My 92-year-old mom was hospitalized for health complications that thwarted all the progress she had made to be able to walk a bit on her own. She was admitted to a rehab facility for care and P/T. She has dementia and continues to try to get out of bed by herself and is having numerous falls.
The facility is asking for a 24/7 aide — which we can’t pay for — and that will cost $6,000 for 10 days. She has refused P/T and basically is not able to walk yet. I just read we could try wedging long pillows to prevent her from getting up, but if she’s refusing P/T I can’t see that staying there any longer makes sense and think they are going to ask her to leave.
We think we will be sending her back to her AL home (memory care), but seriously question the care she’ll be getting there as the facility is poorly managed and there aren’t many caring aides that work there. We have to go every day even though we can’t always do that.
She will be basically immobile and unable to get out of bed. We selected this facility because they have a Hoyer lift, but I doubt the aides know how to use it.
Her funds were enough for two years at a facility, but we have spent down quite a bit and are in a financial bind which is going to impede what quality facility we can afford for her now. I think she needs to be in a nursing home, but the best ones in my area are private pay.
Anyone have some thoughts on what we should do if her AL facility is unable to care for my mom now that she is unable to walk? I'm not at all saavy with the world of care facilities when the money isn’t there. Is a nursing home the answer?
I will say it’s all in their mind. at some point they just give up. We have the technology to extend life far beyond what nature intended so have that conversation while everyone is thinking clearly. I found once I could not get her the care she needed hospice stepped in and did a good job
Hopefully you know where the best SNFs are in your area. Limit your search to only those that take Medicaid. Go visit them and also look up the reviews. Figure out if she can start as private pay and transition to Medicaid or if she will have to go on Medicaid right away. Make sure she will even qualify for Medicaid. If so, get the ball rolling on that. Some of the better SNFs are hard to get into unless you have help from the hospital case manager. They know all of the facilities.
I have been caring for my bedridden mother at my home for almost five years. Similar to your situation, she refused to cooperate with PT in the rehab. In her defense, I believe she was suffering from a UTI that made her reasoning skills go bonkers. But, the result is that she has never been able to walk or even stand again - I have to use a Hoyer. I chose not to send her to a SNF because of the lack of sufficient care and the high cost for that sub-standard care. The rehab she was in was a Laurels institution that charged $9,000/month at the time. While in there for rehab (during COVID) they left her immobile for long periods without changing her and caused a class 1 bed sore to develop. Prior to that she had no issues with her skin. My brother and I actually witnessed her being left in a chair for hours when they mixed up her discharge day. They left her dressed in a chair all day with her bed striped until after 8PM. We saw through her window. Long story short- but there was no doubt she was left there for hours until we intervened. So, I am not a fan of institutional care, but sometimes that is all you can do. I have help at home 5 days a week for a few hours. If you go with home care, you will need help to keep your sanity. I tried home PT and she did start to make progress early after coming to my house. But, her fear of falling prevented her from actually standing. Maybe you will have better luck.
Hire a social worker to help you through the process.
Many are independent (hires) and some are medical social workers.
Gena / Touch Matters
If her money has been mostly depleted, you can call and help her apply for medicaid. Sometimes a medicaid worker will visit nursing homes, to assess the patient and assist with your application process. At least, in the small Minnesota town my husband was in, because he was considered a vulnerable adult, the county worker was required to visit him and inform me of his options.
It sounds like it's time to say goodbye to the memory care AL. If you feel uncomfortable about their level of capability to care for her properly, they probably can not.
The rehab facility should have a social worker. That would be your point person to start the process of transferring her to SNF and applying for Medicaid. I would start the conversation now as they could discharge her sooner than you expect.
Medicaid does cover Skilled Nursing Facility where is will not cover Assisted Living.
Typically codes will not allow AL or MC to use "equipment" to transfer. You mention the one mom is in does have a Hoyer. If that is the case then there should be people trained to use it SAFELY. you can ask for a demonstration as to what they would do to get mom from her bed to a Wheelchair.
If you are not happy with the response you get begin looking for a Skilled Nursing facility.
Generally many rehab facilities also have Long Term Care as well so they may be able to keep her there. Talk to the Social Worker about Medicaid if that is necessary.
Ask the rehab social worker to help you find the right facility for your mom.
I wish you well in this endeavor to find the right facility for your mom.