Rehab or Home?

UPDATE/PRAISE REPORT:
My Gma was transferred to her rehab facility last night. We went to go see her today. My cousin visited and she videoed me at the same time. Gma seems to be in minimal pain. She is severely bruised I believe from all the poking and part of it from the fall itself. She has a small skin tear that's new on her opposite leg, thats new.
Yesterday she pooped and ate 80% of her dinner. Her eating seems to be getting less, because she having swallowing issues so shes on baby soft foods right now and thick liquid. Also she is pocketing saliva which scares me but they a re e keeping a close eye on her with it. Hopefully she can soon eat normal foods. As far as the dementia, her words seem less but she still engages and still seems much like her old self just more frail. So her cognitive decline isnt terribly apparent. I watch them transfer her to a wheelchair from the bed and she even took a couple of steps with the Walker! Overall she seems to be doing great considering what she has been through, she survived surgery and seems to be on the road to recovery with Gods help & some AMAZING STAFF between the Hospital team & her rehab team.
If you pray please continue to pray for her recovery 💗🕊🙏🏼
As for me I've been on the phone nonstop for 3 days, my cousin & I had a great visit together. She is in agreement that I take a few days & go the ocean, so that is what I'm gonna do. 💗🌊 When I get back I can start prepping the house for her return Lord willing. Also tomarrow me, my husband & son are going to dinner & a movie for some needed family time. We are not gonna waste this precious time we have while we have it. Then when she does return home we can all be refreshed especially me & ready to continue her rehab. Hopefully she'll come home to a new hospital bed & new bigger TV for extra comfort. Plus all the cookies she could ever want lol
Just wanted to update you guys, thank you for all of your support & advice. Our journey is by far not over but I'm so Greatful shes been ok up to now. 🙏🏼🕊💗

Let her go to rehab to get stronger..she won’t do any physical therapy at home. You can go there to visit & see how she does . She might need to go from short term rehab to long term care. You have no idea how she will be after surgery. Expect major decline. Since she memory impaired, the anesthesia will have caused more cognitive impairment. At home, she’ll just want to sleep & stay in bed. Hugs 🤗

Rehab provides so much more than physical support, including people interaction, usually activities and hopefully music and animal therapy.    And unless you're a combination nurse, physical and occupational therapist, home care and possibly an angel on earth, this is more than you or anyone else can reasonably handle.

Seriously, the home nurse, physical and occupational therapists are trained for this kind of work; they have insights and suggestions that can really be helpful.

I've been through 2 hospitalizations and subsequent rehab with my father just for hip fractures -  first when he was 96 and the second time when he was either 97 or 98 (I can't remember now).   Rehab was amazing; he went in not walking, worked hard, and left walking with a walker.  

He did have good support through his church friends though, both in rehab and at home.  That makes a critical difference, and is a method by which your cousin could also help....visiting, calling, sending cards.    A cousin living on the Michigan coast visited, bringing a very large bulletin board for cards, plus push pins.   Either one of the rehab staff or I, or my cousin when she visited, put the cards up.  Dad enjoyed them immensely; they became a source of conversation for staff and other visitors.

If your cousin can't visit, she can send cards to support you.   I'm also not sure though why you feel you need to explain to her.    After 9 years I would think you're entitled to some support.

What I would do is list all the items you'll need at home (walker, rollator), clear the throw rugs, etc. and bring your cousin in on this preparation.  Make it a family project, bring your husband in on it as well and create a safe environment for her return.  You can then judge realistically whether or not she can stay in the home longer, or if it's time to consider an out of home placement.    But at least you're giving the home environment a trial period.

Rehab staff also know how to properly lift and move someone who's recovering from hip surgery.     Your husband probably doesn't realize how necessary they are.   He needs to learn.    Is it possible for him (or is he willing) to visit her?  If so, I would try to arrange for a visit when the hospital PT or OT plans for an in service visit.   Someone who hasn't seen in-facility vs. home therapy can't possibly realize the need for therapy in a supportive setting.

I would speak privately with the treating orthopedic doctors as well as the hospital therapists and let them know that their support and advice to your husband would not only be helpful, but probably necessary as this is far too much for you to handle.


You mentioned that she's begun to have swallowing problems.  This is in my opinion a reason why she absolutely needs to be in rehab, to be tested with a videoscopic swallow test, evaluated by a speech therapist, and have her diet adjusted to the appropriate level of dysphagia food preparation.   Choking and/or "frank aspiration" could result if this doesn't happen.   A speech therapist can assist you at home AFTER discharge from rehab, and could provide you with lists of dysphagia levels and corresponding acceptable foods.    

I would also raise this issue with the treating hospital doctor, and even ask for a videoscopic swallowing evaluation in the hospital.      It'll be easier to do in the hospital, while she's already there.   And it may be noticed by the nurses if they see her in an episode.

I know it's often hard to stand up to relatives, but you can't take this on w/o rehab first.  It's just not realistic, and in all possibilities, could prevent her from healing properly.

You can still "be with her to the end", but not necessarily in your home.  

The best thing you CAN do for her is to get her the proper level of help.

Good luck!

If she were to come home, would she be able to do PT in the house? And by that I mean would she be able to understand the exercises and do them? And would you be willing to keep on her multiple times a day every day to do them?

