Rehab will have mom in physical therapy a few times a day and occupational therapy as well. Staff in rehab will help her to become stronger, quicker than if she were at home. They also watch for symptoms of ailments that may not have been apparent when in the hospital. I assume she is being discharged from hospital to rehab? What was she hospitalized for?
Another plus is the rehab center has the equipment needed to get the patient moving; bar support, OT, PT schedule is usually very strict and it's more conducive. In the three weeks or so the patient will be there, they should have learned how to get around better once home; walker, hygiene, etc.
In theory going to rehab is the best way to come home strong BUT the patient must be willing to live in a nursing home environment for a period of time. If the patient is mentally alert and the reason for rehab is a sudden severe illness such as a major surgery adapting to the NH routine may be very difficult and frustrating. There will be about 2 speach therapy 2 1/2 hours of therapy daily , PT, OT and speech therapy. The resident will be required to get up and dressed every morning and be taken to the dining room for breakfast. The Dr will visit once a month and a FNP more frequently. Little attention paid to general health. Most of the care provided by Aides who may or may not be well trained and empathetic to the patient. There is usually a RN present 24/7 but it may only be an LPN. Staff must provide all treatment as prescribed by their own MD and may not be allowed to call directly to the staff in the hospital from which the patient was discharged. This was my own experience in one facility where i only lasted a few day until returned to the hospital at my husbands insistence after he contacted the hospital and told them I had an infection in my newly repaired hip fracture. that morning I refused to get dressed and go to the dining room because i had a leaking infected wound. One of the aides yelled at me that I had to get dressed but need not go to the dining room. My wound was not infected and was healing well, and did not stink!!!!!!!! Next time I adamantly refused rehab although I knew it would be best for me and had home care. I had a bath aid twice weekly, an RN visited once a week and could call for a visit in an emergency. I actually refused the OT as i could still manage alone. Did not need the speech therapist either. The PTcame 2-3 times a week and I recovered just fine. Going to rehab takes a lot of pressure off the family in my case DH who does not cook. The patient needs to be co-operative to rehab at home and able to do exercises without professional supervision. So it really depends on the personality of the loved one you are caring for and the availability of high class rehab facilities in your area. I stress this was my personal experience and choices. I am 78 and pretty strong willed and have a DH willing to advocate for me. As usual do your homework and don't be swayed by the loved ones desire to just come home.
What type of rehab does the person need? My Mom was in the hospital for 5 days. Enough time for Medicare to pay for rehab. The "only" reason my Mom was sent to rehab was because they don't walk them in the hospital. All she needed was to build up her strength. I was told by the AL nurse that for every day in the hopsital, you may need three in rehab to...get your strength back. I would never put my Mom in rehab again just to help her get walking. They maybe had an hour of therapy in the morning and and hour in the afternoon. The rest of the time they sat my Mom in a wheelchair and then had the gaul to say she would never walk again without assistance even with a walker. WHAT! was the AL nurses response. (she was in the meeting) My Mom walked over over the AL facility with her walker. I told the therapist I don't know how they expected a person to "walk" when they are in a wheelchair most of the day. I had already told the rehab that there was no money past the 20 days that Medicare allowed. That they better have my Mom to her plateau by then. They released her the 18th day.
If a person has had a knee/hip replacement or a stroke, yes a stay in rehab is probably called for. But just to get their strength back after a short stay in a hospital, no. You can have the doctor make an order for home therapy. They will give the person exercises to do on days they may not be there.
Rehab is good in some instances but I think it can be a rip off. They told me on a Thursday that Mom had hit her plateau but she wasn't discharged until the following Tues. I was so made because they stopped a thyroid medication she needed that I didn't worry about the discharge thing.
It is a possibility depending on her condition and the resources available in your community. My dad was in rehab for three months and instead of getting stronger he got worse from all the side effects of the meds. I would try and talk to the doctor or social worker and explore all your options.
tranay, a lot depends on the patient, what kind of rehab they need, what is their age, if they can cope with a nursing home environment, or do exercises on their own at home on the off days when the therapist aren't there.
