Talk to me about rehab facilities for PT for elderly

[PeterPan]

9 minutes ago, matrips said:

I was greatly dismayed that going to the bathroom on their own was more frowned upon and discouraged, than encouraged.  Both in hospitals and rehabs.

So I actually asked outright, and he said he's using a urinal at the side of the bed. They wanted him up and he was having a hard time, so that was the compromise. That's way better than Depends, definitely. Would be spitting upset if they put him in Depends. That is not the level of care appropriate here. 

So I'll definitely be asking. And if it takes us paying more to get him in some place, he has it. I don't think he's going to get the progress he needs to get back to walking if the care isn't pretty serious.

11 minutes ago, matrips said:

Yes, and if he’s says he hurts and doesn’t want to get up, they may just leave him in bed.  And if he says he doesn’t want to go to pt because he hurts or is tired, they will not typically force it.  They say it’s because they do not want to force them against their will, but it also makes it easier on the staff.  And this is how some patients get worse in rehab instead of better.

Oh my. I need to think about this. I probably need to flat ask his doctors too. See, I'm just being honest, but I think he's at a place where it's easier not to fight it. But then where does that get him? You don't die just because you give up. So he'd be alive in bed??? I mean, this is kind of a mess and the mental is definitely a part. 

Is it ever done to pay for an outside aide to come in and see him daily or some kind of outside accountability? Or am I doing that by phone? I live several hours away and he'll basically say anything on the phone. I'm not sure how I'm supposed to supervise this if his will doesn't get him there. He has money to pay for extra service if that would help. Like when you bring a doula to the hospital, kwim? 

14 minutes ago, matrips said:

I hope you and your dad have a terrific experience.

Me too, but it sounds like I also need to have some realistic talks with the doctor about ways this could turn out and how to prevent problems. And look for an upbeat, highly structured place that keeps his brain in mode.

[PeterPan]

6 minutes ago, Faith-manor said:

rehab only

Your stories about rehab only vs. rehab in nursing homes are helpful. I'm definitely opening some days this week to get the visits done. It sounds like that's where a lot of the battle will be won/lost. And while I can see why a nursing/rehab might make sense, my dad should have a lot of potential with enough care. So I'm with you that the rehab only should make more sense. I think the nursing home mindset would push him over the top. It was hard enough moving into AL at 65. Up until the covid vaccine and this flare up, he was the most active one where he lived and took a lot of pride in it. 

[PeterPan]

11 minutes ago, prairiewindmomma said:

I would look at Amazon for sweats.

Wow my pea brain really was off. You're right, they have them in 3XLT!!! Might not be soon enough for this week, but I'll keep looking. They at least have them which hadn't occurred to me. Amazon is a super easy way for me to get stuff definitely.

12 minutes ago, prairiewindmomma said:

Because this is a Thing, it’s ok if you need to do things less than perfectly (not everything fully prepared upfront), because you are just at your own capacity limits.

Thank you. I take your permission. 

[Faith-manor]

4 minutes ago, PeterPan said:

Your stories about rehab only vs. rehab in nursing homes are helpful. I'm definitely opening some days this week to get the visits done. It sounds like that's where a lot of the battle will be won/lost. And while I can see why a nursing/rehab might make sense, my dad should have a lot of potential with enough care. So I'm with you that the rehab only should make more sense. I think the nursing home mindset would push him over the top. It was hard enough moving into AL at 65. Up until the covid vaccine and this flare up, he was the most active one where he lived and took a lot of pride in it. 

I wish you and your dad all the best. One thing we did for our family members was decorate their rooms before they arrived and made sure favorite items were there so it would be cheery and comfy. This might not be easy during Covid, but maybe ask about it. We just wanted to do everything we could to lift spirits and remind them that home was the goal so keep that chin up!

[matrips]

2 minutes ago, PeterPan said:

s it ever done to pay for an outside aide to come in and see him daily or some kind of outside accountability

I lived close by which I realize you don’t, so I was there a lot.  I also hired her a companion for a couple hours a day that was supposed to look out for her, so it can be done.  And maybe you can find an encouraging aide that will keep the place on its toes with your dad.  We went with a basic cna, but a higher qualified aide or nursing student may have provided better results in our case. Only because it tends to be their calling, rather than just a job.

my experience: 1) my mom didn’t exactly like people hovering and was super fussy, and the one she settled for wasn’t very ambitious.  She used her to go out to Panera and get her better food 🙄. 2) the staff saw a hired hand there and therefore thought that aide would take care of mom and they didn’t need to, so it caused some confusion.

