Suggestions or advice for family member just admitted to care facility?

[sun starved Gayle]

My older sister was just discharged from the hospital after a 5 night stay after a fall. She did not break anything, just was dehydrated and extremely weak. She was on the ground for two days before we pound her. She has gone into a care facility for rehabilitation. She is a widow with no children, so my other sister and I are her support system.

Any pointers or tips of what we should watch out for, do or ask for her ? My other sister and I will be her only advocates. This is all very new too me.

Thank you in advance for any suggestions or advice!

 

[Passepartout]

A good rehabilitation center will know how to best get her up and about. She will need encouragement to follow the specialist's orders. They can only do so much, and she will have to be motivated to do some on her own. Perhaps walking around the facility with her would be a help. Making sure she is getting proper nutrition. Think about joining her for lunch. Care facilities often allow free or low cost meals for family members. She will find some comfort in a favorite robe/ slippers/ pajamas. make sure her name is on everything. (stuff has a way of disappearing) If there is a salon in the facility, and she enjoys being fussed over, get her a hair or nail appointment.

When she's a little further into rehab, and is able to leave the place for an hour or two, you can spring her out and go out for lunch or something she enjoys.

Find out if she has a lawn service or housekeeper that can keep her home up while she's out. iirc, Medicare allows abut 100 days of rehab, then she will be discharged to either go home or to a long term (assisted) care facility. Her goal SHOULD be to have her strength and 'ADR' (Activities of Daily Living) abilities that she can return to the life of her choosing.

Good Luck with this. It fell to me to be my mom's care giver after she suffered a stroke and laid on her floor for a night and half a day.

The care center will have social workers who will work with all of you to guide you (and her) through this. Remember- they've been through this hundreds of times and you haven't. Listen to their suggestions. Wishing you all the best!

Jim

 

[DrQ]

God Bless.

How far does she live from you and your sister?

 

[easyrider]

Medicare will pay for 90 days or rehab. If there is no rehab then she will need to pay. My mother in law fractured her back and was placed in a nursing home but medicare rehab wouldn't pay as she was there for observation. I think it was about $4,500 we paid to the nursing home for her observation care which couldn't really be accomplished at home because we didn't have the needed equipment.

We thought she was going to the nursing home for rehab and would be covered under medicare. About a week into it we figured it out when the facility called to find out who was paying. The reason we thought she qualified for rehab was we just didn't know. She was at the hospital for a week and moved to a facility. We did have long term care insurance that kicked in so the $4500 wasn't all out of pocket.

Good Luck

Bill

 

[Tia]

Consider one of the emergency alert systems she can wear when/if she is able to go home after rehab.

 

[moonstone]

My older sister was just discharged from the hospital after a 5 night stay after a fall. She did not break anything, just was dehydrated and extremely weak. She was on the ground for two days before we pound her. She has gone into a care facility for rehabilitation. She is a widow with no children, so my other sister and I are her support system.

Any pointers or tips of what we should watch out for, do or ask for her ? My other sister and I will be her only advocates. This is all very new too me.

Thank you in advance for any suggestions or advice!

Is it possible to meet with the resident care coordinator (or similar) to find out what plans as far as rehabilitation they have for your sister? Ask what kind of rehab/physio therapy she will get and how often. Do they have a recovery timeline for her, what about after discharge? Also ask if they are persistent in getting her to attend physio if it is required.

When my dad went into a rehab facility after he fell down the bsmt stairs and broke his pelvis, the physio staff would not wake him to go to physio if he was sleeping, or if he said he didn't feel like going they'd just say ok. After I met with the staff and dad to stress (mostly to Dad) how important physio was they made more of an effort to convince him to get up and go!

If your sister is anxious to get home and enjoys living on her own she will be more motivated to follow the instructions. If the fall and laying on the floor for 2 days frightened her, she may be hesitant to return to live on her own. As mentioned above a "help I've fallen & cant get up button" will give her great confidence. Many have a sensor that will signal for help even if the person is unconscious and cant push the button. They also have a 'stationary for too long' feature. My dad's pendant even has a GPS feature built in it, and I can log onto the company website and see exactly where Dad (or at least his pendant) is at any time. I can even click on a spot on the website to make dad's pendant beep (which I did when we arrived safely at our vacation destination).

