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Mom 83 progressed into majority of 6th stage of Alzh. After UTI, pneumonia, getting septecemia, Dr recommended hospice. After hospital she was put into rehab (don't know who talked my brother to make that decision) which is trying to get her to exercise, use walker again, has to be awakened otherwise will continue to sleep, appetite varies from couple of oz to just liq to half a plateful. Mom uses 3-4 words infrequently to communicate, mostly just looks around or seems like in her own world, recognizes relatives & her home caregivers that visited her after 5-10 min. There is no way mom will be as good as she was just before her hospitalization. When I spoke to Hospice of CNY they said in order to get mom home we would have to tell Rehab that we want hospice & they (Rehab) would have to call hospice & meeting w/family can happen in 2 days. I explained mom got care from 9am to 10 pm from 4 women who mom was familiar with, spoke mom's language, helped her with most of her ADL skills, exercises, took her for walks with walker, cooked, cleaned house. Due to mom's condition getting worse when she was hospitalized, weak muscles, no solid food except pureed, she will not return to condition prior to hospitalization & between 3 daughters that will alternate in giving 24/7 care with the help of the women 7 days a week probably from 9am to bedtime 8pm we want mom to come home from rehab for 4 reasons. 1 is Dr made hospice recommendation, 2 insurance will not continue to cover, 3 her condition is degrading due to Alzh. 4 we have coverage for home care with hospice 24/7 on call nurse. We do not know really if she has less then 6 months or if she will go beyond 6 months, but normally a dr wouldn't recommend if it was more. Rehab said we can't take her home until she meets certain criteria. Mom says a lot she's tired, why are we forcing her to eat, but at times she eats but NOT like before w/solids. Her muscles are weak, it would take intensive amts of PT or a little each day over a very long period of time just to be strong enough to walk with out being supported from behind with a walker. Alzh would most likely worsen. Dad wants her home, family wants her home. Can Rehab prevent mom from going home? My sister currently is there on average fr/8, 9 am to 8pm while dad is home alone. It will be my turn coming Mar 7th. Home environment is safe easy to get around. Dad wants his wife home even if it means to come home & die. Mom know she lost ability to communicate properly & is always suffered from back pain, many surgeries, living with 1 kidney, fatigue, neuropathy, & always wished & prayed in the last 2 years for the end to come. If mom comes home and decides she doesn't want to get out of bed, we will try coaxing but will not force her. ANY ADVICE. HELP!

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Hospice in place or no money for payment would have her released so fast your head would spin.

They have to by law have a safe release plan in place. Get hospice set up as soon as possible and then she can go home. They will have bed, oxygen, wheelchair, walker, nurses etc in place therefore, safe release plan. To many people are sue happy and that is why the law. Yes, you can take her home, however, insurance can refuse to pay for the entire rehab stay and you don't want that.

Go today and talk to PT facility and tell them you want to follow Drs orders, put her on hospice, then start interviews, be sure you understand what they provide, costs, time frames involved for help, hours of availability and I'm sure others can help with what you should ask and expect.

Start now as it could take several days to find a facility you are happy and comfortable with, then it could take a couple days to get all the equipment in home. My sister was so bad that they even arranged the ambulance to take her home.

May God bless you and your family on this difficult journey. I pray that you all can find joy with mom in her end times.
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It doesn't sound to me like the OP is looking for an alternate facility. She wants to release mom from rehab.

It sounds like there is lack of communication between whomever signed her out of the hospital and into rehab, and the part of the family that wants her in hospice.

Big difference! Someone medically thinks that mom can get back to some level of function. Someone else
( family?) wants to comply with mom's wish to stay in bed.

You all need to talk to each other. Uncomfortable conversations, I know. I've had them.
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Who has POA?
Who signed admission papers for rehab?
Did anyone call a hospice organization to come and evaluate her? In my state, if she's been declared " Hospice eligible" by an MD, someone with Medical POA can ask for a hospice eval.
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thank you for all you suggestions. Has phone Conference Meeting w/siblings. All are dedicated to committing taking care of mom at home, we worked out schedules & tomorrow will be calling back the ladies that worked there before & getting their schedules & then looking for emergency backups. Also the Rehab team is calling a meeting so we will do conference call. I know mom made progress in PT but that was after 5/6 days of facilities screwups. I just pray we have enough time to gather the help before her release. we will also ask about hospice to help with some service's for home.
Love & thanks to all for your love
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Do not take her home from rehab without a doctor's order. Medicare may refuse to pay the bill. If that happens she would have to pay out of pocket.
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Elizabeth, if mom is making progress in PT, why not have her stay in the facility as long as she is still progressing. It will give you time to make all your care arrangements.

Also, the stronger mom is, the easier it will be to care for her at home. The difference between caring for a patient who can assist with transfers and one who just lays there is huge.

My mom, who resided in a NH, post stroke and post hip repair, developed pneumonia and sepsis, was in the hospital for 6 days. She was sent back to the NH looking like a writhe. But we had her readmitted as a rehab patient, and my goodness, after two weeks of in bed stretching and massage, she was up walking again. She was decidedly NOT ready for hospice at that point.
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If mom has started making progress be sure that you get Drs order for in home rehab. My dad got 2 months OT and PT after release from rehab.

Best of luck, maybe mom isn't ready to go just yet. Whatever is to be, may your family find joy with mom.
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Your mom can receive hospice services at home. If she would be discharged from PT to go home to hospice services I can't understand why PT won't discharge her. Maybe they won't discharge her until hospice is in place?
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Elizabeth, if mom is making progress in PT, why not have her stay in the facility as long as she is still progressing. It will give you time to make all your care arrangements.

Also, the stronger mom is, the easier it will be to care for her at home. The difference between caring for a patient who can assist with transfers and one who just lays there is huge.
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It gets me sick that the system can imprison the elderly against family who want to take their Loved One Home. There is much corruption and the benefit of any doubt where taking a loved one home somehow gets lost in corporate money making and politics. Dysfunctional families are most at risk no matter where families are at odds with each other.  In these cases it is easy for the loved ones best interests are lost. Will keep you and your mother in prayer. Please let us know if you get her home safely where she is loved and cherished and how you did it.
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