing so well. I live 1000 miles north of him and couldn't afford to travel to meet him, but he had a neighbor who told me on Facebook that she was keeping an eye on him.
Fast forward a year, and he developed a serious urinary tract infection requiring hospitalization. Since then he has had another infection with another hospital stay, and two bouts of post-op treatment at different nursing centers.
The complication in all of this is that it turns out my father is a hoarder. His last care worker (who isn't on the case anymore, not sure why) said his place is also a biohazard, full of human feces and mice droppings. If I didn't know better I would think he was immobilized, but in our conversations he said he often took walks to his favorite restaurant for take-out, and he was always befriending people on the street.
So to find out that for some time--maybe years--he has been either incontinent, or unable to change his clothes, or unable to get to the toilet, or unwilling to deal with self-care for some other reason (Diogenes Syndrome?), has been a shock to me. Never having met him, I had no idea all of this was going on. He always behaved as if he was on top of the world in our phone conversations.
His last care worker said one thing that troubled her in particular was his habit of removing his soiled pants, spreading them on the bed and sleeping on them. He's got layers and layers of soiled clothing all over the bed, and this is where he sleeps. I believe this is why he continues to get UTIs. She told me they were delivering diapers, but since his surgery he was so tired he couldn't dispose of them outside. So the aparment keeps getting worse.
I got upset and arranged to have a sterilization company go to his place. He initially agreed, but when they got there he flew into a rage, screamed at them and drove them off.
Four days ago I got a call from a nurse at Pacific Nursing Center where my father was staying, saying they were going to release him. As far as I know, he got a ride from a staff driver and has been in his apartment since then. I assumed he was at least mobile, or they wouldn't have let him sign out.
An agency called Helping Hands Home Health Care called me trying to get in touch with him. Apparently his phone is dead. I don't know why this is, but he's spent most of the last three months in either a hospital or a care center, so he probably didn't pay his bill. I begged them to go to his apartment and knock on the door, but they refused to do it! The woman on the phone said, "We can't work with him if he doesn't have a working phone." "You really can't go over and knock?" "No." I was in disbelief. Also couldn't believe the snarky attitude. Just amazed and horrified at this point.
So now it's been four days that my father has been home from the care center, and no one has checked on him as far as I know. I'm frantic because I can't get in touch with him. I just messaged one of his neighbors who she said she's going to knock on his door today, so we'll see.
If he doesn't answer, I'm thinking I should call the landlord and have them open the place. Or I could call the police and ask them to do a welfare check or break in.
I left a message for one of his old case workers, but she's working other cases now and I don't know when she'll get back to me.
Is there any other agency I can contact before I call the police? I know my father doesn't have AC. My fear is he is so exhausted from surgery (his former case worker mentioned this) that he might be unable to reach water or food. I just don't know what to do.
I'd appreciate it if anyone in San Francisco could steer me toward an agency that might help. Helping Hands is more like Helpless Hands at this point.
Best answer: Yes, call the police for a welfare check. You might check with San Francisco Aging And Disability Resource Centers for additional help. Is there any other family? Does he have friends or neighbors who are close? How about a primary care physician?
posted by Rosie M. Banks at 10:26 AM on July 12, 2018 [3 favorites]
posted by Rosie M. Banks at 10:26 AM on July 12, 2018 [3 favorites]
Best answer: Welfare check.
Also, I hate to say it, but if you can, you may need to travel down here and sit down with him and go over his situation. This is the point where he is no longer competent to manage his own care and you (or someone) need to step in.
So things to consider:
1. What kind of financial resources does he have? Do you have access to those resources? Do you have power of attorney over his property? Does he have a will or trust or any other kind of document addressing property ownership and management? You want to make sure he's paying his bills (you already suspect he may not be) -- you don't want him evicted on top of everything else.
2. Does he have an advanced directive? Medical power of attorney giving you (or anyone else) the ability to coordinate his care? Is there a competency clause? Do you know who his GP is? Does he even have one? He may need a neurologist to evaluate him so you can get a diagnosis for use in obtaining services.
