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So my grandma broke her ankle (had it not connected to her fibia and tibia). She had it corrected with surgery and was in a cast for 10 weeks then a boot for 4 more weeks. As soon as the boot was removed she was up and walking on it. PT from medicare came into the house and supposedly did PT. What they did was tell grandma to move her ankle and keep walking on it. She walked but couldn't move her ankle and since she had dementia they just said she's fine. All they wanted her to do was walk which she was doing from day one of the cast being removed. After three visits of them telling her to move her ankle and them just talking to my helper about nonsense. they said they were releasing her. I asked how they can release someone who hasn't regained movement of her ankle yet, and they said their job is to teach the patient what to do and then leave. They do not do actual PT. I have never heard of such a thing having dealt with medicare tons in Connecticut where we previously lived, and they did wonderful things completely having her regain all movement with worse breaks than this. Is this normal? Does anyone know if medicare comes in and releases her (which they did) is there anything I can do to have PT done through someone else? We have home services which I think cover PT or I'd even be willing to take her to a local hospital for PT but I'm concerned that since she already received PT services for that injury that she's done and won't ever regain proper movement on the foot.


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Unfortunately I've seen PT do this. Come in and touch base and race off. It's like they don't get it. They are supposed to teach you or the helper how to help her do the exercises when they aren't there and try to get her back to the level of activity that she had before the break. Call your dr for more therapy. You could take her to a therapy facility and have them evaluate her and get their recommendations. Yes, it does help to do more therapy according to what I've read and witnessed but I'm not a therapist.
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Dementia patients rarely do the PT well. They need to do the assigned exercises independently on the days in between visits. They don't do them and they fail to progress. Once they plateau, PT is over. The therapists usually submit weekly reports. Medicare insists that services end when progress ends. My sister does not move her ankles. She does not remember how to do it. I have even rotated my ankles and asked her to do the same. She just doesn't get it. PT can't fix that.
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Yes ask her surgeon for an order for out patient PT. Out patient centers have more equipment for the patients to use and can challenge them further as well as offer ice or TENS for relief after a session.
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