[matrips]

9 minutes ago, PeterPan said:

Your stories about rehab only vs. rehab in nursing homes are helpful. I'm definitely opening some days this week to get the visits done. It sounds like that's where a lot of the battle will be won/lost. And while I can see why a nursing/rehab might make sense, my dad should have a lot of potential with enough care. So I'm with you that the rehab only should make more sense. I think the nursing home mindset would push him over the top. It was hard enough moving into AL at 65. Up until the covid vaccine and this flare up, he was the most active one where he lived and took a lot of pride in it. 

Is he not allowed back at his AL yet due to his condition? He could have PT done there, either by their in house folks or another agency that would come in. 

[TechWife]

As far as having someone else come in, check with the facility, I honestly don’t know. My inclination would be that a health aide from the outside would not be allowed due to liability reasons. 
 

The last time my dad was in rehab his roommate’s administrative assistant  came in and sat with him for four hours every afternoon. It was weird to me, but she explained to me that he was keeping her on payroll and she wanted to be available to him. She brought his mail, read to him & just sat with him. 
 

Visiting policies may be different due to Covid-19 restrictions as well. 

[PeterPan]

5 minutes ago, Faith-manor said:

One thing we did for our family members was decorate their rooms before they arrived and made sure favorite items were there so it would be cheery and comfy.

Very smart! There's definitely some timing there. I'm going to fight hard to have the hospital do the transfer, so I don't have to deal with both the physical (300 pound man who can't walk) and the anxiety he'll have with the move. So I think like you say, taking the extra time to slow it down mentally, get it set up, then have them bring him in, it will make it go smoother. I was trying to rush it in my mind, but there's just some process here to keep it calm. 

I need to think through his stuff. He's not very attached, so that will be a trick to find a few things. I might just get him an inflatable balloon or something. Would the workers help water a plant or are they very anti-plant?

5 minutes ago, matrips said:

I also hired her a companion for a couple hours a day

How do I find this person? Care.com or somewhere else? 

 

6 minutes ago, matrips said:

the staff saw a hired hand there and therefore thought that aide would take care of mom and they didn’t need to, so it caused some confusion.

Hmm, that's sort of backfiring, lol. 

5 minutes ago, matrips said:

Is he not allowed back at his AL yet due to his condition? He could have PT done there, either by their in house folks or another agency that would come in. 

They were trying to provide it and it was awful. Substandard, haphazard. AL is not set up to do rehab. It's more like you're fine and just want a little touch to say you did. If you actually need something serious, having random people show up doesn't get it done. 

6 minutes ago, TechWife said:

The last time my dad was in rehab his roommate’s administrative assistant  came in and sat with him for four hours every afternoon. It was weird to me, but she explained to me that he was keeping her on payroll and she wanted to be available to him. She brought his mail, read to him & just sat with him. 

LOL I love this. Yes, I think if someone actually came and just talked the news with him, it would be good for him. Not medical care, just visits. He has this crazy bright mind that goes every which way from meds, anxiety, ptsd,  you name it. But really, he can't handle much. It's hard for him to fake that he hurts, so a visit or even phone call can be fatiguing. 

Guess I'll have to see the vibe of the options and go with my gut. 

[PeterPan]

8 minutes ago, matrips said:

Is he not allowed back at his AL yet due to his condition?

So they'll take him back, but they can't help him get well. If he wants to walk again or feel well again, he needs stepped up therapy. That's why they're doing this referral to make it happen. It's the limitation of AL. It's only good when you don't need medical care. Once you need that, much harder, not ideal. 

[PeterPan]

2 hours ago, TechWife said:

a favorite book, if he’s a reader.

This was such a good point!! I just ordered him some new chicken soup books. He likes them and does like to read, yes. They will keep him out of trouble and give him something to talk about.

[matrips]

11 hours ago, PeterPan said:

How do I find this person? Care.com or somewhere else? 

We asked around at church, other people with older folks etc.  maybe his AL place may have some suggestions of local agencies?  Or does he have a favorite aide at AL that may want to moonlight as a companion?

[prairiewindmomma]

We got a list of agencies from the local elder care government board and interviewed from there. They averaged around $25/hr and could provide companionship, do laundry, pill prep and whatever other a la carte services we chose from their menu list.

[PeterPan]

He’s worse than I realized. Gave the social worker a list and she’s checking. Not sure he’s returning to his AL after this.

[Faith-manor]

7 minutes ago, PeterPan said:

He’s worse than I realized. Gave the social worker a list and she’s checking. Not sure he’s returning to his AL after this.

PeterPan, I am so very sorry! Hugs to you today.

[catz]

I don't have time to read all responses here. But I will say my grandmother went to rehab after a stroke at age 89.  She got GREAT care and therapy there and was forced to work much harder at recovery than  she would have in another setting.  And her rehab was at a facility that also had a nursing home wing and a hospice wing. I think you just really need to do your homework.  My grandmother physically was in better shape after rehab than she was living alone before her stroke.  She then transitioned to an assisted living/memory care facility. 