3. Get in touch with city and county resources for the elderly. You need a geriatric case manager who can meet with you and him and help come up with a plan.
4. Given the multiple UTIs, he's probably at least partially demented (if the evidence of his behavior wasn't enough), which will make it extra hard to provide help or care. He is frightened, suspicious, and paranoid. When my mother was in her last years, she was willing to let family come in and clean and care for her, but very reluctant to admit to weakness in front of strangers. You may need to accept that there's not a lot you can do for him, if you cannot be there and he won't accept help.
5. You may not be able to get the apartment completed cleaned out -- hoarders find that sort of thing horrifying and very upsetting. But if you can get his mental state stabilized, you might be able to get the business with his bedding addressed, which would help a lot.
I'm really sorry. This is so complicated and frightening and sad. I wish you and your father the best.
posted by suelac at 11:46 AM on July 12, 2018 [5 favorites]
Also, I hate to say it, but if you can, you may need to travel down here and sit down with him and go over his situation. This is the point where he is no longer competent to manage his own care and you (or someone) need to step in.
So things to consider:
1. What kind of financial resources does he have? Do you have access to those resources? Do you have power of attorney over his property? Does he have a will or trust or any other kind of document addressing property ownership and management? You want to make sure he's paying his bills (you already suspect he may not be) -- you don't want him evicted on top of everything else.
2. Does he have an advanced directive? Medical power of attorney giving you (or anyone else) the ability to coordinate his care? Is there a competency clause? Do you know who his GP is? Does he even have one? He may need a neurologist to evaluate him so you can get a diagnosis for use in obtaining services.
3. Get in touch with city and county resources for the elderly. You need a geriatric case manager who can meet with you and him and help come up with a plan.
4. Given the multiple UTIs, he's probably at least partially demented (if the evidence of his behavior wasn't enough), which will make it extra hard to provide help or care. He is frightened, suspicious, and paranoid. When my mother was in her last years, she was willing to let family come in and clean and care for her, but very reluctant to admit to weakness in front of strangers. You may need to accept that there's not a lot you can do for him, if you cannot be there and he won't accept help.
5. You may not be able to get the apartment completed cleaned out -- hoarders find that sort of thing horrifying and very upsetting. But if you can get his mental state stabilized, you might be able to get the business with his bedding addressed, which would help a lot.
I'm really sorry. This is so complicated and frightening and sad. I wish you and your father the best.
posted by suelac at 11:46 AM on July 12, 2018 [5 favorites]
Best answer: It sounds like this is going to turn into a huge mess that is going to take a lot of time and energy to untangle enough that he is safe and stable (and even then it might be impossible if he refuses to cooperate with the people trying to help him).
First, you need to figure out who else in the world cares about your birth father's well-being. If you hadn't come back into his life a year ago, who would be getting these phone calls?
Second, social services are going to want to make this your problem - from their point of view, they are overworked, you are the kid, it is your job to take care of your father. From your perspective, it is far more complicated and it is up to you how much of his mess you want to take on as your own problems. Some of the advice is appropriate for people who are already committed to being intimately involved in the well-being of a senior. I think you need to be thoughtful about your motives and resources for how much you get involved.
Third, beyond the welfare check, the agency charged with taking care of adults who are incapable of proper self care is Adult Protective Services. Here is the link for the SF Human Services Agency. Call them and report your concerns - they will know the local resources and they have the mandate to get involved.
posted by metahawk at 1:38 PM on July 12, 2018 [6 favorites]
First, you need to figure out who else in the world cares about your birth father's well-being. If you hadn't come back into his life a year ago, who would be getting these phone calls?
Second, social services are going to want to make this your problem - from their point of view, they are overworked, you are the kid, it is your job to take care of your father. From your perspective, it is far more complicated and it is up to you how much of his mess you want to take on as your own problems. Some of the advice is appropriate for people who are already committed to being intimately involved in the well-being of a senior. I think you need to be thoughtful about your motives and resources for how much you get involved.
