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My mother fell and broke a couple of ribs, a bone in her hand, and the bone above her elbow. She was in ICU for 6 weeks and is now wheelchair bound. She was admitted to skilled nursing for recovery and rehab. Everything is healed up now, but the nursing home is not being very cooperative with PT/OT. After Medicare part A (skilled nursing) ended at the beginning of July, they got approval for 8 more sessions under Medicare part B, ran through them in less than 2 weeks, said she plateaued and she hasn't had any more since. We do exercises with her when we are there and she is improving. She wants to stand up and eventually walk, but is still too weak. We have told the nursing home we are willing to private pay if Medicare won't, but they are resisting starting new PT/OT. They seem to have the attitude that she won't ever leave the nursing home, so why does she need to walk again. My mother is mentally about 95% fine and wants to eventually go back home. My question is, how do we get her the PT/OT she needs at this facility? If they aren't willing to help her, is it better to move her to a different facility or move her home and work with home care and outpatient PT/OT? At this point, I'd be happy if she can get to the point where she can transfer to the toilet and bed with only one person assisting, instead of complete reliance on the Hoyer lift.

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The therapy department are the ones who evaluate patients and determine if they still have room to progress. Its them you need to talk with. Find out if they think she can benefit from more rehab. Oftentimes what these folks need is more time to heal and recover.
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Thanks for all of your replies. She broke her rib back in February and doesn't have any residual pain from that. I have been participating in all care conferences and the last one was on 8/1. I have also spoken to the rehab manager and that is who I am getting pushback from although she doesn't seem to exactly know what exactly is going on with her situation. She still has a feeding tube in although she is only getting nutrition 8 hrs a night through it. The rest of the time she is eating normally and putting on weight. I'm thinking that as soon as the stomach tube is out, we'll bring her home. This facility doesn't seem to have the will to get her mobile again. Most likely she will need some form of home care, since I can't be there 24/7, although without the stomach tube, it will reduce/eliminate her need for nursing care.
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Switching rehabs will not help. She has already had therapy thru them. Its so many days before she could get it again. If ur willing to pay, then pay for help in her home if someone can't be there 24/7. Call ur state Ombudsman. They may be able to help.
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If she plateaued then Medicare will pay for no more sessions. Why is she still there? Once Medicare stops people are usually released. After 20days you pay 50 percent, after 100 completely. You need to speak to the doctor overseeing her. Can she go home and be safe? Someone nearby who can check on her. See if therapy can be done at home. Get her primary involved.
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I agree - communication is key. Have you been able to attend any of your mother's therapy sessions, by the way? I just wonder if it could be that they're harder for her than perhaps you realise. It's great that you keep up the exercises, but that's not quite the same thing as intensive PT.

Also, you don't say when this happened. I can tell you from experience that broken ribs go on hurting long after they've technically healed and "you can't see the join."

May your mother continue to make good progress, and I second the support for your advocacy too.
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When was your last care Meeting? You should have one every 90 days. At these, the therapists should be present and be able to tell you what is going on from their perspective.

There may be reasons that they feel that more therapy would not be beneficial, but they certainly aren't explaining it well if that is the case.

I would contact the head of the rehab department to have this conversation.
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Dear CaringD25,

I'm glad you are advocating for your mom. If this facility is not cooperating with you, I would try and escalate your concerns with a manager. And if they won't cooperate with you about getting more help for your mom then yes, I would move mom to a different facility. I would not accept what they are saying kindly. You know your mom and knows what she needs. Find a facility that will be more proactive in getting your mom rehabilitated.
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