She is 96, in amazing health- no medicine. She took a fall and because she didn’t have her lifeline on, she had to yell for a neighbor. Firefighters came and took her to the hospital. They did a full work up and said maybe she was dehydrated. She lives alone, takes full care of herself and her home. Rehab doesn’t think she is strong enough to go home alone, but- I keep telling them that she is at PT for one hour a day- other than that she sits in a chair, of course she is losing strength! Ugh. We feel she should be able to go home with PT. She has mild short term memory loss, but is pretty sharp most times.
I’ve had a couple of instances ( in hospitals) where medical staff made noises about insurance not paying if you leave AMA. However what I read on line said that’s a myth. I guess you could call her provider to find out?
Usually hospitals don’t keep a patient 3 days and then send them to rehab unless they need to be there. Ask the therapists what the goal is for GM and what their evaluation shows that she needs help with.
I think you would hold yourself liable if you took her home too soon and she fell.
Is there someone who could stay with her a few days if she goes home early?
Being dehydrated takes awhile to come back from.
Put in a request for an aide to walk her in addition to her PT sessions if she needs supervision. If she is cleared to walk alone, she should be walking around the facility.
At her NH, doc ordered this " walking protocol" for mom and it was adhered to.
I would guess *the fall* to be the true, primary cause of many of the problems you are seeing. If she only has PT for an hour a day, that would leave the rest of the day for her to do many of the things she could do at home... if she wanted to and was able... things like read, watch TV, go for a walk with staff, do light exercises, fold clothes if you are bringing her laundry, pay bills, play cards, etc.
She is not doing those things because something is wrong, not because the rehab is forcing her to sit around and do nothing.
Also, unless you live with MIL, what the family sees as “mild, short-term memory loss” in someone who is living alone is usually quite a bit worse in reality. It probably isn’t the rehab that is making her worse, nor is it a matter of “losing confidence in her abilities”.
The more likely scenario is that she had some cognitive decline that she could mask in her familiar home environment and wasn’t obvious in front of family. A fall can accelerate that decline. Or just being in a different environment without props.
If they aren’t even clearing her to walk with someone else, she is still a huge fall risk. It could be strength, but it could also be balance issues that will or will not resolve. Dehydration could have caused weakness and contributed to the fall, or it could be something else in her brain, stroke-type activity, etc.
She obviously cannot care for herself at this point. Bringing her home means you assuming her care. Only you can decide whether you are ok with that.
You may want to really listen to what the rehab folks think about the situation and consider the fall as the catalyst here rather than the rehab causing problems. If she is going to get better, chances are it will happen at rehab rather than at home.
If it doesn’t get better, the family will probably find their time better spent to start sorting out a contingency plan if she can’t return to her home.
Just some food for thought.
Talk to the doctor, he does the discharge. Tell him that Mom wants to be discharged and you feel she will do better at home with PT/OT coming in.
When we had Moms care meeting with rehab, I was told that she would never walk without her walker and assistance. She was in the hospital from Tues to Friday. For everyday in the hospital its 3 days of rehab. Lets say Moms was 4 x 3 is 12. I told them that she had been walking around her AL with a walker before her hospital stay. I said that I could not understand how having PT one hour in the morning and maybe one hour in the afternoon and then sitting in a wheelchair the rest of the time would help someone get stronger.
Don't let them tell you that Medicare and your insurance will not pay for her stay if you go against medical advise. Not true, Medicare and supplimental will pay up to her discharge.
By the way, Mom got back to her AL and within 24 hrs was walking around unassisted with her walker.
it was pretty clear they were planning on keeping her for life. The facility was new and looked really nice, but they didn’t actually do any rehab. I went there to be with her for dinner during her second week, they required me to check out a wheelchair to bring her to the lunch room. She wasn’t even allowed to have a wheelchair for her own use! the vast majority of the patients there were obviously long term and incapable of helping themselves.
Mom checked herself out. Called me from the corner shop to come pick her up.
too many of these facilities do not do the job they get paid to do.