83 Yo Dementia..... severe right hip arthritis... unable to even transfer without severe pain. Dental issues... cannot tolerate narcotics. Post surgery will be 24 hour 1-1 x 3-7 days
While it's not always the case that non-profits are better, my own experience has been to go for them rather than for-profits. My own experience has been with a wonderful non-profit for whom I can't say enough good things. We had a for-profit in our community for less than a year and they didn't get such good reviews.
I do like the hospice idea for a woman with all of these issues - taking into consideration her age. If this were me, I'd choose hospice care.
I don't know how long the hospital will keep your mother post surgery until she goes to rehab. Some rehabs, like the one my husband was in following a fracture of a femur, are also skilled nursing facilities. He remained there until his death. See if the hospital where she will have the surgery has a social worker with whom you can talk about your mother's post surgery needs. She may need to be placed in a skilled nursing facility if she cannot be cared for at home by a professional caregiver. Do not undertake this responsibility yourself, you cannot afford the physical and emotional stress. I speak from experience.
You might want to check into the option of Hospice. The goal of Hospice is comfort. They will be able to provide equipment if you are going to be bringing your Mom home. In a facility, if she currently resides at an AL facility, they will go in and bathe her, dress and make sure she has the supplies necessary. If pain becomes too great most Hospice have Units where a patient can be taken to help with pain so they are not usually in a hospital but more of a home like setting. But again comfort is primary. There are Non-Profit Hospice and For-Profit Hospice. When you check out a few and interview them ask what their status is I think that makes a difference in the level of care. Dementia patients do not do well with anesthesia and rehab is also very difficult if not impossible for most. If directions can not be followed that makes rehab more of a challenge . I am guessing that your Mom has Lewey-body dementia and medication can be a challenge. And that can make pain management more difficult.
Thanks for mentioning there are Non-Profit Hospice and For-Profit Hospices. I didn't know that the two times I had to make arrangements for someone else. The one I chose is named Hospice of (name) County, which implies that it is nonprofit. At the time it was the only one available. I will ask which it is in case I need the information in the future.
Mom [then 87] had to have surgery to replace her shoulder/rotator cuff. She had her left arm literally pulled out due to a fall, and also broke part of her collar bone. She ended up with a 'tinker toy" artificial shoulder. Yes, it was essential / not elective surgery, due to extreme pain and her arm was hanging by a few tendons - and dropped 4".
She did _not_ do well with the anesthesia. The Rehab / NH faciility that she was forced to go to for Pt called it "dementia induced anesthesia". i did not know she had dementia - vascular dementia - until it said so on the death certificate.
Had i known -- i would have pursued looking into pain management options vs surgery: perhaps cortisone injections, etc. i did not realize she didn't understand or have the ability to ask any questions about the surgery. She always took things in Faith - never complaining. Please ask specific questions re inhospital PT etc so that you know what to expect. It really surprised me that she had NO Pt in the hospital. Her doc knew i was disabled -- yet did not take that into consideration as to her post-op care.
She never recovered from the surgery - and due to NH neglect, ended up with UTIs, renal failure, bed sores - even on her feet!, and much worse. She had only been in the NH for 3 weeks and spent 4-5 days in the hospital for these secondary/ NH neglect caused pain and inhumane treatment.
How i wish i'd just brought her home - the hospital did not do any rehab. For the surgical procedure - she was admitted overnight - which turned into three nights - and i had 5 minutes' notice that she was being discharged. The NH nurses complained when i wanted her out of bed - into the wheelchair - so i could take her outside. She could no longer stand up nor transfer. She was at the NH for rehab - which they did not do. How long does it take, if ever, to stop feeling the guilt and pain of caregiver helplessness?
One thing i do know about -- if the person is in Hospice - they do not receive rehab or PT. Please ask if your mom would receive PT in the hospital -- even if to prepare her for PT at a rehab facility [please be sure to pick one out in advance - you don't need to sign anything - but oh my, how they do vary in cleanliness and patient care. i was at the facilty every day for many hours a day for over 4 months. Countless times, i had to ask for her meal tray, change her into the hospital gown at night, etc. They took her off of solid foods - just because of the "dementia label" - and offered her nothing else, excess instant mashed potatoes. So everyday i was taking her Ensure, puddings, etc for her lunch and dinner . i regret putting her into the facility - but she had inhome PT to prepare her for surgery, and wouldn't do the exercises except when the person was here for their 15-20 minute sessions. She's still my best friend and i did the best my prayers and stamina could do. Does one ever feel it's enough? i did bring her home - her joy and sense of humor dwindled -- but she lit up when anyone visited - which were the nurses.
