My uncle has uncontrolled diabetes with frequent UTIs and never really recovered cognitively from his amputation surgery of his leg and toes. He is cared for by his elderly wife and daughter in his home with a variety of day health care visits. He is currently waiting for his prosthetic leg and rehab that will follow. Home care is becoming difficult but family has concerns with placement in care facility before full recovery from past procedures. Unsure that a nursing facility would work with him to give him back some mobility or would he just end up bed/chair ridden. Post surgery care at a nursing facility with shared room and limited medical capabilities did not go well. For example it took several days to get him iv antibiotics and they had no clue how to manage delirium. Who can best provide a full evaluation and suggest the right type of facility. Is it realistic to think an 80 year old can use a prosthetic leg?
I'm sorry that the post surgery care at a nursing facility did not go well.
If they couldn't administer the iv antibiotics and manage his delirium, perhaps he should have been sent back to the hospital. Is he stable now at home?
I'd like to say consult with his primary doctor or the doctor who managed the amputation and prosthetic, but in my experience, those doctors don't really know much about the skilled nursing facilities. The person who fits him with the prosthetic can probably refer him to a suitable physical therapy program.
It is usually up to the family to tour several skilled nursing facilities - some are intended as short term, rehab and others are dedicated to long term care, which really doesn't attempt to provide any valuable rehab and physical therapy. During these tours, you will ask the admissions director questions, and they will ask you about his needs. They will help to determine if it is a good fit and they can meet his needs.
Realistically, I think he will not be walking on a prosthetic leg. He will need long term care and will probably be bed-bound and require assistance to transfer into a wheelchair. Unless he is very strong and motivated to use the new prosthetic.
Start with his primary care doctor and the social worker at the hospital he had his amputation at. His family may need to look for a facility that is not inept like the one you are describing that he was in for rehab. They can visit local ones and ask many questions and do tours. As others have said if he has delirium, not sure how well he will be able to be taught how to use a prosthetic leg.
I had two friends who both had a leg amputated because of diabetes. Both in their 60s. Neither could wear their prosthesis other than for decoration. One friend could not get rid of the sore on her stub. The prosthesis irritated it. Both had kidney failure and chose not to do dialysis. Both passed away within two weeks.
This man, if they can't get his delirium under control, will not be able to do rehab. He needs to be able to follow instructions.
So focus now is on HEALING of the wound. This is crucial. And if this is hospital induced/anesthesia induced delirium, the first test is in seeing what recovery at home looks like.
You will need now the guidance of PT to keep these limbs stretched and exercising even if done at home and by family with passive exercising. You will need wound specialist at the FIRST SIGN of any healing. You will need excellent followup and hopefully by in home RN. You may need psychologist or neuro-psyc consult. In short you need a TEAM and you need management.
If you ever thought that everyone could chip in for the guidance of a nurse-manager, I highly recommend this for the initial part of all of this. I am sorry for what you are, as a family, facing down now and wish you the best of luck.
Since delirium can be a symptom of infection, I would call 911 and get him back to the ER to be diagnosed and hopefully readmitted which would buy some time in contacting his primary doc or surgeon for guidance.
Whether or not he will adapt to the prosthetics is not knowable to us, since it depends on his future cognitive condition, participation in PT, etc.
I wish you clarity and wisdom as you figure out how to help him and as good a recovery as he can have.