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My 84 y/o wife was discharged from hospital requiring at least sub-acute rehab to improve her balance, strength, range of motion, walking or self-propelling a wheelchair. I can assist in her bathing, toileting, dressing at home, but she will need a 'handler' to competently help her into and out of bed, getting into and off a chair, couch and toilet seat. I could be the assistant to the handler, but not the lead.

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Please do not be shy about telling your wife you cannot do this on your own, at all. It will result in you being injured without a doubt. Then you will certainly be no good to your wife. Her wishes are not your commands. Tell her because you care for her she absolutely must go to inpatient rehab, and if she doesn’t progress enough to be able to do a good amount of self care in a home setting, it won’t be possible for her to return. It broke my dad’s heart to tell my mother this news, but there was simply no choice. He couldn’t handle her level of caregiving needs post stroke in a home setting. Sometimes there are tough realities for us all. I hope you’ll guard your own wellbeing so you’ll be available for your wife
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Reply to Daughterof1930
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Zookie Nov 17, 2024
I am going through this right now. Husband had 1st stroke March '22 and 2nd stroke May '23. The first affected him cognitively and the second took his right side. Now he is almost always a "2-person assist" (into his wheelchair, back in bed, etc.), fully incontinent with frequent infections, and cannot do anything on his own (except watch TV, 😉). I took care of him at home after the first stroke, with home health care assistance a few times a week. But now there's no way he can come home. I still have to work (I'm only 62, he's 65), and he's a big guy. I was able to physically care for my parents over ten years ago -- I couldn't do all that now. Because if the first stroke, he doesn't understand that he can't come home. Anosognosia at it's "finest". He asks me to take him home, we talk about it, I explain, we both cry, then "rinse and repeat" a day or two later. I visit almost every day and do all I can to comfort him, but it's very stressful. Sometimes the reality is we don't get what we want, and it has to be okay.
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Your Wife ‘resists inpatient rehab’ because she thinks that she has a better option – going home. She probably assumes that things at home will be much the same as they were before the episode that took her to hospital. You can only manage this by making rehab her best option. Tell her bluntly that if she refuses it and gets no better, she will need a Nursing Home permanently. Extra care for long hours at home, with you as an assistant to the handler, will be staggeringly expensive and you both can’t afford it.

If you do decide to try home care, you should consider splitting your finances, to protect your half of your joint assets for your own future care. Make it clear to W that this is what it would take. The home care will only be able to continue until her half of the assets is used up. Then it's Medicaid with no options. The bitter truth (probably with tears for both of you) is the only thing that will work to change her mind about trying rehab.
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Reply to MargaretMcKen
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If she refused going to Rehab, she could have gotten in home help. She would get PT and OT and an aide 2 or 3x a week to help her bathe. Medicare covers this. But its not a permanent solution. Wife is a 2 person assist, it seems, so no Assited Living Will take her. To have the assistance you would need would be hiring someone for at least 12 hrs a day. No one can be hired to just be there when u need them. If you can't afford this, she may need to go to LTC.
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Reply to JoAnn29
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If you’re in her age range or higher, there’s no way you can do this yourself.

She needs to understand fully WHY it is to her advantage to really TRY in rehab. As long as someone is progressing, the longer Medicare pays. Most advantage plans pick up the remainder.

If she fails rehab, the truth is that you’ll have to have somebody besides you to help lift dw onto the toilet. It will be 24/7 care that at 20 an hour is about 250k a year.
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Reply to PeggySue2020
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Igloocar Nov 19, 2024
In St. Louis, $32.00+/hr.
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Sounds like assisted living might be the best choice because it will likely not improve much. There are assisted living places where you could move in with her. Believe me, your health will not hold up. Even the light lifting and constant care is hard on you. What will you do if something happens to you? Having her in assisted living is something you should do while you are able to make a good decision rather than a rash one when you fall down, or somebody hits the rear end of your car. You have to be forward thinking now. At this age we cannot plan to be caregivers for the long term. Something will happen and it will come out of the blue and you will not be ready. You need to make a good supportive plan for both of you. Face the facts and be wise.
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Reply to RetiredBrain
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TouchMatters Nov 17, 2024
Excellent support / suggestion. Thank you. Gena
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These are extremely sensitive and difficult times - transitions of caring for a loved one.

You will need to be the giver of 'tough love' - doing what is needed for her welfare/safety - which is what she doesn't want for herself (her resisting).

* It is understandable that she is frightened and doesn't want change although I believe she knows 'deep down' that she will need more care - from others and/or a different living situation - and is so frightened, scared, and sad losing her independence (as it is) as well as losing you as she knows you. And moving into the unknown(s).

* Since she is 84, I presume you are older too. You must start putting yourself - if not first - on equal footing with your own well being and needs. You want to be there for as long as you can be to support (and love) her - which means taking care of yourself.
- This means making the hard decisions (unilaterally, as she will resist). As others as suggested /recommended, it appears she needs long term care facility - be it a nursing home or assisted living.
- Do not argue with her. I would tell her as little as possible in terms of 'what the next steps are' as it will only scare her and cause her to resist more. I am not saying to keep her in the dark, but do not argue with her. When she resists what you tell her ("I cannot handle your needs at home anymore and I am going to investigate assisted living facilities") - let her talk 'get it out emotionally' and just listen with a response ("I understand" what you are saying and feeling" and leave it at that). This is being compassionate, caring, and the best husband you could ever be. (As you are now).

It isn't clear to me that she is in sub-acute rehab nor OR if she is back home.

Whatever the situation, the time is NOW to find out what is available in your community re assisted living facilities / nursing homes. Some have waiting lists.
- I would do this reseach on your own ... go with a friend or another family member first. I am not sure that your wife would be able to do an initial visit anyway. She may need to be moved directly into it w/o an initial visit. Even so, if she not 'like' or 'want' to move in ANY facility. She wants things to stay the way there are - and whle emotionally and psychologically understandable, the time to make this needed life transition is now.
As another said, you might be able to find a place where you could move in too ... although that may involve selling a home, etc. Get the help / assistance you need to manage these transitions. They are not easy emotionally and you will need all the support / help you can get. Come back to us here too ... we are good people wanting the best for you and your wife.

Gena / Touch Matters
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Reply to TouchMatters
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Check to see if your insurance will cover home health aide during the daytime for the length of time needed for rehab. If it is not covered, then tell your wife she needs to go to rehab since there isn't enough money for "an aide" at home for as long as she needs one.
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Reply to Taarna
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One of the best physical therapists that my Mom had, came to the home. Pre-covid, I was told that she couldn’t have in-home PT since she had already had gone to a PT in an office. Another fall, 2 years later, I requested and she received in home PT…..and it was continued as we moved her into a MC unit. In-home PT was covered by insurance.

Also, I needed my sleep, so we used an agency and had a care giver, 9 hours at night. During the day, she went to senior daycare while I was at work. Having all those able bodied seniors, older than her, triggered her competitive spirit, and also provided entertainment and stories to share.
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Reply to ChoppedLiver
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AIWassler: This should have been deemed an unsafe discharge to home.
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Reply to Llamalover47
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Sorry, but your wife needs to be placed in assisted living. It's not going to get easier since you are getting older too. It's a difficult decision to make. You could sell your house and live wit your wife too. Look into different options while you can.
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Reply to Onlychild2024
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