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My Mother fell and fractured her hip and had it repaired.Was in hospital 3 nights and at short term acute rehab but has arthritis in right knee and is bone on bone.She has pain from groin area all the way down below knee.She has had pt and ot.She can't put weight on that leg and therfore can't walk at all.What happens now.She was on pain meds coming from hopsital and continued in rehab and was confused for about two weeks which made any therapy difficult.What happens now that time has run out?

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Thank you, MsMadge. My heart breaks every time I think of my Mom's last days. I only pray I will NEVER have to go into a nursing home. God help us all.
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Help2day
I'm so sorry for everything you and your mom went through together but how fortunate she was to have you
Hugs
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MsMadge ~ Unfortunately, no. She didn't even survive her 100 days of Medicare rehab. I went out of town for 1 week (previous commitment) and the very day the plane landed I immediately went to the rehab/nursing facility to check on my Mom and found her slumped in her wheelchair unresponsive, her face drooped on one side, confused, slurring her speech, and her right arm swollen and limp. I (not a medical professional by any means) recognized the classic symptoms of a stroke and immediately brought it to the attention of no less than 5 nurses and PT people. No one would listen to me. "Oh, her arm is probably swollen because she's not sitting upright and it got caught between the chair and her body" or "she doesn't have a temperature" were the answers. WTF!!! It took me 4 days to FINALLY get them to acknowledge this was not "normal" behavior for my Mom!

Nursing home personnel are so conditioned to see the elderly slumped over in wheelchairs that they don't even care to check on them anymore. If I weren't badgering them, she probably would have expired with another massive stroke in days instead of 2 weeks later. The lack of caring for the elderly in nursing homes is appalling in my opinion. Sorry to vent, but she passed on March 29 but my emotions are still raw.

My heart goes out to everyone who is caring for an elderly family member. Again, if you must make the agonizing decision to place your loved one in a facility, PLEASE visit often! I know it's rationalizing to think their mind is gone or they "won't know or remember you were there", but I could never live with myself knowing they were not being properly cared for. Sigh.....
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Help2day,

You DO know what you are talking about. It is very helpful to all, truthful, straightforward and honest.

M 8 8
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Help2day
May I ask if your mom is still living?
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And also, pain medication management in elderly is tricky. When they have a broken hip with also the added pain of arthritic knees (bone on bone), getting the correct timed dosage without them being "confused" is a conundrum. Incorrect medication of the elderly can go south really fast. Please let us know how you and your Mom are doing. We care.
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Wrecko58, you do not mention how old your Mom is but when an elderly person has a traumatic injury such as this (broken hip, femur, etc.) complicated with arthritis in the knee(s) -- bone on bone -- and 100 days of rehab of PT and OT has not garnered much progress and your Mom requires a hoyer lift with 2 people to lift her in and out of bed for toileting, etc., you need to do some real soul-searching about what is best for your Mom's future care.

My Mom broke her leg and had bone-on-bone arthritis in BOTH her knees. She was a 2-person lift with a hoyer in rehab. She was 86 at the time. Because of her limited mobility BEFORE the broken leg happened because of her arthritic knees, it was apparent to me pretty quickly that no amount of rehab (PT or OT) was going to get my Mom out of her wheelchair. When she broke her leg and had to have surgery, the surgeon told us she couldn't put ANY weight on her leg for AT LEAST 3 months (which is 90 of the 100 Medicare rehab days). I knew she wasn't going to miraculously stand up in 10 days after the first 90 days of sitting in a wheelchair and be discharged home. Wasn't going to happen.

As medical POA, I had to make some very difficult decisions for my Mom's continued care. The handwriting was on the wall. Although I imagined myself as Florence Nightengale, I knew deep down I could never bring Mom home to her little tri-level house (which wouldn't have been feasible with a wheelchair or hoyer lift). Plus, my own home was an old 2 story colonial with NO bedrooms or bathrooms on the first floor. I would have to have aides 16 hours each day, plus dealing with all the stress, guilt of my own inadequacies of being a caregiver, dealing with my uninvolved local siblings, dressing, bathing, cajoling her to try to eat, her increasing paranoia, mild cognitive impairment (dementia), dispensing medication, her depressive attitude, etc. etc.

Even though GardenArtist suggested home care, ordered by the rehab doctor, I'm not sure what she meant. If it's home PT and OT, the chance of Medicare paying for that is probably nil. If she wasn't making any progress in a dedicated rehab facility, then it's highly unlikely they would pay for home PT and OT. That's what happened to my Mom. I had a very heart to heart meeting and talk with the OT and PT specialists at the rehab/nursing home facility and it was very obvious my Mom's injury (broken leg) and limited function of her horribly arthritic knees (bone on bone) that she was EVER going to rise out of a wheelchair (even just to pivot to a toilet). A walker to steady herself was totally out of the question, lest she fall again. Therefore, as the end of 100 days of Medicare coverage neared, I had to make the horrible decision (in my mind) to start the process of moving her to the nursing home side of the facility for skilled nursing care. During her 100 days there at rehab, I watched over and over again the process of getting my Mom in and out of bed EVERY TIME she wet or soiled herself. My Mom could also not articulate her toileting needs to the aides or use the "call" button. So unless I or someone else was there to check her, she sat in urine. She couldn't even tell she was wet.

Technically, in rehab or skilled nursing home care, residents are to be repositioned or changed EVERY 2 hours to avoid pressure sores and keep clean. In reality, it does not happen. There are not enough aides in these facilities to do that. Sometimes one aide has 12-15 residents to care for. It was daunting for the aides, as I had to FIND 2 aides each time I needed them to change my Mom. Many times she had to wait and wait and wait. If it was during the "dinner" hour, then forget it. Most of the aides are in the dining hall helping patients eat. Sometimes, my Mom would soil herself, have to be hoyer lifted out of her wheelchair into the bed, be undressed, cleaned, changed and then re-hoyer lifted back into her wheelchair. Then 5 minutes later she soiled herself again because she "wasn't done" -- then I would have to find the aides again to do this all over again. You can see how the lack of aides can cause people to sit in their own feces.

I'm not trying to scare you but this is the reality of skilled nursing homes. The one my Mom was in was considered "5-star" by Medicare. I shudder to think of the lower rated ones. Unless you think you can dress, feed, change, hoyer lift, conduct PT and OT yourself (because let's face it, even in rehab, the patients only get 50 minutes each), you will burn yourself out in weeks. Sometimes, the harsh reality is come to the conclusion to need skilled nursing care. The best advice I have for that is to do your due diligence and research every skilled nursing facility near you and find one that best suits your Mom and then VISIT, VISIT, VISIT. Let them know you are there advocating for your parent.

I wish you the best of luck and will keep you in my thoughts and prayers.
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Take her back to the orthopedist who performed the surgery for an evaluation and determination of what can be done. That doctor is the best one to determine what her future holds in terms of mobility.

She should also get home care, ordered by the rehab doctor, but with a lift involved, you are facing some complications.
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My Mother has been in this facility the maximum days medicare allows.I think the therapists were too aggressive since she had surgery on her hip and her right knee is swollen.They have to use a lift to get her in and out of the bed.When she is wet or dirty they put her back in the bed with the lift and change her and put her back in the wheelchair.
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Talk to the discharge planner at the facility. Id mom being discharged due to " lack of progress"? Medicare has very strict guidelines about rehab.

If mom can't bear weight, is she wheelchair bound? Has she been taught how to manage herself in the chair and a safe way to transfer to toilet and to bed?
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