Start letting your VOICE be heard loud. I had to at my dad's nursing home, and things are changing. I'm an advocate for all patient at my dad's nursing home
AgingCare1485: Perchance his physician ordered the 15 minutes of PT x2 per week. You could speak to his physician. Best of luck during this most difficult time in your lives.
Make a point to visit when he does get physical therapy to learn his exercises. Then, visit on days he doesn't get physical therapy to work with him through his exercise regime. Also find out if he needs to have any equipment purchased (walker, cane...) and get it for him. Eventually, he should get stronger.
Does your partner want more PT? Is he motivated to do the work necessary to gain strength and mobility? Is he able to speak for himself? Does he want more help?
If so, then do everything in your power to make it happen - you've gotten good advice already about how to pursue more PT/OT for him.
However. If you're the one who is motivated and he's not as motivated, then all of the PT in the world won't be of any benefit long term.
Perhaps you can arrange a consult via zoom? Second Opinion or getting a new doctor? Needs an evaluation based on his current situation (i.e., mental and physical limitations).
I have been in rehab and on dialysis and having PT. It is all very difficult. Doing all the arm exercises and trying to push up places stress on your dialysis ports and is painful. In and of itself dialysis is very tiring. He may not be strong enough to do a lot of PT. all the advocating in the world won't give him the energy he needs. I worked very hard in PT to accomplish the things I needed to do to go home. I was very fortunate. My family was supportive of my goals. I will never stand up by myself and walk, but I am able to live with at home with little assistance. Be supportive but don't push for things that may be beyond what he feels like doing. That is his decision. Also consider that 15 minutes a week may be all the PT his doctor ordered and/or it may be all that his insurance would pay.
Touchmatters has a good point. Is this Rehab? If so, I am surorised he has not been discharged. If he is in a NH permanently, thats a different matter.
Is your partner competent to make informed decisions? If so, he needs a Care meeting and can have you attend it. At this meeting should be the therapist, the DON and the SW at least. Thats where he asks why he is not getting enough therapy to strengthen his legs. Maybe like said, his dialysis weakens him so he can't do dialysis. He has at least 3 sessions of dialysis a week for 6 to 8 hours. Some places may not do therapy on weekends. So there's the two days.
If he is incompetent and ur Medical POA then you ask for a meeting.
In addition to my comments here/below and above, it is imperative that you, the writer, do your research. Talk to nursing home case manager. Know what government will pay and won't. You need to ask questions / do research.
Another aspect of this situation is realizing that this person cannot walk. Perhaps likely declining. It is important that you emotionally take care of yourself as this person's ability to function declines. Let your sadness (and all emotions) come out. Talk to a professional yourself and/or find support through friends or church, or wherever you find emotional support. This is a sad situation / sad time. Often, due to finances, we (the person managing care / family) cannot do all that we would like to be able to do and need to accept 'what is.' The more you can learn / investigate / education yourself, the more present and emotionally / psychologically available you will be for this person. Take care of yourself.
Are you formally designated as your partner's POA?. I am sorry about your partner's illness and, I know that you grieve his decline. However, I ask the POA question first, because this POA status will determine to a large degree what you can or cannot do for your partner with regards to communication with the health care team etc. You of course can and I know will support your partner with your presence and encouragement. If you pray, pray. Determining what your partner 's wishes are and, allowing him to make his own decisions and, honoring " patient rights" supporting his decisions will be helpful. Practice good self care , get support for yourself from facility chaplains or social workers or other community support services. You and your partner ( all people and families) grieve the present illness, decline and also what the future may hold . Chaplains or other designated professionals can be very supportive of you both if you are open to the support. Blessings... ( anticipatory grief) ....
Follow Lealonnie’s advice and move him somewhere else as soon as you can if at all possible.
In the meantime before the move AND after… Attend his PT and replicate the therapy when you’re visiting. (If you can attend, you also can help ensure that he’s getting a higher quality session). Make sure to ask the therapist for “homework.” Ensure your partner is following through with that. If he is assigned doing this at least 5x a day, work him up to more.
Demand that his doctor order additional PT and add OT.
Is the dialysis new? He may feel depressed about his change in condition and the food and liquid limitations. Reward him with “non food” treats: massage, magazines, his favorite games, a movie, crafts, come early one day to watch the sun rise, music in his room that he loves, engage in debates which impassion him… of course you can’t change the situation, but give him momentary vacations from thought which may be draining his mood.
Think 5 senses: a soft new blanket, aromatherapy, gentle music, beautiful pictures, something special to taste that he is allowed that won’t harm his new diet.
Visiting a loved one who has experienced a change in ability or mood may also have an impact on you. Make sure to do nice things for yourself to build your mood too. This is hard and don’t overlook your own needs.
Hello, it isn't a matter of 'demanding,' it depends on what options are available within the financial and/or health care plan (MediCare? MediCal? personal insurance?) It is standard (in California, from my experience) that 15 minutes happens after other financial. means are exhausted.
IMPORTANT: The continuation of PT and OT DO depends on if there is improvement as a result of the PT and / or DO. If no improvement shown, these services are not allowed to continue to be paid for by the state / federal government. Even so, if they are allowed, this writer needs to investigate why 15 minutes? These services / amount / are stipulated clearly in government assisted care. If paying out of pocket, it could cost over +$300 an hour. Person asking question here needs to talk with the institution and perhaps call Medi-Cal or whatever services this person gets to see what is available. Every state may be different in benefits. As you or someone else suggested, who is the POA ? if there isn't one, it is imperative that this be put in place ASAP. Out of pocket costs are huge. Everything depends on this person's financial situation. Gena / Touch Matters
See my response above. Out of pocket may not be an option, financially. The writer here needs to do their research. Nursing homes do not 'make' rules for these services for themselves; they are affiliated with government programs such as Medi-Cal, Medi-Care, or others.