Good luck!

~Diane

 

[rhonda]

On the topic of "fall detection/alert" devices ... you might also consider the Apple Watch. While the newest model (Series 4 with Cellular service) will both detect a fall and auto-alert, even the older versions can be used to "monitor" one another via Activity Sharing.

I use Apple Watch Activity Sharing with my brother and one nephew. The intention was to motivate one another in meeting the daily activity challenges ... but a curious side-effect is that the watch becomes a simple monitor: Is that person up and about? Have they done any steps today? Easy to check-up on each other in a quiet and subtle way if all have a desire to wear the watch daily. At this level, event the older Apple Watch models can provide monitoring w/out having additional subscriptions or fee-based services.

 

[Panina]

If you can, try to visit often. Sadly staff sometimes ignores patients needs when no one is there and when family members are present care is better. Talk to the staff and therapist about her care and how long they anticipate she will be there, so you know what the plan is. I would also talk to the social worker to find out what your sister can be eligible for once she goes home. Talk to your sister to see what she wants, does she want to go home or go to assisted living. Give her options such as the alert home buttons if she falls or doesn’t feel well as well as a camera system. Let her be part of and feel in control of her path.

 

[Passepartout]

^^^^ This^^^^ I agree that people get better care if family members take an active role in the rehab. and that much can be gained by keeping close ties to the social worker(s) in the facility.

I'm not so sure about the electronic 'evesdropping'. I can see value in a medical alert button, but think some of these things serve little other purpose than to give care giving family members some feeling that they are 'doing something' when truly, from the point of view of the person most affected, these things are simply intrusions. For instance I'm sure that for some, an Apple Watch would be useful, but for me, having to keep something like this charged and learning it's functionality would drive me nutz.

Gayle, how old is the sister? Is (or has she been) fairly active? Does she have a circle of friends? Church activity? Would she be better off- and can she afford- moving into a continuing care facility? Answers to some questions like these can help guide you to better options for your sister.

Jim

 

[geekette]

If you can, try to visit often. Sadly staff sometimes ignores patients needs when no one is there and when family members are present care is better. Talk to the staff and therapist about her care and how long they anticipate she will be there, so you know what the plan is. I would also talk to the social worker to find out what your sister can be eligible for once she goes home. Talk to your sister to see what she wants, does she want to go home or go to assisted living. Give her options such as the alert home buttons if she falls or doesn’t feel well as well as a camera system. Let her be part of and feel in control of her path.

Yes, visit or call as often as possible.

Take her comfort items. My mother likes to have a pic of her dog and her own robe and socks.

 

[Icc5]

Agree with Jim. We need a lot more information to help you help your sister.
Bart

 

[sun starved Gayle]

Thank you for all your replies, it is much appreciated !

My sister will be 70 next month. She is a widow with no children. She lived alone on 5 acres about 35 miles from my other sister and I. She is unable to drive. She has always been a difficult person. She has been depressed for years.

She was in a horrible car accident 40 years ago, broke both femur bones, her pelvis, shattered a knee, was actually "scalped" by rear view mirror, among other injuries. She has long steel bars in both her legs. She was in the hospital for six weeks and in a body cast for another six weeks. My sister was told years ago that she was going to need both knees and both hips replaced. One knee was done, and it did not provide the results she had hoped for so she just quit going to the doctor and started self medicating with alcohol. She has not been to the MD in probably 12 years. She could barely creep around with her walker, now she cannot get out of a chair without help. I believe she was in constant pain and has been taking Aleve every 10 hours for years. She is not a complainer.

Her husband passed away at home about three years ago, My other sister and I have been taking turns going up once a week to bring her supplies and check on her. She sees no one but us, (by her choice) and has not even been out of her home in three or four years.

You can see we have our work cut out for us.

 

[Passepartout]

She sees no one but us, (by her choice) and has not even been out of her home in three or four years.

You can see we have our work cut out for us.

