The care coordinator (social worker) at the hospital helped get approval for my MIL for rehab. She was wonderful. Even if your MIL isn’t currently in the hospital, if she was recently admitted and discharged, maybe the hospital social worker can help?
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Mil is currently in the hospital. The PT who recommended she go to rehab was the hospital PT.
I don’t have a ton of information but I know my husband and he is not one who is very forceful.
My husband is also not the medical POA, his brother is. My mil is in pretty good cognitive shape, at least she can fake it at this point.
I recommend that MIL advocate for herself about going to rehab if that is what she wants. I’m sorry that your H and BIL don’t see her current condition and predicament as you do and what may be best for MIL. I was in a similar situation with my FIL. H and BIL did not believe in “interfering” in FIL’s situation nor would FIL ever listen to sound advice.
Just like parents advocating for their children, I advocated like hell for my D when his vascular dementia caused so much trauma in the last 3 years of his life. It definitely wasn’t fun, but it was necessary since his reasoning was not there and I could not allow my mom to take on more burden than she could muster. I am sorry for all you and your H are managing. This is for all the other posters as well who are currently caring for parents locally or from a far. None of this easy.
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Just talked to my husband. It sounds like the hospital is not helping or helpful at all.
It sounds like they don’t want to work on getting mil a placement in a rehab facility.
The hospital sounds like a disaster and disorganized mess.
Local sibling is not around. He’s on his way to his daughter as she is having a baby.
Tomorrow there is a meeting, maybe they will have ideas of the services they offer
The neighbor found an assisted living facility that maybe they can go on a temporary basis. No one can do anything until the hospital decides if they will send my mil to rehab or not.
My husband says that he doesn’t want to put them in assisted living if my mil will be fine in 2 weeks. Right now my husband says she can’t get out of bed without assistance.
And yes, my husband is not good at any of this. It’s his parents and he wants to defer to them.
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If they won’t send to rehab, you can threaten to contest discharge and that usually makes discharge planner work more closely with family to meet patient needs.
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We had my FIL go to an AL for respite care after a hospital stay. PT came to the facility. He ended up moving into a permanent room in the AL after his month of respite ended. We paid a daily rate during respite care and a monthly rate now that he is a permanent resident. That might be worth looking into.
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Someone who can’t get out of bed definitely needs SOMETHING that is NOT independent living when discharged. AL or Rehab are possibilities, with PT/OT.
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I would address all the things that were incorrectly self-reported ahead of time. The best way to do so in your situation.
When you are there, you can reinforce the details. LIsten and guide. Make sure the medical providers have correct and current information.
It takes diligence to keep all health care providers properly informed and up-to-date.
Ultimately your dad wants your mom to have appropriate care - and correct information is essential for her to have the best care possible.
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No one wants patient and family to contest and make them do more paperwork. It can kickstart the org to get more proactive & cooperative.
When they were going to discharge my mom from in person PT/OT I told them I disagreed as we still had to work on making sure mom was as safe as possible transferring in and out of the different places here she was living and different vehicles. They extended and we worked on these issues.
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My mom is in a 2 week rehab herself right now.
Hospitals care about ADLs (activities of daily living) and rehab involves a minimum (usually) of 3 hrs of PT/OT a day. If a patient is deemed unable to cope with that much, they don’t qualify for rehab. How many of theADLs a patient can do independently or with minimal supervision determines what kind of AL insurance will cover or facilities will accept. Safety is not an issue. (If MiL can ambulate, insurance doesn’t care if it isn’t safe for her to do so). AL independant wings can’t lift patients, patients need to transfer bed/chair for example,all on their own or they need placement in nursing care,
Someone needs to tell the hospital the specific situation to which a patient returns. Does shehave help, what else is going on, are there steps (that inexplicably is always a question), and how many times have she or S.O. fallen. Hospitals only know what you tell them, and you have to tell them lot of times. Information never trickles down and often the most important piece is lost.
You don’t need to be mean or aggressive. Simply stating the truth of what you face is enough. Ask if they can stall. Ask if there are other choices than discharge to home; sometimes there are options available only if families ask.
Feel free to hand this whole post to those who need a friendly push. I have spent so. much.time in hospitals as someone’s advocate (oooh – ask if the hospital has a patient advocate’s office) and there is just no substitute for speaking up. Good luck with all of this, it is hard and challenging to be sure.
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My MIL is unable to do 3 hours of rehab a day, so she was admitted to a subacute rehab (skilled nursing) instead. That is an option when regular rehab is too much for a patient.
We were so impressed with MIL’s hospital. The care coordinator was a huge advocate for her, and the palliative care doctor made sure that she wasn’t released without 1) a workable pain management plan and 2) a safe place to stay. The hospitalist wanted to release her to rehab before her pain was under control, and the palliative care doctor, care coordinator & PT worked together to convince him that she wasn’t ready.
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our experience has been that the hospitalist almost always is focused on super quick discharge. Palliative care is is another good source of slowing it down and investigating options
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We had the “get him out quickly” experience with my brother. I learned from that. I typically stay out of it when it comes to MIL, but my nose was in her business when it came to the hospital discharge, based on that prior experience. I made sure that I got everyone on board and kept them on board. But I realize how lucky we were that the staff all were willing to help.
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This is just a reminder when elderly parents need skilled nursing after hospitalization: “Medicare Part A covers SNF care, but only after a qualifying inpatient hospital stay of at least 3 days.” As @greenbutton posted, hospitals may want to discharge quickly even if patients need more time. I learned that SNF does not like medicare advantage insurance. I was advised that traditional medicare patients are easier to place in SNF, even for rehab.
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Thanks, the hospital told my mil she could be discharged the day after she was admitted
I told everyone she needed to stay 3 days before she could go to rehab.
I was afraid that the advantage plan might be difficult to place.
@kelsmom with my mom, my experience was similar to your mil
That’s why I think we are perplexed by the treatment my mil is getting at her local hospital
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Wow, I am really surprised about the hospital’s initial proposal to discharge. It’s truly pathetic. Can you share which state this hospital is located? This is for my future self of avoiding the state if I never need medical care.
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Yes, my mom was in hospital for many days and needed skilled nursing at discharge because she was extremely weak, much weaker than she had ever been. She was never able to get stronger. The skilled nursing was helpful but by the time she started it she was sadly way too weak to get much benefit. She still needed 4 trained people to help her get to the toilet and help clean her up.
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We have a good friend in hospital (with Tufts plan, I think it is Medicare Advantage? - in Massachusett) who will need a post-surgery rehab stay of tbd length but possibly long. Retired, no spouse or kids. The extended family thinks best rehab location would be near them a few hours away in another state. Not sure if that is even possible but would appreciate any suggestions.
It’s good to have suggested rehab options but it all depends on the availability in each place. There are definitely pros and cons of having the patient move closer to family but it can be disorienting to leave an area one is more familiar with. No easy answers, for sure.
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I have heard, but I have no idea if it’s true, that if you say you are worried about “the fall risk,” hospitals are likely to do better things. Apparently there are key words in dealing with all of this stuff.
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