Is therapy in skilled nursing facility typically weeks-long or just a few days?

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Is therapy in skilled nursing facility typically weeks-long or just a few days?

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Mom had a stroke in her memory care facility. She is now 2nd day in hospital. Doctor says MRI shows "new and old strokes in same vessel". They want to send her to skilled nursing facility for therapy, and they will have her wear a halter monitor to see if afib might be happening. Doctor says they won't give her a blood thinner until they get 2 weeks of results from monitor. Two years ago she had afib due to thyroid medication adjustment. They got the medication straight and never gave her a blood thinner. Apparently it can cause other problems.
Her left arm is weak, but she can feed herself with some prompting. She can swallow. Her mouth hangs open now. She can't remember her birthday and has a hard time talking. That's new. I'm wondering how this event will affect her delusions. Wait and see.
I am hoping beyond hope that the SNF will get her functioning well enough to go back to memory care. I have no idea how long therapy usually takes in a SNF. Will I have time to go to work, or will they need me there helping?
So many unknowns. But I'm thankful to have this forum to read others' experiences.

Alzheimer's & Dementia Physical Therapy Rehabilitation Center Stroke

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Based on my experiences with a family member who has been in and out of rehab/skilled nursing, the PT and OT usually try to work with a patient on a daily basis. How long they work with your mother will depend on how much she improves. It will also depend on insurance/Medicare coverage and how long they are willing to cover her recovery therapy.

From what I saw, two or three weeks was the average length. You don't have to be there for the therapy. However, some of the therapists like family members to be present for the therapy as it can calm the patient and family members can answer questions that the therapists may have about the patient. Good to visit your mother at the rehab itself as the patients in those facilities need personal advocates to make sure that their needs are being met daily.

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What is her memory care criteria to have her return? Usually not a 2 person assist for transfers and mobility. Ask, can she pay privately for additional help/caregiver and still stay at memory care? What is the criteria? Is hospice a possibility? If hospice is engaged, Sometimes this allows them to stay in MC with additional paid caregivers.,If all this fails, it’s good to know, what is next. What LTC facility is her choice and does she have LTC insurance or will this be spending down her money. Work while you can. She’s in a facility for a few weeks. She has care. If you can work remotely, work from her facility.

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BlueHeron: The therapy timeline will depend on whether the rehabilitation facility is acute or sub acute care. I was in a sub acute care facility last August into September and received both PT and OT 3x weekly as well as speech therapy.

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My dad is currently in a rehab from a fall from his wheelchair and from Pneomina. My dad's memory Care said my dad needs to be able to stand and pivot to be able to come back. His 20 days will be on Monday. I would have thought they would have contacted me that his days are getting numbered and close to his 90 days. I tried to call them on Friday. They had already left. I was working on another project that took longer than expected. It got finished!

I know if we think our loved ones need to stay longer, the facilities can see if we can request that. I feel like he should have stayed at the first rehab longer. They pushed him through.
What is the difference in acute and sub acute?

Thank you!

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The Therapists both Physical and Occupational will or should follow the doctors orders. If he orders daily PT and OT that is what she should get.
If she shows improvement then the therapy can be ordered again. If there is no or little progression/improvement then the therapy may end .
It will depend on what her insurance will cover.

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there should be daily therapy for your mom, and should continue until there is no room for improvement.
my son recently had a stroke and cardiac incident. he was in one rehab for 1 month, until he made progress enough to move into a nursing home rehab environment. He will be there for about 4 weeks, we are seeing some improvement. State of WI.

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As previously mentioned, progress in therapies will influence how long services will be covered unless there are also skilled nursing needs(doesn’t sound like it), and that will be influenced by the severity of her dementia. Insurance also comes into play with some advantage plans dictating length of stay. Traditional Medicare relies more on therapy recommendations, at least in my experience. Her prior level of functioning also comes into play, so if your mom was fairly independent with her mobility, etc. keep emphasizing this with the therapists. Keep in regular touch with them, whether through phone calls or sitting in on an occasional therapy session if possible so you can really understand what’s happening. I know it’s very stressful, wishing you the best.

