Broken Hip Part 2

RunningWorried76

Posted on here a couple weeks back but can't find it now. Quick summary and update - just when we got into a nice routine caring for mom (with middle to late stage dementia), mom fell and broke hip, had surgery, now in rehab nursing care. Hated the first rehab place, got her transferred to a better place that is also closer so I can check on her more. That transfer is the good news. The rest is not...

Insurance coverage became an issue, so I'm fighting that battle. I think she plateaued because of lack of motivation, so the insurance says she doesn't need it any more. Such BS. Paying privately to cover care in the meantime. She's healing slow and still cannot get out of bed without serious assistance. I  want her to come home eventually but I can't bring her home yet. It just won't work for several reasons. She needs at the very least to be able to get out of bed with minimal to no help.

She only likes to eat certain foods and refuses to eat what they're serving at the place. I keep telling her if she wants to come home, she has to eat and get better. She keeps saying she is ready to come home. She even tells people that call her that she is up and about walking around, which could not be further from the truth.

Whether it's me, a family member, or our hired caregiver that was helping when she was home, everyday one of us goes to visit and bring her food she likes and talk with her. But every time, she thinks we are there to bring her home. It's getting difficult to go.

Today she called me on the phone crying, begging me to bring her home. It was crushing.

dayn2nite2

What is your plan if she can’t get out of bed herself anymore without significant help?  It sound like it could end up being the case.

harshedbuzz

RunningWorried76 wrote:

I am sorry you find yourselves in this situation. Unfortunately, often when a PWD suffers an orthopedic trauma like a fractured hip, pelvis or femur, everything changes and a new plan needs to be implemented. 

Insurance coverage became an issue, so I'm fighting that battle. I think she plateaued because of lack of motivation, so the insurance says she doesn't need it any more. Such BS.

Assuming she's on Medicare, the rules for physical rehab require consistent progress towards benchmarks and goals. Sometimes the symptoms of dementia can interfere with the real work of PT. Even if the person could presumably physically get back to a baseline, they no longer have the bandwidth to get there because of poor executive function (understanding cause & effect), anosognosia (the ability to recognize a change in abilities) and memory issues. 

Paying privately to cover care in the meantime. She's healing slow and still cannot get out of bed without serious assistance. I  want her to come home eventually but I can't bring her home yet. It just won't work for several reasons. She needs at the very least to be able to get out of bed with minimal to no help.

Even if the bone knits well, she may still be unable to assist in her transfers. You need a Plan B now. There are tools and strategies for caring for a person who needs considerable help to transfer that an OT and PT could train you and her caregivers on if she is plateaued where she already is. Or you could look to a more permanent placement. 

She only likes to eat certain foods and refuses to eat what they're serving at the place. I keep telling her if she wants to come home, she has to eat and get better. She keeps saying she is ready to come home. She even tells people that call her that she is up and about walking around, which could not be further from the truth.

This may be her perception of reality (see anosognosia above). 

Whether it's me, a family member, or our hired caregiver that was helping when she was home, everyday one of us goes to visit and bring her food she likes and talk with her. But every time, she thinks we are there to bring her home. It's getting difficult to go.

Today she called me on the phone crying, begging me to bring her home. It was crushing.

   

I'm sorry. That sounds miserable.

RunningWorried76

Plan A is to have her stay in rehab/skilled nursing care a few more weeks and then bring her home and see how things go with in-home care.

If Plan A fails, Plan B is to start the Medicaid nursing home application process. I have a CELA advising me on that now.

On a positive note, I visited her yesterday afternoon and brought her some of her favorite soup. She was in a much better mood than when we spoke on the phone. 

Also, this morning she was out of bed and eating breakfast sitting at a table.

I'll take whatever small victories I can get...