Example, my Dad was in his late 80's when he had heart attack, rehab was scheduled. My Mom refused to let Dad go to a facility to live to get his rehab, so they make arrangements to have therapy come to the house. My Mom was a force to be recond with, because she thought she could take care of Dad and help him with his physical therapy. Picture this, my Mom was in her 90's and frail.
Dad would fall because he was too weak to walk any distance within the house. Of course my Mom could only lift something the weight of a loaf of bread. I couldn't lift Dad so it was either my sig other if he was home or EMT's. No way my Dad could walk up stairs to the bedroom, thus he slept in his recliner and Mom slept on the sofa, neither a good choice. He took bird baths in the kitchen sink. Mom thought she could learn the physical therapy but she couldn't, and oh how she hated having a young girl come in for physical therapy.
Next time my Dad had a medical situation, Mom was ok with Dad going to live in Rehab for 3 weeks. Dad got excellent care, the food was real good, and there were machines that Dad liked to use.
Need to say something else. My Mom has Dementia and rehab was not a good place for her. She was scared and declined a little more. Too many different faces.
Yep, it depends on the individual patient and their needs, but I say if any physician takes the time to order rehab which means the patient was in house (Hospitalized @ least 3 nights, then I would probably think the doc wants her to have a need assessment and have her demonstrate that she can walk safely with an AD, negotiates shower of function, etc.
Here in my area MD/VA/DC the rehab patients are housed in a separate wing as those designated as rehab beds are generally considered tailored to the patient's individual needs and how long they get authorization from their insurance (most important, of course). The beds turnover fairly quickly. The NH side can't have such a frequent change of roommates due to the possibility of interrupting a dementia person's routine, which it's important to maintain for their well being.
Sometime elderly people can get weak and lose muscle tone from even 3 days of inactivity. You'd be surprised.
If her doctor ordered it, please reconsider and let her try it. There is no penalty for getting released early if she reaches their mutual goals and she can demonstrate that she can perform ADL's. There is a huge problem, however, with signing out AMA. Thus weigh all your options and make the best decision for mom using resources available to her. Good luck!
My mother is 88 and has 6 stage Dementia, but doing fine for the most part. I'm taking her out of a rehab center. Which is way different than what was presented to us. Your money determines which center you can go to and the treatment you will receive. And when we are not around, we walk in on her twiddling her fingers with wads full of paper. the staff is there true enough, but after they do what they suppose to do (sometimes), they are gone, the patients have no more stimulation with the staff, sitting there wet and not checked w/dementia, they are there like zombies. Maybe if you have a ton of money this won't happen, but this is happening to my mom. So I rather do the best I can to take care of her at home.
Kelly I don't think money has anything to do with the rehab center a patient is sent to. When some one on Medicare is appropriate for rehab they are usually sent to the first place that accepts Medicare with an available bed. In my case the discharge planner asked me where I would prefer to go out of the four in my area, The one on the top of my list had an open bed so that was where I went
What you observed is the reality of life in a nursing home. The staff is not there to provide entertainment for the patients that is the job of the activities director. Hopefully a dedicated rehab center is not located in a NH and the residents will be more capable of interacting with each other and providing their own activities. for example I spent a lot of time on my computer and was able to say "NO" forcefully enough to resist coercion. I was also cognisent enough to pick up the phone and call the front desk if they took too long answering my bell. I bet they were glad to see the back of me!
There will be about 2 speach therapy 2 1/2 hours of therapy daily , PT, OT and speech therapy. The resident will be required to get up and dressed every morning and be taken to the dining room for breakfast.
The Dr will visit once a month and a FNP more frequently. Little attention paid to general health. Most of the care provided by Aides who may or may not be well trained and empathetic to the patient. There is usually a RN present 24/7 but it may only be an LPN. Staff must provide all treatment as prescribed by their own MD and may not be allowed to call directly to the staff in the hospital from which the patient was discharged.
