Is Mom in too much pain to participate in rehab, or suffering depression? - AgingCare.com

Is Mom in too much pain to participate in rehab, or suffering depression?

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My mom fell about two weeks ago breaking her elbow. After the hospital she was taken to rehab. At rehab she is refusing to even stand, she just tells me repeatedly that she hurts. In addition to this the rehab has been a nightmare, it is unsanitary, the staff is inadequate and we have had nothing but problems since she got there.

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With my aunt, something was missed. Pain may be coming from another area near where she hurts. They xrayed where it hurt, found nothing till a few days later. Higher up on the spine was a compression fracture. Something is definitely wrong. Good luck.
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If you break your elbow as a sane and valid person, it is extraordinarily difficult to move that whole arm or to dress oneself for months. If the person is old or frail or in any way impaired, you can double the time for the healing process. So rehab after surgery is essential. And proper nursing care. If the facility is horrible, change it without changing the status of the patient. The degree of care is important.

Depression has nothing to do with it. Refusing to move is common if the patient has only just found a position where the pain is least, and decides to freeze there.
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It sounds like it may be time to have her evaluated both physically and mentally he because it sounds like there may actually be some underlying mental conditions as well as possible physical reasons she's having so much trouble. If it's not physical, then have her checked mentally
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Suggestions others have made to have mom checked for any additional issues would be the place to start. Rule out any possible injury, especially since she refuses to stand but the surgery was on her elbow! Since she is there 24/7 but you are not, is there a chance she fell and no one is telling you?

If no other injuries are found, I would request the doctor prescribe IN_HOME PTor outpatient PT. If she is living with you (or vice-versa), she has someone watching over her; there's no need to be in a rehab place if she just needs to do exercises! If she is still somewhat mobile, then Rx from doctor for a PT facility (they would have more/better equipment that might help, but get referrals from others as not all places are the same). Our mother was mid-upper 80s when she had rotator cuff surgery - after an overnight stay, she went home (lived alone) and had PT come in. She did fine.

Personally I prefer being home, ever after major spinal surgery. I usually went home the next day and once it was approved went to PT - no rehab. I did get stuck in the hospital for almost 4 weeks once, and kept begging them to let me go home, even threatening to walk if I had to (might have taken several days, but I HATED being there!) They finally relented and brought in med delivery, all kinds of equipment and a nurse to prep my "feed bag" every day as well as do vitals, draw blood, etc. HUGE improvement!!! So perhaps mom just hates being there, and I do not blame her!!
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Good Evening,
6 and 1/2 years ago I fell down a flight of stairs and broke my elbow. I would have been 60 at the time and did not look forward to surgery, but I had NO movement in my arm and the pain was out of this world. After surgery, my arm was just as swollen, hurt just as bad and I still had very little movement in my arm.. Long story short. The pain and swelling were normal. I had a PT that I went to for 3 months. I exercised a lot. All of the exercises given by the PT. Then it took a couple of years to really get my strength back in that arm, but I have better motion in that arm than in the one I did not break! I think it is a combination of a great surgeon, a physical therapist who expected me to get all motion back, and my own determination to do just that--get back to normal. but it was not easy and did take a lot of work on my part.! P.S. I actually exercised both arms with all the exercises because I could really see where I was supposed to get to!
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The protocol is that the patient goes to the rehab unit of an NH from a hospital. First a Medicare bed must be available. Then the patient is transported to the NH via ambulance.
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See if Mom can have therapy at home. I agree, call the surgeon. If Mom refuses, 3x I think it is, Medicare will not let her continue treatment. I don't understand how the rehab a dementia patient. In my care meeting the therapist said Mom didn't follow directions...duh, she had Dementia. She didn't know where she was.
I have never heard it said its recommended not to visit in rehab. Therapy is only done maybe an hr in the morning and again in the afternoon. Not much for patients to do in between. You have to be there or even rehab gets away with murder. My Mom was in the hospital five days so rehab was recommended to get her walking. What a joke. She was in a wheelchair most of the day. I swore the next time she would have therapy in her AL.
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Recently my FIL fell and broke a hip while at the hospital for testing. After surgery he was sent to an Acute Rehabilitation Center. 
Dad’s roommate was discharged from the rehab center with a surgically repaired shoulder fracture much sooner than we imagined he would be. This man’s son explained to us he would be taking his dad to a therapy center every day for therapy as an out patient so his dad could be at home with his family.
I’m wondering if this could be an option for your mother?
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First your Mom is lucky to have you watching out for and listening to her but I know first hand how hard it is to navigate when you have no experience. I agree with the others here, it's time to get her into a new rehab facility and while they tell you moving can't be done, there have to be ways. First as far as Medicare is concerned rehab is a hospital, they are charged out on the same benefit so she would be coming from a hospital. The facility is going to do everything they can to discourage (read prevent) you from moving her so you will probably have to work around them unless of course you can make their lives so miserable they want to get you out of there, hehehe. Seriously though, making a stink about this is not only watching out for your mom but also watching out for patients that come after her. Keep a list of every issue you have and share it. If people don't know that they have problems and aren't caring for patients the way they should be then it wont get better and they will keep getting away with it. Looking for other injuries and medical possabilities for her pain is a great suggestion and the professionals there should be receptive to that. Based on your description there are lots of other reasons to get her out of there but still while your working on that suggest, strongly, they check for other physical problems but stick with your instincts about the facility and advocate for what you feel is best for your mom. Absolutely bring your mothers doctors into it, her surgeon, her Orthopod if they are different and her primary, the more people with clout the better. The surgeon probably has the most because they have patients going to rehab every day and if they start saying to their patients "don't go here" well... I would also enlist the coordinator at the hospital who sent you there, they may care they may not but they are the ones steering people and if they are good they care about where they are sending them. If you are that unhappy they might even want to help you navigate the system for moving her and be a good resource, at the very least they need to know the issues. Good luck and keep up the good work advocating for her!
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I see that responders are missing the point of the OP. She injured her arm but she refuses to stand. She is stuck in this rehab most likely because insurance will not allow a transfer. There should be some person in charge of medical issues to speak to or request a family meeting to hear what PT has to stay. Once her insurance for rehab runs out, I expect the recommendation will be that mom failed to progress and the dreaded words " she needs 24 hour care" will appear.
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