My husband had both hips replaced when he was in his 30's and then a revision on one in his 50's. He rehabbed at home - BUT - while PT came in 1/week, it was on him to do the therapy daily, multiple times. Now, with my husband being so young and relatively healthy, I didn't have to nag or remind him once to do his exercises., he did them and recovered 100%.

My mom, on the other hand, much more difficult, when she had her knee replaced when she was 82. Oh, she did the PT when the therapist came, but was not vigilant about doing her therapy on her own once PT left. And when I reminded her, she accused me of "nagging". She never really recovered properly from the surgery; she always had some degree of pain in that knee. She was annoyed she even bothered with the surgery in the first place. And my mom didn't suffer from dementia.

What is your husband's concern with Grandma going to rehab?

Rehab. Bringing an 89-year-old home that quickly after surgery could kill her. I mean that. She needs professional medical nursing care 24/7 for some time even if you all decide you don’t care if she ever walks again by denying her proper physical therapy.

I read all your info and updates. “Caring” for someone also means acting in a way that is in that person’s best interest. Home care is simply not the best “care” in every circumstance.

UPDATE:
FULL TRANSPARENCY.
I've been my Grandmothers CG for almost 9yrs. My aunt I ew I was a Caregiver back then and asked if we
( my husband & son ) could move in and take care of her. In exchange we all her home bills & groceries would be taken care of by my Grandmas retirement funds. My aunt was her power of attorney over all of that. It's been working out great until my Aunt passed away from pancreatic cancer last year. That responsiblity transferred to her daughter which lives in Washington DC & as I was scared of that transition, my cousin has been doing an amazing job. Shes even flown in yesterday to help me with this awful situation. There was always this overriding fear that my GMa would end up at a facility which is why I was called in to help 9 years ago. I told my aunt & my cousin that would NEVER happen & that I would be with her to the end. Fast forward 9yrs, the last 3 years I haven't taken 1 single vacation with my husband or son. Since my aunt passed 1yr ago
I HAVE ZERO SUPPORT & with Covid have been a prisoner in my home because of the threat to my GMas health even to where I've stopped going to Church. 3 days ago she fell, now we are where we are. She was already in end stage Alzheimers and starting having swallowing problems her mobility was good though until now 😭
I just dont know what to do, or how to tell my cousin I'm not equipped for this. I know I said I would be with her ro rhe end but I feel like my mouth wrote a check my body may not be able to cash. My Grandma is one of the most special people in this evil world, she was a nurse for 40yrs, a dedicated volunteer to children & the homeless. I just want to do the right thing, while also taking my own life & my families life into account.
Thank you all for your advice.
God Bless You.

Rehab, give yourself a break. She needs the therapy. If you find she is not doing well there, then bring her home and ask for therapy to be done there.

I'm 65+. I was in NH or 2.5 months rehabbing from a shattered ankle. I'm now on my fifth surgery and will be going back to NH for rehab. As much as I would like to be home and have plenty of support and have plenty of support at home, the NH is much easier on me and everyone involved. the physical therapy is good and got me back on my feet quicker. Plus they will the post surgery wound care, etc.
Do yourself a favor use rehab not home. Do what is best for your mother and YOU.

Rehab!! For the love of all that is holy, REHAB.

In the nursing home, dad was afraid to move. The therapist swore he could walk but would never let us see. Then something happened in the nursing home and suffered a pelvic fracture (story kept changing).

After rehab in a hospital setting, he can transfer from wheelchair to bed, wheelchair to a recliner or regular chair, wheelchair into a vehicle, and walk short distances with the help of a walker. If he had gone ahead with the other knee replacement back in the day, I believe it would be even better on him now.

Hope that helps!

My mother’s situation at exactly the same age.

Since SHE went to rehab for 70 some days, then came to MY HOME for 9 disastrous months, I feel fully qualified to say Do NOT ”bring her home”. I gained 60+ pounds and never slept more than 4 hours a night.

My mother finally moved, and lived for 5 1/2 years in a wonderful local SNF. They loved her and she loved them. I visited 7 days a week.

Your husband’s optimism is perhaps partly based on the fact that he leaves the house to go to work every day. His optimism is inspiring, but hopefully not contagious. You have no reason to EXPECT that you will be qualified to take care of her. Go for balance- her welfare, but YOUR WELFARE TOO.

OMG! What kind of dreamland does your husband live in? Of course she should go on to a rehab facility so she can regain as much strength as possible before returning to your home for her care.
It's always easy for the person who does the least amount of care, to tell the person who does 80% of the care what they should or shouldn't be doing.
Please let the professionals now take care of your grandmother for as long as they deem necessary, before you decide you bring her home.
I'm glad to hear that her surgery went well. Now you want her recovery to go just as well, right???

I would try rehab even just a few weeks -so they can work with her better and even get you comfortable with her exercise and the. you could always transition to in home therapies from rehab after she gets a little stronger. She could come home with in home therapy and they could further help her get situated and stronger .

Definitely rehab…….she needs skilled help to be mobile, do her PT, etc. She will need PT several times a day to build up strength etc. You are not a skill physical therapist…….

Rehab. A few weeks will give her the time to recover before she comes home, and if recovery isn't happening it will be clearer to everyone that a different option is needed.