Third, beyond the welfare check, the agency charged with taking care of adults who are incapable of proper self care is Adult Protective Services. Here is the link for the SF Human Services Agency. Call them and report your concerns - they will know the local resources and they have the mandate to get involved.
posted by metahawk at 1:38 PM on July 12, 2018 [6 favorites]
Best answer: I'm so sorry about this situation, it's truly heartbreaking. I also want to emphasize what metahawk wrote: social services are going to want to make this your problem - from their point of view, they are overworked, you are the kid, it is your job to take care of your father.
Be very careful about how much responsibility you take on as you're very far away from the location and you're also not the best equiped to properly care for him as you've only known him for a year and it's quite likely that you got a very idealized, fantasy version of him from how he wanted to frame himself to you. He likely has some very serious, long-standing mental issues that you're not well equiped to deal with as you know almost nothing about his personal and medical history. Interface with social services, but make it clear that you're not in a position to be of much assistance overall and you cannot take responsibility for his care.
posted by quince at 1:47 PM on July 12, 2018 [8 favorites]
Be very careful about how much responsibility you take on as you're very far away from the location and you're also not the best equiped to properly care for him as you've only known him for a year and it's quite likely that you got a very idealized, fantasy version of him from how he wanted to frame himself to you. He likely has some very serious, long-standing mental issues that you're not well equiped to deal with as you know almost nothing about his personal and medical history. Interface with social services, but make it clear that you're not in a position to be of much assistance overall and you cannot take responsibility for his care.
posted by quince at 1:47 PM on July 12, 2018 [8 favorites]
Response by poster: Guys, great responses and thank you so much. How true--social service agencies so far have been shockingly unwilling to work with me on this.
My father has some brothers in their 80s from whom he's been estranged--they live on the West Coast. Thanks for the reminder to search for family members, I'll give that a shot.
I just had the San Francisco Police Department do a welfare check this afternoon. They said they knocked on my father's apartment door and nobody answered. They looked through his windows, couldn't see anything. That's all they were willing to do. When I asked them to enter the apartment, they refused. Didn't have a key, didn't have permission, blah blah blah. They sounded like they didn't give a shit and couldn't wait to get off the phone with me.
I just spoke with someone named Deidre Coleman at In Home Supportive Services. She said even if she finds out what's happened to my father, she may not be able to tell me anything about him, if he didn't indicate on some paperwork that I'm permitted to be involved. (And I see some of you guys mentioned that above. Thanks for your suggestions on how to improve the documentation situation, if it turns out my father is okay and we can tighten up my official status with regard to him.)
Deidre was sympathetic, though her hands are tied. She said her report of my father indicated he was "on leave." I asked her what that meant? She said he wasn't at the apartment. I think it really meant that they merely tried to call him and found the phone line out of order, then dropped it. She did say she would make some calls for me about this, so that's the first positive response I've had so far.
I also contacted my father's landlord and asked him to go over to the apartment with a key. I just need to know if he's lying there injured or worse. That was a couple of hours ago, and I've heard nothing yet.
I suppose my next step will be to file a missing person's report.
Thank you again for your detailed responses about documentation and suggestions for agencies to call. I will keep trying.
Oh, and remind me never to get old and sick in America someday...
posted by cartoonella at 2:26 PM on July 12, 2018 [1 favorite]
My father has some brothers in their 80s from whom he's been estranged--they live on the West Coast. Thanks for the reminder to search for family members, I'll give that a shot.
I just had the San Francisco Police Department do a welfare check this afternoon. They said they knocked on my father's apartment door and nobody answered. They looked through his windows, couldn't see anything. That's all they were willing to do. When I asked them to enter the apartment, they refused. Didn't have a key, didn't have permission, blah blah blah. They sounded like they didn't give a shit and couldn't wait to get off the phone with me.
I just spoke with someone named Deidre Coleman at In Home Supportive Services. She said even if she finds out what's happened to my father, she may not be able to tell me anything about him, if he didn't indicate on some paperwork that I'm permitted to be involved. (And I see some of you guys mentioned that above. Thanks for your suggestions on how to improve the documentation situation, if it turns out my father is okay and we can tighten up my official status with regard to him.)
