Dad fell and broke his femur while in FL on vacation. He's in a rehab in FL, but we want to transfer him to rehab back home in NJ. What to do?

I also vote to keep him FL until the full course of his rehab.

I've taken the train from NJ to FL when I was younger. It was a long trip that had unexpected and very long delays. Is all of the train ADA compliant? A lift to get the wheelchair into the train? The bathrooms? The sleeper compartments? The restaurant? What if he has a medical emergency while on the train? Breaking a femur creates a stroke risk, not to mention infection. At his age it won't be a comfortable trip. Wait until he's more mobile and healed and then fly him home on a direct flight.

Given the relatively brief period of time rehab is covered I think it would be better to have him complete his recovery there before attempting to move him home, there will be more options to transport him plus a trip will be less physically taxing once he is stronger. But I'm basing that on the picture of a relatively hale and hardy man who was able to take himself to FL for a holiday and they had an unfortunate accident - is there a reason he needs a high level of daily advocacy, and is there no one who can temporarily relocate to provide it there?

I am a geriatric care manager and live in Florida, so I get this all the time! My professional opinion - do not move him during rehab. He is at risk for any number of things to go wrong on the arduous journey and there would be no medical staff to handle an emergency should one occur. Most of the families of my clients live in NY or NJ, so oftentimes I’m asked to bring their loved one to them for a permanent move to be near their families. It’s always difficult, whether train or plane, and that’s for a senior with no medical issue such as this.

Rehab is a short time deal. Why not let him complete his rehab where he is and not put any undo pressure on him, both mentally or physically.

If he has gotten through this far he doesn't sound like he needs a daily advocate.

No way. Much too stressful
for him. If your concern is that rehab in Florida isn’t as good as that in New Jersey, I can assure you that there are many fine rehab facilities in Florida.

I lived in Florida. My parents and other relatives were in and out of rehabs there. So many older people live in Florida, and facilities are accustomed to their needs. They know what they’re doing. Don’t risk dad’s health by moving him back up nawth.

Have you ever been transported with a broken bone or an illness? I have.

Every little jiggle was painful for my broken bone. It's so important to keep the bone immobile, which is why they're put in casts or boots or some other immobilizing device. Start moving around, accommodating to cramped quarters, etc. - there's a chance that the bone will move. The other thing is that pain itself is so debilitating. Pain wears a person out, even a young one. That changes the mood and the determination to complete certain tasks. When considering the whole patient, this becomes majorly important.

I was transported in an ambulance with a painful kidney issue. Every little bump in the road to the hospital was magnified by the pain. The ambulance seemed to have little in the way of a spring suspension. It was agony.

This is why I'm against transporting an elderly man with a broken femur and recent surgery.

In the Florida rehabs that I've had experience with for my elderly relatives, they worked them. They worked them hard, the goal being to get them up and out of there ASAP so they could go forward and live their best lives. That didn't include plane, train or automobile trips until they were in the best shape they could be for such a journey. As for a support system, what? Rehab doesn't need relatives standing around holding flowers in the busy PT rooms while their LO is struggling to concentrate on relearning to walk for 6 hours per day. Or learning to transfer to the toilet from the wheelchair and back again. Or watching the educational videos about how to cope with their new health issue. And when they get back to their rooms, all patients need rest before they go to dinner (required) in the dining room. They get to know each other and the aides. The support is built in right there, even "graduation" with a fancy celebratory dinner with diplomas at the end.

If you want to be supportive, call every day, be encouraging and send cookies.

I have no idea how much companies like this one...

https://medic-trans.com/non-emergency-medical-transport/

... charge, or whether his care insurance (or travel insurance, did he have any?) would cover it; but maybe it wouldn't hurt to find out?

While I was in a similar rehab situation for an emergency hip repair I would not have wanted to travel anywhere by any form of transportation, It was enough trouble to get to the bathroom in the room. If by Support System you mean family, one or more of you could rent somewhere near your father's rehab to "support" him until he is better able to travel.

Breaking a femur is a big deal and depending on the other damage done around that bone rehab can take a while. I’m curious who warned you this was difficult to do? It sounds like you believe it isn’t the transport but more the red tape which surprises me a little bit. I would start with the doctors, if he has a doctor at home that you all know and trust he or she should be able to get the information on exactly where your Dad is medically and then be able to advise you on the idea of moving him as well as when and where to do that. Personally I would consider driving him yourself as well as the train or flying, much of it will of course depend on where he is in his recovery and how stable he is. This is where discussing the possability of moving him, the pluses and the minuses, with his medical team in FL as well as his medical team or what will be his team in NJ is really the only way you can make the decision. Certainly being around family, having visitors would be beneficial to his recovery not to mention how much easier it would be for those family members caring for him so I understand the desire to do that. However you can’t really make the decision to do so without knowing the all of the pluses and minuses to weigh them properly.

The facility administration where he presently is receiving care should have a " case manager" assigned to him. This " case manager" should be able to facilitate helping him get back " home" to a facility near his family. Being closer to his family may in fact be an important part of his recovery...as you would obviously be able to see him regularly as wished.
You can also contact his primary care physician in NJ and, ask for their assistance or direction/ referrals to get him back home. Or you can reach out to a care facility of choice in NJ and find out if his insurance would be acceptable there etc etc.
His PCP should be able to get you in touch with a Case manager there in NJ or from the PCP office who can provide facilities in your area that will accept his insurance and that have bed availability.
His "patient rights " should be honored and, if he wants to be home in NJ, the " systems" are obligated to facilitate that.
As for transportation, confer with his Physician and care plan professionals caring for him as to which mode of transportation will be safest and best for him.
( Remember that trains are bumpy and getting to the bathroom on trains is challenging for a healthy person and, it is a LONG train trip from Fla. to NJ. Airlines are certainly accustomed to accommodating injured people .....and are much quicker than trains or cars..... ). A few thoughts to consider.....
Follow medical directions .....