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I apologize in advance. This is a long post.
Advice is desperately needed, please.
I am my mother's full-time caregiver. She had a Silver Alert in 2017- and I moved in to help her.
My mother has Alzheimer's Disease with Sundowner's. On 3/19/2023 she fell at home- breaking the right hip and femoral bone. After hip replacement surgery- she was considered a "Fall Risk", because she continually tries to leave the bed to wander.
The hospital chose a rehab for her. I told the coordinator my mother needs a secure rehab, because she wanders.



The first day at rehab #1 she fell. No broken bones, luckily.
A week later - she fell again-breaking the left hip.
I learned about this when I called the desk to check on her at 6pm.
I asked what time my mother fell and I was told 11 a.m.
I learned later- the staff waited until 8pm to call 911- knowing from the x-ray that her left hip was now broken.
After hip replacement surgery for left hip- my mom was sent to a different rehab-she fell while there as well.
I spoke with rehab #2 nurse, who informed me they were not sent any instructions- from rehab #1 or hospital-regarding the right hip-and had not been rehabbing the right hip.
Next-
I received an angry voicemail last week from the head nurse.
She said "Your mother had a bottle of wine in her room, she was trying to open it and we took it from her. You need to get someone to come pick it up- it is locked in my office." I called her back and told her I am my mother's ONLY visitor- and I have not now-or ever- brought wine to her room. I had not even been there for a week- because I caught Covid while visiting her.
I learned they had "Happy Hour"- but the wine was not their brand.
I asked if anyone was in my mother's room. I asked if they had a video they could refer to- the answer was NO.
Finally- the nurse informs me that the staff was given wine baskets- which were scattered all over- on Mother's Day.
My mother took one.
They just called to tell me she will be discharged
Tuesday.
I feel they have not fully treated my mother for both hips. Yet they are releasing her.
I am overwhelmed and I need some advice please.
Thank you for reading this long post.

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You can contact your state ombudsman and express how alcohol is being distributed to staff with access to patients. Heck, staff even drinking water near patients can be cited
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I’m so sorry that you and your mom are going through this difficult time. Falls are so frightening for our family members and for us as caregivers.

It’s completely obvious that your mom needs care. I certainly don’t understand how they could even consider discharging her in good conscience. It’s disturbing and is certainly a shame regarding how they are handling this situation.

As far as the wine goes, I find it ridiculous that they weren’t responsible with proper storage of the wine instead of just allowing it to be lying around.

I wouldn’t be impressed with this rehabilitation program and I wouldn’t hesitate to report this incident so it will not happen again with another person.

I hope that you will find the proper facility for your mom to receive the help that she needs.
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I cannot fathom wine baskets being set about an ALF, but I guess that is neither here nor there compared to the issue currently facing you.

I agree with so many below that Mom requires placement, not going home, and that she requires very careful management, which means MC so that the staffing level can match her tendencies to wander when she is clearly not safe to do so.

It is terrible to hear that these things happen, but when some dementia meets a fragile body with balance issues, falls are the result and they can happen constantly, as comments below show. I am so sorry. I hope you find a safe answer, but I surely don't have one. Laws are such today in most areas that no type of restraint is allowed, and without constant 24/7 supervision it is hard to imagine a safe answer.
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Sounds Like Long term care is Needed unless you Can hire caregivers to come In . I would speak to who ever is in charge of this rehab and tell them you are reporting them to Medicare and she is a Unsafe discharge and needs long term care or a transfer to another rehab . I Know I had to go to the senior center and get advice On the best nursing home for my mother . If you Look on Propublica and YELP you will see a Pattern of neglect with these Places . This is Not Uncommon . You could try a third rehab I Know there is about 100 days with Medicare . What ever you do Please report the neglect to medicare .
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Trying to offer rehab to a dementia sufferer is an exercise in futility as they are not able to follow cues or properly engage in PT/OT exercises. Falls will happen no matter what or where they live, too.....nature of the beast. My mother fell 95x while living in AL and MC. She did not make progress in rehab and became wheelchair bound upon release back to her memory care AL. She had no interest or ability to participate in their exercise program, so there was no other choice but to get her into a wheelchair for safety purposes.

With 2 broken hips and dementia at play, your mom sounds like a candidate for long term care in a Skilled Nursing facility vs rehab. Taking her home would require full time caregivers be hired, imo, because this level of care is way too much for you to manage.

While wine should not have been left around the facility, I don't know if it's the main issue you need to deal with right now. Even if the facility were to be punished for such an oversight, mom still won't get the help you're looking for there....so look into what's needed now instead.

Best of luck to you
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I would report them to your Ombudsman. You should have been called as soon as Mom fell. It was their fault that gift baskets were allowed to lay around where patients could get to them. Yes, I think they are going over the top and I am sure its because they are at fault and are trying to get rid of her. Find another rehab and have her transferred. Then get them to request records from the other 2 rehabs. Then from those records ask them to evaluate Mom for rehab on both hips.

I agree they will fall but the rehabs are suppose to do everything they can to help prevent it. I would claim "unsafe" discharge at this time so you can get ur ducks in a row. You might want to call Medicare and see if they discharged her or this is just the Rehab.
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The rehab have duty of care. If they cannot provide her rehab, they must find a other location or dischage home *if safe to do so*.

Your Mother may be partially wheelchair dependant now. She may need other equipment (different walking frame, over toilet seat/commode). That needs to be arranged & you as her caregiver trained & component. Or other care eg aides arranged.

Sounds like you need a family meeting - push for this. With updates from PT, RN, OT. If this rehab stay is not working out, then what can be done to improve it?
- What falls prevention strategies are in place?
Or, if unable to continue onsite, what other options are available?
- Another in-patient rehab?
- Home with equipment, hlextra home services & PT visits?

*Discharge home* Tuesday sounds very reactive. Is this really in the best interest of their patient? (Makes it appear like embarresment over the wine incident..) 🤔

"No, I can't possible collect Mother on Tuesday. Please arrange a Family Meeting to discuss her rehab & discuss discharge planing. Thank you".
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Yes mom needs to go to long term care. Lol about the wine. Talk about making a mountain out of a mole hill. They act like she was snorting cocaine and throwing a wild party in her room.
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I agree with igloocar -- your mother needs LTC.

If she hasn't been rehabbed, how are you going to take care of her? I'm assuming her mobility is now greatly reduced.

How old are you? Did you give up a job to move in with your mother? What is her financial situation? Do you have POA/HCPOA?

Will you tell the rehab that it would be an unsafe discharge for your mother?
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It sounds as if in this situation rehab is not an option for your mother. She almost certainly needs to go to LTC. When hips keep breaking it does not make good sense to keep trying to rehab them at this age and with dementia. We went through a similar situation with my mother years ago after 3 broken hips. Tell the rehab this is not safe discharge--which it isn't--and that she cannot go home nor can you care for her safely. They will need to find an LTC for her unless you are able to do so. This may involve their taking temporary guardianship of her if they have to place her. I am not knowledgeable in this area, but someone else here can advise regarding guardianship, and/or you could probably still talk with an elder care attorney today about options.
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