Deidre was sympathetic, though her hands are tied. She said her report of my father indicated he was "on leave." I asked her what that meant? She said he wasn't at the apartment. I think it really meant that they merely tried to call him and found the phone line out of order, then dropped it. She did say she would make some calls for me about this, so that's the first positive response I've had so far.
I also contacted my father's landlord and asked him to go over to the apartment with a key. I just need to know if he's lying there injured or worse. That was a couple of hours ago, and I've heard nothing yet.
I suppose my next step will be to file a missing person's report.
Thank you again for your detailed responses about documentation and suggestions for agencies to call. I will keep trying.
Oh, and remind me never to get old and sick in America someday...
posted by cartoonella at 2:26 PM on July 12, 2018 [1 favorite]
Response by poster: Oh, and Metahawk, I see you mentioned Adult Protective Services. Yes, Deidre asked me to call them as well. I just did. The woman stated that they only deal with cases of suspected elder abuse. My father being injured, out of contact, missing, whatever, doesn't qualify for their help. And she had no suggestions for further steps, but I will try the other SF Human Services agency you linked to in your comment. Thank you so much!
And thanks to all of you lovely people for taking some time out of your day to post a helpful comment. You're making this a little less lonely for me, and I am very grateful for you right now :-)
posted by cartoonella at 2:30 PM on July 12, 2018
And thanks to all of you lovely people for taking some time out of your day to post a helpful comment. You're making this a little less lonely for me, and I am very grateful for you right now :-)
posted by cartoonella at 2:30 PM on July 12, 2018
Response by poster: Just a follow-up to a question above -- my father has no physician that I know of, but he had a very good surgeon a few months ago who was lovely with me over the phone. She seemed to care about my father. I'm trying to find her details right now. Thanks for the reminder to contact medical staff who might remember him.
posted by cartoonella at 2:37 PM on July 12, 2018
posted by cartoonella at 2:37 PM on July 12, 2018
Response by poster: Quick update -- my father went back to the hospital because he wasn't feeling well. I AM SO RELIEVED! So happy he's alive. I got snippy with him during our last conversation. Got really worried I would never get to talk to him again or be able to tell him I love him.
Thank you so much for your advice and suggestions above. I'm printing this thread so I can refer back to them. There are still so many challenges. Husband and I will add a new line for him and ship him a phone asap. Love you all. - Kim
posted by cartoonella at 3:33 PM on July 12, 2018 [17 favorites]
Thank you so much for your advice and suggestions above. I'm printing this thread so I can refer back to them. There are still so many challenges. Husband and I will add a new line for him and ship him a phone asap. Love you all. - Kim
posted by cartoonella at 3:33 PM on July 12, 2018 [17 favorites]
Best answer: Just to take one thing off your worry list? You mention that he doesn't have AC -- almost nobody in the inner Bay Area does. The climate is ridiculously mild all the time. The high today was 66 degrees. (The high.) People complain when it hits 80, but it doesn't look like it's going to even get into the 70s for another week. Glad he's safe!
posted by salvia at 9:21 PM on July 12, 2018 [5 favorites]
posted by salvia at 9:21 PM on July 12, 2018 [5 favorites]
One more thing about Adult Protective Services - they don't deal with missing people (that is a police matter) but they can get involved in cases of self-neglect (where adult is incapable of taking care himself).
This is from their Website:
Our Adult Protective Services (APS) division accepts and responds to reports of abuse, neglect, exploitation, and self-neglect involving older adults and adults with disabilities. If your father is mentally competent AND refusing help, they probably won't be any good but I could see this case going in directions where you might want to call them again.
posted by metahawk at 11:06 PM on July 13, 2018 [3 favorites]
This is from their Website:
Our Adult Protective Services (APS) division accepts and responds to reports of abuse, neglect, exploitation, and self-neglect involving older adults and adults with disabilities. If your father is mentally competent AND refusing help, they probably won't be any good but I could see this case going in directions where you might want to call them again.
posted by metahawk at 11:06 PM on July 13, 2018 [3 favorites]
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posted by praemunire at 10:23 AM on July 12, 2018 [17 favorites]