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Hey everyone. Not sure where to post this, but this forum has been so helpful in the past and so I thought I would try it again. My grandmother had a stroke and she is in the hospital currently, and with their short staff and well disregard for elderly patients, my family and I are worried that my grandmother is not getting enough of the physical and speech therapy she needs to show improvement. When she was in the ICU, there were therapists coming in each day and she was showing improvement, but then they moved her to a stroke unit and all but forgot about her. She is now getting minimal therapy. I was wondering if there's a way to fix this. If anyone has experience with this? How to get more help ( other than trying to advocate because that hasn't been working). Is there any way to pay more to get more help? Or agencies that partner with hospitals to do this thing? I don't know just trying to exhaust every possible option. Thank you!

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Nowadays, hospitals only provide Acute Care. Physical therapy falls into Rehabilitation which is not considered Acute Care.
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Your grandmother's MPoA needs to have a discussion with her doctor or PT. The PT will end if the patient "plateaus" in progress or is uncooperative -- no matter how much the family thinks it should continue. The doctor has to order it and insurance will pay for a specified amount of it. If your grandmother is depressed, or her pain isn't being adequately addressed, these would be obstacles to her having successful PT. This should also be discussed by the MPoA with her medical team.
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We found that the hospital stay was focused primarily on getting our LO stable and making sure she could stay stable for a few days. Once she was ready to start rehabilitation, she was discharged from the hospital and transferred to a rehab facility that was within a local nursing home. If this has not been discussed in your grandma's case, please ask about it and a lot of your questions should be answered within that conversation. Once at the rehab place, the focus was on getting my LO recovery and therapy. Preparation to return home was a primary goal. I honestly don't recall her getting much therapy while still in the hospital. However, I don't remember my LO actually being in ICU as yours was. My person went from the ER of the closest hospital to a stroke unit of a "better" hospital. Sounds like your grandma is still an inpatient at the hospital, so possibly she's not ready for the type of therapy she will eventually need/get? All strokes are a little different. My LO's stroke was bad enough that she could no longer live alone afterwards, but it was also mild enough that she could appear very normal at times and do therapy when she chose to.
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She will not be long in hospital getting acute care. Speak with the Discharge Planner or social worker or nurse manager now about discharge planning and ask that grandma be discharge to a rehab facility. If the doctor feels she can tolerate rehab he will discharge her to such a facility. PT is great in hospital but it is for minutes a day or several times a day only.
Speak to the above mentioned as soon as possible. You will be able to give and get a lot of information, and possibly help with the discharge planning.
Good luck.
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Yes. I don't know about your area, where I am at there is PT was minimal (and expensive). You may not know, but the the hospital is paid by the facility for sending a patient there. It's a big incentive, and a money maker for the hospital and a new "customer" for the facility, without doing a lot of leg work.
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This has been going on for years in rehab facilities. Back in 1996 when my late husband had a massive stroke at the age of 48, and had to learn how to walk, talk, dress himself and anything else pertaining to self care with the use of his one arm/hand that wasn't effected by the stroke, I would go down to the PT and OT rooms with him, to watch his progress. I'm sure because I was there, they made sure that he received the therapy he needed and deserved, but daily there were older folks that they would typically wheel down in their wheelchairs, and then just let them sit there for the hour and then wheel them back to their rooms. It was heartbreaking to see, and this happened at one of the supposed best rehab facilities at the time in our area.
I will never forget that, as it let me know that older people were less of a priority to these people. It also let me know the importance of having a family member or friend accompany the person in rehab to make sure they are receiving the therapy they need and deserve.
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They used to call in hospital therapy "acute" vs. the subacute given in standalone rehab centers. Now they call in hospital therapy "inpatient" but only certain conditions qualify --- stroke, some joint replacements, etc. and even with that not every stroke patient is considered a candidate for inpatient therapy which is usually fairly long and intense. Patients who can't keep up are then sent to subacute therapy which is shorter and less intense. Even then if they do not participate or continue to progress, insurance (even Medicare) will stop paying. You sometimes have to play the mean Queen to get the hospital to even give your LO a shot at the intense inpatient therapy. There is a feeling that elderly or those who have other compromising health concerns will not be able to keep up -- and admittedly sometimes that's true. I had to threaten to call the state dept of health to get my Mom (who shall we say was being a difficult patient) into the hospital's inpatient unit for therapy after her stroke. But to everyone's surprise, including me, she became their star patient. You never know.
First thing is find out what level of therapy is he being given now? Discuss this with the social workers ...... right now! If you don't .... he will fall through the cracks. It was difficult getting Mom her therapy 10 years ago when hospitals and rehab centers were well staffed. Then came covid and it's a totally different story now. Health care staff at all levels and titles are running for their lives and everything is short staffed.
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