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About a month ago my grandma started getting weaker, had a few falls, a few moments of confusion, then last Tuesday, she went a little crazy so I got her to the doctor where she was diagnosed with dehydration, UTI, and high calcium levels, she stayed in the hospital over night where she was given IV fluids came home with antibiotics, then this Tuesday she fell again I called an ambulance where she was admitted for the last few days mostly because of dehydration everything looks good. Every day when I go to see her she looks worse she barely even talks anymore she is confused. She is weak the doctor is ordering in home physical therapy, they said I can take here home tomorrow she lives with me, my cousin has been nagging me to keep her in the hospital, I need to get her home, she is not the 86 year old grAndma that I. Brought in, I have set up caregivers and she will get the therapy, and if this doesn't work we can do the rehab in a nursing home. I know that I don't bring her home she will get worse. Am I making the right choice?

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Question, where r her children?
Where I live, if hospitalized and they feel therapy is need, they suggest rehab. Medicare only pays fully the first 20days and then 50% up to 100days. While in rehab, you can have loved one evaluated for longterm nursing. If found they qualify, this is the easiest way to get them in. Only problem, isif a bed is available in the facility you would like.
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Grandma came home on Saturday, the first few days were tough very confused did not do basic tasks, but now except for a few things she is doing great, the caregiver is awesome, she is eating more than she has in a while, drinking water as she does not want to go to the hospital. she is getting up and using the restroom, dressing herself. she does not want help. The nurse that came yesterday was surprised how with it she was. the therapist starts tomorrow. I will keep everyone updated.
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Regardless of what decisions need to be addressed, just be informed! Ask questions... If there is a treatment (Rx, PT, etc.), ask how long before reasonable results should be expected? ... If evaluation tests (for any reason) are ordered, what will the results help define? Know your options with the best interests of grandma at heart.

Good luck. And keep reaching out, we are all out here together; what one person knows can teach someone else, who in turn pays it forward.
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I think you are making the right choice for now. The in-home therapist will be able to show you and her what she needs to do to be safer so she doesn't fall again. UTIs definitely cause confusion and delirium that can result in not eating and drinking enough, so keep an eye out for its return. Imagine if that happened in a strange environment with strangers around her? I believe that it is better and easier for anyone to recuperate in their own home if possible.
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If you can do it take her home. I wish now that I would have brought my mother home either to he house or to mine. Her time after that last hospital visit was very short and I so wish that she could have sent those last days where she wanted to be.
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Do you think you can hydrate her with an IV? If she is badly dehydrated, and hallucinating, getting fluids into her is going to be difficult. She probably has dementia and will be going downhill from here. All the efforts in the world will not prevent a death and you need to come to terms with that. Best wishes!
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Tell her doctor that you are afraid that if you take your grandma home she may not survive. Hospitals do not like to keep the elderly under medicare rules unless someone states the situation is crucial. Then ask the Doctor to sign and order for PT at a skilled nursing facility to gain strength back. Medicare will pay this at 100% for the first 20 days as long as she is receiving PT. That will give you time to monitor her and decide what is best.
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Best wishes 1teach. Many would not care to try it. Hope all goes well!
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We are getting therapist 4 times a week, I am going to try this and they said I have 30 days for the nursing home therapy doesn't work
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FF, it is so terribly sad about your mom. I am sorry. These elderly get so darn stubborn, and often causes problems they ordinarily would not have. See it in mom's hubby all the time, refusing recommended treatment, and thinks he can do everything. Why, he was in the closet at ALF to get out financial paperwork to go through at 2:am because his daughter was coming the next day. He wanted so badly to show her he had everything managed. And guess what... He fell in the closet, he was not hurt, but all the same, thank goodness by then he had at least started to wear his fall pendant!
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1teach, think of it this way.... where was Grandma just prior to her fall, having dehydration, UTI, and high calcium levels? She was living at home. Where was Grandma the second time this happened? Yep, living at home.

Grandma isn't being the same person you brought in, that is very common with elders when they go from home into the hospital for whatever reason. The mind becomes confused by all the new faces and new noises. I saw that with my Mom.

My Mom refused to go from the hospital into a rehab facility where she could get help with her balance and dehydration. Nope, she wanted to go home. She felt she was back to normal so she even refused the visiting nurses and the physical therapist who were coming to the house. She even told the professional caregivers to leave and not come back.

