I have one friend whose dad, in his mid 80s, broke his leg last winter. He was kept in the rehab facility for at least 2 months, because he has some memory loss or dementia and the health care providers didn’t think he should go home until his leg was 100% healed; he couldn’t remember from day to day that it had been broken and that he shouldn’t be doing certain things.
Similar situation, although not the forced stay in rehab, for the mother of another friend; she hurt her shoulder or arm and didn’t remember that she had injured it, so kept doing things that were counter to proper healing.
It seems fast to give up on PT. Good therapists that have elder experience can be creative with ways to work around challenges; building confidence after an injury and learning how to participate in PT can take time. There may be value in trying.
As an aside, it sounds like your mother may have had a recent cognitive decline. We have talked a lot here about how infections, particularly UTIs that may be asymptomatic can cause confusion and decrease in ability to manage, even in elders without dementia. If there is a chance of this, it is worth evaluating.
Old Folks Home update:
MIL has been booted off PT again, they say that if she is staying there, she has progressed as much as she is likely to & if we move her to a care home, there could be maybe one more week of prep PT, cue billing of nearly $300 daily!
FIL has been adjusting to AL, the head of AL is fantastic, she is his new hero & he has forbidden us to talk to her. She & we agree that no one will tell him we are talking 
She got him set up for PT & told him no driving for now & he has to be evaluated by PT, she plans for PT & the home Doc to tell him no driving ever.
He was a ranting fool today, grilled and ranted to one son for half an hour, then called and left ranting messages for the other son, 1500 miles away, that he does not know anything about what’s going on (things the first son just told him!)
We girls are ready to tear our hair out, it actually made me cry today 
For me the worst thing is that he has announced he will take over MILs care & he was obsessing that I need to leave and go home, it was bizarre and urgent to him, we could not figure it out. Then we eavesdropped and found out he wants to hire his old caregiver to come in and help MIL (and him, of course) and that is why he was shooing me away, I am the one with MIL all day and I would see her if the caregiver came back. He wanted to sneak her in and not tell us.
The AL & SNF absolutely shut him down, it was a beautiful thing. That was great,
But I am both hurt and furious, he as told the SNF that they cannot tell me anything about MIL, now he did not think to mention DH, so we put DH on the call list. But I have been #1 contact person, have been there every day, have done everything for her including spending time with her. It is just mean spirited and once again, he is not thinking of her, he is thinking of him.
She was dropped on the caregiver’s day off, as he always dropped her on those days. That’s how she broke her hip. We had warned him about that very thing. He refused to let anyone but that one caregiver in the house because he has a crush on her and cross the line in terms of being appropriate.
Now he wants to cut all of us out of MIL’s day in hopes of bringing back his crush!
So, we have a 95+ man who is still, technically, competent and we have his wife, who is technically incompetent due to stroke. He will not do right by her, but we cannot prove elder abuse.
I wish there were a way to change her health POA, and I know she would sign on, but I don’t think we can make that fly & he is bad for her.
I am so frustrated today. I did not talk to him about it, not the right time, but before i leave, I will!!
Aurgggh Somemom. I understand the frustration and the pain your FIL causes. Glad the AL place is there and you are not just in the wind with someone who honestly is very irrational.
@travelnut, yep, had Mom checked yesterday for UTI, plus now that the RN sees her weekly, they are much more on top of it that the med aides were able to be. I think it is low blood pressure but could also be that she is catching whatever the caregiver had that kept her home with a fever. Hard to know, but good to know that I can call and get her extra help fairly quickly. The AL place doesn’t give me much status, never did. Hospice sends weekly reports and texts and also gives the caregiver girl lots of support.
And they raised both the rent and Mom’s level of care this month. ouch. $3799 to $3950 and another 400 for level of care. I need to sell something.
oldmom, thanks for the really great articles you post.
somemom, oh no. I get the hurt about being cut out, but genius move to get your DH on the call list. I wish I had some words of wisdom for you. Sometimes there just comes a point when it seems like nothing can be done. You all can probably develop work-arounds that will be effective for a while, but it seems like he’s just hell-bent on having his way and will get it, off and on, making things difficult for everyone around him. I’m sorry. (((( ))))
Regarding the getting-rid-of-stuff discussion a couple of pages back, my brothers and I recently went through boxes and boxes of stuff that’s been at my house for 5 years, and more boxes that ended up here when Mom moved to the board & care a year ago. It was actually a good time to do it; Dad died two years ago, and Mom is still with us, so we weren’t burdened with the emotions of a recent or impending loss. We got rid of almost everything except for a couple of boxes of mementoes of a very interesting section of my dad’s career. Some really cool unique stuff. I kept a few of Mom’s 1960s necklaces which I sent to D because they just might be retro enough to be back in style. (I told her if she didn’t like them, to feel free to donate them, no guilt.) Plus there are still massive quantities of photos which my recently-retired brother is going to make a project of putting onto electronic media of some kind. Hopefully. I just want them out of my house.
