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if you are her legal medical person- you have a lot of input!
all facilities have care planning requirements- Be vocal.
Communication is key here. Give information and listen to the plan. Question anything.
My mom fell a couple of times at home. she had to have knee replacement. She fell again and broke her foot and wrist. Refused to do the safety things we suggested. A hospital stay and surgery convinced her to do something different. I’m an RN and we were able to take her home with home health and me taking leave to care for her. She did fabulous because she did everything they told her to do- and we faithfully did exercises. We charted her progress. We celebrated small successes. A little praise goes a long way. She was also afraid of falling, so OT And PT worked with her and me to develop a workable plan. And she hasn’t fallen again, praise God! She has a medical alert system because she doesn’t want to fall again. She’s 84, lives alone. She has regained her independence with minimal assistance needed.
I encourage you to write out your plan, needs, expectations and care challenges for when she is discharged. Make it all a part of the plan for how she is treated now. Then you can do the follow up at home with home health PT and OT.
Bless you for what you are doing.
Not sure if you can get in to the facility with the covid rules in place, but if you can go and observe her going through the PT sessions. Make a mental note of time she spends on each machine. Later, ask someone about her progress - look at the notes to see what is recorded there. Often what it says is no where near what's really going on timewise. If you can't go in, you won't know how much progress there is until you get her out. Make sure the dr orders home therapy to keep things going.
Most important!!! Find out if they have slapped a diaper on her while she's been there. If they have, start talking with the director about 'bathroom training' to get her going to the toilet again. Be quite firm in letting them know she didn't come to them that way and you don't want her to leave in that condition. You are really retraining the brain to say it's not normal to go to the bathroom in your pants. It's pretty common for people in facilities to end up in a diaper - short on staff, the ones who are at work have too many patients and helping people on/off the pot takes a lot of time, patient can't wait 30 or more minutes and they end up having an accident. It doesn't take long for the brain to say - it's ok to pee while I'm sitting in the bed. They CAN help her to reverse the problem and they should.
Been through all this with a parent - broken shoulder at 83, compression fractures of spine at 91. Although she could walk quite well on the walker at 91, she was considered improved and leveled out on progress with PT - discharged to me in a diaper and in a wheel chair. It took me about 6 months to get her walking with walker again without having to hang on to her as she walked. It took me about a week to end the diaper fiasco - when she called for help, I was there. Back to toileting on her own. As a note, I complained because (1) they dropped her on first day there and (2) she was given the wrong meds on 3 times while I was sitting there w/her. No telling how many times it happened (to her or others) when I wasn't there. Day before the last complaint, she was to be there at least another 2 weeks. Day after I complaint, she had leveled out on her progression. I started to fight it, but I knew she'd be safer coming home.
She can come out of this! Continue to encourage the exercise even on days the PT person doesn't come. As she becomes more stable, fear will ease up. May not go completely away, but that can be a good thing. Might keep her off a step ladder if she was a former climber! Best wishes to both of you.
If she has other issues that led to her fall: dehydration, possible malnutrition, possible hygiene difficulties... they can be addressed while she is their client. Please allow them to do their job BEFORE taking her home. The assessments, insights, and plans to address her care needs will only help you when she is ready for discharge.
While she was there she was doing great! She was able to walk on her own again after 2 weeks (with walker) - but she thought she had made so much progress that she kept getting up by herself. At first of her stay she did it 2x and fell both, both times no one was there to help her up! She managed to do it on her own... but was badly beat up. She finally stopped, and actually put effort into her therapy and was getting better.
I think it gave her a false sense of security? Bc last Saturday, exactly 1 week ago today, she got up and fell, had to try and get herself up again and fell once more, breaking her hip 😢😓
She had surgery last Sunday. BUT she hasn’t been able to do much rehab because she had a horrible reaction to the pain meds... did/are they making your mother confused or making her sleep too much?
My mom was basically unconscious, we changed the pain meds, but could not wake her up except when she was in pain or moved etc... they took her off all pain med, she was still confused sometimes but she was awake and able to talk like normal (her mental facilities are at least 95% usually). Then yesterday she was again almost a vegetable, unconscious like cuz they gave her pain med -it’s a very low grade pain med so they thought maybe something else is doing this but I called first thing this morning and she face timed me; she’s still confused but she’s awake. I think meds must be slow to get out of her system or something, she’s so sensitive to meds cuz she never took them until she got older (literally, she rarely would take even an aspirin if she was in pain)..
they checked to make sure it’s nothing else but they took her off it again yesterday and today she’s mostly back but I’m so scared she’s gonna go back to what she has been like; it was like I lost her totally and it’s more terrifying than I realized it was gonna be and I already knew it would be horrific :(
I’m her sole caregiver and it’s so hard - but this has made me realize I don’t mind; even though I know when it’s time again I’ll probably forget how much I currently long for it. I feel guilty admitting but it would be kind of nice to have a week off if I knew she was okay, but anyway! I just want her home and not falling; if she can’t do successful rehab I don’t know if she can live here because she is determined to walk alone even when she is dizzy and unable to; she won’t call for help most of the time.. I fear if she comes back strong she may fall again and hurt her hip or break the other one but it’d be less likely. I’ll just be a nervous wreck all the time but I am anyway lol. That said, if she came back still weak It’s only a matter of time... I don’t want her to be in this pain again... bah.
sorry for sharing so much especially given I have yet to know myself if it’s gonna be successful; I’m really scared she’s not gonna try because of the pain (impression she gave on phone this am - I’m stuck at home and she’s stuck there now that she’s awake due to snow storm)... I just thought I’d share if you ever wanna talk to another going thru it, I’m here... I know there are tons of amazing ppl here, I’m not amazing but I do care and understand 💖
Sending Hugs!
But the truth is that our own success stories are unlikely to have much bearing on your grandmother. Her own story will be hers, and will be dependent on so many things that add up to a whole. I sure do wish her the best of luck.
PT is very important. Or she will lose a huge amount of functionality which would likely reduce her quality of life, etc. Hopefully she did some of the hard work in the rehab. Those are the best places to recover from an injury. The rehab in a nursing home is usually only a fraction of the amount that you receive in actual rehab. I say this due to my mom's experience after 2 knee replacements.
Think hard about moving her in with you. Of course, you love her and want the best for her. But providing long term care for someone is very difficult. Especially if they are not willing or able to do the work needed to get better. Where was she living before the fall?