Brunswickborn Asked July 2017
How do I get my husband to willingly go from hospital to skilled nursing home for rehab?
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He is insisting he can come home. But to be home he needs to be able to get in and out of bed, transfer in and out of wheelchair and independently go to bathroom and take care of toileting needs. He is so angry that I think he needs to go. For the past two weeks he has been refusing PT and OT. So this is where we are. He is weak. It is creating a big chasm in our 48 year marriage. BIG!
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About 5 years ago I discovered one which we both liked, and have been using that as the need arises post hospitalization. The last two stays were a bit different, and the last stay was just not of the same caliber as the earlier ones. Some areas of support remained excellent, but the direct medical care had clearly deteriorated.
The nurses were less available, not particularly friendly; the speech therapist was still great as were some of the aides, but the physical and occupational therapists actually seemed somewhat hostile and annoyed that they had to work with my father. He's an easy going guy, and will push himself to meet their demands even if it wears him out.
The PT was in such a hurry one day that she shoved the transport wheelchair into and nook and scurried out. When my father got up to walk, I jumped up to follow him and fell over the wheelchair's extended leg support. That should NOT have happened, but the therapist was in such a hurry to get back to the little work out area that she became sloppy.
I noticed these last 2 times that there seem to be a number of changes in administration, and the new people are younger, in their 30s or so. Other than older CNAs and the physician, I didn't see many staffers over 40 or so.
A friend and I were discussing this today and comparing observations. She noted that unlike in past years, there are an increasing number of people from about 50 to 70 and less 80 and 90+ year old patients.
This facility has boasted in its literature that it provides quick turnaround for rehab. I did learn sometime ago that it is their goal to get people in and out as quickly as possible.
The first rehab facility where we took my mother wanted her to stay until the 100 days or so were reached. The one where I've taken my father was ready to shove him out after about 3.5 weeks, even though neither of us thought he was ready. And in fact he wasn't. In retrospect, I think there's some negligence on their part in forcing him into a discharge before he was ready, but I'm not going to pursue the issue; I'll just take him elsewhere, and probably let them know they've lost a long time customer.
So, if he needs rehab again, I'm taking him back to a top notch facility in another county, with close proximity to a major teaching hospital. That was the best place he's ever been.
Freqflyer , I sure hope he finds that he likes it there. I am so emotionally spent.
GardenArtist ,. I was under the impression that you had to go straight from hospital to rehab or it wasn't covered. Anyway that is what I had already told him. Oops.
Jeanne,. You are right. Those are exactly the tasks that I told him he had to be able to do before coming home. He was having some strange uncontrolled movements of his arms and legs, so I took him to ER. But after we arrived and were back with the docs in the ER, he had a heart attack. A couple trips to Cathe Lab, gout that settled in his knee and then the entire leg became swollen, plus Kidney problems. If it wasn't one thing it was another.
Cdnreader , thank you for your suggestions. Our doctor was so kind and gentle with him. And for yourself, do not place blame because you know you did the best you could. Forgive yourself for not knowing more at the time. Remember using hindsight to judge the past is a bad idea.
All of you have given me hope and shown me compassion. Thank you.
I'm not certain of this w/o checking my notes, but a hospital discharge planner could tell you what the time limit is on going home but then going to a rehab facility. It might be 3 days - I'm positive this was discussed during the last hospital stay but just don't recollect specifically right now. Perhaps someone else here does.
The problem I see is that he's refusing PT and OT at the hospital, so he's not cooperating. If he even would agree to go to a rehab facility and won't cooperate, they can't and won't keep him.
You're facing a real dilemma, as you're battling denial by your husband. You might even have to get sick a few days and not visit him so he can think about how he's going to be able to get around at home. If you're helping him at the hospital, start backing off and let him rely on the nurses and aides.
Lastly, let the doctors and nurses help you convince him. They can be much more firm with him, and even if he won't listen, at least he'll be directing less anger towards you. Second lastly, you might just have to put your foot down and make it clear you can't and won't attempt to take care of his complex needs alone and w/o help.
I wish you luck; this is a challenging and frustrating situation to experience.
Be clear with the discharge planner that you cannot care for him in your home until/unless he can get in and out of bed, transfer in and out of wheelchair and independently go to bathroom and take care of toileting needs. Obviously given the length of your marriage you are not in your forties yourself. Taking on those physical tasks is out of the question. Be very clear about that.
What put your husband in the hospital?
I hear you. No one wants to admit they need help or they can't do it anymore. Of course we all want to go home, I would too. But it sounds like this is not safe option. I wonder if the doctor, nurse or a social worker could talk with your husband. Maybe he would more willing to accept this information from a third party.
I brought my dad home after his stroke. I tried to the best I could but in hindsight, I feel like I caused his death. He was so stubborn. I would just back off to avoid a fight with him. But in hindsight this wasn't best for his care.
Sounds like he knows if he refuses, that after 21 days he will be sent home. But he is his own worst enemy by not doing the physical therapy and occupational therapy.
Might be time to hire caregivers to help hubby. He won't like that, but it would be difficult for you to try to transfer him to his wheelchair. If you got hurt, then what?
My Dad, after having a heart attack, my Mom refused to let him go to a physical therapy rehab center. Oh no, she said she could help her husband. Well, Mom was in her 90's, and she found out rather quickly there was no way she could pick Dad up when he fell, or be able to help him out of his recliner, and Dad had to sleep in his recliner because he couldn't do the stairs to the bedroom. Mom slept on the sofa. It was a very slow recovery. Mom didn't even want the physical therapist into the house, especially if the therapist was a young woman.... [sigh].
Next time Dad had a health issue, Mom was all in favor of having him go to rehab. Dad actually liked it there. He got excellent care. Enjoyed the food. Mom didn't visit much as she didn't like how the placed looked, well yes there will be people in wheelchairs, etc. This isn't a resort hotel.