One category that was sticky at first was travel mementoes. Mom and Dad did a lot of travelling after they retired, and for example, there was an entire bag full of Greece items. Magazine articles and other pre-trip research, brochures from the travel agent, brochures and handouts from every place they visited, coasters from bars and menus from restaurants, postcards, ticket stubs, receipts for every purchase. Basically every scrap of paper which was generated surrounding the entire trip. Our first thought was, “We can’t throw this out, it means a lot of Mom,” and the subtext, “If we throw this away, we’re throwing away a little piece of our mother.” But then we decided that Mom’s never going to see it again, so then the question became, what does it mean to us? And while we enjoyed hearing about the trip and looking at that stuff back in 1992, it was her memory, not ours. So that kind of became one of our major filters: Whose memory is this? If it was Mom’s memory, we thought first about whether she’d ever look at it again. If not, we asked whether it was also our memory. In the case of the bag of Greece trip paper, it wasn’t, so out it went. In the case of Dad’s cool work memorabilia, it was – I vividly remember that job of his and how cool it was. So we divvied that stuff up between us. D may someday decide that that’s not her memory, and that will be the time for it to leave the family.
We also had her jewelry appraised, and the results didn’t surprise me, but disappointed her. She evidently believed she had a jewelry collection second only to Queen Elizabeth’s! Her pearls are excellent fakes, but they’re fakes. Her mother’s amethyst engagement ring is priceless as a family heirloom, but worth maybe $30 if we sold it. (Mom believed that because it was old, it was an antique and therefore automatically worth thousands.) She has an amethyst necklace and a lapis necklace worth maybe $100 each. The rest was essentially valueless, except for her diamond ring, which would go at auction for just about what Dad paid for it 30 years ago.
DH’s idea was to be brutal about tossing anything that can be easily replicated today, via the web. Eg, all sorts of travel-related info. Last weekend, D2 got me to throw out a few stacks of cooking magazines by reminding me I can go to the archives online. It felt good to let them go. Lately, I’m using the Japanese principle of thanking some object “for its service” and then getting it into the outside bin before I can re-think. (Even the library told me that what donations they can’t sell, they guiltlessly send to the recycle bin.)
I may have said that D1 had announced that, when the time comes, they’ll just hire a clean out service. (It was part of a former convo about my mother’s immense mess.) This came up again at Thanksgiving and the good news is that the few things I hoped they’d treasure, the girls do want. Eg, MIL’s and her sister’s good china. That alone is pretty reassuring. I was surprised that knowing they want a few pieces, after all, made me feel better about letting go of other things.
Oh my gosh, LasMa, don’t even get me started on the jewelry, FIL thinks it rivals Elizabeth Taylor’s and it’s huge, so guady, so no one wants it. The “investment” items bought in places like Aspen in La Jolla not NY or LA; and purchased in the scary times in the late 70s & early 80s when interest rates were high, gold was high, diamonds were high etc. Most things will be lucky to go for 10% of the replacement appraisal. And, of course, if we tell him that it means we did a bad job not that he is a sucker
somemom, your FIL gives me nightmares. My own FIL might be willing to do something reasonable, I’m keeping my fingers crossed. He is home from the hospital after a stroke, going to rehab 6 hours a day, 5 days a week. They pick him up and drop him off. 6 weeks out from a stroke he is, of course, prohibited from driving. This has been enforced up until now by a) him being in the hospital/residential rehab for 3 weeks and b) BIL “borrowing” his car for 3 weeks. The car has now been returned, I need to make sure tomorrow that the key has not been returned. Sometimes he “forgets” that he is not supposed to do things.
He refused to accept paid household help when MIL was home in hospice care for 15 months - 3 weekly visits from nurses or home health aids were the extent of the help he would accept, because Medicare paid for it. He tried to keep his kids from doing any work when they came to visit, insisting that he could handle everything. It was not pretty. Now that he is home alone, he has continued to refuse paid help, and SIL has been enabling him by stopping by multiple times per week and taking care of all household chores. She has finally had enough, and we have enlisted the aid of a neighbor, who likes FIL and is employed only part time now, and could use a little extra income.
