Find Senior Care (City or Zip)
Join Now Log In
R
rainedunder Asked April 2021

What options do I have to get my mom into an inpatient rehab program to build her strength? She was thought to be too advanced.

She was in a "skilled" nursing facility for "care" and fell four times in two months. The last fall resulted in an ER visit and stitched to her forehead. She cannot hear, and can only see in one eye. Unfortunately, the injury is to her only seeing eye. The eye, and that entire side of her body, has some issue daily. I removed her from their "care" immediately from returning her to the facility from the ER. That was February 20th. My family had been told she was progressing well and could walk 600 feet. She came home to me and could not stand on her own, could not walk, was grossly underweight, a filthy mess and now has to wear diapers. Prior to going to the "skilled" facility, she lived on her own with minimal care. She has issues sleeping and is in fear of falling with every movement. I am working with her and she has PT/OT during the week. We were contacted for rehab and it sounded good but she was rejected for being "too advanced". I am near her at all times in case she attempts to move and I don't want her harmed. I am a month into this and am worn out. I have Lupus and this is not the best plan but better than the "skilled" facility. I was excited to hear an option to help her and also give me a break. I would like 8 hours of sleep with consecutive hours to sleep. She naps and awakes asking about falling and how she got hurt. Recent tests show she has signs of dementia due to an abundance of times for high BP (200+ range). She has never had a stroke but the constant high BP has affect brain cells.
She can walk with me next to her, if her eye is swollen that day, I am her eyes. She can feed and bathe herself but has to be watched.
I guess I am looking for another rehab facility with different criteria for entry.


Any thoughts? I also just learned about Respite care and she does have Medicare so I will check into that as well.

againx100 Apr 2021
When I needed rehab for my mom after a knee replacement, I found different facilities had different criteria. The good one had high standards - person needed multiple modalities (PT/OT/speech/etc) and they had to be willing to WORK at least 3 hours a day. She did not qualify so went to a different facility, much further away from home, that was great. Next time she ended up in a nursing home for rehab. This is an OK option, but not the best.

Given your mom's multiple issues, she needs much more help than one person can possible provide. I would find a better nursing home for her that has a decent rehab program. Or you should get some in help assistance. You're just doing too much and need to remember that YOU matter too. Your health and sanity matter so take care of them.

Re: her high BP - is it under control? Over 200 is a bit scary, at least to me.

Re: falls - they happen all the time. Don't judge the facility too harshly about that. My MIL falls a lot in her apartment. At least we got her trained not to call 911 every time. Only if she's hurt! And to call us first so we can help her figure it out. She'd fall, call 911 (cuz that's what her sister told her to do!), get transported and then complain about how long it was taking in the ER. Yup, ER takes a long time. All for a little bruise or two.

Good luck.

igloo572 Apr 2021
They all fall. Even if you had help or a monitor watching her 24/7 or they were in a top tier facility, something gives out, you look somewhere else for a minute and they’ve fallen.

For your mom it’s especially challenging as she can’t hear or see very well. There were reasons why she went into skilled nursing care, so what were her diagnosis for that admission? Does she still have the same problems? Did she have a TIA (transient ischemic attack)?

I’m guessing the PT / OT is providing services to keep her ok for “maintenance” which MediCARE will pay for. Actually that she is getting this is pretty good as getting Medicare to do maintenance therapy is usually for those who have a long standing disease, like MS or now in thier 60’s are having secondary polio issues. If therapists told you that she wasn’t a candidate for rehab, that means she’s been evaluated not be ever get better or back to whatever she was like before her admission into the SNF. She’s plateau’d. Geaton is spot on as to what this means.

If you are determined to continue to have her live with you and be her primary caregiver, I’d suggest that you get her evaluated for hospice. If she is approved, the hospice group will come out maybe 2-3 times a week for a few hours and in that period hospice can bathe her, help her eat a meal, check on her vitals. It gives you a brief break from having to be right there next to her.
And you need to hire in home health workers.
Mom has some sort of income, like her SS. She uses that $ to pay for help. Or you get family to come in an help and stay overnight so your “off duty” when they are there. Most family caregiving is done for free out of a shared sense of family responsibility.
or she moves into a NH that is geared to the blind. These do exist. Lighthouse for the Blind sometimes have info on which places are better suited for those visually impaired. My MIL was legally blind & Lighthouse was a great resource for her. They had all kinds of adaptive stuff that MIL could use. Like these magnification readers that they loaned out.

ADVERTISEMENT


Geaton777 Apr 2021
With my own MIL I learned that once they plateau or refuse to participate, that's the end of PT/OT. And Medicare/Medicaid will only pay for so much. After that it's on your own nickel and even then only if they think she can make progress and cooperate. I'm not sure you have appropriate expectations for your mom's physical improvement given her cognitive level (your profile says she has dementia/ALZ and a host of other physical issues at 84 years old). FYI it is extremely common for elders to fall in facilities since they cannot legally be restrained and you are not paying for her to have a personal minder 24/7 in her facility. Elders fall in their own homes all the time. I hope you can find the right solution for the both of you!

ADVERTISEMENT

Ask a Question

Subscribe to
Our Newsletter