Rehab opinions? - AgingCare.com

Rehab opinions?

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My fall's recent fail ended with him "doing time" at a rehab -- my insistence over his refusal. I had found a place that looked fine but his primary overrode my choice and because "he visits there"; i am naïve and said okay. Come to find out, his associate is on the board and its a nursing home as well as a rehab. Didn't know that until after we moved in.

Dads made it through over 10 days with only 2-3 shots of "postal behavior" and he's started to settle in. They put him on Ativan to counter his DT's that he obviously had to go through cause he's the drinker (was, I hope)... I had a meeting with the director of nursing when he was hit with some pain that no one had time to deal with for an hour. It was civil but we got through it. Yesterday he was doing well. today when I called his roommate had screaming dementia and I couldn't even hear dad from all the "help me. somebody help me". It was the second incident of a screaming nursing home patient sharing a rehab room with my dad, who is shaky at best.

I called; they moved him, but I am now getting pretty frustrated. Is there such a thing as relocation at 10 days (our "planning session" for the rehabilitation plan hasn't even occurred yet).

I like most of the staff, but its a nursing home first and then a rehab and they run constantly move rapidly. Lots of minimum wage nice workers but I have never seen the doctor yet who I remember to be rather patronizing (my father's primary's associate who ive met at the hospital when dad got his ankles surgery) If I talk to him, I want to be completely educated on my fathers rights and my expectations.

On the other hand, sleeping dogs could lie. The 2nd "screamer" is out of the room and tonight its quiet; and I could simply go to the social worker and tell her ...tell her what? anybody know what I should do here?

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I think I need to be the patient here! I have so little help with the doctor; he is so remotely involved. They shipped him off to a rehab and I haven't even seen the doctor. And the nurses are rude. Im going in to talk to the case worker in the am to see if she sees this. i wondered if he had "scored" some alcohol but it would have to be from within because he has no way around and is wheelchair bound. none of the drugs (water pills, blood pressure, etc) have ever done this before. only new thing is Ativan for withdrawals but they were instructed "as needed" and nurses are always so nervous about what that means that they just don't give it. so it had been 2 days since it had it. the strange thing was i was talking to him on my mobile; he said here comes my dinner, let me eat and ill call you back. la dee dah kinda mood. an hour later and he was rabid. an hour later and he doesn't even remember the rabid stage... i have NEVER seen him do that--with or without alcohol... maybe just dementia progressing? maybe because hes in a long term and short term institution with full blown dementia and altzheimers all around him? thanks Jeanne. it was like twilight zone for me....
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I don't know much about alcohol withdrawal, but the National Institutes of Health website, Medline Plus, says the symptoms can last weeks, and that other health conditions can make the withdrawal symptoms more severe. Hmmm ..

I also don't know if Dad "blacked out." Both my mother and my husband have had many episodes where they didn't remember the drama and trauma just hours after it happened. Neither were in alcohol withdrawal. Both had dementia. I have a niece who started "blacking out" as a teenager, as a result of having seizures -- neither alcohol nor dementia involved. If I were you, I would definitely discuss this total lack of short-term memory in this situation with his doctor.

You mention that he blacked out when he used alcohol, and that he slurred his words on the phone call tonight. Is there any possibility he could be getting alcohol? (Seems remote, doesn't it?) Could any of his drugs be causing these symptoms?

Discuss this with his doctor. Get help (from someone more knowledgable than me!) about what to expect from the alcohol withdrawal, and also to understand the other symptoms he is experiencing.

I am so sorry you are going through this!
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Even after 10 days without booze???? They go into blackouts 10 days after booze?
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You are dealing, poor Linda, with the added challenge of alcohol withdrawal. I don't know much about that, but I suspect you would be dealing with it no matter where he was placed right now. (And I suspect other residents might be complaining to their loved ones about "that crazy man down the hall.")

