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Small details-- grandmother (86) fell broke her shoulder, before that she was independent - not really many health problems (usual aging decline) but did everything. Has arthritis. she came down with UTI and dehydration and that triggered inpatient stay- from there two weeks rehab in hospital (some days she did ok, others not) now she's at rehab in NH. I am hoping you can share some injuries and success stories. She just got there yesterday from the hospital.


We did see an ortho before she was admitted and no surgery was suggested. She is so afraid of falling again its hard for her to want to do PT- our plans are to bring her home with us. My mother was her only child and she passed in 2016.


She is staying at NH for rehab.. praying for good results

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Wow. That’s a tough situation!
if you are her legal medical person- you have a lot of input!
all facilities have care planning requirements- Be vocal.
Communication is key here. Give information and listen to the plan. Question anything.
My mom fell a couple of times at home. she had to have knee replacement. She fell again and broke her foot and wrist. Refused to do the safety things we suggested. A hospital stay and surgery convinced her to do something different. I’m an RN and we were able to take her home with home health and me taking leave to care for her. She did fabulous because she did everything they told her to do- and we faithfully did exercises. We charted her progress. We celebrated small successes. A little praise goes a long way. She was also afraid of falling, so OT And PT worked with her and me to develop a workable plan. And she hasn’t fallen again, praise God! She has a medical alert system because she doesn’t want to fall again. She’s 84, lives alone. She has regained her independence with minimal assistance needed.
I encourage you to write out your plan, needs, expectations and care challenges for when she is discharged. Make it all a part of the plan for how she is treated now. Then you can do the follow up at home with home health PT and OT.
Bless you for what you are doing.
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tboudreaux1982 Feb 2021
That’s awesome to hear. How is she doing now ??? I’m praying for same results
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Hi Dear Tboudreaux 1982. I write from the patients perspective. Roughly 15 yrs ago I was diagnosed with Muscular Dystrophy, on top of that I have High BP, Type 2 Diabetes, Rheumatoid and Osteoarthritis, capped off with Early Onset ALZ almost 5 years ago. This time last year the Arthritis was getting terrible in my knees, feet, legs. My Ortho Dr prescribed PT 3x a week, this very week in 2020. The facility was .9 miles from our house. Easy to get to. Within 6weeks going to PT 3x a week for the first time in 20 yrs I was able to walk upstairs and down from the ground level one step after another and not using the railings. I continued on with PT until late June, when I was told that I had improved to the point they could not do anything more for me. I am in my early 60's. At the end of March, I'll have been going up the stairs as I described for a year. The two Therapists I had both had training in communication with patients with Dementia and always found a way to explain things to me in a way I could understand what I was to do. I was not a big fan of PT back in the late 90's I had a torn Rotator Cuff, I was prescribed PT and it did absolutely nothing for me. The two therapists that worked with me were exceptional. I've been doing the PT at home 3x a week since late June 2020. Family and friends have been amazed at what I am able to do for myself.
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WendyElaine Feb 2021
Wonderful news!! Thanks for sharing your progress.
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She has been in mostly good health and handling her own affairs, so that is a big deal when coming out of an injury like that. The UTI after an injury and/or a stay in a facility is quite common. Many people will think their loved one has had a stroke or other issue because UTI can cause total change in behavior - crazy talk, unable to really hold a conversation, accusations, etc - totally out of character for them. For some odd reason, it's common for facilities to overlook this problem in regard to running a simple test even though they see the problem every day. A friend told me about it years ago and I've told countless people to have a loved one checked for it when the behavior changes came after an incident or a move to a facility. (I'm no medical expert, but I still think it has something to do with these patients needing assistance to pee and being put off for way too long.)

Not sure if you can get in to the facility with the covid rules in place, but if you can go and observe her going through the PT sessions. Make a mental note of time she spends on each machine. Later, ask someone about her progress - look at the notes to see what is recorded there. Often what it says is no where near what's really going on timewise. If you can't go in, you won't know how much progress there is until you get her out. Make sure the dr orders home therapy to keep things going.

