Out of sight, out of mind in rehab facility. Anyone else deal with this?

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I'm so concerned that my mother isn't always getting the best care at the rehab facility she's at. The goal is to get her hip pain under control and through PT, back to being able to walk unassisted (with a wheeled walker) and return to her assisted living apartment. At what point do I just trust and let go of the worry? They weren't adequately addressing her pain relief right from the beginning (and thus, her ability to do the PT), but we had a big meeting yesterday morning and a care plan was put into place. So many things seem to fall through the cracks when the patient is alone, and in my mind, she's sitting there miserable and despondent, as she was evening before last. Do you simply get used to mistakes being made? I simply cannot be there all the time, nor is it in her best interests for me to do that. I myself am disabled, so the physical toll is exhausting, along with the mental toll. I even fell asleep for a spilt second on the way home, while sitting at the stoplight. If anything happens to her there, it will just have to be. I have done my best...so why do I feel so awful?

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Thank you all so very, very much for your kind words and insightful advice. I can feel the frustration that several of you have had with your own personal situations, and I empathize with how painful it must have been for you.

My parent is back in her Assisted Living apartment as of this morning, and she is quite tired but happy to be in her normal environment. The move would have occurred yesterday, but the facility had state surveyors in and were otherwise engaged. Anyway, for now she seems to be in a good place, and we are all relieved to be out of the Rehab area. She will continue to receive PT/OT, and we will monitor her pain level to make sure the pinched nerve continues to behave itself. It was a long haul for sure, and as I read the advice you all posted while I sat in the Walgreens parking lot, I felt like I had an online comraderie of others who knew what I was experiencing. My mom said, "don't get old" to me and my sibling...but as we all can't avoid growing old (nor would we want to), it seems little to ask that we do so with our dignity intact.

PS...thank you pstiegman for your concern & comments about the stoplight issue. I will keep those in mind. It's likely that two back to back nights of 3.5 hours sleep may have contributed to the incident, but when I next meet with my doc I may bring it up. I look forward to the holiday weekend when my dear spouse can be my chauffeur and resting on the way home is a treat!
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in the nursing facilities their medication is doled out on paper tabs like those penny candy sales receipt looking things that we used to eat when younger, the medications are less than adequate, maybe even old.

When my brother was in the rehab facility, the medication did not work, so he had his delivered by Walgreen's.

Second of all, they were expecting him not to be sharp but believe me he is...
and he went in everyday to the pt. like clock work, they did not entertain his idea of morning and afternoon or everyday... but if it says rehab facility, one would think the rehab would be their primary goal, right? WRONG!
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Dear Diavalon12, You are right. There are many people in elder care who go that extra mile to help their patients. My daughter is a social worker in another facility in another state and she hosts parties out of her own money and brings small mementos to those forgotten by their own families. But this facility fought us tooth and nail although we visited EVERY day and fed her meals and asked to walk up and down the halls with her. They kept the walker away from us. And then they said she was not improving. No s***, Sherlock! What gave you the first clue!!! Thank you for your kind answer. Hugs to you.
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Dolly Girl, I think you seriously need a break from all this, and promise me you will see a neurologist about falling asleep at stoplights. Five years ago Mom was falling asleep at stoplights, it was early vascular dementia/TIA issues. Get someone else to drive you to her visits so you can sleep on the ride home.
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Dear FedUpNow, I don't where you are at, but yes you had a really bad facility, None, and I mean none are perfect, but many try as hard as they can to get the
residents back to their old self, or at least as close as possible. At our facilities our gold is to get you so that you can go home again. Many facilities here in california are transferring to short term rehab only. After 21 days you are either ready to go home or you transfer to a long term facility. It is intense therapy only. Sorry for your bad experience.
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You need to be like a Rottweiler on this. My MIL was in a NH for six weeks during which they took away her walker and wouldn't let us walk with her when we were there with it. As a result, she lost her mobility and came back to our house needing to be pushed in a wheelchair. It was a short time later that she died. This was really the push into that final time. No matter how we begged, what we said or who we met with (after all their promises to do better), her PT consisted of propping her on an exercise bike and then saying she wouldn't do that. She couldn't balance but she was always able to use her walker. What a**holes and idiots you will have to deal with like we did. Oh yes, and they charged $450 for pedicures and manicures to smear her nails with purple polish but they couldn't find time to walk with her with her walker. Be forewarned. Sadly, there is not much you can say or do that will fix this situation. NH workers and case managers will tell you what you want to hear and do as they damn well please after you leave. Good luck.
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I work for a NH/Rehab and I can tell you that yes you do need to be a part of her care to the point of asking questions and encourage your loved one. So many times when the family goes home the patient decides they have been deserted and then refuses to work with the PT dept. So encourage and remind her that the harder she works at getting better the faster she can go home. Usually if you keep puting the idea of going home in their head they get their act together. DON"T let her get away with just sitting there. Pain is pain and remind her to ask for something to relief it as many suffer in silence. This will not get her home quickly. Good Luck to you!!
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I know exactly how you feel as I felt the same way when my dad was in a nursing home. Initially he was there for rehab but began going downhill so he became a resident. In the beginning I tried to be in on every aspect of his care. I too had meetings, care plans put into place, etc. Eventually I realized that I was trying to micromanage his care. After all, no one could give him the level of care that I could and in the beginning I expected nothing less. However, I wasn't trying to care for 25 other people at the same time as caring for my dad and I realized that the staff was not capable of giving my dad the same care I had. They made a point of trying, roping me into one meeting or another the minute I set foot into the place. It got to where I'd be meeting with this person or that person and it would be an hour before I was even able to get to my dad to visit with him. The care was uncoordinated and the left hand didn't know what the right hand was doing. And as they say, there were too many cooks in the kitchen and nothing was getting accomplished. Gradually I learned that I had to pick my battles. On one day my dad's clothes went missing from the laundry plus he had fallen and gotten a horrifying black eye. He said he laid on the floor for quite some time before anyone found him. So the fall is what I dealt with and just pushed the missing clothes out of my mind for that day.

