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We just left my mother (76, mental health issues) at the only rehabilitation center/SNF that her insurance covers, after a serious UTI infection which caused confusion and delirium. After 6 days at the hospital, she still didn't understand why she was there, or what she had, or what she needed to get better. She's been declining steadily for past 2-3 years, and has lost interest in showering/tending the house/etc this past year. We've tried a caretaker (she lives alone), but that only helped her so much... and these past few weeks even the caretaker can't get her to take her meds correctly, or shower, or get up to eat, or do much of anything. And now with the UTI, I felt this was the only route: hospitalization to stabilize her, SNF, and then hopefully ALF... but I am heartbroken.


I left her confused, and uncertain, and her worst qualities of paranoia, distrust, and anger are all surfacing and I know this is going to be very traumatic for her, but I saw no other choice. The social worker at the hospital said that we could go the in-home rehab route but Medicare would really only cover a few days a week, for two weeks. Everyone at the hospital thought she needed more than that. Is this true, re: Medicare's short-term in-home nurse care isn't that great? (We're in Florida!)


The only place that accepted her for temporary rehabilitation doesn't seem great online, lots of 1 star reviews... how much of this can we trust? I'm so frightened I made the wrong choice.


My biggest fear is this entire episode shifted us all onto a different path, where she will decline rapidly, and that my decisions are accelerating that. What are the advantages of keeping her home, even if the care isn't around the clock?

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Truth is, you can never 100% 'trust' any rehab facility to take good care of your loved one unless you can go in there personally and SEE for yourself what's going on and be the advocate.

Play it by ear & see how it's going with rehab. If you don't like the SNF where she's at, you can always move her to another one with a higher rating, which is what I wound up doing with my mother in 2019. The rehab I wanted was full, so I had her placed in a 1 star rated facility which turned out to be terrible. I went to look at another rehab SNF right away, liked it a lot, and made arrangements to have her transferred for the remainder of the 21 day stay Medicare was paying for. Then I left a very bad review for the first place I took her out of.

While your heart (and other commenters) may be telling you to 'take her home', your head should be telling you that it was NOT working out at home, was it? You said yourself, "She's been declining steadily for past 2-3 years, and has lost interest in showering/tending the house/etc this past year. We've tried a caretaker (she lives alone), but that only helped her so much... and these past few weeks even the caretaker can't get her to take her meds correctly, or shower, or get up to eat, or do much of anything." What are YOU qualified to DO for her 'at home', exactly, physical therapy wise, occupational therapy wise, and medically so that she can get rehabilitated and back on her feet again? That is the true purpose of rehab, don't forget.

In reality, your mother may need to permanently move into a Skilled Nursing Facility since an ALF may not provide enough care for her as they expect the residents to be fairly independent. Keep that thought on the back burner for now as you see how she fares in rehab.

Wishing you the best of luck with everything on your plate; I know it's a lot to deal with.
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I'd take her home where she would be comfortable . and i would know she would be safe .
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When my dad had in home rehab and nursing services it was poor quality each time. They seemed to expect little from him and didn’t spend much time. He definitely got better rehab in an inpatient setting. It came with the cost of him not being very happy about it. Rest assured your decisions are being made with her best interests in mind and love from your heart. The sad fact is that decline does happen and will happen despite your best efforts. You don’t have any “accelerating” events in your plans. Give her some time, monitor her care, ask lots of questions about what progress is being seen. In a little while of this you’ll come to see the next best option for her care going forward. Your mom is lucky to have you and I wish you both healing and peace
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dear primiana,

hugs to you and your mother!!
i hope you're both ok.

regarding online reviews: actually i would trust the negative reviews. in my own experience, i've often totally agreed with negative reviews. people often want to warn other people.

regarding choice between SNF vs. home:
in general, my opinion, is that after hospital, home is always best! everyone wants to go home, can't wait to get out of hospital (even though your mother didn't know why she was there). i do believe we recover much better at home.

----only you know, your home situation.
as you said, it was very difficult for the caretaker and you, to help your mother.

only you know, if home is possible.

we all want to go home after hospital, and we all feel so glad to be back home.

hug!!
think what is best for you too!

bundle of joy :)
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Yes it’s true about Medicare. They don’t pay for caregivers. They pay for very short-term home health following a hospitalization. It’s not because you are in Florida either. Medicare benefits are the same for everyone in all 50 states. It’s not state specific. You can’t trust online reviews 100%. Keep in mind, people are more likely to complain than to praise & compliment. Use the negative reviews as a tool, a guide, so you know what things to watch out for & what you can expect.

She may decline at home. And she may improve. Without knowing the exact situation here, it’s hard to say what the advantages to taking her home are. We can tell you all of the disadvantages—if she can’t take care of herself and doesn’t have the means to pay for full time caregiver, who is going to take care of her? Are you prepared to put your life
on hold to take care of her? Her world will probably become yours. You’ll run yourself ragged real fast if you don’t have enough help. If she’s low income, she may qualify for a caregiver through Medicaid but it won’t be round the clock. It will be got a few hours a day, 5 days a week.
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