Wow! There will be huge life changes for all of you. As I gaze into my (admittedly cracked) crystal ball, I can see her not being able to return home. Is there a chance that her home can be cleaned out, fixed up and liquidated to pay for her care in a continuing care facility? She probably has her husband's SS. Any other income? Medicare will only cover her as long as she actively participates in rehab and even then for 3 months then they will stop paying and the rehab center will want paid. Not trying to pry, but she should probably not be living alone, and a ccrc is the most logical choice. The other choice would be her moving in with either you or your other sis.

I'm sorry for your predicament. It isn't easy. As has been said before, "Life is what happens when you're making other plans."
Work closely with the social worker(s) in the facility where she is. They will know what programs are available in the area. I wish you well. This is one of those 'one-day-at-a-time' times.

Jim

 

[easyrider]

If you don't have the time or just don't want to take on the huge responsibility of caring for a relative, then maybe let the social workers help her figure it out. Your sister can use an ombudsman for advice or an elder care attorney. Both probably know more about what is going on than you.

I guess what it come down to is asking yourself , if I was in her situation would I want her to help me ? If you really wouldn't want her help she likely doesn't want yours, imo.

Bill

 

[Teresa]

When my mom was in rehab she was also under the influence of Alzheimer's. She would often 'refuse' (always politely) the rehab stuff. 'No, thank you, not today.' And that's all they could do. They could not force her to do anything. If one of us was there (she had 8 children) then we'd say, 'come on Mom, you should go,' and she would. Yes - she was there for rehab. Just not happening if we weren't there. We could convince her but the rehab staff doesn't have the time or 'permission' to try to get her to do it by trying to convince her to go. If sis doesn't want to do things they can't force her. So if she's stubborn or even if she's not - if she says, 'no, thanks - not now' or something similar they'll just mark it on her chart as 'refused' or 'declined' or something. And when insurance/Medicare looks at the records they'll see she's not 'cooperating'.

You're in a tough spot. But I don't need to tell you that. Best wishes and good luck.

 

[VacationForever]

She fits the profile of one where Adult Protective Services should have been on her case many years ago. It is what is considered self neglect. I would suggest to start there. Quality of APS social workers vary by who is assigned to her. The social worker can help with decision tree and process as to what is the best course for her.

Good luck.

 

[Tia]

Visit local facilities and put in applications for those that you see as acceptable or good. She may not get into the first place you like but it may have an opening in a short while if you apply. Takes some effort but worth it, we moved my mother x3 last year.

 

[lockewong]

I am sorry to hear about your sister. Echoing the advice by Passepartout and Panina, you must visit often. I had to be the only one of my siblings when my mother fell and was unconscious for over a day to visit her at the rehab facility. I noticed when I spoke to the nurses and the social worker, I-and in turn, my mother, received better service and better care. I would show up at different times to watch how the staff and the occupational therapist worked with her. The weekend people are also different. I was lucky to be able to take family leave to accomplish this. There are often waitlists for the nursing homes that are higher quality. In-home attendants are very expensive if the long-term care insurance does not cover. It was an extreme learning curve. Medicine and medical care is very squeaky-wheel oriented. You must be the squeaky wheel and very verbal with the covering physicians to get the best care. On a side note, it will be very emotionally draining, you must do self-care and take mental health breaks for yourself. Good luck.

 

[Patri]

I am sorry to hear about your sister. Echoing the advice by Passepartout and Panina, you must visit often. You must be the squeaky wheel and very verbal with the covering physicians to get the best care. On a side note, it will be very emotionally draining, you must do self-care and take mental health breaks for yourself. Good luck.

Totally agree. If your sister cannot or will not advocate for herself, you will have to. I have been through this a couple times. It is wonderful when you connect with particular staff. They go the extra mile, and also let you know if some things need to be watched.

 

[simpsontruckdriver]

One thing people don't realize about Medicare. They DO NOT want to pay for long stints at a nursing home, which is understandable. Most often, they will pay 100% (but no less than 80%) for in-home nursing care. One of you may need to be there while the nurse is there to make sure she does what is expected, like washing up or meds or rehab. I am not sure if there's a time limit like with nursing homes, but it is an option if she's not being cooperative at the center.

Sadly, if the person does not improve and Medicare stops paying, Medicaid is an option. At that point, all assets must be liquidated.

TS