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My mom is 76. She lives with me now bc she has bad knees and kept falling. Otherwise, fairly healthy.



She got pneumonia and was in ICU for 5 days, reg room 2 days and now has been in rehab 2 weeks and 2 days.



Phys therapy gets her up 1×/day. She walks a little better but mostly they leave her laying and only make her raise and lower legs and rotate ankles in bed as therapy. A nurse gets her up about 1x/day to go to the bathroom. Otherwise, she lays there. I don't feel like this is rehabilitation!



She's elderly but she could still drive, go places with me etc. Now she's just laying there. Also, she's laid so long now her legs are swollen and bothering her.



Shouldn't I find a new rehab for her? I'm ready to take her home and do rehab on my own! What's the point in rehab that's not helping?

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You need to be, if you are POA or next of kin, included in the care conferences that Rehabs must have weekly. You should contact Social Worker in this facility at once and ask about expectations. If PT is only "working with" (this doesn't mean getting up) Mom once a day this is very poor rehab.
However, your Mother entered with bad knees. You mention she was already suffering falls at home PRIOR to the diagnosis of pneumonia.
Has there been an Ortho MD assessment of your Mom's knees? Does she need need surgery? Is she still suffering long term issues doe to the pneumonia? Does she have complicating factors other than knees (ie obestity?).
All of these things are factors in recovery.
Especially worrisome is that there have been knee issues at home, and falls, before anything like the pneumonia showed up. I am 80 and walk over a mile a day, so what you have here is a real physical issue. The longer Mom is bedridden the worse she will get. Laying about in bed in rehab is unusual to say the least. You need to get a consult with the Rehab doc and explore what is going on. Is this an issue of lungs, overall condition, knees??????
Be the squeaky wheel. I wish you luck.
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Oh....you hit a hot button with me.

If you have an older person who is healthier than others their age, they are "screwed" by the health system if they should get an injury.

At the age of 97, my Mom lived independently and was using a walker, could cook, wash dishes, walked to the grocery store (nearly 1 mile each way), balance her own checkbook, etc. We went on a 23-day cruise and she led her life while I led my life and went all over the ship, by herself. We ate and did a few activities together during the day. She got back home from the cruise, and within 24 hours, ended on the floor with a compound fracture in her left upper leg. She ended up with 3 screws, intense pain and of course, unable to walk.

They wanted to take her to a Nursing Facility because that is where injured people her age go. My siblings and I said NO and managed to get a rehab hospital where they did PT 3 times a day. However, the rule of the hospital was that she had to leave in 11 days. It was intense, however, my Mom was up and walking with her walker, although painfully, for over 100 feet. Because I had a trip scheduled and there was no one in her home that could take care of her, she was moved to another nursing facility with rehab. When I saw her a month later, she was a zombie, constantly in pain, and couldn't get in or out of the wheelchair or stand by herself. Medicare said she was well enough to go home. I was beside myself.

Through sheer perseverance, luck, and talking to my friends in another state for recommendations, she was out of the wheelchair in 3 months and not using the wheelchair at all in 5 months. However, she was never able to live independently again. But at least, she had the freedom to move, to get out of her bed when she wanted to, go to the kitchen when she wanted to, etc.

So why is it my hot button? The first rehab hospital was able to get my Mom walking again (my Mom hated that place). However, the second one felt that she was lucky to be alive. Her mental state and pain were so bad, she was not lucky. They didn't work with her to regain her independence because they expected 97 year old people to be in a hospital bed and medicated. When we left there, they told me she would need this pain med for the rest of her life (it wasn't cheap). When the pain meds didn't relieve the pain, I tried to figure out why and what to do about it. That is when it came to me that she was now a drug addict. I weaned her off the addictive pain pills and we are now on a drug regimen that she has used for the last 3 years. Pain is tolerable and drugs less expensive.

When I was looking for a PT to work with me to regain her ability to walk, no one wanted to help me. They didn't believe me when I said she cooked for herself and was able to walk 1 mile at a time. They passed me around within the practice until I happened to get some fresh grad who had very few patients. I told him that if she were a 2 year old who didn't walk, what exercises would we do. At night, I worked with her on her exercises. By 1 month, she went from totally in wheelchair to mostly using the wheelchair. That's huge for a 97 year old body. He really didn't want to work with us so when COVID came, he dropped us immediately. I guess there is no recognition program for PT people that help elderly regain an active lifestyle.

People who saw my Mom during that time say that I was a miracle worker. I was not. I was just someone who thought that my Mom could have an active lifestyle.

Depending upon the injuries, you can repeat what I did. Find a PT who will work with you and your Mom. Find a doctor who will educate you on what to do and what to watch out for. Get the equipment to help you. My Mom had swollen legs for not walking enough. I did it and you can too. I am just an ordinary person.
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Beatty Apr 2022
This is being a 'Patient Advocate' at it's best!