We talked chores and pay with the neighbor yesterday. It was funny, she is almost embarrassed to charge for her time, and SIL is ready to shower her with money to take over some of the daily tasks. It really looks like an ideal situation - someone who FIL knows and likes, and who can come over in about 30 seconds any time she is needed. I hope this works for a while. I will continue to monitor medications, and SIL and I will continue to handle doctors’ appointments, and the other kids will continue to visit, but we won’t have to worry about whether he has taken the trash out or is out of food.
My only worry is that if anything happens to set him off ( something gets broken when she is cleaning, something gets misplaced) we will be back to square one. My mother would consider that kind of worrying “borrowing trouble,”, so I’ll try to enjoy the peace and not stress over how long it will last. But I do want to make sure about the car key.
update on the att&t modem with the target regular phone and $20 a month bill for local and long distance unlimited. it is going very well. it is just the right thing for my FIL -95 year old in the nursing home .it is transferable to another room by just a electric plug.
Ssshhhhhh…we spoke to FIL’s PCP about the adjustment to the move & he prescribed an SSRI & it was faxed to the home; I think they will add it to his meds & maybe he will have a chance to relax and lose the agitation.
No solutions for old age
https://www.bostonglobe.com/opinion/2015/12/07/solutions-for-old-age/nMYkUBhOOOPcWUIKRlHF7L/story.html
This is excellent.
Imagine a Medicare ‘Part Q’ for Quality at the End of Life
http://opinionator.blogs.nytimes.com/2015/12/09/imagine-a-medicare-part-q-for-quality-at-the-end-of-life/
Medicare Part Q is such a good idea. And patients who are never offered the treatments of dubious efficacy, extreme cost and nasty side-effects are not going to miss them.
It’s optional, for those concerned about death panels. And it would save big bucks.
I’m dubious about the saving big bucks part. It’s optional. The people who wanted the big-bucks treatments wouldn’t opt for Part Q.
But even if it was revenue-neutral, it would be better than what we have now.
Just had an interesting talk with an assisted living director. FIL’s stroke recovery has been a bit of a roller coaster. Some days he can do laps around the rehab wing, some days he has trouble getting from the car to the front door. It turns out that to qualify for assisted living vs. SNF, he will need to demonstrate that he can get out of bed and propel himself to the evacuation area of the facility in 5 minutes, with minimal verbal direction. hmmm. Some days yes, some days no. So a guy who is living alone in a house right now with minimal, ad hoc assistance, may not be healthy enough to “qualify” for assisted living.
Also, his PCP just told him he shouldn’t be living alone. Hearing it from his kids he could argue, but he has trouble arguing with a doctor. It really shook him up. The AL director also told me that if the doctor thinks his living situation is unsafe, he is required to call the state senior hotline and report it. Since we aren’t able to “make” him move, maybe this is what it will take. I wish he would “accept the thing he cannot change” rather than trying to fight it, but then he wishes he were healthy enough to do the things he used to do. Sometimes nobody wins.
Momifjandl- transitions can be hardest. The fact that the PCP and AL director are making direct statements may light a good path forward. Hopefully, your FIL can digest this info and proceed constructively, with family members being allies in responding to requirements. Being home alone or without support available does sound sub-optimal at best and dangerous at worst in this situation.
Hang in there. He is lucky to have your support to walk him through what needs to happen. I know the countless hours that go into processing these changes with reluctant elders. Developed quite a repertoire of reassuring phrases…
Now Mr. Fang and his sisters are having to think about my MIL moving to some facility. She’s living alone now, at 91, and (I’m sorry to say) driving, but she seems to be losing mental capacity. They are dragging their feet, and I’ve stayed out of it until now, but I’m starting to push more. I’ve seen how this ends.
MIL had been relying on a neighbor to take her to doctor appointments. She assured my SILs that this was a fine arrangement. When SIL eventually talked to the neighbor, it turned out the arrangement was not fine at all; the neighbor felt put upon. Since the neighbor wasn’t sitting in on appointments, she also thought that MIL was not fully understanding the doctor’s diagnosis or recommendations. Fortunately, that bad plan is now ended.
I’m urging Mr. Fang to move MIL sooner rather than later.
I wonder how the neighbor got roped into this in the first place. My mom was having real transition issues. Her place is amazing. However she thought she’d be happier at the low income no services apartment. When asked how she’d get to appointments or get food she said she was sure the new neighbors would take care of her. Though she never helped a neighbor in her life she has always thought her neighbors should take turns helping her.