[jen3kids]

7 minutes ago, PeterPan said:

He’s worse than I realized. Gave the social worker a list and she’s checking. Not sure he’s returning to his AL after this.

I'm sorry.  That's hard to deal with.  When my mil fell and broke her ankle, her AL place refused to take her back due to the amount of care she requires.  She's in a LTC facility and hates it and just wants to go back to her beautiful AL room.    Only she controls whether or not she gets there, and PT is hard, especially when overweight and having low muscle tone.    

I hope your dad gets the PT and support he needs and can get back to his AL place.

 

 

[prairiewindmomma]

16 minutes ago, PeterPan said:

He’s worse than I realized. Gave the social worker a list and she’s checking. Not sure he’s returning to his AL after this.

The assessments are thorough and now you have data to work with. I hope you can find a safe and healthy placement for him post-rehab—sorry that is so much extra right now on your very full plate.

[PeterPan]

5 hours ago, jen3kids said:

I'm sorry.  That's hard to deal with.  When my mil fell and broke her ankle, her AL place refused to take her back due to the amount of care she requires.  She's in a LTC facility and hates it and just wants to go back to her beautiful AL room.    Only she controls whether or not she gets there, and PT is hard, especially when overweight and having low muscle tone.    

I hope your dad gets the PT and support he needs and can get back to his AL place.

 

 

That helped me reframe what I’m seeing and explains why they keep hoping to get him back in his AL. I just have to make sure it’s ok (enough care at that time) because the AL is letting in people now who look to me like they need nusrsung not just AL. They’ve lost people and aren’t saying no so quickly 

[PeterPan]

5 hours ago, FuzzyCatz said:

grandmother physically was in better shape after rehab than she was living alone before her stroke.  She then transitioned to an assisted living/memory care facility. 

That would be a great outcome!! We’re still dickering over the place. Apparently tomorrow is the day. They did their kick him out chest X-ray and are hoping to have me acceptable names.

[Storygirl]

I'm sorry he's not doing well. I hope it becomes clear to you where to send him tomorrow for rehab, and that he gets good care there.

[PeterPan]

2 minutes ago, Storygirl said:

I'm sorry he's not doing well. I hope it becomes clear to you where to send him tomorrow for rehab, and that he gets good care there.

Thank you! He was looking better at the end of today. He wanted me to sit with him, which was sweet . 

[PeterPan]

Problem is the best places don’t have openings. And the social worker was going down the rung trying to get coverage and I’m like come on the cost is a nothing, find him the BEST. She’s like oh… so hopefully they get me happier options. The Medicare.gov site has ratings so you can see upfront. 

[LifeLovePassion]

Both of my parents have spent time in TCU's (Transitional Care Units) Post surgery, post stroke and towards end of life (various circumstances). They also were at several different facilities throughout the metro area here (MN). My mom spent her whole 100 allotted days in rehab post stroke. They did various therapy throughout the day. She had a shared room. 

Mom later moved to AL after my dad was hospitalized/passed. AL does not do the rehab type stuff. We transferred her medical care to a team that visited the AL facility weekly, they saw her monthly. They were able to order PT that visited her on site after she fell. She did a couple of rounds of that in her year or so of living there before she passed. 

I didn't have time to read all the replies, but LMK if you have questions. It's a challenging road and probably varies somewhat by state. Be sure to take care of you too. It can be quite intense and time consuming to try to manage your own life and be an advocate. 

[jen3kids]

17 hours ago, PeterPan said:

That helped me reframe what I’m seeing and explains why they keep hoping to get him back in his AL. I just have to make sure it’s ok (enough care at that time) because the AL is letting in people now who look to me like they need nusrsung not just AL. They’ve lost people and aren’t saying no so quickly 

I think each AL facility has different requirements, and some probably aren't as honest as they should be regarding what level of care they can offer.  MIL's AL was adamant that she couldn't return to her apartment.  They would allow her to move to their higher level of care wing, but we would have had to continue paying for her apartment (to 'hold' it for her return), pay for the increased nursing, as well pay for a private nurse.  It's unfortunate, but $ had to come into the decision making.   

[matrips]

In our state, they have different rated levels of AL care.  We moved my mom to a level 5, the highest.  You paid by which level you were (how much help you needed). We didn’t want to have to move her again, and this one could continue into memory care or hospice.  At the end, she didn’t meet even the level 5 requirements to be there, but since she was on hospice they let her stay and the staff took extra care of her.  So if you are looking at other places, you may see what level care they can provide should he deteriorate over the next years, and can they/will they handle it.