Rehab pushing my mom into nursing home she doesn't need.

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The rehab hospital my mom is at currently has been making references to my mom moving into their "assisted living" if she can't move back to her apartment. Their assisted living is really in name only. It is nursing home rooms where they can't have their things like the rest of the nursing home is. The rehab therapy people work for a different company but are at the rehab facility. They seem confident she can do the things needed to go home by the time she is done there. So the facility side of the rehab hospital trying to push her over to their nursing home is a bit ghoulish. They presented it to her as her only other option. Even though we have assisted living options in town if she needs them, they just don't run them. This of course has my mom rather freaked out.

We think she will be able to move back to her senior apartment with some home health care and be ok. The apartment thinks she is capable. So the facility acting counter to her goals is a bit worrying. The facility fought her about allowing her to move herself from her wheelchair to her chair in her room even though she had been doing it on her own for weeks. She just ignored them and did it anyway and they eventually dropped the issue. Now they don't want her getting up to go to the bathroom at night on her own. They cited her being groggy and possibly dizzy when she first wakes up. So I don't know if this is good caution or holding her back?


I work for NH and part of the reason that they would prefer your mom not get up at night without assistance is in regards to her falling. Here in California every time a
resident falls we must report it to the state. After so many falls the state comes to investigate. (Not a good sign as many a strong willed person will continue to get up and fall just because they want to be up and don't want to wait). If your mothers doctor believes with a home health nurse that she could be good at home, then take her home regardless of the NH staff. Just a warning though, If she discharges AMA (against medical advise) alot of NH will not take them back. Talk with the doctor incharge of her and then decide.
I can't tell you what your mother's best options are, but I'd like to share an experience I had a couple of years ago.

The rehab (TCU) held a pre-discharge care conference without letting family know. Oops, tee-hee, silly mistake, we'll reschedule and you are welcome to come. My three sisters and I attended and of course my mother was in the room, along with OT, PT, Nurse, Social Worker and I think some other "team member." No one acknowledged her presence. They talked about her as if she weren't in the room, and they talked over her head. I asked what her prognosis was and I got the strangest non-answer. (My sister told me later that she didn't think the PT knew what the word meant, and that explanation fit the sitation.) They advised that she should not go home to her senior apartment. For one thing, she didn't follow directions well and they frequently saw her using her hand to do crossword puzzles, etc. (Hmm .. doesn't seem like being in rehab stopped her from doing it, so how would placement help?). She shows general confusion about names and has poor orientation to location, getting lost in the halls. (We nearly laughed out loud at that. Our ditzy mother gets lost in each of our homes, and she doesn't even get our names correct. This hasn't prevented her from successfullly reaching age 90, the last 15 of those years on her own. They had no idea what her normal baseline was.) They had some other reasons that sounded pretty bogus to all 4 of us.

But, good news, they just happened to have an opening in their assisted living unit upstairs, which they would be glad to show us right now. The room was for 3 people and looked kind of crowded and lacking in privacy. The building is fairly new and nicely appointed. When the social worker talked about the ratio of staff to residents, I asked if all of the workers who come in contact with the residents spoke clear English. "Oh, yes, it is a rule that our employees have to speak English," but she added as an aside "(but often I can't understand them.)"

The 4 of us daughters decided that Mother was definitely not moving from the rehab unit to the unstairs unit! And talking it over one sister was able to arrange to work from home for 2 weeks and bring Mom there. And, by the way, when the rehab doctor dropped in while my sister was in the room she asked how important it was to help Mom remember not to use her hand. He said, "Oh, using her hand is fine, in fact we want to keep it limber. She's just in a sling to help her remember to be careful of her arm until it heals and not to lift things. She won't need the sling when she is discharged."

So Mom finsihed her healing in my sister's home, who observed her carefully and advised the rest of us that she just seemed like her old self. She returned to her apartment where she has continued to live on her own for these last two years. We keep a careful eye on her, and realize she may not be able to do this forever. If we do need to find long term care for her, you can be certain that it won't be at the one where she had rehab.

Don't know if any of this is relevant to your situtation, but it was our story.
Jeanne this sounds much like where we have been or are at right now. I already had them pull the "conference when nobody will be there" nonsense. Luckily it wasn't a care conference. Some of the things your telling me I think I need to see if my sister can be in town for her next care conference. I'm glad the therapy people are still focused on getting her as healed as they can. The limit on rehab stays seems to put an arbitrary time limit on recovery. This all makes me wonder how many people get shuffled off to some situation they may not really need simply because of where they are at the end of their medicare coverage or lacking enough people to stick their nose into the situation.

DiAvalon - thanks, I will talk to her doctor. She has been very objective about everything. I trust her opinion and my mom seems to trust her. Her doctor is also divorced from the whole situation at the rehab facility so her opinion would be based on the medical situation.
lillylilly, I wish we had more family members like you and jeannegibbs. So many just are to busy. If it were my mom, and by the way at one time I was in your shoes. I would be as concerned as you. Keep up the good work and good luck to your mom and huggs to you girls.
I am too busy. My life is unraveling everywhere. I spend my days putting out fires. The rehab hospital comes up with a new problem created out of thin air at least twice a week I have to go fix. Today's was screwing up how many days she needed the portable heart monitor for. I told them the doctors specific instructions and saw them write it all down and they still managed to not be able to figure it out.
Go to the Director of Nursing and the Admisistrator with the problems you are having. They should be able to help fix the problems.

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