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Our mom, 84yo, had a compression fracture. RN at hospital recommended rehab facility, but we opted to get care at their home. What can we do to make it work?
Does a hospital bed make it easier, TV in the bedroom?
I have a feeling the caregiver[brother] may have a hard time communicating with the PT and homehealth aides, [hard of hearing]

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We've used rehab after a fall with surgery and and illness. There's no way I could have done at home what their staff was able to do. Dad was not happy staying there 24/7, but he liked the therapy staff, and I thought they were very good with him. They allowed me to come and watch too.
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If you're going to do it at home, here are a couple tips. Make sure she gets out of bed and walks up and down the hall as frequently as her doc allows. Many folks prefer bed rest, but the walking will keep her from developing a DVT and it's the only way for her to begin to gain her strength.

Also, make sure she has a home care RN visiting at least once per week. A good nurse will give you details on what to watch for. If the nurse isn't helpful, change home health companies.

Make sure she has the equipment that she needs. Gait belt, toilet riser with hand holds, walker, etc. The PT person can recommend.

Watch her diet. Make sure she is getting enough fluids and protein. And enough calories.
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One of the drawbacks to home care directly from a hospital is that there's no step down (intermediary) care as would be available in a rehab facility.

If you're not comfortable with the rehab facility recommended by the discharge planner at the hospital (and by all means interview there, do a walk through, particularly at dinner time, ask many questions, including staff to patient ratio, whether meals are prepared on site or trucked in, etc.) search, and find your own. There are ones out there that are much better than the ones often recommended by hospitals. That's been my experience for 14 years.

Rehab facilities at least have some machines, which are like "force multipliers" and can leverage the therapy to make it more effective. You won't have those machines and equipment at home. Nor will you have as much therapy time at home; progress will be slower.

Care will be more difficult, so be prepared for that. A hospital bed would definitely be helpful, as would care for (sponge) bathing.

How many people would there be to offer help?

To make home therapy work, again, interview a number of companies before selecting one. Also discuss with the doctor the possibility of returning to a rehab center ( usually requires 3 days of hospitalization for Medicare to cover) and whether or not Medicare would in fact cover if she comes home first, then goes to rehab. This would be a major concern.
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You heard that rehab facilities aren't effective...from whom?

Is mom going to do exercise at home after PT leaves? PT is effective in good facilities in part because they have a variety of equipment on site as well as supervisors you can go to if things aren't going well.

I'd check if admission to rehab is allowed after discharge home. I'd also start researching rehab now for "the next time".

I so recall running around Connecticut one afternoon with my brother, visiting 4 rehab before picking one for mom. Do you and your siblings have the ability to do that sort of thing?
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I think my mother would try to opt for in-home rehab, if it became necessary. My father died in a rehab facility. While I wouldn't make her go to that particular one, I would refuse to have anything to do with in-home rehab. I will not become her personal care attendant and stay at her condo.

I will probably make at least one of my (all out of state) brothers participate in the "which rehab facility?" discussion (and make the ultimate decision), because I do not want to get constant complaints about the facility if I am the one to make the decision.
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Thank you. Mom has and RN and PT every other day. We also got an aide to assist with bathroom and companionship(although dad is there we need other eyes on her)
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esposla, twice my Dad had 2 choices, one was living at a Rehab for a couple of weeks, the other was having physical therapy at home.

The first time around, it was my who choose that Dad stay at home and she would take care of him. It wasn't easy as both of them were in their late 80's, early 90's. Mom found out she bit off much more than she could chew.

Physical therapy came to the house, but Mom wasn't user friend, she would glare if the PT was a pretty young woman. The Mom found there was no way she could help Dad up the stairs, she was frail herself, so Dad slept in his recliner and Mom slept on the sofa, either of which was good for either of them. Plus Dad didn't practice his exercise when the PT wasn't there. Recovery took a very long time.

The second time around, Dad choose the Rehab facility. Mom agreed. Dad liked physical therapy especially using all the machines. He couldn't wait for his time in the gym. Plus where his room was located and the dining hall, he got a workout walking back and forth. The food was very good, and Dad enjoyed talking to all the new people.

It depends on the person with what they are comfortable with.

Your profile says that your parents or is it your Mom and her brother or son are living at Independent Living.... or did you mean they are still living in their own home? Usually Independent Living facilities have their own physically therapy, plus options that your Mom can order to help your Mom until she is back feeling better. These options come with a fee.

If your Mom is still living at home, like my parents were, I remember they had to bring in a plumber to add grab-bars in the bathroom. A hospital bed would be nice, I think you can rent one instead of buying. Yes, a TV in the bedroom would be great for those days when Mom just can't get around. Depending on where the fracture happened, maybe a really nice rollor walker, but ask PT first.
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thank you freqflyer. i'm becoming a freq flyer myself these days. It's my mom and dad at independent facility. they do have options in-house ,but we've been using a different agency. She does have a walker and seems ok using it. was your dads' physical therapy for back issues or something else? my dad seems to get in the way , but not on purpose, just wants to try helping and it's too much for him.
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If your Mom has medicare, the insurance will pay for rehab at a facility. Are you sure that you don't want her to go to the facility? I found with my Dad that it really helped him gain strength and recover.
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Thank you for your replies. One of my siblings had a bad experience with the rehab; so it's not say they are good. I'm sure many are , but research would be necessary. My brother opted to have the PT in my moms home. Unless 2 of us want to search for a rehab, we are likely to use the home care....at least as long as it's working. I've checked out an assisted living facility and don't like it, but I'm the only one searching or considering it, *thanks CTTN55. Only one of us can't be the decision maker for a big step like that.
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