Most important!!! Find out if they have slapped a diaper on her while she's been there. If they have, start talking with the director about 'bathroom training' to get her going to the toilet again. Be quite firm in letting them know she didn't come to them that way and you don't want her to leave in that condition. You are really retraining the brain to say it's not normal to go to the bathroom in your pants. It's pretty common for people in facilities to end up in a diaper - short on staff, the ones who are at work have too many patients and helping people on/off the pot takes a lot of time, patient can't wait 30 or more minutes and they end up having an accident. It doesn't take long for the brain to say - it's ok to pee while I'm sitting in the bed. They CAN help her to reverse the problem and they should.

Been through all this with a parent - broken shoulder at 83, compression fractures of spine at 91. Although she could walk quite well on the walker at 91, she was considered improved and leveled out on progress with PT - discharged to me in a diaper and in a wheel chair. It took me about 6 months to get her walking with walker again without having to hang on to her as she walked. It took me about a week to end the diaper fiasco - when she called for help, I was there. Back to toileting on her own. As a note, I complained because (1) they dropped her on first day there and (2) she was given the wrong meds on 3 times while I was sitting there w/her. No telling how many times it happened (to her or others) when I wasn't there. Day before the last complaint, she was to be there at least another 2 weeks. Day after I complaint, she had leveled out on her progression. I started to fight it, but I knew she'd be safer coming home.

She can come out of this! Continue to encourage the exercise even on days the PT person doesn't come. As she becomes more stable, fear will ease up. May not go completely away, but that can be a good thing. Might keep her off a step ladder if she was a former climber! Best wishes to both of you.
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tboudreaux1982 Feb 2021
That is great information !!!!! Yes they have a diaper on her !!!
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Let rehab do their job. I have done clinicals as an RN in NH/Rehab facility. She will get a couple physical therapy sessions every day to strengthen her injured area and address her mobility issues. Physical therapists can also address her needs for mobility devices and train her in their use. It is much harder to do this at home, even with in-home physical therapy.

If she has other issues that led to her fall: dehydration, possible malnutrition, possible hygiene difficulties... they can be addressed while she is their client. Please allow them to do their job BEFORE taking her home. The assessments, insights, and plans to address her care needs will only help you when she is ready for discharge.
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tboudreaux1982 Feb 2021
I don’t plan on bringing her home until she’s better - I did not mean to sound like I’m rushing the issue !!!!! I also work in a hospital for 18 years I just was looking for stories
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omg thank u so much for sharing and asking! Going thru similar; my mom (83) broke her hip, she was in rehab becuz she had lost strength while in a previous hospital stay.
While she was there she was doing great! She was able to walk on her own again after 2 weeks (with walker) - but she thought she had made so much progress that she kept getting up by herself. At first of her stay she did it 2x and fell both, both times no one was there to help her up! She managed to do it on her own... but was badly beat up. She finally stopped, and actually put effort into her therapy and was getting better.
I think it gave her a false sense of security? Bc last Saturday, exactly 1 week ago today, she got up and fell, had to try and get herself up again and fell once more, breaking her hip 😢😓

She had surgery last Sunday. BUT she hasn’t been able to do much rehab because she had a horrible reaction to the pain meds... did/are they making your mother confused or making her sleep too much?

