Residential rehab or in-home healthcare?

With bone cancer to think about, there is a clear priority far away ahead of everything else and that is pain management for your husband. Isn't there a hospice service involved? They can advise you on whether and how it would be possible to guarantee effective pain management at home; and if the truth is that it isn't possible to guarantee it then I'm afraid your husband and you don't have a real choice. He will have to be cared for somewhere it can be done.

Before the discharge to rehab, if that is what has to happen, ask the rehab unit to explain to you what their policy is regarding end of life contact. I believe, though I'm sorry I can't be sure, that if your husband were to enter the "actively dying" phase you would be enabled to visit him.

This is an awful time for both of you, but there's no place for guilt in it. You did not do any of this. Wishing you comfort, please come back and let us know how you're getting on.

He has bone cancer and she is not able to care for him alone. He needs to be evaluated by hospice first. There may be a hospice unit he could go to. I don’t disagree that in normal times, he would possible be better off at home but this lady sounds very stressed with talking care of him. His pain management is going to be an issue soon if not already. And home care agencies are very short staffed.

I'm so sorry you're going through this. Do not feel guilty. He has cancer. You did not do this to him and you certainly don't have any control over the Covid virus that is keeping folks from seeing their loved ones.
You are correct, in home care is terribly expensive and most insurance will not cover 24 hour care ($25 an hour is the cost in Texas).
Because he has advanced cancer and a UTI that is causing hospitalization, he needs hospice. I'm sorry to be blunt, but the social worker at your hospital in charge of your husband's case can help you not only find a place for him, but arrange hospice care for him. Hospice people are angels on earth! Once he is transferred to a rehab facility, they can help you be in touch with him via phone, text, Facetime or Skype.
Again, I'm so very sorry you're going through this and feel so badly that you can't be there with him.

I have been through much of what you are experiencing in the past two years. I have to say that I am grateful that the journey ended before COVID began. That complicates every decision you make x10. I will not attempt to advise you how to care for you husband. It is too complicated. However you can, find your calm. This is hard. Even if you do something as simple as focus on your breathing while you put on hand lotion that smells nice, that can help. Seek help from others as much as you can. Send your husband love in any way you can. Above all else, realize that you are doing the best you can in every moment. Inevitably, you will look back and think that you could have done something better. But you can have compassion for yourself because you are in a very tough spot and are doing the best you can in a complicated and painful situation. Much love to you!

In a similar situation with my elder father. Have they given you a time estimate of how long he will live and what future stages he will most likely experience over what time? Write down all the pluses and minuses of the different options, including costs. Be aware of with which hospice service you talk to. All are not the same. Some offer services that others don't. Make sure you have a list of all his needs and in the future. He can have hospice at home or at rehab. Does the hospital have a homecare program? Despite all his ailments, he seems like once over his UTI, he will be much healthier at least for the time being.. Try to imagine him at home, what it would like. And of course try to get any input from him. When his infection is over, would he be able to toilet himself? Shower? Eat? See how he is after this infection is over. Try to buy time with the hospital so you can gather more information. Try to find out why they want him to go to rehab, what can rehab offer that homecare cannot? How is the level of COVID 19 in your area? Have any care facilities been affected? The situation is like juggling in the dark, and quite difficult for the average person to deal with. But don't let it all drive you crazy. It sounds like you are weighing the options well and are quite the loving wife. Try to imagine this; If the situation was reversed, with you having the bone cancer and UTI, what would you want your husband to do for you? Home? Rehab? Hospice. I think we are all praying for you.

He could get in home care thru Medicare if PT is needed. But, its not a 24/7 thing. You would still need help. Hospice if done at home you would also need help because they aren't there 24/7.

Hopefully some of these restrictions will be lifted and at least spouses and children will be able to see LO. I think for now DH needs rehab. Unless you can afford round the clock care of at least an LPN. Aides are limited with what they can do medically.

Bless you, Ceecee65. I feel so very much alone in having to grapple with this current situation with no support (his adult children live far away and do not even communicate with eachother well). Intellectually, I know that where he is now is good for him, and that rehab and/or hospice would be best going forward. It is simply very hard to admit that we have come to this. thank you so much.

I am in a similar situation - I had to send my 87year old dad to the ER two weeks ago, and now he is in rehab. It's incredibly difficult he is not getting much better and I am looking at him coming home next week. My 84 year old mom was doing much of the car and now I need to find some private aides quickly because although we will get aides I think he will need more care. It's only me dealing with the whole thing and I am about to reach my limit. It was a hard enough decision to put him in the ER and then to rehab- I would prefer him at home now but I don't know how the two of us will handle it.

Hi Dalisuan99.
You are in a difficult situation. I can't advise you on what to do, that of course is your decision.
I suggest that you have a list of questions for the social worker.
Including:
What services are available for inpatient hospice? Versus at home hospice?
What are the options for inpatient rehab? Could you take your husband home at any time?
Is his oncologist involved with his hospital care? What is his advice?
When you know what your options are, I suggest you talk directly to the possible facilities.
I would find out if a first floor room is available, so you could "visit" through the window

These decisions are made very quickly with a short turn around time. Do you know his rights under Medicare?

I can tell you that in home care is limited. Make sure that you know what care your husband will receive, but you will be responsible for most of his care, unless you hire someone .
Best wishes to you and your husband and make sure that you take care of yourself

I am so sorry that you are facing and experiencing such a difficult situation. In my part of the country, there has been a higher incidence of COVID in skilled nursing facilities and assisted living. Some facilities are not admitting new patients from hospitals or the community due to the pandemic. The fact is due to your husband's advanced age and underlying medical conditions, he is at a higher risk to contract the virus. If he goes to skilled nursing for rehab, he will receive 5 to 7 times a week therapy. If he returns home and receives home care, he will receive 3 times a week therapy. Have you asked the physicians his prognosis? Another question is can he tolerate as well as participate in therapy due to his condition? What the hospital wants is the safest discharge for his situation. I think that you should speak with the hospital social worker to determine if skilled rehab is available to him due to the pandemic. I would also suggest that he be tested for COVID prior to discharge. Bear in mind you need to stay safe too. Good luck.