Find out why he's only getting 30 minutes of PT per week. Speak to the case manager at the SNF/rehab facility he's at and get the 411 on what's going on. Traditionally, a patient in rehab gets at least an hour a DAY of PT and OT; why is this case different? Is your partner able to do more than 30 minutes per week and the SNF is dropping the ball? If so, get him OUT of there and into a better rehab SNF. That's what I had to do with my mother in 2019 when I had her in a terrible SNF for rehab, and they were doing nothing to help her at ALL. In fact, they had her oxygen cannula hooked up to NOTHING at one point! I was livid. So I went around to a few other SNFs and checked them out, found one I liked a lot better and had room for her, and had her transferred over a few days later. The difference in care was night & day between the 2 facilities!
So you shouldn't have to be doing anything to help your partner, physically, it's on the SNF to be doing their part. See what the case manager has to tell you and go from there. If you're expected to do all the PT exercises with your partner, then something is wrong somewhere, in my opinion.
Perhaps you can go in and have the physical therapist show you what kind of exercises your partner can be doing and then you can do them with him/her. Often folks are overlooked in nursing facilities when it comes to PT, so make sure YOU know what they should be doing so you can help them regain their strength. It shouldn't be all on you, but sadly that is often the way it goes nowadays. You can also check with your partners doctor to see how much PT was actually ordered. I wish you both the best.
If so, then do everything in your power to make it happen - you've gotten good advice already about how to pursue more PT/OT for him.
However. If you're the one who is motivated and he's not as motivated, then all of the PT in the world won't be of any benefit long term.
Perhaps you can arrange a consult via zoom? Second Opinion or getting a new doctor? Needs an evaluation based on his current situation (i.e., mental and physical limitations).
https://stanfordhealthcare.org/directory/directory.html#x1=sp_spec_care_phy&q1=true&sp_x_2=sp_dr_title_groups&sp_q_exact_2=Nephrology&sp_q_location_12=%2b37.7257-122.1568&sp_x_12=sp_lat_lon&sp_q_max_12=10000&sp_s=sp_lat_lon_proximity&page=1
Is your partner competent to make informed decisions? If so, he needs a Care meeting and can have you attend it. At this meeting should be the therapist, the DON and the SW at least. Thats where he asks why he is not getting enough therapy to strengthen his legs. Maybe like said, his dialysis weakens him so he can't do dialysis. He has at least 3 sessions of dialysis a week for 6 to 8 hours. Some places may not do therapy on weekends. So there's the two days.
If he is incompetent and ur Medical POA then you ask for a meeting.
Another aspect of this situation is realizing that this person cannot walk. Perhaps likely declining. It is important that you emotionally take care of yourself as this person's ability to function declines. Let your sadness (and all emotions) come out. Talk to a professional yourself and/or find support through friends or church, or wherever you find emotional support. This is a sad situation / sad time. Often, due to finances, we (the person managing care / family) cannot do all that we would like to be able to do and need to accept 'what is.' The more you can learn / investigate / education yourself, the more present and emotionally / psychologically available you will be for this person. Take care of yourself.
Touch Matters
( anticipatory grief) ....
In the meantime before the move AND after…
Attend his PT and replicate the therapy when you’re visiting. (If you can attend, you also can help ensure that he’s getting a higher quality session). Make sure to ask the therapist for “homework.” Ensure your partner is following through with that. If he is assigned doing this at least 5x a day, work him up to more.
Demand that his doctor order additional PT and add OT.
Is the dialysis new? He may feel depressed about his change in condition and the food and liquid limitations. Reward him with “non food” treats: massage, magazines, his favorite games, a movie, crafts, come early one day to watch the sun rise, music in his room that he loves, engage in debates which impassion him… of course you can’t change the situation, but give him momentary vacations from thought which may be draining his mood.
Think 5 senses: a soft new blanket, aromatherapy, gentle music, beautiful pictures, something special to taste that he is allowed that won’t harm his new diet.
Visiting a loved one who has experienced a change in ability or mood may also have an impact on you. Make sure to do nice things for yourself to build your mood too. This is hard and don’t overlook your own needs.
it isn't a matter of 'demanding,' it depends on what options are available within the financial and/or health care plan (MediCare? MediCal? personal insurance?)
It is standard (in California, from my experience) that 15 minutes happens after other financial. means are exhausted.
IMPORTANT: The continuation of PT and OT DO depends on if there is improvement as a result of the PT and / or DO. If no improvement shown, these services are not allowed to continue to be paid for by the state / federal government. Even so, if they are allowed, this writer needs to investigate why 15 minutes? These services / amount / are stipulated clearly in government assisted care. If paying out of pocket, it could cost over +$300 an hour.
Person asking question here needs to talk with the institution and perhaps call Medi-Cal or whatever services this person gets to see what is available. Every state may be different in benefits.
As you or someone else suggested, who is the POA ? if there isn't one, it is imperative that this be put in place ASAP.
Out of pocket costs are huge. Everything depends on this person's financial situation. Gena / Touch Matters
So you shouldn't have to be doing anything to help your partner, physically, it's on the SNF to be doing their part. See what the case manager has to tell you and go from there. If you're expected to do all the PT exercises with your partner, then something is wrong somewhere, in my opinion.
Best of luck!
Often folks are overlooked in nursing facilities when it comes to PT, so make sure YOU know what they should be doing so you can help them regain their strength.
It shouldn't be all on you, but sadly that is often the way it goes nowadays.
You can also check with your partners doctor to see how much PT was actually ordered.
I wish you both the best.