My mom insists she can take care of herself when she goes home from post-stroke rehab. How can we explain reality to her? - AgingCare.com

My mom insists she can take care of herself when she goes home from post-stroke rehab. How can we explain reality to her?

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How can we explain reality to her? My mom is on week 4 of post-stroke rehab. She has progressed, but she still can't walk or use her left arm. Her cognitive abilities are about 98 percent intact, so she is not demented. Even before the stroke, she was in major denial about being old and unable to care for herself in some ways. She lived alone and she seems to think she's going to go back to living alone. When I tell her she is going to need 24/7 care for the foreseeable future, she tells me that's ridiculous. When I point out that she can't walk or use her left (dominant) arm, she insists she will be able to recover all of that and live at home by herself. Furthermore, she needs 2 people or a lift to get her from bed to wheelchair.

I find this really upsetting, because I, as her only child, am going to have to either put her in a "home" or get her full time care in her own home. She is not going to accept either one of these options. I hate to feel like I'm forcing this on her and taking away her independence, but there's no other choice. How have you dealt with this siituation?

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I feel so bad for your mother, xina. I feel bad for you, too. I know it makes you feel crazy and stressed when she says she is going home. I do wonder how rehab is handling it. Legally they can't keep a person who wants to leave. But if there is no one who would help her leave, she is rather stuck. I guess maybe the best thing is to keep saying "when you get better." Maybe then it will keep hope in her so she will keep trying. ((((Xina))))
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Today my mom told me she is going home later. She's going to hail a taxi and she will be just fine alone at home. She is nowhere near going home, and I'll be surprised if she ever does, given that right now she needs 2 people to transfer her. She is in touch with reality on all levels except regarding her abilities, so it's really upsetting and confusing. Nothing sinks in. Just needed to vent. I think we are meeting with the PT/OT/SW later this week.
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Medicare will only pay for short visits in most cases a few hours a week. If this woman can't transfer by herself it is obvious that she will need 24/7 care. That is much different from what medicare can supply which would make her inelligable for medicare paid home care.
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If your mom's husband was a veteran there is a program called Aid and Attendance that will pay the spouse of a deceased veteran, who served during a time of war, up to 1,200.00 per month for home care. Although this is not enough to cover all of the costs it will stretch her dollars so she can stay at home longer. you can go to www.veteranaid.org for a full explanation of the benefit.
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Thanks, Jessie. My mom does have a decent chunk of savings, though nothing like what she "should" have at her age. I hate the thought of blowing through all of that, which would happen in 2-3 years with 24/7 care. But that's the only way to get Medicaid, I guess. UGH. I'll check out PACE.
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Xina, Medicare will pay for a limited amount of home care, up to the goals set by the therapists. I would think she could benefit from home nursing as well.

It's an entirely different environment for therapy at home, more relaxed, and the therapists are often more experienced with older people in their own homes. The activities and exercises are easier as well.

You could prepare her focusing on the fact that they will help her find new ways to adapt to her own home, which they will do if they're good.

I'm surprised no one told you that Medicare would pay for limited home care.

And sometimes that's enough to spark and maintain motivation, while allowing the person to be more comfortable in his/her own surroundings.

There is one caveat though; too many people too close together can cause fatigue. Through experience, we limited home care to no more than 2 people daily.
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I see PACE is also available to people on Medicare alone, but can be adapted to Medicaid if needed.
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xina, you can look into getting Medicaid for your mother when her money runs out. If she is going to be in a facility, normal Medicaid could help you. If she is at home, there is a community-based program Medicaid called PACE that you may find helpful. PACE has specific guidelines. I'm not overly familiar with it, but it does appear to be a good program for low-income senior who want to age in place.
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Have a sit down with the discharge planner and social worker and discuss emergency guardianship (court order). Mom's medicare will cover 100 days of rehab, but only if she shows progress each week.
Now is the time to find a trustworthy attorney to advise you.
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