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Hi all, some of you may remember my previous post https://www.agingcare.com/questions/grandmother-broke-her-wrist-i-feel-overwhelmed-450145.htm
Thank you again for all the replies and wonderful advice. Sadly, we now face a new set of challenges. Less than 2 weeks after the fall that broke her wrist, she has now had a major stroke. I was lucky enough to be in the room and caught it very quickly, however the stroke was caused by a large blood clot, and when going in to remove it via catheter, they discovered she also had an artery that was almost 100% blocked.
They did manage to open everything up and remove the clot, and she has already regained most of her speech, but even less than 12 hours after the stroke she is already causing a fuss wanting to come home despite a broken arm and near complete paralysis on her right side (the same side as the break)
Any ideas on how the break with effect her recovery? Will they send her home half paralyzed with just me and help from my mother twice a week? Can my mother, as her POA, push for a short term care facility until she is able to start therapy even if my grandma wants to come home?
Her neurologist is suppose to be calling in the morning, but it is more of a "whats happening right now" update than a long term planning call, and I would like to know some good questions to ask or recommendations to try and plan ahead for her post-hospital care.

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So sorry to hear about your grandma's distress and confusion -- how upsetting to have a loved one lash out like this when they are ill. But I am glad she is going to be in the hospital at least for awhile longer. Hoping for the best for you and grandma.
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Update: My grandmother will be staying in the hospital for quite sometime. Whether from the dementia, post-stroke depression, or other factors, she called me earlier today threatening suicide by pulling her IV with her blood thinners out unless I pulled her from the hospital against medical advice. Her daughter (POA) and nurses were alerted, and she is now under a mandatory 7-14 day evaluation on top of her broken arm and stroke. They had to postpone stroke therapy due to needing to restrain her.
I feel so horrible because i know she wants to be home, but I honestly believe she is where she needs to be right now. Today was a huge wake up call about my limits as a caregiver.
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Beatty Jul 9, 2019
Could be another stroke (or bleed)? Or reaction to strong pain meds. Keep asking questions. Take care.
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Aquacrush: you asked about "long term planning call, and I would like to know some good questions to ask or recommendations to try and plan ahead for her post-hospital care".

It will really depend on what type of recovery is possible. This will determine what level assistance will be required & then the harder matters of how to/who will provide that.

Just love & support her.
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Aquacrush Jul 9, 2019
Hey, thank you for the reply. From what her doctors are saying she has been "rapidly recovering" since the clot was removed, and should be near perfect (excluding the broken arm) by the time she is discharged in a couple days (making it all of 3 days in the hospital)
They did actually let me talk to her this morning and she is under the impression that she is coming home tomorrow, but even over the phone she still has very slurred speech, and I worry about the effect of the blood thinners, as we have pets (little kitty nails) and she has always been very stubborn and trying to do more than she should. I worry about her getting cut or scratched if I don't have eyes on her 24/7.
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I would push for a rehab stay for her. Are her doctors not suggesting rehab? If not you need to push back against this as rehab is the best place she can be, especially with a fractured wrist on her affected side. Thus rehab staff can teach her how to exercise the wrist after the cast is removed. Family can be taught to provide passive range of motion on that arm as well.
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Aquacrush Jul 9, 2019
Hey thanks for the reply, the doctors are actually going against rehab sadly. We have talked to both the doctor that removed the clot and the neurologist and explained the situation, but they are saying that she has been "rapidly recovering" since the clot was removed, and should be near perfect (excluding the broken arm) by the time she is discharged in a couple days (making only 3 days total in the hospital)
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I am not US (if you are?) so will be different too.

If usual pathway of *hospital - rehab - home* is not suitable, then *hospital - transistional care bed - rehab - home*. Transistional bed would most likely be in a Nursing Home.

If arm is broken, no rehab can commence on the arm, but what about her leg? Is there movement there? It's possible the hospital may wish to start rehab on weak side (leg & shoulder for now) but... I suppose be guided by the Neurologist & Physiotherapist? Usually starting rehab ASAP is good - but common sence must prevail!

Wanting to come home & being ABLE to be cared for at home are differnent things. You can empathise with Grandma & but also assure her she has to be where she needs to be for now.

Update if you can & ((hugs)). From a fellow Stroke Survivor family member.
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Aquacrush Jul 9, 2019
Hey there, Im in the US also, and I thought that was the normal course of action, but we have spoken to both the doctor that removed the clot, and the neurologist and explained the situation, but they are saying that she has been "rapidly recovering" since the clot was removed and should be near perfect (excluding the broken arm) by the time she is discharged. (Which they said would be a couple days, a whopping 3 days total)
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You and your mother need to be very clear with the hospital that your grandma will not have adequate care and supervision at her current home. Don't be shy. Proactively speak with the social worker at the hospital, and any and all persons involved in directing her care. Your poor grandma needs more than you alone can provide at this point.

Best wishes to you all.
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Aquacrush Jul 9, 2019
Hey, we have spoken to the doctor that removed the clot and the neurologist and explained the situation to both of them. They are saying she is "rapidly recovering" after the clot was removed and should be at near perfect (excluding the broken arm) by the time she is discharged.
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In am in Canada, so it may be different here. When Dad had a major stroke, he was in rehab for 3-4 months. Won't your grandmother be sent to rehab?
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Aquacrush Jul 9, 2019
Hey, I'm actually in the US. From what they are saying she has had "rapidly recovering" motor function after the blood clot is removed and are saying she should be able to come straight home within the next 2 days (3 days in the hospital all together) even after explaining our situation, they said she should be back to near perfect recovery by the time she comes back excluding the broken arm.
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