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Morning - We are looking for advice as FIL doesn't remember that he has a home at Assisted Living he truly thinks skilled rehab is now home. Obviously he will receive upped care going back to Assisted Living. He is 88 & has done remarkably well with rehab from hip replacement surgery even tho he has no idea how he got there etc. Any advice on the transition from skilled rehab back to AL? He will be wheelchair bound but he still insists on getting out of the wheelchair as he wishes. We know there will be another fall soon it is just part of the process...

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Alicia I read your reply to me and this is what I have to say. The surgeon may want him to use a walker but what matters is the assessment of the physical therapist in charge of his rehab. When you have a care conference before discharge from rehab, most likely, from the way you describe things, he won’t be safe using a walker. It was hard to hear this about my dad too, and him being wheelchair bound required we move him to LTC because AL doesn’t have the staff to help him with all the transfers needed. Also, if you are his POA, then you have ultimate decision power as to what is best for your dad. Do not give your power away to the surgeon. If your dad is allowed back to AL and you let him, then is this in his best interests? Unless you get a caregiver to be there to help him you are possibly dooming him to break another hip.
he should not be using a rollator as yes they get ahead of them and they don’t set the brakes Mathis happened to my dad too. Better to use a regular walker. But still, he will need assistance. Ask rehab to attend one of his therapy sessions to see if he uses a walker WITHOUT assistance. I bet he can’t very well.
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Reply to Harpcat
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Just my experience with Mom.
She left Rehab using a wheelchair, was not to get up without assistance.
She had Dementia bad enough that she did not remember that she was not to get out of the wheelchair.  SO........After a meal and an hour of visiting, she got up managed to stand and promply fell and broke the other hip. 
The answer was a different facility.  The ALF's have different ratings.
The one she went back to had only an A rating and could not put a seat belt on her.  (No restraints) They have to have the choice to fall?!! Anyway, where she ended up they could do a loose belt ( to remind them not to get up,) with a Doctors written order!!!  This is important!!
The 2nd facility was also rated with a B  and possibly C rating. They took very good care of her there.  So be aware they can only do what they are allowed to do!!  This is in Montana.
Blessings on your Journey!
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Reply to vicky64
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You say "You know there will be a fall soon as it is just part of the process." This seems like he should be in his wheelchair as mandatory for his Parkinson's.
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Reply to Llamalover47
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AlisaD Jul 26, 2018
My thoughts exactly but there is some sort of push from dr/rehab people to try to get him up on this dang walker - just seems to add more stress to him at 88.
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I’m wondering why he is wheelchair bound. Is he never going to use a walker? Will they continue PT and OT using Home Health to enable walking?. I am surprised they are releasing him to AL as wheelchair bound. How will he get help when he needs it?

my dad broke his femur around his hip prosthesis, had surgery but could never bear weight and walk unassisted. He is wheelchair bound and AL would not allow him back. Hence he moved to LTC from rehab/SNF.

It is not IF but WHEN your dad falls again. I think having him in AL wilthout being ambulatory since you said he will get up out of the wheelchair, will doom him to fall. I’m sorry to say this but being realistic. You have good reason to be nervous. Find out what his Care Plan is before moving him back.
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Reply to Harpcat
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AlisaD Jul 26, 2018
Thank you - these dr's seem to think he will be able to use a walker I personally dont think its in his best interest (he cant remember to engage the brakes on the walker & these walkers always get ahead of him making him feel like he is going to fall) but whatever i ts what the surgeon says is best. I suppose to get to the bathroom is the big push for the walker but he will use the wheelchair 90% of the time to get around. At 88 I dont understand the big push from healthcare advisors to have him on this walker. We know it will be a matter of time before another fall - will try to keep him as comfortable as possible for now.
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You think he will get better care at the AL? ALs can only do so much. If Dad thinks the rehab is a nursing home attached. Maybe it would be better now for him to be there. Private pay till money runs out and apply for Medicaid.
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Reply to JoAnn29
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Try referring to the AL by NAME rather than as an abstract (ie "home"). I found with my friend who had moderate dementia that words like "home" had meant too many places in his 80+ years of living, whereas referring to his residence of 25 years by it's address made it clear where, exactly we were talking about. What is interesting is that even with moderate dementia, he was able to make certain emotion-based decisions (ie I explained to him that if he went back to his home of 25 years his situation would be exactly the same as when he'd left, with the same caregivers, after which he never ONCE asked to go back there. Hm.)
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Reply to horserider
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Just stay calm and keep reassuring him all is well. Let the people at his AL know your concerns. Put his favorite things within reach and call or visit until you are sure he is comfortable and settled back in. Deep breath!!!
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Reply to Anniepeepie
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Watch closely for hospital-induced delirium. Also with Parkinson's and Dementia combination, please research Lewy Body Dementia. Often this is misdiagnosed.
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Reply to jjariz
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I'm wondering how long he's been gone from AL. He had a fall, needed a hip replacement, and then on to rehab so.....4 or 5 weeks? I also wonder how long he was in AL before he fell.

I don't think FIL going back to AL will be traumatic for him. Once he gets into his room and sees all of his things it will probably start coming back to him. It might be a good idea to have someone in the family be with him in the AL when he goes back. Someone who can stay with him for a while until it appears as if he is comfortable and familiar with his surroundings.
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Reply to Eyerishlass
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AlisaD Jul 23, 2018
Thank you for the response - we are just a little nervous I suppose about him going back to AL. He had been in assisted Living about 4 months before the fall. My fiancee does visit daily to check on things & the staff are pretty good there
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