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As I said earlier, my brother had to force him down to rehab for hip replacement. Otherwise no motivation and not really eating. Have meeting with center on Tuesday. Wondering if his onset of not caring his way of giving up or underlying medical condition?
This behavior was similar to earlier part of stay. Is it maybe meds since he was active and responsive just three days ago.

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The whole matter might be a UTI. Any infection can cause lethargy but Urinary Tract Infections are rampant in the elderly.
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Glad to hear he's doing better!
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G: re your question about whether he will get better/full time care in nursing home, the answer is yes that is what they (NHs) are about. Some elder care attorneys offer free first time consultation - ask them about the steps to getting Medicaid for him.
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Dad doing better. I think now he just wants to get out if there. I keep reinforcing his need to do PT.
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Having had both my knees and both my hips replaced in the last 12 years I can assure you that yes, the rehab is very HARD and often very painful. But definitely worth the effort. I am nearing 80 now and can still walk my dogs, move in the local pool, drive and shop etc. I could not have done any of that 10 years ago.
It is worth all the effort but it also helps to have family members sympathize AS WELL AS encourage the person going through it. Pain meds help ( but not opioids) using a walker for a while is essential, having some "cheerleading" cards help, good food helps, having a project to work on and to look forward to each day is also essential to give the "patient" a reason to wake up and GET up every day. Try to find a "personal motto" ( sort of like a mental bumper sticker)
for the person too...It took me a while but I finally adopted two:
1)STOP COMPLAINING and 2) SUCK IT UP and KEEP GOING.
I knew I had to do the PT or I would lose my beloved dogs if I could not walk them.
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Visited dad today with nephews. He was doing much better and was eating with and without help. Found out he had a fever for several days. They said temperature was normal but will get X-ray to see if it was pneumonia plus check blood and urine for UTI.
In the past when he has gotten fevers he gets extremely lethargic. Visited again tonight and he was lethargic and sleepy. He did not eat and was not hungry. He did take meds and water. I let him sleep, he was upset because when changed this morning nurse grabbed his neck and his neck now aches.
They also said podiatrist will be in in Minday to cut nails. However, I fear they are throwing him out because not doing PT. Yet they let him go with long toe nails, shoulder pain and fever.
He is a fighter and can communicate. He can do much better if he gets past these hurdles.
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Call the head of social work. If you are POA, you are the one who should be getting the information. Be the squeaky wheel. But bring a plate of cookies for the staff, as well. Or order in some pizzas for lunch.
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Asked the floor nurse about condition. I requested neurological exam and saw psychiatrist. Yet no update given to me. The doctor assigned is difficult to reach and I get no answers.
I wish his own GP doctor could see him.
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G, who are you asking for medical information? The aides and LPNS are not going to be sources of information. You need to sit with the nurse practioner, or doctor or Director of Nursing to get real information.

Before the care meeting sit with your brother and get on the same page. Discuss what questions you need answered. Find out what you each know, what you don't know and what you want to know.

For example, why do you think there has been a sudden change in my father's mental status? He was talkative, but now appears lethargic and less responsive? What do you think caused the change?

I would not question the doctor's expertise ( if you do, you should bring in another doctor) rather, you need to find out what they think dad's prognosis and long term care needs are. You need to find out very specifically why they did the neuro exam and what the results were. Do they suspect dad has developed dementia? (This would not be uncommon after anesthesia). Do they recommend more testing?
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I have POA and health care proxy. Just not given info regarding condition and medical results. Odd that just three days ago he was talkative.
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Who has POA and Health Care Proxy. Without HCP, they can give you no information. What information are you trying to get that they won't give you?
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He had a psychiatrist come in. I spoke to him but was not given any info. My brother seems to always side with the professionals regardless. He never seems to really question their expertise. Even dads previous stay for a c diff infection, my brother seemed inclined to not really help. Leaving me to do everything.
Even after surgery he became belligerent. We both told he what he must do but I fear he may have given up. He was always a fighter but this place gives me little information. He is 86 and prior to surgery was as responsive as anyone that age.
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How old is your father?