Hang in there! Let's hope things settle down long before he comes home.
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My dad called me 2 hrs ago ranting about "this outfit" and "I need to be transferred" and on for 45 minutes and I couldn't get him to stop. so I called his nurse and she was rather pissy with me ---said he was fine. I asked for him to get an antivan and call me back. she didn't call me back so I called him and hes fine now (I just called) and he is watching a football game. he doesn't recall the conversation at all. He is blacking out without alcohol. I said "dad, is everything going okay?" he said yes, why should it be? what are you talking about. geez, I almost moved him..... I am totally out of my element and I don't know who to turn to for a reality check. can anyone help? he has NEVER done this without booze, but he sounded in the last phone call like he was slurring his words... OMG....
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When my husband was in rehab both he and his roommate had dementia. Neither were nursing home patients. (Rehab was in a separate wing.) My mother just came home from three weeks of rehab. She has dementia.

In other words, being in a unit that only has legitimate rehab patients does not assure that none of them will have dementia.

Just so you know ...
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In my humble opinion your choice should not have been overriden, especially if it really was for some marginally ethical primary doc's profit motive. My vote would be to switch primaries AND rehabs to ones you think would be better. I think you probably want your dad to be around more people with better chances of making it back to a more independent setting rather than this one that is possibly just soaking Medicare for the hundred days on anyone they can round up out of a hospital. Unless you can see he really is making progress and has adjusted well and formed friendships where he is, in which case you may both want to stay put and put up with it. It is usual for rehab and long-term care patients to share facilities, but not usually to share rooms - and it is usual for some people in facilities to be quite confused and quite a few will have sundowner's.

Go to the director or manager at the facility you want and tell them the story you have told us; see if they can help you make the switch.
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Thanks Jeanne. I was at the rehab today and confirmed that all patients are on one single floor, some sharing the same room. The hardest part is trying to establish a safety/friend system with dad because most of the nursing care people start these conversations that sound logical until you realize they are just words and it will never end. today a lady started talking to me about why George but a big hole in these pants and I said , "that was to make it cooler for you, I guess" and she said you don't know anything do you? and then I had a man call me and said "lady, please help me. please". I said what do you need? he said reach in this pocket and get me some tobacco.. I said I don't know if im allowed to do that; he said yes, yes you are...
all dad can do to keep what sanity he has left is know im coming every day. I like the staff; dads getting used to them. im going to try to talk to the case worker and see if we can agree to only use the (empty now) bed beside him for another rehab patient, if its necessary.... what do you think of that? you sure cant go far out of your room unless you expect to let reality ride for a while. and my dad is just on the verge of loosing his connection with reality now. that's why im worried.
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Rehab is short-term. I've dealt with three different transitional care units with my mother and one with my husband. Some were a lot better than others. All of them required being an advocate for the patient. And the best thing about the situation was that none of them were permanent.

Here, transitional care units/rehab centers usually share a building with a nursing home, but they are their own floor or wing and do not share staff. Are you sure that dementia patient was a nursing home resident, or could he have been there for rehab, too. I'm glad they moved him out of your dad's room in any case.

If your father is on medicare, he can go to any rehab center that accepts medicare and has an opening. There are advantages to having him in one where his doctor visits, and oversees the meds, etc.

Did he have to wait an hour in pain because they were too busy, or because they checked and it was too soon for another dose?

If you want to move him, how will you decide which (among the ones that have openings) would be best? The one that looked fine to you -- was that not associated with a nursing home? How could you be certain that Dad wouldn't have had to wait an hour for pain meds there, too? How could you predict what his roommate might suffer from or be like?

Dad has settled in. That sounds valuable. You have begun to establish a relationship with the director of nursing. That is good. They did remove his unsuitable roommate. That is good. You like most of the staff. Good again.

No transitional care/rehab facility is going to be perfect. And it is important to understand that this is not a hospital, and also not a nursing home. Do have that discussion with the social worker. Learn what are realistic expectations. Tell him or her your specific concerns and see if those are because of unrealistic expectations or slip-ups. Also wait for the first care conference, and get some idea of how long Dad is expected to need this. That may make a difference in your view of whether to change facilities.

Caregiving does not come with a manual. Most of us learn much of what we know the hard way. I didn't know what to expect from rehab the first time I encountered it. You'll get through this! Dad really does need you to advocate for him at this time.
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