My dad was recently moved to a well-rated subacute facility following a stroke. He is on day 5 of his 20-day stay covered by Medicare. When my mom and I toured the facility we were told he’d have approx 2 total hours of therapy per day (PT, OT, and speech). However, he hasn’t even come close to that. He has only had 1 30-min PT session, no OT, and the speech therapist has covid so he may not see her for a week or more. We have complained to the administration, but what else can be done? Medicare is only covering for a limited number of days and my dad is regressing in some of the progress made in acute rehab. How can we get him home if he’s not getting the rehab he needs? He’s motivated and not refusing, but can’t get home until he can master transfers with my mom’s help and get some strength back.
My mom was put in a room right across from the nurses station because of her propensity to get up and walk, even though she is not supposed to. (that is not rehabs fault) . But I went back and she was wandering around while the aides in the station just across the hall were on their phone playing games.
So if OP could find a place that truly was better, sure. But how do you know? Then are issues where Medicare or the Advantage or Supplement plans dont cover all places in the area.
And he received great daily therapy I believe because I was there with him every day to make sure that it happened.
I do recall while I was sitting on the sidelines in the therapy room that the CNA's would wheel some of the older patients in and they were just left sitting there where no one worked with them at all.
However no family members were with them either. Now it's a shame that you can't trust the therapy to happen unless a family member is there to make sure it does, but I witnessed it first hand, and that was back in 1996, so I can only imagine that things have gotten even worse.
So my question to you is....is your mom or someone else from the family spending a lot of time at the rehab facility with your dad to make sure that things are getting done as they should? If not, there is your answer right there.
If your dad can't advocate for himself right now, then you and your mom must do it for him.
If he is not getting his therapy, then tell them to find a facility that has a speach therapist. If they will not do that, then you find one. Everyday that Dad is not getting therapy isca step back for him. I may even as if he can get "in home" care. Talk to his PCP. You are under no obligation to stay in a Rehab that the hospital recommended. Be aware though, his 20 days does not start over in a new rehab, it just continues.
All I can say is advocate and be pushy. A transfer decision can be especially difficult in those rural circumstances!
What made my brother’s situation especially frustrating is that the PT at Mayo, where my brother started out, was cutting and pasting his old notes into his charting, so as social workers at facilities were making decisions, they were seeing an incoherent blob, rather than someone who was making an effort and progressing. So his applications to choice facilities were ignored for nearly two weeks before we realized what was happening and demanded that the PT update his notes. Then he was accepted immediately.
Be sure that someone in the family is present at some of the therapy sessions and knows what is being reported. What they put in their notes matters for continuing therapy as you move ahead.
Could luck, I’m with you!
I saw you had a meeting scheduled last week. What happened?
My mom had broken her arm - went to one rehab and then to a hospital for issues contracted in that rehab. After her hospital stay she ended up in another rehab for a few more months. When she first got there, they were leaving her in the bed and I had to intervene - SHE WAS TO GET OUT OF THAT BED EVERY SINGLE DAY and I didn't care if they were short staffed. This type of 'care' only keeps patients dependent and weakens the little stamina they may have.
Some CNAs get minimum wage and as a result, patients get subpar care. During the week nurses are on shift and give great care but on weekends 'agency' employees come in to care for patients and that is a different situation.
My mom was there for physical therapy but it was hit or miss. They had a walker in her room and was told her not to use it and to stay in the wheelchair. She was not to go to the bathroom by herself (yet no one would respond when she buzzed for help - they said 'just use the diaper). They would use a Hoyer lift to get her in and out of bed instead of helping her stand on her own.
I told mom she NEEDED to tell them NO MORE HOYER or she wouldn't be able to go home (a rule of theirs). She got her fight back and started going to the bathroom on her own. I finally told them she WAS coming home on the Thursday before Mother's Day.
Things I learned:
1. ADVOCATE ADVOCATE ADVOCATE for your loved one.
2. SPEAK UP if you see something wrong and if there is no resolution GO HIGHER until you GET a resolution.
3. VISIT as often as possible - I went every day but if you can't do that, HIRE someone to check in on your loved one.
4. DO NOT accept whatever is said - QUESTION EVERYTHING
5. TAKE NOTES and ASK for printed out reports of patient progress
6. ENCOURAGE your loved one to SPEAK UP if they are able to
7. Don't always GO BY THE RULES - they are intended to keep that bed filled
8. Hire an ELDER CARE ATTORNEY if needed
9. Do not GIVE UP
10. BE A PAIN IN THE ASS - the squeaky wheel gets the grease. Many times I went into closets to get clean bedding, towels and supplies Mom needed.
11. DO NOT BE INTIMIDATED by ANY worker there - they are hired to do a JOB
12. Educate yourself on patients' RIGHTS
I hope my long comment helps - Update on mom: she came home (she lives with us) a year and three months ago and is completely recovered. She is making her meals, chatting to friends on the phone, doing laundry and performing self care. I am extremely PROUD of her and grateful we got her home.
There is no situation that cannot be made better - don't give up... even if your loved one is not able to go home things can ALWAYS be improved.
Inspiring!
Sending love and congratulations and wishing you well.