Palliative care is a first option also - PT is/should be available - but be sure the legal documents are in order so that her bills/medicine/etc can still be obtained and utilities etc paid for. i also had to get not only the POA but a special letter from her dr - saying that she couldn't make financial decisions - which really helped moving her funds around to pay for the NH and expensive meds/equipment. Her IRA holdings were being mishandled. The NH was $245 a day plus meds were separate.
I do like the hospice idea for a woman with all of these issues - taking into consideration her age. If this were me, I'd choose hospice care.
Take care of yourself,
Carol
The goal of Hospice is comfort.
They will be able to provide equipment if you are going to be bringing your Mom home. In a facility, if she currently resides at an AL facility, they will go in and bathe her, dress and make sure she has the supplies necessary.
If pain becomes too great most Hospice have Units where a patient can be taken to help with pain so they are not usually in a hospital but more of a home like setting. But again comfort is primary.
There are Non-Profit Hospice and For-Profit Hospice. When you check out a few and interview them ask what their status is I think that makes a difference in the level of care.
Dementia patients do not do well with anesthesia and rehab is also very difficult if not impossible for most. If directions can not be followed that makes rehab more of a challenge .
I am guessing that your Mom has Lewey-body dementia and medication can be a challenge. And that can make pain management more difficult.
Thanks for mentioning there are Non-Profit Hospice and For-Profit Hospices. I didn't know that the two times I had to make arrangements for someone else. The one I chose is named Hospice of (name) County, which implies that it is nonprofit. At the time it was the only one available. I will ask which it is in case I need the information in the future.
She did _not_ do well with the anesthesia. The Rehab / NH faciility that she was forced to go to for Pt called it "dementia induced anesthesia". i did not know she had dementia - vascular dementia - until it said so on the death certificate.
Had i known -- i would have pursued looking into pain management options vs surgery: perhaps cortisone injections, etc. i did not realize she didn't understand or have the ability to ask any questions about the surgery. She always took things in Faith - never complaining. Please ask specific questions re inhospital PT etc so that you know what to expect. It really surprised me that she had NO Pt in the hospital. Her doc knew i was disabled -- yet did not take that into consideration as to her post-op care.
She never recovered from the surgery - and due to NH neglect, ended up with UTIs, renal failure, bed sores - even on her feet!, and much worse. She had only been in the NH for 3 weeks and spent 4-5 days in the hospital for these secondary/ NH neglect caused pain and inhumane treatment.
How i wish i'd just brought her home - the hospital did not do any rehab. For the surgical procedure - she was admitted overnight - which turned into three nights - and i had 5 minutes' notice that she was being discharged. The NH nurses complained when i wanted her out of bed - into the wheelchair - so i could take her outside. She could no longer stand up nor transfer. She was at the NH for rehab - which they did not do. How long does it take, if ever, to stop feeling the guilt and pain of caregiver helplessness?
One thing i do know about -- if the person is in Hospice - they do not receive rehab or PT. Please ask if your mom would receive PT in the hospital -- even if to prepare her for PT at a rehab facility [please be sure to pick one out in advance - you don't need to sign anything - but oh my, how they do vary in cleanliness and patient care. i was at the facilty every day for many hours a day for over 4 months. Countless times, i had to ask for her meal tray, change her into the hospital gown at night, etc. They took her off of solid foods - just because of the "dementia label" - and offered her nothing else, excess instant mashed potatoes. So everyday i was taking her Ensure, puddings, etc for her lunch and dinner . i regret putting her into the facility - but she had inhome PT to prepare her for surgery, and wouldn't do the exercises except when the person was here for their 15-20 minute sessions. She's still my best friend and i did the best my prayers and stamina could do. Does one ever feel it's enough? i did bring her home - her joy and sense of humor dwindled -- but she lit up when anyone visited - which were the nurses.
Palliative care is a first option also - PT is/should be available - but be sure the legal documents are in order so that her bills/medicine/etc can still be obtained and utilities etc paid for. i also had to get not only the POA but a special letter from her dr - saying that she couldn't make financial decisions - which really helped moving her funds around to pay for the NH and expensive meds/equipment. Her IRA holdings were being mishandled. The NH was $245 a day plus meds were separate.