If his change of behavior started three days ago, that would suggest they put him on something new. Find out what it is by calling them tomorrow. You have to educate yourself as to the various types of medications available. He needs to have the BEST PSYCHIATRIST that you can find available. If you don't tell them what YOU want, you're going to get what they want. I've found out that you have to be the squeaky wheel. It isn't pleasant. But they do respect you in the morning.

I don't understand how he can refuse rehab. My mother has to go down six days per week for PT and they come in six days per week for OT. Also, not eating isn't allowed. In other words, you cooperate with us and we'll cooperate with you. That's the way it works. He's there to get better, not to go downhill.

Now, that being said, if he's depressed, I'm going to give him a bit of lee way here. But I can tell you right now, if I thought my mother was giving the rehab a hard time, I'd go in there myself and tell her to stop the garbage and start doing the exercises so she can get the heck out of there and come home. In fact, I have done it.

When you go in there Tuesday for the meeting, make sure you take a notebook/pen or your iPad/laptop/whatever (because they're going to have them) and make sure you're in charge, not them. That's number one. They scheduled these meetings one right after another. They are expecting to do all the talking. YOU START ASKING QUESTIONS, i.e., WHY IS MY FATHER this, that, and whatever. What are you doing to stop this type of behavior? Why aren't you making him do his exercises? And the list goes on. Make sure they know you're watching them.

Of course, all this depends on whether or not you have POA or Health Care Proxy.

As for the Medicaid, I'd suggest you find someone knowledgeable to tell you how to spend down the money. However, that being said, I've never thought much about my mother's money, number one, because she doesn't have all that much money, and number two, I figure if they're going to use it to care for her, it's better them not me. I look at Medicaid as a gift.
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We tried to plan and he wanted us to have assets since I coukd use it badly and have been living with him and out of work.. I saw him like this before and bounce back. I just feel helpless without answers and did not expect any of this prior to surgery.

If he goes to nursing home, could he get better and full time medical care? Plus coukd a change in meds or new ones make a difference?
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His assets are for his care. His current situation certainly isn't your fault. Sometimes, we all just get "down." Give him a few days. Most nursing homes aren't the worst thing in the world. (My mother is 95 and in a NH. My MIL is 92 and in an AL.)

I was wondering, before all of this - did he have plans for how he hoped to spend his last years? I mean, most people don't just drop dead. They need 24/7 care.
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No G, it is not about seizing assets, it is about getting him the best care possible. The treatment team will assess what he has done so far, and the test results will help predict how much more he can accomplish. All of life is guesswork and often there are changes that were not anticipated.
Mom is in Assisted Living with a failing heart. We take one day at a time. We may have to call in Hospice. ONE DAY AT A TIME.
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G, please stop thinking about money. It's your father's money, yes? Earned by him? So rightly, it gets used for his care. If he needs skilled nursing, then he deserves to have it.


Are you his POA? Talk to the social worker tomorrow or next week at the care meeting and understand the whole Medicaid process better.
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I do not know what meds he is on accept some anti psychotic meds for belligerence but doubt he is in anti depressants.I have not spoken to neurologist and they have not told me anything. They say he did not have a stroke, but just tired.

I am afraid they will seek funds and shuffle him into the nursing home and seize assets under Medicaid. I so regret him going for hip replacement and blame myself, yet he was in such pain. I keep thinking if only he went for another cortisone shot.
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If he's had a change in mental status and become lethargic, he must be evaluated. Didn't you say they had done a neuro exam? What was the result of that?
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Oh, mom did not want rehab either. She was yelling and throwing stuff and demanding her walker to leave. STAY AWAY until the nurses change his attitude. I called the RN every day for three days, and finally they got her to cooperate and work, really work on her PT. Once she learned her tantrum was not working, she turned around. He can too.
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If he's been in rehab for seven weeks - did you say? - and progressing, albeit reluctantly, then suddenly three days ago you notice he has changed and become lethargic, there is something new happening and it warrants medical attention. Has either of you - yourself or your brother - been able to speak to your father's doctor?
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What meds are being given? Is he on antidepressants ?
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