How to tell Spouse the Care Center (convalescent hospital) stay may be permanent?
Spouse was admitted to his 100 day VA and Medicare rehab last Saturday. He's under quarantine that possibly will lift on the 15th of September, when I will visit because we're both vaxxed. He's sounding about 3 percent better spirited than when he was in County General. He's traumatized and reassures me that "I won't be any more trouble than before I fainted/fell the two times on 9/1 and 9/5." He is 79 and I am 68; he weighs about 230, is diabetic requiring shots and currently pain shots for his four broken ribs, and about 15 daily pills. All this is VA 100 percent.
He's eating a tad more than last week, drinking some more fluids, and believes he can be released "in a few days." On 9/10, I observed his hand tremors which are worse; Parkinson's isn't on his official list of problems and the tremors likely are exacerbated from simple weakness. I've not yet spoken with rehab personnel about his general condition and PT prognosis. I dread fielding his calls to "go home because that's where I will get stronger." There's no official stamp saying "you're in here for good" yet I'm fearing that. I'm dealing, however.
What are kind, encouraging things to say to him?
You may know the stay will be permanent, but he does not need to know. There is no need to upset him.
When I faced that situation, I just told her that she needed to keep getting stronger. I will take her home as soon as she is ready. (She remained in AL/MC for fourteen months.)
Do NOT take him home because he says he wont be a burden, because he thinks he can do his ADLs by himself, or because he hates the staff/food/other residents, etc. By bringing him home before he is ready/able, you are putting both of you in jeopardy. The next round of falls/outbursts etc will be worse. Maintain your strength, keep him there as long as possible. He will get better faster with professionals than with you.
Two things to remember:
1. You are his greatest asset, don't waste your strength.
2. Don't kill yourself keeping him alive.
I would tell him that you *both* need to take this one day at a time. Tell him to put his focus and energy towards his rehab; the rest of it will work itself out over time.
It's not a lie; neither of you know where he'll be at day 100. A lot can happen between now and then; there's no sense in getting ahead of yourselves now.
Give him - and yourself - a chance to adjust to this new normal. With him in rehab, it gives you a chance to reboot as well...you don't have to make any decisions right now at this moment. Just be as supportive as you can without making any unkeepable promises.
We were both big at throwing the doc under the bus--any doc. "The doctor says you need to be here".
I asked mom once what she would do if dad's PCP said he could go home. Mom said "I'd say 'Oh, not THAT doctor--I meant doc X, the specialist'".
This must be both heartbreaking and nerve-wracking. Ate the kids being supportive?
With Medicare, when a person hits a plateau or is not progressing, they are discharged. All that 100 days means is that Medicare will pay up to then. Out of that 100, 80 days is 50%. The first 20 is 100%. Does the VA cover the 50% that Medicare does not pay?
Is the VA ur husbands secondary insurance? Because if not, it could cost you to have ur husband in rehab. Its been at least 5 yrs, but my Mom paid out of pocket $150 a day. 80 days x $150 a day = $12,000.
Tell your husband he gets discharged when the doctors say so.
Therefore you can use these as reasons why he has to stay for now. Regarding being in somewhere for good I think you are jumping the gun and worrying about something that may not happen. If you get to day 80 and he is still in need of more support than you have give then discuss with the rehab, get them onside and get them to see he needs to being somewhere supported - they can do this whilst talking to him about his PT or at other times. If you are all talking from the same page then it will be easier to have the conversation.
However don't lose hope that the 100 days will see a big change physically and mentally and he may be able to come home with little assistance. Best wishes to you as you work through this difficult period.
I think he needs a chance to rehab from this recent injury before any decisions are made or communicated to the patient.
Just read one of your replies. Has ur husband been diagnosed with what type of Dementia he has? As u can see Lewy body dementia and Parkinson's are similar. I would ask for a Neurological eval while husband is in rehab to find out what is involved.
Yes, Rehab can not discharge him if they feel its unsafe to do so. So, if he is evaluated as 24/7 care and you feel you can do longer do it then claim "unsafe discharge". That you personally cannot care for him, nor can u afford to hire care. Your house also needs to be safe.
Great big warm hug!