I know that I don't bring grandma home she will get worse. Am I making the right choice?

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.

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.

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.

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?

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.

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.

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.

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.

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.

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!