I need tips to help me get answers from busy nurses in rehab for a very difficult mom (90 yrs. old with fractured femur, arthritis, memory issues). Any advice?

If the facility is open 24 hours you can call and ask or walk in during the late night when things have quieted down and speak to the nurse on duty.

Ask to speak with the Director of Nursing ( DON). You can also ask for a meeting.

I would plan on a long visit. Plan to stay the entire day with her, lots of days in a row, including a weekend or two.

While you are there and in her room, you can hear what they are asking her. You can watch her PT and OT, you can see if people are really coming in and doing their job. I found PT to be the most enlightening as it showed what they are trying to do. Also, you will be able to talk to the nurses one-on-one and understand what is going on.

My Mom had a compound fracture and had 2 screws put into her femur. At the first rehab, I was very involved, encouraging my mother to walk, watching what they were doing (and what others were doing). By the end of 11 days, she could walk (with pain) 500 steps. Unfortunately, they couldn't address the pain totally, so my Mom didn't improve as much as I had hoped. I had to leave town for awhile so she went to a second rehab. At the second rehab, they didn't push my Mom enough, ignored her pain, etc. When I got back, she was a zombie. Medicare ceased to pay because she was no longer improving. What really got to me was the PT verbally said that she walks well for her age (she wasn't walking at the time...she had regressed under the 2nd rehab's care).

When I saw the Medicare report, it said that she was improved as well as she could given her age and that she had a heart attack (um, no heart attack that I know of). It did not say in the Medicare report that the PT guy didn't expect her to walk at her age so therefore, he made no attempt to increase muscle tone toward walking. The report also did not say that they made no attempt to address her pain which was in her back, not at the site of the compound fracture.

So, medical reports are nice and sanitized. They may not be willing to talk to you on the phone either. Therefore, I would go visit and plan on staying there consecutive days. At both rehab hospitals, the weekend schedule was significantly different than the weekday schedule, hence, I would plan on being there during the work week also.

It isn't about what they say....many times, it is about what they don't say, and you don't know that until you are there in person.

P.S. The pain that was preventing my Mom from walking was from arthritis. Once we got that under control, my Mom was walking with her walker, independently, within 3 months. She was 97 years old at the time.

cmotta: If the busy nurses in the rehabilitation facility have not answered your concerns/questions in a reasonable amount of time, you could attempt to speak to their superiors. Prayers for your mother's broken leg.

thank you all for your guidance and helpful suggestions!

Your profile states you live far away, but you should try to make a personal visit. I was a son taking care of my mom. When she had hip surgery, she was sent to a local NH for rehab. The head social worker, along with other staff, met with mom and I, laying out a "care plan" that would be followed during mom's stay. Since we lived down the street from the facility, I would make twice a day visits at different times to monitor her progress. One day, I came in to find her still in bed during the time when she was supposed to be seen by PT staff. I went directly to the social worker to express my displeasure that the "care plan" was not being followed. I ended up attending the PT sessions with mom so I would know what to do when she came home. When there was a question regarding medication, I spoke to the nursing supervisor. I identified CNA's who I felt treated mom well, and I always thanked them.

I was acutely aware that staff could take out frustration on mom because of my questioning her care, so I was as very diplomatic when I confronted staff. At one point, a family member of another patient asked me for advice on how to address a situation as she noticed I had been proactive with staff. Even if you are unable to visit personally, at least request a video conference as suggested by another responder, and have a list of prepared questions. This is your mom. They owe you answers.

As suggested, speak to a supervisor, social worker, director of the facility.
Do this in person. Certainly ask for a copy of their medical chart / report.
Find out how they can email it to you or get it to you as it is updated.
This isn't the same as talking to someone although it will help you have more information on a regular basis.

I had to advocate daily ... weekly ... monthly.
These staff people are over-worked and have a lot to do / contend with. And, you need to get the information you are entitled to.

Have your questions written down (to discuss with social worker, etc., director of facility or department). Give them a written copy, with your email / contact information. Clearly specific 1, 2, 3 what you want. Ask them to put a copy of your request in their records / in his or her chart.

Gena / Touch Matters

I have found quick emails to the unit manager RN effective. By quick i mean yes & no possible answers.
did mom require narcotic meds today?
did mom eat today?
Best wishes to you both and i hope some of the responses resonated with you

My husband can't talk due to a stroke. I MUST be there all day, every day to get any information and to "translate" because he can't tell them anything or even ask for a glass of water. I come early, stay till bedtime and then I know everything that's going on and what's happening. And I can make friends with some of the caretakers & nurses and get a good rapport with them so I know what kind of care he's getting.

There are usually scheduled patient care planning meetings; speak with the facility administration about when these occur and be sure that you are informed and invited and attend. Speak with administration in the facility about what options are best for you to establish communication with the nursing staff and, to get the information you need.

I have found a nice box of candy in the room slows the nurses down at times. A little sugar increases their blood sugar and their chat.

Ask for a social worker or case manager

Call the head nurse or whoever is in charge. Hopefully not get the runaround as it's so expensive to live in an NH.

