My mom is in rehab from a knee replacement. She is still not walking after 20 days of rehab. What are my options? -

My mom is in rehab from a knee replacement. She is still not walking after 20 days of rehab. What are my options?


They say she has plateaud. But she is not walking on her own or even able to go to bathroom. I and my brother live away and can’t get there for another few weeks. She is in a rehab/ nursing facility. What are my options? Any ideas. This is our first time dealing with the Medicare system.



What was your mother's health like before the knee replacement.? How old is she ? Does she have any other medical issues or dementia. Was the knee replacement needed because of an injury or was it planned? How mobile was she prior to the surgery.
After a replacement the patient is usually up and taking a few steps before she leaves the hospital usually in four days either discharged to rehab or home.
I rehab she should have daily PT which includes walking every day.
Unless there are other reasons you don't know or haven't shared 20 days is far too short a period to have reached a plateau. For an older person expect improvement to continue for 6-12 months.
Did the surgery alter her mental status which is very possible in the elderly.
I agree you should get to rehab as soon as possible and find out why she is not improving. I can't remember the Medicare rules for rehab but I think 20 days is a magic number. you should probably go to the medicare web site and look up the rules.
Helpful Answer (1)
Reply to Veronica91

You need to contact the rehab social worker to discuss those options. The social worker will discus that she may stay up to 100 days at a certain rate (maybe $150 per day). After that is usually $400 per day similar to what it costs for a nursing home. . These are estimates. This is the way Medicare operates. She may be able to get a few more PT sessions during the next set of days, but it depends on the insurance that she enrolled in. Generally every time one of my parents entered into rehab after the hospital, I was always told by a rehab rep how these costs go.
The plateau that you mentioned, means that this will be her future quality of life. You may have to determine if she is Medicade eligible or if she will have to spend down her assets. Or you may take her into your home to help her, however from many posts, you may not find this as a good option. 
Helpful Answer (2)
Reply to MACinCT

You need to contact the social worker ASAP, like tomorrow, and let them know what her home situation is. Does she have other medical issues besides the knee problem? Can she live on her own again although in a wheelchair? Is she mentally capable? Or do you need to find alternate living accommodations as soon as she is released?
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Reply to rocketjcat

At a plateau she will lose Medicare benefits and will have to start paying out of pocket for any additional stay. Have you looked into a nursing home for her? Is there one associated with rehab facility? If other arrangements need to be made now, and it sounds as if they do, it may not wait two weeks. You could ask for assistance from the social worker at rehab or hire a geriatric care manager to assist.
Helpful Answer (4)
Reply to gladimhere

SMR, one of the unfortunate aspects of nursing homes is that the therapists and staff aren't always top notch or even good, and don't work well with patients. Another trend I've seen is that some facilities want a quick in, quick out rehab so their statistics show that they're turning patients around more quickly

The presence of family absolutely, definitely makes a big, big difference in the way the patients can and are treated. Since you can't visit for 2 weeks, you could start calling there regularly and ask to speak with the therapists, getting more details on the reasons for the alleged plateaus.

And the reasons may in fact be legitimate, but they could be interpretive, could be many things could factor in.

Real makes a good suggestion of speaking with the doctor. If he/she has seen your mother recently, he/she can assess the situation just as well if not better than rehab staph, and could do so independently.

You can also consider moving your mother to a facility closer to you and your brother; then you could visit more often and make your presence known.
Helpful Answer (3)
Reply to GardenArtist

That is there way of saying this is as good as it gets. They tried telling me that my dad being able to transfer himself to wheelchair from bed and back again was it. I knew that he had not received good rehab and transferred him to another rehab, he can walk, get in and out of bed, my 4x truck, so get there and find out what they really did for your mom, when there is no advocate it is crappy care, minimal rehab, sickening what companies do for money.

Have you talked to the Dr that did replacement, my mom had a staph infection that caused untold issues.
Helpful Answer (3)
Reply to Isthisrealyreal