My dad would call me late at night in distress over something small and in the beginning I'd spend the next hour, from my home late at night, trying to get a supervisor on the phone. Gradually I learned to not react like that especially late at night. I'd try to soothe my dad instead, telling him I'd take care of it in the morning. And usually by then he would have forgotten the whole incident. He had the luxury of forgetting. I didn't. As his condition progressed I had to learn to take a step back because being his advocate was a 24/7 job. I learned to focus on what issues I could resolve and just let the rest go. It was damned difficult but for my own sanity this was the only way I could go about it. Eventually hospice came on board and they were a Godsend, running interference between us and the NH. My dad got the attention he needed and the effect of that lasted most of the day. He was happy and we were happy.

But my suggestion to you is to let the little things go. In our case, I learned that 'care plans' and 'goals' didn't mean crap. The first few we went to we were thrilled to be able to be an active part of my dad's care but those plans and goals were required by the insurance company and had very little basis in his reality. It's paperwork that has to be completed and, in my opinion, totally useless.

Be an advocate but try not to react to everything or else you'll be running around in circles, driving yourself nuts.
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DollyGirl, when my mother-in-law went to a nursing home for rehab after breaking yet ANOTHER hip, they admitted to me that they couldn't keep track of people as much as many family members would like, since there's not enough workers per patient. And since at that time my mother-in-law kept getting up by herself for the bathroom unaided, they were really afraid she'd fall. Because by the time someone would respond to the alarm the hooked to her, it was too late. They suggested that we hire someone to sit with my mother-in-law, especially in the evenings. Just a suggestion. By the way, we never did hire someone. Just started making a schedule for family to take turns staying with her off and on, keeping her walking so she could get the heck out of there. When it comes to a broken hip, 'move it or lose it' should be the saying. A little hurt now will reap great rewards when the person can get out of a chair in the future and walk by themselves (never without a walker again tho) ha.
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I feel so bad for you.I know this has to be a physically and emotionally draining situation for you. I don't have any perfect answers and if in your shoes I would feel the same way.That being said ,for me I would do this. I would let technology help me. Every day I would call for updates,get to know the names of your mother's physical therapists and nurses, keep a daily written log of any conversations and interactions with the staff. I don't mean to get yourself in an adversarial situation with the staff.It is okay to be assertive ,not aggressive,there is a difference.Make sure you know the names of the administrative staff and have "meet and greet" meetings with them.Again,not aggressive,just assertive.I don't know how her care is being paid for,but make sure she is getting the services that are being charged. Knowing the "hotline" number for medicare fraud is a good idea. For example, the nursing home my grandmother was at tried to put through a charge for physical therapy that was timed about 5 minutes before my grandmother was found dead,there was no way this woman was able to participate in physical therapy. I guess they thought that since her bill was so extensive that the family wouldn't really look through it,wrong, we did and notified the hotline of possible fraud and guess what, the charge was removed.Again, I would keep a daily log of her nurses and physical therapist and what was done with her each and every day.Ask for a copy of any bills and make sure that the services that were charged for were actually done.Again, be nice but assertive. Word will get out that your mother is carefully monitored by the family and that questions will be asked.I don't know what the laws of your state are but if possible I would even set up a nanny cam,again check on your local laws about this.Take care of yourself,this will also help your loved one because you can't help her if you are ill.
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