Mom, would you just GO to rehab? Please. (long)

Miscellaneous and Personal Stuff I Must Share
1

No, not THAT kind of rehab. This is postsurgical inpatient rehab for the hip she broke last week. She’s been in the hospital since Saturday (she hasn’t spent a night away from home in 20 years before this, to my knowledge) and of course she wants to go home. All the hospital staff, and my brother, and I, want her to go to a rehab facility for a course of physical therapy first.

The good news is, dementia’s not an issue; she’s perfectly capable of making her own decisions. That’s also the bad news: she’s as free to make a stupid decision as a smart one.

Mom lives alone, in an apartment complex for the elderly. (She’ll be 78 later this month.) She fell in the bathroom (yes, classic) last Thursday night and sat on the floor all night until my brother arrived Friday morning on his usual Friday-morning grocery run. She then refused to go to the hospital and had my brother help her to bed. Sometime Friday afternoon she made it from bed to the bathroom and back (with a wheelchair) by herself; this took two hours, she said. My brother returned Saturday morning to check on her, and she finally agreed to call the rescue squad. She had surgery Sunday morning and has been doing fine, according to the medical staff.

Me, I live in another state and don’t have a car. Mom’s apartment is along one of those once-an-hour bus routes that doesn’t run Sundays (and it takes a bus and train, or two trains, to get to where I can catch that bus), so I don’t visit very often.

Mom seems to think she can do rehab at home. If Medicare won’t pay for home rehab (I have no information about that) that could settle the argument, or it could make her decide to dispense with rehab altogether. As far as I can tell Medicare WILL pay for the inpatient rehab.

Her basic arguments (aside from “wanna go home”, which is an emotional argument and not susceptible to logic) are that people she knew got infections in rehab, and that it won’t help. I don’t know how to answer the first other than point out that lots of people get infections at home too. I’ve already answered the second argument with “You won’t know if it can help you if you don’t go.” She has arthritic knees (and hands) and hasn’t been very mobile for a long time (this is why there was a wheelchair in the apartment, not that she used it much), and she argues that rehabbing the hip won’t make her knees any better, so she’ll just end up spending weeks away from home for nothing.

I won’t deny I have a personal interest in this: my own peace of mind. I want her in rehab so I’ll know she isn’t sitting on her bathroom floor all night (or all week). I don’t want her being alone at home again until she’s at LEAST as mobile as she was before she fell. (I’m hoping rehab might make her somewhat more mobile, or at least show her ways to cope with her arthritis; I don’t know how realistic that is.) This whole thing has been hard on my brother (he sounds exhausted) and I’ve lost weight since Friday. OK, I want to lose a few pounds, but not this way. Plain English, I’m scared for her.

I’m also a bit surprised I am this emotional about it. I spent my childhood scared OF Mom, not scared for her. I hauled ass at 21 and have been on my own since, only visiting her for holidays. It’s not like we’re friends or something. She’s just my mother. Dammit.

2

That’s a really tough situation. Can you get the hospital social worker involved? When my parents went through various hospitlizations during which we couldn’t convince them to make the dicisions we needed them to, the Social Services staff were a godsend.

They clearly articulated the options and the consequences and benefits of each. They were an authority that somehow was more acceptable then taking direction from the kids.

So, I would advise getting them involved, through the hospital she is currently at.
I’m sorry you have to deal with this- it’s always really hard no matter the relationship (I feel pretty much the same about my folks as you do…)

3

I think medicare will pay for a physical therapist to come to her home, my grandmother had one that came to her home. Before she was released from the hospital we had it arranged that a nurse would visit and the physical therapist would visit. Check before she’s released and have all the arrangements made.

That’s not to say it’s a good idea at all. I doubt if her results would be as good as going to a rehab. My grandmother became extremely thick headed and because she wasn’t cooperative with physical therapy she ended up confined to a wheelchair full time.

I think at that age, people are afraid that if they go to a hospital they’ll never be able to go home again. That’s what my grandmothers fear was and why I think she wouldn’t go to a rehab.

4

I will add my best wishes to you in dealing with an emotionally charged situation. In my experience as a nurse tech on an orthopedic floor, hip replacement patients are not discharged to home without adequate care covered by insurance (rehab is covered so she would nearly by default be discharged there). The social worker assigned to her case should ensure that she will be discharged and moved to whatever is most suited to her condition. Talk to the charge nurse/nurse administrator and caseworker and they will help determine the best options for your mom. One thing I can say for sure, they will not just let her go without proper treatment unless she leaves AMA (against medical advice)

5

Good advice IvoryTowerDenizen.

6

Update: Mom’s in the rehab center as of tonight. (Insert huge sigh of relief.) At the moment they’re talking about a 7-10 day stay, at least according to her. She’s also talking about arranging some home rehab and Meals on Wheels by the time she gets home. That will at least ensure someone will be stopping by regularly.

This is a HUGE relief to me. Now that I think about it more calmly, I should have remembered Mom has always been a lot better at making threats than at carrying them out. Otherwise I would probably not have survived my childhood. Not without serious disfigurement, anyway.

Many thanks for the replies and kind thoughts.

7

What a relief!