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Be practical in your word "hope" and do not deny, With elders, any hospitalization mostly means that there is a loss of function.
Heck, I had surgery for a shoulder injury and am in the middle of cancer treatment and reconstruction. I feel the loss of a triceps muscle and PT only goes so far, compounded with the other 2 surgeries that is setting me back further.

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You are so right. You are in the land of unknowns. I think you can do nothing but move a days at a time, avoid anything even tipping toward "heroic measures" such as pacemaker and etc. At some point, living with this minimum quality of life, death comes as a deliverance. I would encourage you to speak with doctors about hospice if you've any inkling that your mother would not wish to go on in this state.

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It’s only when the stroke is confirmed to be from a clot that blood thinners help. A stroke from a bleed doesn’t warrant blood thinners. Other conditions can rule out thinners as well. In therapy, there should be PT, OT, and speech daily, though likely not on weekends. This won’t take the whole day, mom will likely be on her own quite a bit. Do what’s best for you both during this time, if you need to work, so be it, mom will be cared for, though not well entertained. When Medicare is paying for therapy the therapists must be able to document progress for therapy to continue, this isn’t immediate but the day can come that it stops if progress isn’t documented. My mom had this happen, a sad day for us all. Most progress happens within a few months, though some will say it’s possible for a year. I wish you and your mother both the best with this new challenge

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Don't quote me, but I believe that therapy will continue as long as your mom continues to make improvements with her functioning.
Obviously it won't last forever, but when my late husband had a massive stroke that affected his right side, he was in rehab center for at least 3 weeks and then continued with out-patient therapy for several months after that, as he was determined to improve as much as he could.
So much of this will depend on your mom and how motivated she is to improve. With having dementia though she may not be able to follow through with even some simple prompts, and the odds are that she may not remember what she's supposed to be doing or not doing.
If you are able to attend therapy with your mom I certainly would recommend that, even if you have to go into work later, as often those that are without family members there with them are neglected and don't get the therapy that they need or deserve. At least that was my experience when I would go with my husband to his therapy sessions, especially physical therapy. A lot of the older folks were just left sitting in their wheelchairs.
I hope your mom is able to improve some.

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I meant to say her RIGHT arm is weak. She was right-handed so she's learning to hold spoon with left hand.

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Hi. Acute rehab is more intense rehab, the patient must be able to do 3 hours of rehab therapies per day as recommended by the PT/OT at the acute care hospital. Things to emphasize are the patient's prior level of functioning, was totally independent before the stroke, managed all the household finances, handled all their showering, meals, medications, toileting. The more rehab potential, to get back to prior baseline, the better. Acute rehab costs more per day and since it is taken from the acute medical benefit, the days are unlimited. Not like skilled days. HOWEVER, insurance is loathe to approve acute rehab for these same reasons. They will push for sub acute rehab at a skilled nursing facility, especially for old people. Patient may get 30 min to 1 hour of actual hands on rehab per day. The current trend is acute rehab is only for people who have high medical needs beyond rehab. Like need daily labs, multiple IV medications, maybe dialysis, or intense medical care in addition to rehab. Or spinal cord injuries in young people. Push for acute rehab. It is better rehab with all therapies, PT/OT and ST on site. The support care and facilities are better. There is always the step down to sub acute rehab. Emphasize all of this to the hospital therapists and case managers. They are the ones driving the discharge plan. My father had a devastating stroke at age 92. He was previously independent with all ADLS and managing the household finances. He got almost 4 weeks in acute rehab. I advocated strongly and I was living out of state when this occurred. He progressed but was never fully independent again. It was devastating to our family. I am in health care and advocated strongly for him. He came home and we employed caregivers for him both privately and through agencies. Get as much rehab as you can for her in the acute and subacute phase. This is where most progress is made. Ask for help from friends, family and neighbors and other community resources like meals on wheels and private pay therapy. My dad died at age 94 after over a year on hospice. It was horrible to witness. He became bedridden with all the problems that come with that. Be his advocate as much as you can, a sledgehammer in a silk glove. Praise and be appreciative. You will have many frustrations and the tide is always against you.

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Is therapy in skilled nursing facility typically weeks-long or just a few days?

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