This was my own experience in one facility where i only lasted a few day until returned to the hospital at my husbands insistence after he contacted the hospital and told them I had an infection in my newly repaired hip fracture.
that morning I refused to get dressed and go to the dining room because i had a leaking infected wound. One of the aides yelled at me that I had to get dressed but need not go to the dining room. My wound was not infected and was healing well, and did not stink!!!!!!!!
Next time I adamantly refused rehab although I knew it would be best for me and had home care. I had a bath aid twice weekly, an RN visited once a week and could call for a visit in an emergency. I actually refused the OT as i could still manage alone. Did not need the speech therapist either. The PTcame 2-3 times a week and I recovered just fine.
Going to rehab takes a lot of pressure off the family in my case DH who does not cook. The patient needs to be co-operative to rehab at home and able to do exercises without professional supervision. So it really depends on the personality of the loved one you are caring for and the availability of high class rehab facilities in your area.
I stress this was my personal experience and choices. I am 78 and pretty strong willed and have a DH willing to advocate for me. As usual do your homework and don't be swayed by the loved ones desire to just come home.
If a person has had a knee/hip replacement or a stroke, yes a stay in rehab is probably called for. But just to get their strength back after a short stay in a hospital, no. You can have the doctor make an order for home therapy. They will give the person exercises to do on days they may not be there.
Rehab is good in some instances but I think it can be a rip off. They told me on a Thursday that Mom had hit her plateau but she wasn't discharged until the following Tues. I was so made because they stopped a thyroid medication she needed that I didn't worry about the discharge thing.
It is a possibility depending on her condition and the resources available in your community. My dad was in rehab for three months and instead of getting stronger he got worse from all the side effects of the meds. I would try and talk to the doctor or social worker and explore all your options.
Example, my Dad was in his late 80's when he had heart attack, rehab was scheduled. My Mom refused to let Dad go to a facility to live to get his rehab, so they make arrangements to have therapy come to the house. My Mom was a force to be recond with, because she thought she could take care of Dad and help him with his physical therapy. Picture this, my Mom was in her 90's and frail.
Dad would fall because he was too weak to walk any distance within the house. Of course my Mom could only lift something the weight of a loaf of bread. I couldn't lift Dad so it was either my sig other if he was home or EMT's. No way my Dad could walk up stairs to the bedroom, thus he slept in his recliner and Mom slept on the sofa, neither a good choice. He took bird baths in the kitchen sink. Mom thought she could learn the physical therapy but she couldn't, and oh how she hated having a young girl come in for physical therapy.
Next time my Dad had a medical situation, Mom was ok with Dad going to live in Rehab for 3 weeks. Dad got excellent care, the food was real good, and there were machines that Dad liked to use.
Here in my area MD/VA/DC the rehab patients are housed in a separate wing as those designated as rehab beds are generally considered tailored to the patient's individual needs and how long they get authorization from their insurance (most important, of course). The beds turnover fairly quickly. The NH side can't have such a frequent change of roommates due to the possibility of interrupting a dementia person's routine, which it's important to maintain for their well being.
Sometime elderly people can get weak and lose muscle tone from even 3 days of inactivity. You'd be surprised.
If her doctor ordered it, please reconsider and let her try it. There is no penalty for getting released early if she reaches their mutual goals and she can demonstrate that she can perform ADL's. There is a huge problem, however, with signing out AMA. Thus weigh all your options and make the best decision for mom using resources available to her.
Good luck!
When some one on Medicare is appropriate for rehab they are usually sent to the first place that accepts Medicare with an available bed.
In my case the discharge planner asked me where I would prefer to go out of the four in my area, The one on the top of my list had an open bed so that was where I went
What you observed is the reality of life in a nursing home. The staff is not there to provide entertainment for the patients that is the job of the activities director. Hopefully a dedicated rehab center is not located in a NH and the residents will be more capable of interacting with each other and providing their own activities. for example I spent a lot of time on my computer and was able to say "NO" forcefully enough to resist coercion. I was also cognisent enough to pick up the phone and call the front desk if they took too long answering my bell. I bet they were glad to see the back of me!