I broke my hip 2 years ago, and I didn’t want to go to rehab either. Five days in the hospital was enough, thankyouverymuch. Lucky for me, I had a husband to help at home, plus visits from home health care workers for about two weeks, to check the incision, etc.

The only problem for me was access to the bathroom. Does your mom’s place have wide doors, so she can get to the commode with a walker or a wheelchair?

Another thing that helped was a “riser” on the commode. It’s like one of those potty seats for training toddlers, except it’s for grownups. You can get them with handles on the sides. They cost about $50.

Most commodes are lower than a standard chair, and getting up and down without help is difficult. The riser helped immensely.

If your mom isn’t the type to ask about stuff like this, maybe you can suggest it.

8

Oh, I’m glad she went to rehab! What a relief.

My grandmother (80) just broke her hip on Friday night, slipping on some ice on her front porch. She’s looking at rehab as well.

If I might presume to make a suggestion for when your mother does go home: get her one of those Life Alert (or whatever company is out by you) devices and memberships. My grandmother was outside at 8:30 at night in a Chicago winter, and the only way anyone found out was because she had her little clicky thing around her neck. There’s a little unit that essentially a speakerphone in her living room. She pressed the button on her necklace, and when they couldn’t hear her answer (because she was outside), they called her neighbors and the paramedics. Otherwise, she would have been outside until the neighbors looked out their windows the next morning! She would have frozen to death out there all alone.

Just last month she had been muttering that it was a waste of money, since she’d had it and never used it. I’m so glad she didn’t cancel it! The “I’ve fallen and I can’t get up” ad made for a great punchline, but now you and I both know why it’s really not so funny. I’m actually getting one for my mother. She’s only 59, but she lives alone, and she could get hurt just as easily as an older person, and I wouldn’t know for a week or more.

9

I’ve thought about getting one of those. My stepdad and my aunt both fell and broke hips when they were in the house alone. Stepdad only had to wait a couple of hours for help, but auntie was on the floor for two days.

If not one of those alert thingies, then a cell phone carried in a pocket would be better than nothing. Unless you broke it in the fall. Sheesh. I’ve turned into a worrying old lady. A bad hip will do that to ya, lemme tell ya.

10

Welcome to the club, we have quite a few members already.

Glad to know she finally went to rehab :slight_smile: I think they call it the second childhood not because they need help getting dressed (many don’t) because they can be a pouty and stubborn as any 3yo. And, unlike the 3yo, you can’t send them to their room.

11

Preach it, folks! I am ongoing in this same thing with my mom only add in a big dose of dementia. My mom is used to being a Queen and does not like people telling her what do much less why. She hates exercise of any kind and dosen’t believe ladies should ever sweat. The dementia has been creeping up for about 2 or 3 years and is now at a point I call the “Tide Syndrome” - she phases in and out. She wants to go HOME, she wants good food, she wants people out of her business and she’s becoming a bit nasty from her lack of freedom.

I live in another state but she has several family members around her to monitor her and keep an eye on her even if she is in an assisted living facility. I was in court last month to get a guardian appointed after it was noticed that my brother had slipped over a quarter million dollars out of her investments. Talk about a mess!

So I go see her every other month or so and she bitches. Then I try to explain (being a good Doper!) the how and why and she tells me to shut up or warn me that everyone tells her that crap.

The painful part is that I don’t know this woman. Because of our tangled relationship I left early and mostly stayed away (sound familiar ryobserver?) so now I am getting to know this woman and it’s very odd. On the other hand, I’ve been spending more time with my family there and lots of things have come to light about my mom and me and I am feeling much better about me and sorry for her.

Life’s a bitch and then you watch your parents die and keep breathing. My sympathies for everyone expeirencing this.

12

I’m waiting for this battle to begin this coming Monday. My 70 year old father goes in for a hip replacement tomorrow. He’ll be in the hospital until Monday. The only time he has ever spent the night in a hospital was 6 years ago when he had bypass surgery. He’s a very strongwilled man, and doesn’t take orders/direction very well.

To make it all a bit more weird, my parents don’t actually have a home right now. They have spent much of the past decade + living overseas, and they only have a cabin right now, not suitable for living in in March. So if Dad doesn’t stay at a rehab center, he doesn’t actually have his own house to go to. They have lots of friends and family in the area, but that’s not the same.

We’ll see how it goes next week.

13

I knew broken hips were a common problem, but wow. In addition to all the experiences here, one of my best friends has been going through all this (plus some dementia) with her mother-in-law, who broke her hip right before Christmas–had the surgery Christmas Eve, in fact.

Auntie Pam, Mom’s apartment complex was purpose-built for the elderly, so it’s got wide doors, lever door handles, railings in the halls, extra-large bathrooms, and other features, plus a staff familiar with these sorts of problems. The rehab center she’s in has treated other people from her building who also broke their hips.

WhyNot, best wishes to your grandmother. When I spoke to Mom today she asked me to find information on LifeAlert and on cell phones. I suspect LifeAlert would be a better idea; a cell phone may be a bit fiddly for a woman who needs help changing the batteries in her remote control.

Continued thanks for everyone’s kind thoughts, and my sympathies and best wishes to everyone and their stricken kin.