Transfer from Acute to Short-term Rehab

Wilted Daughter

Mom had pacemaker implanted last week after a terrible fall. She's 89 and frail to start with other health issues. The acute rehab was intensive for her and they wanted to discharge to the home when living space is unsafe (bedroom upstairs, cluttered hallways/spaces...) NOT conducive for a frail senior who is at risk for falling. 

Spoke with staff to arrange transfer to short-term rehab (step down) which I am told is common. This will allow me to prepare the house for her homecoming. The acute environment has too many staff members attending to her providing varying and sometime misinformation which increases her confusion in addition to her sister calling daily asking questions (which is a whole other post about family boundaries). 

I'm told that the short-term rehab will be less intensive with a less intensive schedule. My feelings are that she and the house are not ready for her to come home and I have to work hard to prepare for homecoming with no help. Additionally, her "sisters" make statements about me being with mom at the rehab daily since they took such good care of their mom 22 years ago (not mentioning there were 6 out of 10 siblings available to help). I really don't like interacting with them (falsehoods, backstabbing, controlling...is how they roll). 

I guess all I can do is focus on the matter at hand plan and prepare for the future as best I can. It's not easy and a thankless job. 

jfkoc

Certainly not easy but those of us who have been or are caregivers understand and we give you a big pat on the back!

Cynbar

Just be aware that your mom's time in short term rehab is dictated by the progress she makes. Many patients with dementia lack the motivation and get too confused to benefit too much from therapy, so their insurance will cut them off. Be working now on her plan for the next phase. Ask to speak to the social worker as soon as you can and communicate your concerns. Too many relatives sit back and wait, then get blindsided when told that discharge is coming soon. You can probably buy a little time if that happens with discharge planning as the skill, but not too much. If her home environment is not safe, they will move her to a nursing home (sometimes in the same facility) and then work with you on payment. But it could be a short stay .