Guess what? Less than a week later Mom fell again but this time she hit her head. She is now in long term care under hospice watch. The damage cannot be repaired. She caused her own undoing with her choices :(

Just food for thought.
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There are articles on this site by experts in elder care that may help with your decision. Here is the link to one
https://www.agingcare.com/articles/elderly-parent-inpatient-rehabilitation-138342.htm

Best wishes to you as you struggle with this decision.
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She does not have dementia
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My apologies, I meant prognosis.
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Well, I agree with getting her the heck out of the hospital as fast as you can.

But a TCU (transitional care unit) which helps the transition from full hospital care to going home might really be best for everyone, with the full intention that she is coming home as soon as she regains some strength. You can reevaluate that later if need be, but let her have maximum help during the recuperation period.

You do not mention if she has dementia. That would make a difference to my answer.
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It would be helpful to know the diagnosis. I guess I'm cold/uncouth - sounds like renal failure. So . . . rehab? For what? Why put grandma through that? What does Grandma want, what does 1teach1cory want? None of us know, so no one can definitively answer this question.
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As her POA you need to help grandma understand what option would be best and more effective to help her feel better quicker. I would be very surprised if she wanted to go to rehab! Nobody does but sometimes it is not the best option. Gardenartist makes very good points about how a rehab facility is much better equipped and safer than home would be.
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Grandma is of sound mind. She wants to come home, the caregiver has a nursing background. The reason I want her home is she starting to give up, prior to this hospital stay which was 3 days she got around fine with a walker, I am the POA, the found out the high calcium was because of to much vitamin D that she takes because of rickets
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I agree that rehab would be a better option. Having been through this more than a few times, someone who's very weak needs considerable 24/support, not only for physical needs but for blood tests and monitoring which cannot be done as easily at home.

Given the fact that she had a UTI, was dehydrated and had high calcium levels, I would feel more comfortable with her being in a rehab facility where the nurses can monitor all of these issues to ensure that when she does come home, they are not issues any more.

Monitoring of that nature can be done daily or more often; at home, a home care nurse generally isn't available 24/7 in the event of an emergency or to take blood draws on a regular basis.

Someone who's that weak is not going to feel much like participating in therapy at home, where the furniture, rails, etc. are not as practically configured as they are in rehab. Better that the current issues be resolved so that she has a better change of recovering when she does come home.

I recall after my father had surgery for fractured hips. Granted that it was a more complex situation, I still can't imagine having tried to take care of him without the support of the aides, wheelchair accommodation bathroom, railings along the hall, 24/7 monitoring, catered meals, and other assistance he had in rehab.

Another way to look at the situation is that you can provide more effective care if she comes home in better condition than she is now. If she relapses, if the UTI isn't cured, she'll be right back in the hospital, perhaps more confused and perhaps depressed as well. That's not a chance I would be comfortable taking.
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Biting my tongue. What does Grandma want to do?
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This is one of those issues that people will feel differently about. Jessie asked an excellent question about the skill of the caregivers. Are they companion types or nurse types. Grandma sounds quite ill and very weak. It would be wonderful if we could all see the future and know which choice will be best for grandma. That choice also has to be best for 1teach. Is 1teach home all the time? Is she certain the caregivers have the experience required to provide the necessary care? Do the caregivers have the experience to recognize if something else is going on? Nurses in a nursing home would be. They also have geriatric physicians on staff that are always available. No calling for appointments, no being placed on hold....

1teach listen to your cousin. Who has grandma's POA's? Are all of her documenets in order?
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@gladimhere - she is 86 with hypercalcemia, repeated dehydration and UTI. Sometimes it is better to just go home IMO. I hope the OP shares her dear grandmother's prognosis.
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What is the prognosis from the hospital that admitted her?
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Medicare will pay for rehab if she is discharged there from the hospital. If she goes home first then you will have to go through all of this again if you need her hospitalized or if you decide a nursing home would be better.

No question here, have them discharge her to rehab where they have all services onsite so no excuses for not getting therapies done. Scheduling home therapies is very difficult, schedules constantly change etc. This sounds like too much care for home.
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Encourage her to drink, anything she will take that the doctor approves.
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I'm sorry, I hope I do not sound cold (not at all my intention). It sounds like you have everything in place for her care. 86 year old Grandma with repeated dehydration - I personally would bring her home. . .
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I was thinking the same thing as Windy. 1teach, do you think it would be a good idea to let her stay at a skilled nursing or convalescent facility until she has built back up some strength? It sounds like she might need 24/7 care for a while. I don't know how skilled the caregivers are that you have arranged, or how many hours they will be there. Let us know a little more and you'll probably get some more opinions on what to do.
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I would be concerned that all her medical issues, lack of mobility and age would make it very difficult to care for her properly at home. It's sems like a skilled nursing care facilty would be advisable, at least until she regains some health and strength.
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