My mom has fallen twice this summer. In late June she broke her knee and required a knee replacement. We were livid when she insisted to the hospital staff that she be sent home (she and my father live with us) instead of to inpatient recovery as we are already dealing with my father with Parkinson's and still have kids at home and both work full time. Fast forward to late July and she cracked her pelvis and they discharged her home again this time from the ER. They essentially had her waiting at the curb when I got to there. Since she has been home she hasn't been able to leave the bed for pretty much any reason and seems to be getting worse instead of better. I am trying to determine if she insisted on being sent home again but should have been in a facility.
For the present moment, call mom's PCP for immediate advice about her condition worsening, and see what's suggested for rehab?
For the long term, you really need to consider placing both of your parents in long term care now, together...........they both require a level of care that you're unable to provide for them as at least your mom needs 24/7 caregiving. I don't know what condition your dad is in, but Parkinsons Disease often reaches the point where 24/7 care is also required. In home care is often not feasible for two parents with this level of need, with you working, and also having children who require your attention. It's too much. I had to oversee my parents care in Assisted Living (and then Memory Care) and it was almost a full time job, in and of itself! It went on for 10.5 years, too, and took all of my strength to manage. If I tried to do it in home, it would have literally killed me.
Wishing you the best of luck with all you have on your plate.
The next time she is hospitalized, you start working with the discharge planner on Day 1. You tell them " no, she cannot return to our home; it would be an unsafe discharge."
Start with your primary care doctor or maybe even the orthopedist, especially if they have a social worker to see if they can help get her admitted. If not, contact Medicare ASAP and appeal that she was discharged too soon. I would hope someone there would look at a knee replacement followed that soon with another fall resulting in a cracked pelvis would warrant an appeal that she had not totally recovered. Rehab is less expensive than hospitalizations for repeated falls. The least I would hope for is some kind of home health since she obviously can't leave your home. I'm thinking time would probably be of essence so work as fast as you can to call everyone you can to try and get her case evaluated. I think some issues need to be addressed within 30 days.
If perhaps your father is a veteran, at least check into benefits such as respite care for your father (I get 14 hours a week) and aid and attendance for your father and spousal aid and attendance for your mother.
My heart goes out to you as your plate is flooding over.
you but a year or so ago my Mom fell broke her wrist and cracked her pelvis. She went to rehab for about two weeks after hospital. They had her up using a walker. I went into rehab before her discharge and was shown what she could do/couldn’t do etc. by the PT. The PT told me that if my Mom stayed in bed she’d never walk again. She needed to be up and moving every day. I bought Mom home, she did at home therapy and in 12 weeks she was healed. A year later she broke her hip and same story there. Hospital, rehab, home with at home therapy. I cannot imagine her coming straight home after either of these injuries. I would definitely contact her primary doctor and/or her orthopedic doctor. In my opinion she needs therapy. Best of luck to you!
Is there some way for her to private pay for NH care until the fracture heals?
Have you ever consulted an eldercare attorney about Medicaid?
Your parents' needs clearly outstrip the resources available at your home.
You may need to have a tough conversation with them about the fact that you can no longer do this.
Alternatively, some folks take a "therapeutic fib" route-- we're going on vacation, the house needs to be fumigation, it's temporary for a month, for the winter-- and get their parents into care that way.
For me, we can only get PT at home if we have not gone to an office for PT for the same "illness". Once PT comes to the home, the first thing they will do will evaluate her. Don't expect much from the first session for her. However, from that first session, they should be able to tell you what they they can do and what she is capable of.
P.S. Walking in this case, means walking with a device like a walker or a rollator.
P.P.S. In my case, my Mom refused to do the exercises on her own. Hence, I worked with the PT to figure out what kind of interactive exercises we could do together. Doing exercises together helps you get stronger too.
Emergency or Acute care is just that. It is not recovery care for the time it takes broken bones to heal.
Treatment for # pelvis is usually conservative management - meaning CAN move & walk as tolerated. Bones will heal in time. (But due to pain/fear/fralility many will stay in bed).
Once healed, physio may be useful. Often done as outpatient in community (or in-home if insured for).
If unable to self-care at home, then stay with informal carers (ie family/friends). If none available, then inpatient formal care instead (may be called respite care or skilled nursing where you live). Then, once bones healed, either inpatient rehab or direct home.
For your situation right now: You weren't to know this would be too much. But if it is, speak to Mom's Doctor & arrange a new plan asap.
Where is her primary care physician in all of this? What does he suggest you do?
Is she well enough to tell you her side of the story as to why she didn't want to go to inpatient recovery? Could she have misinterpreted a question someone was asking her?
One option is to take her to the Emergency Room of a hospital. Tell them what happened and that she no longer can leave the bed and that you want to know why. If she gets admitted, make sure that she is not admitted with "observation status". Medicare will NOT pay for "observation". Otherwise, Medicare will pay for some number of days with 0 co-pay.
Come up with a care plan for your mother with the social worker at the hospital. It might include some time in a SNF. I believe Medicare will pay some amount for care at home if she opts not to go to a SNF and still needs medical care.
At this point, it doesn't matter if she insisted on going home or not. You need to deal with how she is now and what future action needs to be taken. The ER has all the records from the previous visit. At the ER reception area, make sure that they have all the approvals they need to share her medical information with you.
As a caution: There are a lot of confusing, contradicting names of medical facilities. Emergency Care at an Urgent Care Center is NOT the same as an Emergency Room in a hospital. In addition, ensure that wherever you go, they accept your Mom's insurance. Not all places do, even though they have an area called "Emergency".
See All Answers