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They did everything for her. When I came to visit in bed uses bedpan. All the money she spent with self pay and her insurance helped, but she is worse than she was before.

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Losing independence isn't unusual when an elder goes into rehab for something. It's guaranteed when they go into a nursing home.
You know your mother better than any rehab center. How much of it is mom can't do for herself or mom won't do for herself? You'd know best.
There are options that can help you. Medicare will pay for some aide care that can help with her personal care and give you a break.
That's a start.
You have to force her to do for herself. As her caregiver you will of course be there to make sure she's safe and to observe. Then you can determine what she is and isn't capable of doing anymore. There will likely be a lot of fights and a lot of messes. You will need a lot of patience. You have to make her try and you do this by not doing for her. I had a homecare client who went into a rehab and nursing home for a while after surgery. I wasn't her first home caregiver. I came after. Everything had to be done for her like an invalid, when really it didn't need to be. I found this out the first time I brought her meal. I put her in the wheelchair and put her right up to the table (she was used to being spoon-fed in bed). Then put the meal in front of her. The food was brought and opened her mouth expecting to be fed. I told her I refused to feed her and either she feeds herself or go hungry. Then I left the room, but watched her. She ate the whole meal. I told her family this who did everything for her to do the same thing. Then she had chores to do like folding the laundry and breaking the ends off fresh green beans. The purpose of these tasks was also to help with dexterity. Then we'd do exercises and walk. Every single day and I take no for an answer. Five months later this "invalid" who had her meals in bed and was spoon fed, was now regularly going out shopping and out to lunches with me.
First order of business with you and mom, is you stop getting up all night long with her. In a nursing home no one goes in every five minutes all night long to toilet someone. You don't either anymore. Twice a night and use a diaper. Next, mom starts wiping her own ass in the daytime, on the toilet. You'll have to check her and make sure she's good. Then give her jobs like the laundry and the green beans. A physical therapist will come and Medicare will pay. They will teach you and her exercises for her. Do them together. Have the aide do them with her too. If you see no improvement, then she's invalid and can't come back. It will take time and patience and outside help. Good luck to you both.
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Sounds like mom needs PT and OT at home. This should have been part of her discharge planning.

Try and get some part time caregivers to help you.

When my dad was released from rehab he needed OT, PT, speech therapy and part time sitters. Never could I have managed alone,

Get her PCP to try and do an assessment or send a copy of the one from rehab. He should have a social worker on his team to set up in home services.

She will improve but it may take a while to build up some strength.

Get a bedside commode or any aides that will help through her day.

Best of wishes
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My mother was involuntarily placed in a nursing facility. It was horrible. She got worse, not better, and died in there. People should not be recommending to someone to send their mother to a facility, when I think all the OP wants is advice on how to deal with the "new normal." If rehab only made her worse, what is a nursing home going to do to her? I saw what they did to my aunt in rehab, pretty much would not let her get out of bed and wanted to send her to a nursing home. Turns out the home was partially owned by the doctor practice and very suspicious. We got her released and she rehabbed at home and had many more years living independently. I don't know what state OP is in, but there are agencies that help elderly continue to live at home. My sister is currently talking to one of them for our father, who is in his right mind but just has some physicial limitations.
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BurntCaregiver Jul 2021
I'm inclined to agree with you Misty9723. Many times going into a rehab for a senior makes everything worse. Families really have to keep an eye on these places and on the doctors of an elderly person because of who might be in bed with who. Medicare pays for some in-home physical and occupational therapy. They're supposed to offer it.
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I am so sorry. Of course, you are exhausted! Have you considered placing her in a facility? Take care of yourself too.

My mom did fairly well in rehab but when you think about it, it’s only temporary. Mom was in he 90’s. How much can they really improve?
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Yes they do tell lies (not sure of intentions - probably just to get them out one way or the other). For example, when dad was coming out the hospital therapy staff swore dad did not have incontinency issues. The nurse told me the truth as she walked me down to take dad to my home. However, she didn't tell me how to handle, learning all on my own. During the day, he tells us when he has to go and at night he still wants to get up and go so I had to put the potty bowl in the room for him to use because he just refuse to use his underwear no matter how I multi-layer up on liners and pullups.

The hospital rehab did much better in getting some improvement than the nursing home did for many months. However, some issues still need work.
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You have your work cut out for you. You may want to start with in home PT and OT.
You need to find a way to get sleep. How old is she? After a few weeks I put a commode at the end of my mom's bed and fed her good food, The first couple of months are the hardest.
It can improve. Hopefully she gets stronger and gets a little better each day.
Find a way to get sleep and help.
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It’s not uncommon for a senior, especially one with a long list of health issues, to come away from rehab with a new normal. Which means a bit of function is lost with each hospitalization, rehab, and health setback. Rehab often doesn’t mean independence, more like trying to hang on and maintain. During my dad’s last rehab we all saw his abilities slip away. I’m sorry you’re seeing this and hope you’ll come up with a new plan soon
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If her needs are above what you are capable of, and that’s not on you, you need to contact someone to help with placing her. I would suggest your Agency on Aging as a place to start.
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Why did you allow her to come home if she's worse now than before rehab? You could have had her sent directly to a nursing facility, until she got better, or even permanently.
You are now going to have to either hire full-time in home help for her(with her money), or look into placing her in the appropriate facility, as you know that you cannot continue on with the way things are now.
Please don't prolong doing what you know needs to be done.
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Carolann2244 Jul 2021
In defense of the OP, my father has been in rehab and inpatient Geri psych units and BOTH times the facility lied about what he was capable of before he came back home. The home rehab person actually showed me the case notes from the rehab he did at the hospital when PT came, which was the exact opposite of what the social worker said he was doing.
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