Caregiving: Physical Rehabilitation, Part 3
It was a short distance from the hospital to the rehab facility. The hospital staff was able to load mom into the car and when we arrived at rehab, they helped her out of the car and took her to her room.
I have never been to rehab or cared for anyone who needed it, and I was not familiar with the process. Trusting the rehab staff was important and I asked a lot of questions. What is the plan? How long will she be here? What type of rehab will she receive? How many hours a day will she be in rehab? The staff were able to answer some of the questions. The one thing that was given is the need for evaluation. Since I checked mom in at around 5pm, all of that would begin the following morning. Mom was evaluated in the areas of her speech and memory, physical capabilities (her ability to walk, dress herself, go to the toilet), and mental capabilities with the goal of getting her back to the level of independence to which she was accustomed. All of this took several days.
The number one rule at the facility was “Do not get out of bed by yourself. Call the nurse.” Being the stubborn woman that she is, she ignored this rule and was constantly trying to get out of bed herself, even climbing over the bed rails. If this continued, I would have two options. The first was to put her in a “tent” bed so she could not get out and the second was to stay with her overnight. I drew the line at that and told them to use the tented bed if necessary. The good news is that she did stop trying to escape from the bed after she became used to her new environment.
For the next several days, I attended her sessions, listened to the therapists, and observed her. It was rough the first few days. She was not able to stand or walk on her own. She would quickly forget her instructions and they would have to repeat them frequently.
Mom and I had many discussions about her release. I was honest and told her that she was in a little trouble because she had lost her independence and that I was not able to provide her with the care that she needed. I told her that her goal was to gain back her independence.
Over the next few days, mom continued with therapy for three hours a day (I think that is the most exercise she has ever done in her life). I continued to attend her sessions and saw improvement in her physical abilities. I cheered her on, told her to keep going, she was doing great. When I left each day, I gave her a pep talk. I told her she was gaining strength and to keep up the hard work. It paid off because the therapists said she made huge strides in her physical ability. Physical therapy went well.
Mom’s challenge was her short-term memory. She was unable to recall instructions, what she had done a few hours ago and had ZERO awareness of the need for safety. Her case manager called me and said that she would need 24/7 care and recommended skilled nursing so that she could continue to work on her rehab.
I spoke to my siblings, and we agreed that was a good plan of action short term. Longer term mom would need assisted living and we would relocate her to live closer to my siblings.
Being new to the area, I was not familiar with which facilities would be best and finding the best place was my number one priority, as these places do not have the best reputations. I researched by (1) speaking to the case manager and her physical therapist and (2) reading online reviews and (3) touring both facilities. I had to determine a first and second choice. I am at the point of having to tour the facilities and will write more in my next post.
There is so much that goes in to caring for an elderly parent. While I find many experiences to be similar, none are the same. There are many components to consider, such as insurance, location, and level of health care.
My learning is my advice to you. Make sure to think ahead and have a plan. I spent nearly a decade working for a company that sold long term care insurance. While long term care insurance has its challenges, one thing is for sure. You need to have a plan and a conversation with your loved one about this and plan for yourself. The conversation may be uncomfortable, and you may not want to think about growing older. You may even think this will never happen to you. Chances are it will, and it is best to be prepared.
One thing that the company I worked for did right was to provide its employees with a long-term care policy as a benefit. It is portable so when I retired, I was able to take it with me and continue to pay the premiums. Coincidentally, I received the opportunity to buy up my coverage and was thinking about whether I wanted to. After this experience, I decided it was worth it. I will have money to be taken care of and not be a burden to my children.
Questions for you:
Do you have any tips and tricks for managing the process?
What experiences have you had with skilled nursing facilities?
Helpful Resources:
How to Choose a Nursing Home | National Institute on Aging (nih.gov)
5 Ways to Choose the Right Skilled Nursing Facility (seniorly.com)
Choosing a skilled nursing and rehabilitation facility: MedlinePlus Medical Encyclopedia