My mom, age 84, had a stroke in May and has been home for a few months now with 24/7 care. She had a lot of PT in the rehab place and then had some private visits at home which were covered by Medicare. She can stand, but her left leg was affected by the stroke. She can't walk and the Pos believe she will not walk again. She has been asking me repeatedly to get her a PT (for in-home sessions) because she wants to walk. I obviously don't want to discourage her, but I can't imagine a PT is going to work with someone who has "plateaued." There really is nowhere else to go with her physically. I guess I will call a PT and tell him/her my dilemma. I'm not even sure where to find one, as most of them seem to work at PT centers vs home visits.
I know Mother had in home PT following all her various surgeries. As soon as the PT had run out, she just did nothing. She can walk, but is definitely slow and walks so hunched over it's painful to watch. Her motivation was zero. I asked her PT if she was "capable" of standing up straight, as it looked so painful to se her bent in a C curve. He said "Yes, she can and if she keeps up her exercises, she will continue to improve, to a point."
By the next week, with no PT coming, she is bent completely over and shuffling in her walk...no cute PT guy coming, no reason to stand up!
If you cannot get PT in the home--see if you can learn a few strengthening exercises and just keep her spirits up, if nothing else. Even bedbound patients are given some kind of PT, improving blood flow, etc.
Your sweet attitude is wonderful--I know how much it would mean to your mom to not be in a wheelchair for the wedding---but that sounds very unlikely. Still and all, I'd do whatever to keep her hopeful without being overly "sure" that that's the outcome she'll get.
I am taking her to a neurologist in a few weeks, so that should be helpful. And I found a PT place that does home visits. Hopefully the neurologist will give us a referral.
Of course we all know what will happen when she can't stand and get out of bed but she has not reached that twilite zone yet so continue to encourage her and believe she can do it. You might be amazed at what she can achieve with her motivation.
You'll also need to wash and dry that hand really thoroughly for her. It'll get sweaty and before long yeasty - not nice. We were told to roll up a soft cloth, a face flannel is a good size, and close her hand around it to stop the fingers getting too tight in a ball. Remember to change the cloth frequently. Be firm but careful when you're manipulating her hand so as not to hurt her.
When your mother insists on unrealistic guarantees, just agree and point out cheerfully that if she wants to reach her goals she'll still have to start somewhere. I really hope you find someone soon - why not call the centres anyway and ask if they know of any freelance practitioners? You can't be the only one whose mother can't go to them.
I believe the key phrase the ordering physician should use with the insurance companies is "the patient will get worse without treatment".
Hope this helps-be sure to appeal their decisions.
Who was it that completely over looked the fact that really wanting to walk is progressing!
I believe you can get a dr to prescribe home physical therapy as she has 24/7 care in home
The key here is that Medicare may only pay for so many sessions per year but it is a new year
The other thing that I found that makes a huge difference is finding the right home PT - did mom like the last one that visited ? If so great - otherwise it can be hit or miss - I found some are difficult and schedule at their convenience I.e., I'd ask them to come in the afternoon but they'd come at 9:00 am when mom was either still asleep or eating breakfast
Please try as if mom is willing any movement and massage will help her
You might even find a PT who agrees with the importance of massage, too.
Short answer: seize the day.
Not true here. My mother gets out to doctor visits (I take her because she no longer drives), and she is now getting home PT. She had some knee trouble, and after the cortisone shot the doctor said she could get PT. "Could that be home PT?" I quickly asked (because I don't want to have to drive her to PT appts.). Home PT was approved.
In home will only be available if she is completely housebound. If she is getting out to doctor visits, then she can get out to a PT at the clinic.
Finally...even with doctors order she will have to pay privately for the PT. This runs about $250 per visit for my Mom...probably about same for her. (Only, Medicare is still paying for my Mom).