My mom was basically unconscious, we changed the pain meds, but could not wake her up except when she was in pain or moved etc... they took her off all pain med, she was still confused sometimes but she was awake and able to talk like normal (her mental facilities are at least 95% usually). Then yesterday she was again almost a vegetable, unconscious like cuz they gave her pain med -it’s a very low grade pain med so they thought maybe something else is doing this but I called first thing this morning and she face timed me; she’s still confused but she’s awake. I think meds must be slow to get out of her system or something, she’s so sensitive to meds cuz she never took them until she got older (literally, she rarely would take even an aspirin if she was in pain)..
they checked to make sure it’s nothing else but they took her off it again yesterday and today she’s mostly back but I’m so scared she’s gonna go back to what she has been like; it was like I lost her totally and it’s more terrifying than I realized it was gonna be and I already knew it would be horrific :(
I’m her sole caregiver and it’s so hard - but this has made me realize I don’t mind; even though I know when it’s time again I’ll probably forget how much I currently long for it. I feel guilty admitting but it would be kind of nice to have a week off if I knew she was okay, but anyway! I just want her home and not falling; if she can’t do successful rehab I don’t know if she can live here because she is determined to walk alone even when she is dizzy and unable to; she won’t call for help most of the time.. I fear if she comes back strong she may fall again and hurt her hip or break the other one but it’d be less likely. I’ll just be a nervous wreck all the time but I am anyway lol. That said, if she came back still weak It’s only a matter of time... I don’t want her to be in this pain again... bah.

sorry for sharing so much especially given I have yet to know myself if it’s gonna be successful; I’m really scared she’s not gonna try because of the pain (impression she gave on phone this am - I’m stuck at home and she’s stuck there now that she’s awake due to snow storm)... I just thought I’d share if you ever wanna talk to another going thru it, I’m here... I know there are tons of amazing ppl here, I’m not amazing but I do care and understand 💖
Sending Hugs!
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tboudreaux1982 Feb 2021
I feel the same exact way and my Mawmaw was very sensitive to pains medication too. Did your mom fall and break her hip twice ? My Mawmaw is doing Rehab but she’s so afraid she takes a long time to do it. Her shoulder break been 5 weeks but I see it take a long time to regain strength my Mawmaw was so independent
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My mom is 96, she still wants to remain in her home. She took several falls and now she has been in physical therapy for about 6 months. They tell me she has plenty of strength in her legs, it's her fear of falling that keeps her from walking. They put her on a Nu Step machine, started her on level 1 and now she is on level 4. About 4 months ago they gave her treatments for sciatic nerve pain and she no longer asks for her pain meds. Progress is slow, but I had to take her to her therapy in a wheelchair back in October because she couldn't walk, now she is able to walk short distances with assistance, so I would say that is very good.
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tboudreaux1982 Feb 2021
Thank so much !!
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Mum 86 had a knee replacement in September 2020. She was very good about doing her physio and has had a fantastic recovery.
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tboudreaux1982 Feb 2021
Thank you !!!!
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I do have good stories, and in fact my brother was very much helped by PT with balance issues. The problem on discharge from it was he didn't keep up on balance exercises and it became a bit of a "control struggle" for all who attempted to get him to do so.
But the truth is that our own success stories are unlikely to have much bearing on your grandmother. Her own story will be hers, and will be dependent on so many things that add up to a whole. I sure do wish her the best of luck.
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tboudreaux1982 Feb 2021
Thank you
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Your poor gram. How did she fall? Is it something likely to be recreated or is her extreme fear of falling a little irrational?

PT is very important. Or she will lose a huge amount of functionality which would likely reduce her quality of life, etc. Hopefully she did some of the hard work in the rehab. Those are the best places to recover from an injury. The rehab in a nursing home is usually only a fraction of the amount that you receive in actual rehab. I say this due to my mom's experience after 2 knee replacements.

Think hard about moving her in with you. Of course, you love her and want the best for her. But providing long term care for someone is very difficult. Especially if they are not willing or able to do the work needed to get better. Where was she living before the fall?
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tboudreaux1982 Feb 2021
she lives 5 mins from me. when she fell she said she lost her balance and tripped which could happen to anyone. i dont expect her to be back to before the fall but i was wondering how do they gain strength and confidence when they are so scared.
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Maybe we were unusual but it didn't take a whole lot of effort to see improvement in stability for my mom, and the exercises were dead easy - seated marching and seated extended leg raises (I believe there was some holding for the count of 5 with these), some ankle range of motion exercises and mini squats while holding the counter or the back of a chair, as well as practising getting up from a kitchen chair.
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tboudreaux1982 Feb 2021
is she back at home or staying with you? did you continue at home? my grandmother lost strength laying in hospital bed 2 weeks.
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