1. Knowing the Person: their pre-injury/illness state, their temperament, their goals. Not just a 'patient' with assumptions based on year of birth.

2. But also Realistic Expectations. Realising recovery is not one thing - not regain of complete pre-injury/illness state. That recovery is often a pathway to a *new normal*.

I believe you need both.

If the go-go attitude is underpinned by Magical Thinking, it won't succeed in the end.

Your Mom is very lucky to have you 😃
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What does her care plan say?

Ask for a meeting with the Director of Nursing and her therapists. Ask them what the plan is and why your mother is not up, dressed and seated in a chair, ready to participate in activities each day?

Whay does the facility doctor say about the swelling in her legs?

If you don't get answers, get her back to the hospital and find out why she is retaining fluid.
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Cover99 Apr 2022
Sorry but care plan? What is that? Some places are more concerned about getting paid then formulating a care plan for a patient/resident.
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77 is not elderly! (I am 72)

I would ask why she is only getting therapy once a day. Also, not being taken to the bathroom like every 2 hours. Why is she being allowed to stay in bed. When you have pneumonia you need to move. Its the laying around that does not help. Why isn't she being sat in a chair for a while. Maybe this rehab is not for her. I would ask about rehab at home. Seems to me she would get about as much therapy. At home you can get her up and sit her in the living room. Get her outside for some fresh air. You can continue her exercises.
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againx100 Apr 2022
Just curious - what do you consider elderly? 77 certainly qualifies since it's around the average life expectancy. Don't take it personally.
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I would bring her home and ask that the therapy be done in the home! It is not like she is all alone at home. She has you there and you can help her. She would do much better!
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LoopyLoo Apr 2022
Not unless the OP is a physical or occupational therapist. Don’t assume that home is always better than a facility or rehab.
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I would discuss this with her doctor, especially the leg swelling. PT won't be continued if she's isn't showing any signs of progress, is uncooperative, or has plateaued. You mom needs to know that it's vitally important she does her best to try to improve. Are you able to go in and help her get up and move around more? Not moving isn't helpful with pneumonia. The swelling in concerning...
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From all I've heard and read, if she doesn't get up and moving more, it won't be long until she's suffering from the after-effects of pneumonia plus even more edema (swelling) and also blood clots in her legs. The lymph system, unlike the circulatory system for blood, doesn't have a heart that pumps to move the fluid through it. Instead it relies on movement. It's no wonder that her legs are swelling.
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Mobility is the key to recovery! But if you find out how to motivate a loved one inquiring minds want to know. I am finding it hard just to get my wife to use the bathroom. The doctor says there is nothing wrong with her other than she has not used her muscles enough!
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JeanLouise Apr 2022
I’m in the same boat! Most of these posts do not apply to spousal caregivers. The lack of motivation is a tremendous obstacle to recovery. Keeping my husband moving is a daily battle. He too would have better mobility if he would comply with his modest PT home exercise plan. It’s so frustrating and discouraging. We’re missing out on so much. Best of luck to you.
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Rehab should be 3 hours a day ! Although when my mom transferred from an acute rehab hospital to a snf that had continuing rehab they said it was 3 hours but it was usually just one ..though she was up and to dining room and in chair mostly. Then got flu there , they weren’t following cdc guidelines and she ended up being worse when she left there than when she arrived. One issue with all these places is their treatment of elderly. I think they just had an idea of how much an 84 y/o should do and got her to kinda that point. Similar treatment always after she reached 80..at emergency rooms and in hospital . They’d assume she needed walker or was normally confused ..not that her normal state was just what anyone else did other - walking , talking and reasoning well. Worst thing for elderly in hospitals now is the hospitalists ..might be fine for younger healthy patient but not for those with extensive medical history. Completely missed my moms extensive second stroke - and that was what we brought her in for! They dismissed our concerns and had her for observation which was obviously a joke. Talk to them ..docs and social worker , and also her health care because they are likely billing as intensive rehab but not doing that at all.
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The sad fact is that staffing at any of these support places is critically low. Independent living, assisted living AND rehabs so not have the staff necessary to support the patients/residents they have. The ratio is usually 1 CNA per every 8-10 patients during the day and 1 to 13-14 at night and that was pre-COVID. Now, it's even more dire. Your LO will not get the proper care, period.

The alternative is bringing her home and bring in PT and skilled nursing (Medicare should cover all of this). Or you can do it yourself which is really a dreadful alternative and takes a huge toll on you. But if you need to bring her home, her doctors can certainly arrange home health care and physical therapy/occupational therapy to help get her moving again and back on her feet. Rehab will let her lay in bed all day. And taking her 1x/day to the bathroom? I'd call the police and have them charged with elder abuse for that one. That is outrageous.
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