I finally gave up on getting reliable and timely information so I got mom a caregiver(s). This is a person who comes in the minimum hours (4 hours) and followed the list of duties I had for her. Mom had companionship, lotions applied, her skin massaged to help prevent pressure sores and warm compresses on her eyes (she has dry eyes). Bed baths or showers if needed. She also got 2 meals because it is hard for mom to eat and she responds well to finger food to eat or being fed. The caregiver would text me daily at how she was and sometimes we would FaceTime if mom was up to it. It was a blessing to have this peace of mind for me and better care for mom. She has bonded with the caregiver (I have 2 so I can have 7 day coverage). The ladies know each other and schedule coverage with each other if needed.

I just went through this..I gave up and went to the nursing director. Our rehab was using agency nurses…so tough to get a whole picture of my moms condition. I found the therapy gals better at communicating with me. ALWAYS use email ….you need a paper trail!!!! Then I started chasing upper nursing staff..such as director, manager etc. so important to be nice…after 27 yrs working these places I know how family gets a bad rap behind closed door meetings..go easy but push forward..keep emotion out of it.

Food, flowers, kindness and understanding. Consider how many patients they are running after while answering calls and emails from concerned family and social workers and others. I don’t know how they do it. My family is a disaster with my sister at the center from hundreds of miles away so she’s supposed to share the info with the rest of us. Just imagine all of those families like mine where siblings don’t communicate and moms complaining they’re not getting to her fast enough … we want answers but we want our loved ones care prioritized too. For me, I lowered my expectations to save my sanity. Not sure it worked though since I’ve been in it since August.

My mother has been in 7 rehabs. I'd get the email of the social worker / and / or who ever arranges the care plan meetings (ask( and go through them. Email leaves a paper trail. They should arrange a care plan meeting with PT & nurse staff present within 1-2 weeks. Problem with asking individual nurses is the shift change, frequency of agency nursing who may not know your mom, and just generally, nurses may be dispensing meds, but not know her prognosis and they are not the doctor in charge, so they won't give you a lot of detailed info (generally).

Trying to prevent an adversarial relationship is crucial. So donuts and flowers. What can I say. A box of candy. Then just grovel. I mean, you have a need to get met here, and that is information. Don't let your pride stand in your way of getting it. Start out by saying "I understand how busy you are, and I just don't know how I can get a few minutes of your time, or when best to try. I would love an update about how Mom is doing. I am so concerned about her".
The other thing is to stay a day and judge for yourself the care she is getting and how she is responding to it.
Sure do wish you the best of luck.

My mom has spent some time in Skilled Nursing Facilities and has memory issues and is quite difficult with staff as well. When calling, I could never get enough information. If your mom has a white board in her room, write your name and phone # largely and circle it. Write criteria for when you want a call (she falls, she refuses therapy, etc...) - this worked for me. I hope you find relief because I KNOW how stressful it is when you can't just call up Mom and ask how she's feeling or if she's eaten enough today, etc. Best of luck my friend.

try calling the physical therapy dept. and ask for a progress report. Maybe you can accompany her to one of the sessions? Nurses give out the meds...if you want to know if she took her meds. CNAs clean and shower her, feed her. If you want to know how much she ate, if she had shower, hair washed, ask them. You may not get answer right away, since everyone is short staffed and short tempered these days. I never really got an answer when I asked I don't know how many different people if my mother got a shower. They said the morning crew gives it...morning crew said night crew gives it....I asked, "Well, can you look in the computer...maybe it is there?" I was called a troublemaker! I didn't think it was a hard question....Hugs.

What sorry of questions did you want the nursing staff to answer?

Obviously us forum folk cannot provide the answers..
But are you wanting How is my Mom today? Re settled? Pain level? Eating/Sleeping?

Getting an update from the nurse in charge after shift handover may help?

Or are you wanting a guide to what to expect longer term for a lady of advanced age with a nasty fracture?

I found the Family Meeting format very useful as the Case Manager would round-up updates from all the team (PT, OT, Nursing staff, Doctor).

I had better luck getting information from the case managers at the hospital where my mom was. The nurses were completely run off their feet, but of course, this was right in the middle of the worst of Covid and everyone was calling for information because no one was allowed to visit in the hospital.

Still, try calling the hospital and asking for the Case Managers' office. See what that gets you. If you're actually able to visit (and are the person who is authorized to get information about your mom), reserve your questions for once a day if possible and don't do it within an hour on either side of a shift change.

I wouldn't be calling to speak to nurses on the floor.

I would contact the Social Worker and ask for a Care Meeting which should include the Director of Nursing, the therapy team and nutrition.

Get a list of the meds mom is being prescribed and check it for accuracy. Check especially for meds listed as "prn" (patient request) as opposed to scheduled. Because when my mom was "asked" if she was in pain, she'd say no and then be in pain (and weep to us).

If words are used you don't understand, ASK!

Is your plan for mom to remain there at an LTC patient after rehab?

Be aware that if she is difficult and refuses rehab therapy sessions, Medicare will stop paying and she will be discharged. So have your next steps planned.

cmotta, hope your Mom recovers smoothly from her fracture.

As for talking to the Staff at Rehab, in majority of cases the Staff will talk to only the main contact person. Would that person be you or another relative? If it is another relative, they will only answer to that person. The reason for the one person contact, the Staff doesn't want to be on the phone all day calling dozens of people for one patient.

I can understand your need to find out how your Mom is doing.