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My 77 yr old mother lives with me and my son. She goes to dialysis 3 times a week; but other than that she is relativelly healthy. Two weeks ago she fell and broke her hip and after 3 days in the hospital she went to a rehab facilty. These first 2 weeks have been a nightmare with pain management; it is either to much and she is a zombie or to little and she is in so much pain she can’t function. Between that and dialysis she has gotten nothing accomplished in terms of therapy. At the care meeting we were told she will not get better, she made no progress and will go home in a week where she will need 24 hour care. So a hip fracture means you go to a nursing home? She can not get herself out of bed pull herself up and they haven’t taken her to the bathroom once; although after surgery in the hospital the nurses there took her to the bathroom. I know next week is the 20 day mark of full coverage. I was there all day today and watched her do an hour of therapy and the therapist said she did 100% better and she ate 90% of her meal. After much research I know we have rights in terms of medicare. If her therapist notes now reflect she is progressing can they still make her go home or is it based on the notes from last Wednesday?

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They said she wasn't progressing enough "as a favor to us" She can stay until Monday. Sigh...not quite sure what to do so thanks for your suggestion...I am going to take her to another doctor for a reevaluation ....She has been declining there and has developed a bed sore she didn't have previously....so unlike my sister and others I don't want her to be somewhere where they are basically looking to warehouse her...my mom and I were never particularly close I was close to my dad and we clash occasionally but I love her and want her to have a good life....Thanks for the information I am going to talk to my siblings tomorrow and we can make some decisions...
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RShaeffer - so how did the meeting go?
Is mom sufficiently "progressing" so that she can stay in rehab at the NH/rehab facility? Susan56 really has it spot-on about the medications.

The Medicare rules are pretty specific and hard to get around unless the PT or OT works the chart to show progression. Years ago when she was still living in her home, my mom "pulled" her rotor cuff and had PT done. Her doc then was a general practice internal medicine guy. She didn't want to go an see anyone else, insisted on her regular old doctor. She didn't progress at all in 2 weeks of 3X a week PT. The PT said to us that their report would indicate no progression and so after the next week Medicare would no longer pay.

It was obvious that something needed to be done, so I then took her to see an orthopedic specialist (his wife is from where I live and he is with affiliated with the medical school in my mom's city) who suggested surgery but he also required her go to see a geronotologist for clearance before he would do surgery. Having mom go to a true gerontologist was a huge difference in her medical care both back then & now. She ended up doing rotor cuff surgery at 89 and very successfully. Went to another PT group for rehab for about 2 months and ended up with about 80% range of motion. She could put her rollers in her hair & totally happy! Huge difference. My point in all this is that you may want to have mom re-evaluated by another MD. If you can get her into gerontology group & better yet one that is part of the medical school, she will probably get a better level of care for both dealing with her hip and her dialysis issues. 77 is really really young and you (& she) want her to be able to go and do for herself. Just imagine if she becomes totally dependent on you all and lives another decade or two. Nobody's happy.
So what did they say?
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Thank you! I am meeting with her tomorrow.
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My mother is 91 and broke her hip 4 months ago. After 4 days in the hospital she went to Rehab for 7 weeks, which was paid for by Medicare. She is now at home, using a walker. Still can't do very much, but she is home. If the PT's report that your mom is making progress, Medicare will continue to pay. When it's reported that she is not making anymore progress, Medicare will not pay, and that's when they will discharge her. If you know she is progressing, ask the PT's to help you. She needs to stay weeks longer.The aides at the facility my mom was at would take her to the bathroom,lift her into bed and in to a wheelchair and recliner. Also, please watch the meds they are giving her. My mom was being given Tramadol. When she came home I noticed how "crazy" she had become. Had to take her of all perscription meds, they all had a terrible effect on her.Talk to the Social Worker and ask for another meeting with the PT"S.
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