I know each person is different, my grandmother has been in skilled rehab for 17 days (NH) rehab- FX humeral head ( no surgery) coming from a hospital stay following UTI and dehydration (2 weeks). Did PT at hospital, did better (150 steps with 2 person / walker). Suggested more rehab on discharge. She is 86 with not a lot of medical problems, very independent BEFORE the fall. What was your LO in rehab for and how long before you saw a change? We want to bring her home after her time is up. Any stories would be helpful.
She is now scared to stand- doing all other exercises well. I think she's getting depressed due to COVID and us not be able to visit- my heart is breaking.
We really want to try to bring her home but what do we do if it doesn't work out? A lot of people say they heal better at home with help and loved ones/family. She is all we have left.
We were on some occasions able to extend that for a few days, and once even longer, but on private pay.
We've been through rehab for post pneumonia and CHF healing, as well as respiratory failure, hip fractures, broken leg, broken foot...I can't even remember all the D'X'es. The only one which extended beyond the Medicare stay was a leg fracture, with a doctor's orders of no standing on the fractured leg. This prolonged the stay.
Change and/or improvement really, really depends on the individual, on family support, on amenities and whether in a private or shared room at the facility, on the food, nursing and care staff, and the individual's own approach, stamina and health. No 2 patients are alike.
Providing a lot of support (which I suspect your family does) makes a world of difference. Participation in activities, especially musical entertainment is an enhancement, as is pet therapy. Most of the facilities we chose had bi or tri weekly visits from pets. At one facility, the DON brought her dog to work with her almost daily.
If I were in your situation, I would ask for a progress update consult with the therapists now to get a sense of where your GM is in terms of a discharge at the Medicare time limit. You might also ask for brochures on companies providing home care. But also do your own research. I got an excellent list from the Alz. Assn. then contacted several before deciding on the one I wanted.
You do know that Medicare will pay for follow-up rehab at home as well? In our experience, it's generally about 4 weeks, with visits from PT, OT, Nurse, and sometimes a social worker (in my experience there were only a few who were worthwhile; the others were advised their services weren't necessary, including one obnoxious woman who insisted that her visit needed to be in the first week, and also insisted on having access to financial information. I wouldn't even allow her to come over.)
I would also start researching home PT companies now, based on a list of questions you'll develop. That way you can interview them before committing to their services for in-home PT. You might also ask the facility PT and OT if they do home inspections. We had that, and got a lot of good recommendations on safety issues.
The fear of standing is very understandable. Falling, as well as recovering from complex factors, can undermine anyone's confidence. I realized that after I injured my back about a month ago. My hands automatically reach out for stability, even though I hadn't fallen.
Did rehab help? Absolutely, hands down, and without a doubt! I only wish we could have gotten much more.
If I haven't answered all your questions, please feel free to post again. I should add that after my back injury, I almost wished I could go into rehab b/c I knew how valuable it could be. (I also liked the idea of not having to cook!)
That's another issue; one of the best had a chef, with daily specials as well as daily standards, so the residents could either eat in the dining room or choose to eat in their own room with foods of their own selection. One even provided tickets for a free meal for a family member, and they made absolutely delicious chef salads.
You are considering bringing her home. Prior to this fall and fracture was she in your home? I ask that so I can ascertain whether you understand 24/7 care in even a positive situation, so that you can "imagine" what this care might be.
You do not give an age. I would like to hope that you and her family understand that no matter your wishes, your love and your good intentions, we cannot keep those elders we so love forever.
All that said, you asked for examples of rehab. 3 years ago my then 82 year old brother had a bad car accident. He said prior to it he "knew something was wrong, with some nighttime hallucinations, some blank out periods, some difficulty with gait." He was diagnosed with probable early Lewy's dementia. It was the beginning of a three year decline leading finally to his death from sepsis (from a leg cellulitis, and not involved with his initial diagnosis). After his hospitalization initially from the accident his balance was quite dreadful and it was difficult to walk even with a walker. After one month in facility rehab he was a whole lot better, and walking with a cane only; shortly after discharge he gave up the cane. His balance and the balance exercises he was given helped, but it was more his adamant DETERMINATION that helped most IMHO. His balance remained decent until his death, as I said, of another cause. So that is my personal story with rehab. As I said, it honestly is of little use to you and your own case.
Again, you haven't told me the age, but some people do become just too tired for it. That is difficult for us to imagine, but it happens, and as a nurse so many patients shared with me that they longed only for rest and peace, and that their loved ones could not hear this from them. It was a source of GREAT SADNESS to them that they could not share the honesty and truth of their last days with anyone but their nurse.
I am so sorry for all that is so difficult now for all your lives. Covid-19 makes it so much MORE difficult because people feel that cannot trust that the work is getting done, that the attention is being paid. I wish you the very best.
My MIL (85), on the other hand, is like a giant baby. Can't stand pain for more than 1 minute, never could. Rather lazy and dependent, whiny. Became addicted to the pain meds (which to be fair she did need but took too many because she wasn't willing to experience the slightest bit of discomfort). She is now bed bound because she wasn't progressing in PT (at which point they will stop it no matter what).
Some of what goes on is we younger folk don't realize that the older one is, the slower one is to rebound back to "normal" -- if ever. It's a lot more work with fewer real rewards. Yes she will be very nervous about falling again. And so should you about her falling again. The only thing I can suggest is to make PT as fun and low-stress as possible and do not nag her or have "expectations" for her recovery. It may not be possible.
Not so well from the 2nd knee replacement. Didn't like the PT and was a little hard to work with. She was in a rehab unit for both knees and they were different ones, maybe that had something to do with her reluctance to do the exercises?
She had a hip replaced and didn't come back much at all. She went from walking with a cane to leaning heavily on a walker. She WANTS the other hip done, but at age 91, no surgeon will touch her. Also, she'd be in a wheelchair, and her apartment at YB's home is not wheelchair accessible. She'd be in a NH and that is not acceptable to her.
The knees rehabbed to the 'best' they were going to within 12 weeks. Then hip, well, the pain is gone, but I can't say it was a success at all. She refused PT, so after 8 weeks in a rehab facility she got sent home. Refused to do in home PT and so the PT signed her off. She has gone slowly and steadily downhill since then. Cannot take a step without a death's grip on a walker. Sad, b/c she really could be much better off. The PT told me he sees a LOT of patients who have more and more surgeries for 'attention' and once the blush of the fussing over them is done, they quit trying.
We all did try to encourage her PT, but she wanted us to shut up and leave. So we did. Once she found she would never 'get' to have any more surgery, she kind of gave up even trying to be mobile.