I'm 25 and my adopted 86 y.o Mother recently suffered a fall and fractured her right shoulder/arm. Struggling to manage things. Advice?

Your mother is reluctant to move because whenever she does move her shoulder hurts like the blazes and she has become afraid. Not that surprisingly. You try being logical when you're frightened and in pain.

Call the [several rude words ending with idiotic] hospital and ask for the discharge team, discharge planner or equivalent term. When you get hold of this person, explain that your mother has been discharged home with no support in place and urgently requires help with mobilising and personal care. Neither your aunt, who is medically unfit, nor you, who do not live there, is able to assist her so she has essentially been sent home with no care. This is an unsafe discharge. They need to rethink their assessment stat.

Check out her insurance and whether or not they will pay for someone to come out and do caregiving things for you. Then get ready to research other plans called Medicare Advantage plans which the local area agency on aging or other senior services can help you sort out. It's info that's available online as well, and the reason it's impt is Medicare pays for some things and not others, and you want to minimize expenses and maximize benefits and services to your mom. Don't bother relying on someone who is flaky. It's good if that person arrives, but don't depend on them at all. There are people who specifically coordinate care for someone with a recent injury or a chronic condition, there are all kinds of helplines about these issues. One thing to keep in mind is that you should never ever say yes, we can take care of this at home. Ever. Let them know you can not take care of this at home, because there is a chance then you will get more help. You'll need to look into having evaluations to see if her home is outfitted for her care etc. An arm will make her off balance and the meds will make it worse. Try holding your arm close to your body and keeping it immobile and you will see how much more difficult it makes things for a twenty something. Believe me, I was shocked at how much worse it makes things like balance and movement. You must speak to her primary doctor. You must also get her to give permission on the phone for her medical info to be given to you, along with the bills. No one will talk to you unless she gives permission. And you can't do this without knowing everything that's going on. You shouldn't pay for anything. When you are asked, you don't tell them you contribute anything. Why? Because they will count on you doing that and you can't count on it at your age and place in life. Contributing may actually cause her to not qualify for certain services. Please check with her doctor and her insurance company for starters. Then you can look into applying for other help for her. This will be a full time job that you will need help to do. Don't delay in making sure things are taken care of because then you'll blame yourself later on and you'll be swamped. You should think of yourself as ushering her through a certain time period of her life and hand that off when you can't do it any longer, to a NH.

Just want to clarify that your Mother does have Medicare and it should cover her medical needs. It is a federally run program. But MedicAID is run by each state slightly differently and covers financial needs for the sick and elderly who qualify. Medicare does not pay for IL, AL, MC or LTC but Medicaid will pay for MC and LTC (if one qualifies both financially and medically) and in SOME states it will pay for part or all of AL. You can look up this info on her county's Dept of Human Services and under for "programs for the elderly". She can permit anyone to fill out the Medicaid app for her, but this person will need access to necessary information like banking, mortgage, assets, cars, properties, etc. and her SSN and assigned case number from a social worker. There is a financial "look back" period on the app which varies by state anywhere from 2.5 to 5 years.

Another issue is her having surgery at her advanced age and the danger of the anesthesia having a permanent impact on her cognition. I would talk to the doctor about this very real concern. My aunt has advanced dementia and at 98 years old fell and broke her shoulder. Her long-time doctor said to just allow it to heal on it's own. I don't know if she had any rotator cuff issues...she didn't do a lot of moving around with her arms prior. Then the next year she fell and broke her knee cap. Same thing: just let it heal. Now she's not in pain but of course her mobility is greatly impacted. She can shuffle if we hold her up with a belt so we're not transferring dead weight.

Usually after a fall that lands one in the hospital, Medicare has you in the hospital for 3 days then you are transferred to a rehab center for 21 days. After that I'm not sure because I'm not old enough to be on Medicare (65) but my in-laws both had stints in and out of rehab from falls. Other forum sages have good knowledge about Medicare coverage.

