Mom (82) just broke her hip.

She was probably let go from rehab because she refused to participate. Please don't feel guilty, you have done all you could. Stay away from the Nursing Home until she is settled in. I would still call daily for progress reports, and ask if they think she is ready for visitors. Usually that takes 2 weeks. (Been there, Done That)

This is too long but I'm not holding back because I am living this myself and it's hard to get answers...ideas...advice. I love this forum!

My parent is 88yo and spunky-but not downright refusing efforts to rehab her hip surgery after her fall in her home. She is very tired of the 'assessments' and scrutiny after a month, plus structured wake and meal times, waiting on someone to go to the bathroom, so so many frustrating pieces. And my mom is not compliant but typically with medical people she is...and she is struggling.

YOUR encouragement and concern helps even if she seems to not be affected, she is. They need to vent and not get hassled with every complaint. Losing all control over your own life is a terrible process and I can't blame your mother for responding poorly. Mine has been on her way to dying a couple of times over these places and trusting them...I would not leave her to anyone else's care without continual oversight and presence. she must be freaked out and scared to death...you are her hope for a future so don't take it personally. she's overwhelmed. and it is her life and you cannot save her. just turn to others in the same situation or contact the churches or senior centers for support, help, ideas.

My parent was neglected and lost a month sitting in rehab recovering from new issues the facility caused by not watching her closely enough. She ended up in the ER and then we moved her to a new facility. EVERY FACILITY NEEDS YOUR OVERSIGHT of your loved one...they care, but they herd everyone here and there without a lot of individual needs being tended to. The staff will abandon your parent on the toilet and go smoke or talk for 30 miniutes (this has happened at both facilities), They scold your parent basically for backtalking and twist things that happened to their view rather than trying to negotiate a reasonable answer and then report it as being argumentative or combative. . It's really a tough deal because we CANNOT do this from our homes, and these facilities have so many people to deal with they just get hardened to an individual patient's first experience in a facility. They are numb to complaints and fears so your parent is ignored or overlooked and it's quite hard to just shut up and take it, I'm sure.

So here are some common issues to watch out for::

1) Bed sores from not moving around on the mattress every 2 or 3 hours and then the sores not being treated quickly and consistently so the infection grows deeper. She needs air on all parts of her body or they will develop and take forever to heal...months.. Mom developed a new sore at 'the good place' on her heel...who knew. Now she has 2 sores to overcome. They use salve and monitor it closely. Family member HAVE TO SHOW UP or it's likely she'll not get moved often enough. She may developed sores despite your best efforts but if the staff knows you are watching you are their supervisor in effect and you will get better care.

These places quickly learn who is watching over what they are doing. Your money spends anywhere. Make sure you ask her if her tail bone is sore - if so, it likely too late but at least you know when to start asking regular progress questions. You cannot let the facility take the lead - it is a business first and no one cares for a loved one like you will.

2) My mom was a diet controlled diabetic when she went in and they immediately put her on insulin after an incident where she hadn't been eating often enough so they didn't have to deal with that. Fine. But it's now very likely she's stuck on insulin rather than doing what her diabetes doc taught her. Just frustrating for her.

3) They put the patients on oxygen and then hopefully can wean them back off. After surgery Mom did not properly rehabilitate her lungs because of the faulty care, despite my telling them she needed to do the breathing exercises. She developed pneumonia and fluid in her lungs. So of course she had no capacity to exercise for her rehab. That spirometer blow thing is huge after any surgery of course, and even WEEKS after and at the new rehab place I took it in and they jumped on it and told her how much it would help her lungs and had her use it 10 times a day (or I heard at every commercial break) to help rebuild her lung capacity, keep the fluids out of her lungs (which leads to congestive heart failure), and likely decrease the need for the canned oxygen. Their lungs get lazy when the oxygen is just right there, and they leave her on most of the day so she never has to breathe deeply on her own. And when she feels light headed she just grabs the oxygen instead. We're hoping that spirometer blow thingy from the surgery rehab will do the work to wean her off the canned oxygen.

Understand this...the rehab place (or nursing homes or whatever) is an institution. Mom had a mean therapist the first time and it was hard AND embarrassing to fumble around after surgery. The 2nd rehab facility has a great therapist and he encourages her so she's progressed beautifully. The attitude of those working with her is key, too. Monitor them sometimes, show up and watch - they cannot stop you :) You are paying for their services..never forget that. Your mother is NOT a number, she is your mother. Keep telling people your story..there are plenty of others in your shoes and you will find the ideas and support you so obviously desire. Follow your heart, I say.

My mother had 100 days of rehab paid for by Medicare...you can move facilities for a transport fee...find a place that works for her if this new one does not. You deserve the peace of mind and she deserves a chance at a full rehabilitation. The doc told us 3 weeks for Mom and with all the new issues she suffered it's been 8 weeks, but it does look promising that she will return home. So it CAN be done. Don't feel guilty, just do your best. Find some young teens to visit with you - that's how we have gotten by the physical aspects of her care. Even just lugging the wheelchair when we break her out of the facility on the weekends (just ask them if she can--that can be a goal for her and reason to get better). But also, never quit. It will get better, you needed a break so take it. I do a lot on the phone, too, because I can't physically get to her with kids home. You will figure it out, or just ask a new question :)

So, step #1 is to NOT pick her up from the hospital at discharge. The hospital should assign someone (a social worker) to coordinate your mom's transition. You are within every right you have to say you are no longer physically able to do caregiving. The discharge coordinator owns finding a place for your mom to go. Ideally a place that can just reclassify her at the end of the rehab period and not make her move to another building somewhere else. A place that does both rehab and LTC.

Mom has to go somewhere that is good for her, which may no longer be home. Don't expect anybody to volunteer to go to long term care, but sometimes it is the only thing that will get the patient and their family members through. It's been a God-send in my family.

My mom would not cooperate with orthopedic PT when she was 45, so it was no surprise she wouldn't cooperate after dementia set in and she was 75, so she never got the full covered benefit of the rehab period. She is now immobile and it takes at least 3 people to maneuver her in/out of bed, using a lift. She can't even scoot herself up in bed because her muscles have atrophied.
She was from an era where you stayed in bed until you weren't in pain anymore and that is the level of rehab she was willing to do (which is no rehab!). Now we know that is the WRONG thing to do, but she's not having it.
She always refused to push past the pain that is part of PT.

You have to look at your life and decide what makes common sense here and what can be done in the real world vs. what everybody wishes could be true.

Hugs and best wishes for this because it's hard, it's not pleasant, and it's never easy on any family. All you can do is your best and remember to take care of yourself!

Lisa, screw the guilt. Your mom is ever so lucky to have you. You will both be much happier with mom in care. I went through hip replacement, and rehab with my 84 year old mom. It sure wasn't any picnic but she was lucky to have a good bone doc and the rehab folks were good. Read all the above responces. There's some excellent advice from those folks. You'll be fine.

Well, I wrote that prematurely, she now has new fractures on her leg. It would take an idiot to see that her legs are atrophied, I think her days of walking are over. I hope I'm wrong but now she's saying she doesn't want the surgery! OMG lord help us.

Lisaiuv, please respect her decision not to have surgery. There are bigger problems now, if she is getting multiple spontaneous fractures, have a long talk with the ortho man and keep her pain well-controlled.