What is the best care option for my mom with a stroke?

Richie, your Mom really needs to have rehabilitation to help her get back to almost normal again. Now Mom can either go to a rehab facility or she can have rehab at home where the physical therapists come to her. If she refuses either, Medicare might have issues with that and future care that is in relationship to the stroke.

My Dad had rehab after having surgery, the place was built back in the 1950's and it looked it. But Dad really liked his physical therapists, enjoyed all the meals, but was pretty bored the times inbetween. But he needed to rest, and that was the purpose of living in a rehab facility for about 3-weeks. The Staff was so very caring.

My Mom, on the other hand, didn't like visiting the rehab center that my Dad was in, because it was so old looking... plus all the people in wheelchairs... etc. Well, it's not a resort so that is to be expected. Dad went in with a positive outlook of wanting to get well and be back home.

One time after Dad had a heart attack, prior to the above surgery, Mom refused to have him live in a rehab facility. She thought she could do everything he needed, she was 90. The physical therapists would come to the house, but since they didn't have the large equipment to use, it took Dad longer to heal. And Dad didn't get much needed rest as Mom needed Dad to help her with this or that.... [sigh]. And Dad being Mr. Fix-It probably was doing repair work he shouldn't been doing.

Richie, after 3 days in a hospital (admitted), Medicare pays for 20 days in rehab. There is a reason for this! Seniors get weakened easily and need to get their strength back. The thing yu can do is to search out THE BEST rehab place for her. Don't take the hospital's advice without researching and visiting on your own.. Sad to say, I volunteer at a nearby hospital that is considered one of THE best. But the chain rehab place is there every day drumming up business. It is easy for the hospital to hand out their name. But it is up to family to seek out the best for their loved one. 5 years ago when my Mom needed rehab, I visited 6 rehab places. There was quite a difference. Ask about the number of hours each person gets rehab, the number of days a week. Ask about their inspection reports and do a walk through. Watch the rehab staff with the patients. Is the staff 'patient' and kind? etc. I have no less than 10 rehab sites within 5 miles of my house. And several of the I wouldn't even visit! Not all rehab sites ae created equal. Your Mom should get Occupational therapy, physical therapy and speech therapy. Good luck and keep us posted.

Sometimes the patient has to go to the rehab facility that has an open bed... if the patient refuses that open bed and there are no others in the immediate area, another bed might be opened way over in the next town.

If that bed is refused, the hospital can no longer keep the patient and he/she is discharged back to home. Then it would be up to the family to find an open bed, but hospitals get first priority to that bed. And the family would need to find transportation to that facility.

Life can get so complicated at times.

geewiz

Cleveland Clinic Hospital, by any chance.

Problem is highly rated rehabs, usually have a waiting list (and for good reason), while lower rated ones, don't.

Richie, if your mom had a right side stroke, she's going to have difficulties, possibly subtle ones, with speech and maybe cognition. My mom developed vascular dementia from a right side stroke.

I was very glad she was in rehab when those symptoms (delusions, agitation, extreme anxiety ) emerged. Rehab was able to do metabolic testing to make sure there wasn't a uti or electrolyte balance provlem. There was a geriatric psychiatrist on call to start and manage medications on site. The nurses were able to explain to us how to handle mom's symptoms. Couldn't have managed this at all at home.

The docs need to tell mom she needs to go to rehab, not you. Let them be the bad guys.

Richie, some rehab facilities do have bad reputations. You have to do some leg work (research) to find one that's appropriate, If I recall correctly, Medicare has a site on which rehabs are rated. Some of the ratings are based on narrow factors which don't necessarily reflect the quality of care or of rehab. But look at the sanitation factors, and other critical factors that could influence your mother's successful rehab (within applicable medical limits).

Make up a checklist, including factors already mentioned in the above posts. Add questions like nurse to patient ratio, aide to patient ratio, whether or not meals are in a common dining room or served in the patient's room, whether there's a chef on site or if meals are purchased precooked and merely heated up (that could be a bad sign as we experienced one where the meals were so bad they were inedible).

Find out what activities are available for moral support - music, pet day, etc.

The rehab facility where I take my father is in a rural setting on one side with an urban setting on the other side. The configuration of the facility provides for outdoor views for every room. This last time my father saw wild turkeys, deer, sandhill cranes and little critters in the area.

Meals are designed by a chef; there are standard meals but also a la carte menus, and are served either in a patient's room or common dining areas.

My father had a private room; many others did. Each room has not only its own bathroom but a shower so common shower areas don't have to be used.

Tour all the facilities under consideration. A discharge planner can give you lists of rehab facilities, but don't rely on their opinions.

Most likely she would be scripted for home care therapy to continue where facility rehab leaves off, but she'll make more progress in a facility because she'll get more therapy, more medical support, more activities and social interaction, and can spend more time resting, a very important consideration.

If you have video capability in your phone or camera, take videos to show your mother. Visit at dinner time to observe how many nurses and aides are around the area, especially after dinner time when bathroom needs can demand a lot of staff support.