This caregiving is out of your league because even after a "successful" surgery it will be a full-time effort and she still most likely will never go back to her pre-injury level of movement. If your Mother has all (or most) of her reasoning and comprehension abilities, she gets to make decisions for herself but you ARE NOT obligated to be part of her care plan. You should not be. If she insists on being home but there's no one there to care for her then you should do what Alva suggested (in her post next to this one) and make sure the ER knows she is an unsafe discharge. Make sure they understand you live out of state and there's no one committed to caring for her full-time. If your Mother has an assigned PoA this person needs to step in to now make decisions in her best interests. If she doesn't have an assigned PoA the social services will work towards gaining guardianship for her and they will manage all her care and affairs. Do not let anyone pressure you into thinking you must be the caregiver. You cannot. The best thing you can do for her is find out if she has a PoA and if not then talk to social services about what to do in this situation. I wish you much wisdom and peace in your heart.

Great that she is going to the follow up appointment tomorrow. Make sure your mom always signs release paperwork for you to have access to her medical records so you know what it going on. (HIPPA) Cousin shouldn’t be okaying her release if she isn’t going to be hands on. Even if the care in the hospital wasn’t as attentive as you would like, it might have been easier there with some help than at home. the social worker at the hospital can help find her placement. Does your mom have social security? Is she on medicare? I’m assuming you are in the US. and I do understand about needed to travel to better medical care. I figured out my parents got better care when I drove them three hours to a medical center to where I got them the care they needed and overall, it took less time than dealing with the small town issues. They had excellent insurance so that helped. It’s a lot to take on. I hope you can get back to your own life soon and that your mom recovers quickly.
Edit:
We are all about the same “age” as caregivers when we first tackle Medicare and other elder issues. In fact with your young smart mind, good energy and willingness to help, you might be ahead of the pack. You need to understand the insurance, moms finances and her condition before being willing to leave your work for prolonged time periods. Someone needs to see an attorney for mom. She needs a POA for finances and medical and to help her determine the best way to liquidate her property to pay for her care.

I am sorry. As a nurse I can assure you that a shoulder injury is VERY painful. Problem is that there is absolutely NOTHING you can do that does not cause it pain. Turn your head? Pain. Try to clean yourself on toilet? Pain. Eat? pain. Turning would be almost impossible. Waling throws you off balance. Back goes out because of how you favor the shoulder, and everything is thrown out of kilter. Moreover, some surgeries require the shoulder to be kind of braced and splinted up in air, making it extremely difficult for an elder whose balance is already bad. Pain pills put you at risk of falls. Just a mess. At 86 this woman has few ligaments and muscles strong enough to compensate and help herself.

So now you know that your Mother/Grandma has EXCELLENT reason to be in pain, whether from a tear in rotator cuff of actual impairment in bones, we can concentrate on the future.
I think that you and your Aunt need to speak with the doctors to make it clear that your Mom/Grandma should go into rehab to learn how to handle pain and activities of daily living for the likely 8 weeks that she will be dealing with the severity of this injury. They will want to avoid this, of course; cost factors. So if they insist you take her home you will need to assess frequently whether you can do this care without rehab. If she is not doing at least somewhat well at home then you may need to consider EMS call on 911, transport to the hospital where you will have to tell Social Workers ON ADMIT that she cannot return home as she requires either rehab or SNF; that you are not capable of caring for her at home. I sure do wish you the best and hope for her speedy recovery.

What condition was your mom in before the fall? My aunt fell and broke her shoulder and it was deemed inoperable. It was extremely painful for her. She stopped her dialysis because of it and passed away. A fracture can be debilitating as well.
I question your mom being sent home without the surgery or going to rehab. She should not have come home. How did she get home?
Have you talked to her doctor to explain what her condition is and to ask for help? A fall, a broken bone, even a bruised arm could render someone 86 year olds pretty helpless. As you say, it could be her meds, her pain, her fear, mental decline, a UTI, any number of issues. Is your aunt her primary caregiver? Does she have POA? Why didn’t she go to rehab? I’m sorry to pepper you with questions but it’s difficult to understand how or why this is happening.
Did your mom have a follow up visit to her doctor after being released from the hospital? How long ago did this happen? Read the discharge paperwork to see exactly what the instructions were. I would call the number listed and let them know what is going on.
Often a senior will want to go home instead of rehab. It’s just not possible in the situation you describe as she needs more help than you or aunt can manage. I am sorry this has happened. Give us more information and hopefully we can help you sort this out.