aj6044 Asked July 2022
Mom broke right ankle, right femur, and left ankle. Any advice about 24/7 bed care?
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Yep you read that right. Two broken legs.
Mom will go to a short term skilled nursing facility for a few weeks until her bones are somewhat healed and then home on 24/7 bed rest - no hoyer lift transfers until her femur heals.
What advice do you have for 24/7 bed care? I have purchased a pure wick, disposable bed pads, pressure alternating mattress pad, and a bed bath kit.
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Get carers in twice a day (or more) if mom has funds - you will need to keep up your own strength/nutrition/rest to manage in between times. Learn from them by assisting a little so you can cope by yourself if necessary.
Purchase some 'slide sheets' to save your back, install a baby monitor, and create a space (or nearby room, cupboard, etc.) as makeshift kitchen and for cleaning supplies so you aren't running around all the time.
Continence pads might be advisable, at least in the short term.
Over and above her injuries, this is a precarious situation requiring considerable attention and vigilance for the physical and mental impacts (for both of you) from being bedridden. Some physio might also help (if funds extend that far) to maintain condition of the unbroken bits as well as monitor rehabilitation/healing as muscles will atrophy, joints stiffen...
Hope she is patient and cooperative/understanding.
To me that's the best and safest way to recover from those kinds of injuries. When my father broke one hip, then the other one a few years later, those were always the routes we took.
During the last days before discharge, we worked with the social worker(s) at rehab to get home care. It wasn't as thorough, but it was adaptable, and very helpful.
A social worker in rehab can also work with you and then arrange for in home equipment that might be needed. During our first go around, the PT and OT folks came to the house, did a visual assessment, and made suggestions on what else could be done to increase safety.
Being on Medicaid was mentioned but that is health and in home care, right. A LTC stay may need to be applied for. This you can run by Moms caseworker.
Rehab and Medicare. Riverdale's Mom's secondary insurance must have been very good and covered what Medicare didn't. First, the 100 days that Medicare allows is not guaranteed. The length of Rehab is determined by how the person is progressing. If the person hits a plateau, Medicare will have them discharged.
Medicare pays 100% the first 20 days. The 21st to 100 is only 50%. Your secondary insurance may pick up the balance fully or partially. In my Moms instance, 6 yrs ago, she paid $150 a day. When admitting Mom to Rehab the financial office should have gone over this with you.
You may want to give this a little more time to see how Mom progresses. Taking care of someone bed bound is not easy.
You need to impress upon the staff that she be moved from side to side at various points of the day in order to attempt to avoid this happening. They can come on very quickly. You also should have a special mattress. It is extremely difficult for bedsores to heal in compromised patients.
I also question whether you should take this on should she become better. She should have the 90 to 100 days of Medicare in place. I forget which it is but it is around that. My mother had that and we had no bill for 3 months.
Ask them to teach you what to do.
And I bet you will notice that her care REQUIRES 2 people. So you will need another set of hands when/if she goes home.
There are ways to change a person in bed but it does require rolling them from one side to the other.
Side note the purchase of an alternating pressure mattress might not have been necessary. The doctor can order that it is considered DME and is covered. And depending on other conditions she has if she qualifies for Hospice then Hospice will provide all the equipment and supplies that you would need as well as having a CNA come to help several times a week. And the CNA is able to teach you the in's and out's of care.
Just managing toileting for a bed bound patient with NO recently broken bones is hard to plan for, and it may be completely new terrain after the pain of her injuries, the shock of treatments on the broken bones, and the initial incident.
Are you open to at least considering an “extended” stay in a care setting. Depending on the geographic area and the finances that you’re dealing with, that may be easier said than done, I realize.
In fairness to you both, though, you may need more information to face the circumstances you’ve got in the fairest way possible for you both going forward.
"No hoyer lift transfers until her femur heals"? What are you going to do?
From past posts, your mother is on Medicaid. Why isn't remaining in a SNF the plan post-rehab?
I'd suggest spending 24-48 hours rooming in at the NH (or spend 2 full days, depending on whatever visitor restrictions allow).
This will give you the opportunity to learn some tips from the staff re positioning, turning, clean-ups etc. To see what & how much will be involved.
Then you can gather what you need for home, equipment + set up home care aides - you will need respite break windows of time to run your own home/meals/bills/life.
Keep the skilled NH bed option open as long as you can (or ensure you can re-open it).
Remind yourself there is no shame at all in saying, No, I don't think this will work. Mother will need to stay.
Two broken ankles and a broken femur will take a long time to heal, and surely she will be bed bound for a long time. My BIL broke a leg in the late stages of cancer, and he never left the bed again. You are making preparations for her coming home, but how long is she expected to be bed bound? Does she have the finances to pay for 24/7 home care long term?
Was the accident alcohol related? How stable will she be when she has healed as much as possible? Will she be able to avoid another fall, particularly if she wants to return to drinking?
Most people in your position (at least with an elderly mother) would decide that this is the time for a NH. It might be worth looking at the options for if the return home proves to be too difficult. Good facilities can have a long waiting list.
Never mind. I'm so sorry to hear that this has happened - how doesn't really make much difference, unless she's likely God forbid to try that again!
I wouldn't buy anything or decide anything now. How many weeks is a few, and what's the plan for reviewing her progress/recovery?
Poor love, how is she?