My mom is in a nursing home due to a fall and broken hip. She can use a walker and wants to come home as do I. Do I need a doctor's OK?

Many years ago, when my mom came home from rehab, she had a full time caregiver. It was expensive, but a huge help for me.

Don't bring her home, unless you have a caregiver helping.

There is a reason people are telling you reconsider taking her home. Hundreds of people on this board thought they could do it themselves too. Now they are exhausted, broken mentally, physically, and/or financially and wish someone had warned them. Consider the following:

-Whatever schedule you have now will be out the window.

-There will be no more dinners out, no vacations. Friends and family will say to call if you need help, but  almost none will volunteer to stay with her if you need time out. 

-When do you plan to get things like errands and grocery shopping done? She cannot be left alone. 

-Can you lift her multiple times a day and night?

-When she worsens, how will you handle the medical needs?

-Are your toilets, bathtubs, etc handicap-ready? Will her bed have safety rails? Are meds stored safely?

-Can you handle multiple toilet visits, butt wiping, diarrhea, bed urine, and getting her undressed/dressed? Possibly multiple times a day/night?

-Later on, you may have to lock down your home to prevent wandering. 

-Are you able to help with bathing daily?

- If she keeps you up at night, how do you plan to handle work/chores the next day? Same goes for working from home. 

- If you get sick or injured, what plan do you have for her care?

- You'll very likely need aides. Are you okay with strangers in the house?

- If you are no longer able to care for her, how will you get her into a care home?

I've said before that people think they can "love their way" through caregiving. That love will be enough to sustain their energy and will. It isn't. Nor is it the same as caring for a baby. Caregivers here loved their elder dearly. They had to place their elder to save both of their lives.

Might I ask why in the world you do not want to go through the normal discharge process of an MD assessment and permission, and a discharge from the facility? In any normal discharge you would get papers with recommendations, perhaps exercises, perhaps in home visits with assessment, perhaps even PT to help Mom get fully back on her feet. It makes no sense to me at all that you are for some reason attempting to sidestep this.

You “can” care for her full time, but should you?

My cautionary tale- my irascible mother had a “killing’ stroked-hemorrhagic in her left temporal artery.

As a speech therapist, I was absolutely frozen to immobility when I realized while talking to her in our daily evening phone call, that her speech was disarrayed, and KNEW what that meant, but sent her to bed, hoping that our morning conversation would be somehow magically repaired.

My husband (whom we always described as being liked better than I ) went to her little house, and he cajoled her into being “checked out”.

She had no doctor, so we took her to our small local hospital, and after a brief sparring match with a nurse who tried to get her to undress, (unsuccessfully, it turned out), she was diagnosed.

Subsequent testing revealed that her physical body was about as healthy as the average 50 year old, but that the stroke effects would take a bit of time to determine.

I stayed with her in the hospital overnight, and when she woke up, I had the TV on with her favorite daily early morning show. When she identified her favorite weather man, I knew, with great relief, that she was cognitively intact. And she was, but very obviously had sustained an expressive aphasia.

After 2 days and nights of hospital life, she told her neurologist she wanted to go home because she wasn’t getting the food she liked to eat.

He agreed, telling me to stay with her for a week, then have her seen by “her physician”. I luckily was able to have her seen by MY physician, who placed her on a low dose of blood pressure medicine and concurred that she was in extraordinarily great health.

After a week, she threw me out “…your boys need you…” and I went home.

Life peacefully resumed until, the week after 9/11, she fell (we never knew exactly where, or how), and shattered her right hip. Her last lucid gesture was a phone call to me, telling me to come because she’d fallen, her last request to me “wash off my feet before the ambulance comes”.

The surgery was long, grueling, and only partly successful. She refused rehab, saying it hurt too much. I was at her side every day before dawn, and one morning a week after her fall, was told that she was to be discharged that day.

I found a placement on the phone, and the PT was a genius. When her rehab was complete, against my better judgment, I brought her to my home.

We’d always laughingly said “We’d NEVER be able to live under the same roof”, and our agreement about this proved to be tragically prophetic.

She was now in the throes of dementia, and needed constant management.

I gained 60 pounds, and stopped sleeping, because she was unable to appreciate the fact that she COULD NOT safely transfer from bed to standing without help.

I ultimately realized that her safety was being compromised and that her life with me was hurting both of us more that was helping either.

In sorrow, I contacted the facility where she’d received her rehab care. She was welcomed back with love and respect by the staff who’d known her then, and lived a truly lovely life until she died 5 years later, 5 days short of her 95th birthday.

Balance. I tried SO HARD, but I couldn’t pull it off.

Don’t be me.

Can you arrange to spend 2 full days proving Mom's care in the NH?

Talk to OT about what equipment you will need at home eg frame, over toilet seat or commode, correct height armchair.

Gain tips from PT regarding safe transfers from bed, standing, walking, getting in & out of the car.

Ask nurses/care staff what help is needed for personal care (bathing, dressing, toileting).

No-one can be home 24/7. Does Mom need some assistance morning & night or all day supervision/assistance?

It will be wise to get a good idea on what *care* tasks are needed & also what level of *fulltime* is needed.

Is your Mom is rehab for her broken hip? Or an actual NH?

Has she completed all her PT?

Does she have a PoA or legal guardian making decisions for her? If she's in a NH I'm just wondering if someone thought she'd be better off there...

She will need to go through a discharge protocol but I don't think she needs anyone's permission to leave. If she has cogntive capacity she can make her own decision.

Is she going to a home that can accommodate her walker (like in the bathroom)? Is there a zero clearance shower she can use? Is it one-level living? Seniorized for her safety?

You don't give other info in your profile... are you financially able to care for her full time? Do you accept the challenges of being a 24/7 caregiver, like a much smaller world for yourself? As she declines she will need more and more help. Just want you to go into this with your eyes open.

You will receive many warnings from in-home family caregivers who have had incredibly stressful experiences in similar situations. Please weigh their advice carefully.

Is she in the nursing home for rehab after her fall? Or is she in the home as a permanent resident?

If she is there for rehab why would she wish to leave? Why would you not want her to remain there until she completes her rehab therapy?

I saw my mom gain strength and balance when she participated in occupational and physical therapy after serious falls. Rehab is tough work but it is worth it.

My mother used a walker like yours does. Fortunately, she avoided being in a wheelchair due to her active participation in rehab in a nursing home and home health programs that her doctor ordered for her.

Please share more information so that we can assess your situation better.

Wishing you and your mom all the best.