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Mother admitted through ER yesterday. I was told she would stay 3 days in the hospital then go to a SNF. What are the most important questions to ask regarding her care?

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SueNW, If Mom is prone to UTI see if you can get her D-Mannose capsules, 500mg. on Amazon (I use Source Natural brand). The capsule is WAY to big for 101 y/o to swallow, but open and sprinkle on food, tastes only mildly sugary. I swear by this. I am an old RN who has NO belief in vitamins or supplements, but this was recommended after my 4th UTI in one year, when they were crawling up to my kidney, and doc wanted me on one prophylactic cipro daily. Said to try this. I have not had a single UTI in a decade. Recommended to two others, one a FB friend and one a dog park buddy, and worked like a charm for them as well. I would give up my heart med before I gave this one up. About 30.00 for 100 capsules. Worth a try. Wishing you good luck. And your Mom as well. So glad she could be home with you.
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Reply to AlvaDeer
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I think delirium happens in hospital settings especially when the person suffers a dementia. So it is normal. One good reason not to send her to rehab. Strange place, Strange people.

Great that you can bring Mom home.
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Reply to JoAnn29
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Apologies I hadn't read the update that Mother came home instead. Fantastic news.
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Reply to Beatty
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I'd ask your Mother what makes a good day for her. (Idea taken from Atul Gwande's book 'Being Mortal').

Does she like to see out the window, eat a few sweets/chocolates, enjoy a proper cup of coffee? What does she like?

My Grandma loved a hot tea & a warm knee rug. She also liked 'talking books' or the radio.

Can you bring a few favorites things, photos, trinkets to make her space more home like? Having a space with a few familiar things is much better than a bland sterile room. It brings more peace.

Can she get meals she prefers? Watch tv if she likes to? Go to bed at her usual time?

Regarding the nursing care: Delerium is a huge fall risk but especially when caused by UTI, as people get uncomfortable & have that rush & frequency to get to the bathroom until the meds kick in. They may try to move from a chair or bed without waiting for assistance. Even falling from a lowered bed onto a crashmat may cause injuries when frail. If able to walk independantly, it is still hard to find the bathroom in an unfamiliar place. Not remembering to call for a nurse/aide.

So I'd be asking;
1. is your Mother able to use the call bell appropriately?
2. If not, what level of supervision will there be?
3. what fall prevention strategies will they use? And how will they know those strategies are working?

All the very best for you both. May there be many many more happy days ahead to share 🌼🌸🌺
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My mom was treated for a uti in another ER on 072120. Given a 5 day course of cephalexen (not sure the spelling.). 2 capsules a day. Then on Monday she suddenly crashed. Confirmed uti. Now they have her on the same antibiotic but via IV , 3 day course, soft food diet and IV for dehydration also therapy. Good news, no snf but will come back home. There will be a visiting nurse and a physical therapist for her at home. She is experiencing some delirium though. I requested she be screened for dementia because I am wondering if it actually that but they can't do it because of her delirium. She had delirium after hip surgey a few year ago too.
She already has a dnr from when her hip surgery was done. She says when her time comes do not try to save her.
Thank you for your responses. Much appreciated.
It is hard to see her so frail but to reach 101 , she amazes me. I only hope when her time comes she will be able to pass peacefully.
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Reply to SueNWPa
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Joann addressed covid-19 issues and payment so very well. I will take on age. You do not tell us what sent your Mom to the ER but you have informed us of her age. At that age any admission is significant. If your mother is severely ill you will be faced now, likely not for the first time, with the question of how heroic you want any measure to prolong life, should be. For instance, do you want CPR (as a nurse I did CPR on fragile people who had died, because the family wished it done. Over many years none survived other than a few weeks after. Ribs are almost always decimated by the force of pressure, causing the elder if he or she survives, to splint their breathes, and the lungs descend at once into pnemonia. If your hospital is a good one you will be approached with the question of heroic measures early on. You may be asked about Palliative Care and Hospice. I would think that you are familiar with both considering Mom's age.
I want to wish you luck and I want to hope you will update us on how you and your Mom are doing. What an amazing age she has reached.
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SueNWPa Aug 5, 2020
Thank you Alvadeer. My mom does have a dnr. When she was in rehab after hip surgery she signed one. At that time she said she does not want anyone to stop her from dying when her time comes. I am hoping to keep her home. She had a friend that lived down the road from us who died at age 102 . She had pallative care and died at home. She has expressed a wish to have the same if possible. It's hard to see her so frail now and with me the only family here. I am just hoping she indeed does come home. At her age things can go downhill so fast. Trying my best to think positive thoughts. I am so glad I found this forum.
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The one thing I would be questioning is if Mom can afford it. Medicare pays the first 20 days 100%. No problem there. 21 to 100 only 50%. If she has a good suppliment, then they may pick up the balance if not its about $150/$160 a day. I am assuming here rehab is for getting her strength back. I was told for every day in the hospital its 3 days of therapy. My Mom had Dementia so very hard for her to learn the exercises. I told the admitting office that they needed to do what they needed to do in the 20 days because there was no money for additional days. My Moms last rehab stay was 18 days. I was pinching pennies to keep her in an AL.

With COVID I doubt if you could get "in home therapy". But I might try. Then you can be there to see what exercises need to be done and continue them after the therapy is done. Unless rehab allows visitors ur Mom is going to be isolated. To me, better she is in her home.

When Mom was in the hospital the discharge nurse called and said "we are sending Mom to rehab here are her choices." Not "we recommend rehab for Mom to get her strength back" It sounded like Mom had no choice but you do have the right to turn rehab down. You can ask for it in your home. But, like I said, with COVID, you may not have a choice. I just would not keep her there longer than possible.
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Reply to JoAnn29
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SueNWPa Aug 5, 2020
Thank you JoAnn. She will be sent home after discharge from the hospital as it stands now. The hospital social worker is setting up physical therapy and a visiting nurse. What worries most is that delirium. They can't screen her for dementia because of it. I think it may actually be dementia.
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