My 94 yr.old mother fell and broke her hip, surgery is today. How to find the best rehab place in her area?

Hi Bonnie - My Mom fell and broke her hip last September. The hospital and doctor will have suggestions as to the best places to rehab - listen to them. I took the list they gave me and went to each place, and found that their recommendations seemed to be spot on. Medicare will pay for up to 21 days of rehab at 100%. After that, they may pay 80% depending on need, but my mother was able to be discharged right at 3 weeks. However, we were living at home with Mom in a one level house. Mom was walking very well by the time she got home. She only needed help with showering, dressing, and getting into and out of bed.

Stairs are not allowed, so yes, an elevator or a downstairs bed will be needed. An over the toilet commode and good straight backed chairs are necessary also. Make sure grab rails are in the shower and bathroom - she will need them. Remove all loose rugs and anything else she could trip over. Mom's occupational therapist took a trip home with Mom before she was discharged to check out the house and inspect for any dangers to her or concerns we might have. It was really helpful. Your rehab facility should offer both physical therapy and occupational therapy. The physical therapy is to get your mother stronger. The occupational therapy is to teach your mother how to do those things that she will need to do in everyday life SAFELY, without hurting her new hip until it heals. Things like putting on socks and shoes (she's not allowed to bend over), getting out of bed, showering, if she's going to continue living alone (and they will evaluate her ability to do this), safely cooking for herself (they have kitchen set ups) when they can't reach, bend or twist. They may advise that she go to an assisted living facility for awhile after rehab, or have someone come in and stay for awhile to help out with cooking and cleaning.
Hope this helpful.

Hi Bonnie - My Mom fell and broke her hip last September. The hospital and doctor will have suggestions as to the best places to rehab - listen to them. I took the list they gave me and went to each place, and found that their recommendations seemed to be spot on. Medicare will pay for up to 21 days of rehab at 100%. After that, they may pay 80% depending on need, but my mother was able to be discharged right at 3 weeks. However, we were living at home with Mom in a one level house. Mom was walking very well by the time she got home. She only needed help with showering, dressing, and getting into and out of bed.

Stairs are not allowed, so yes, an elevator or a downstairs bed will be needed. An over the toilet commode and good straight backed chairs are necessary also. Make sure grab rails are in the shower and bathroom - she will need them. Remove all loose rugs and anything else she could trip over. Mom's occupational therapist took a trip home with Mom before she was discharged to check out the house and inspect for any dangers to her or concerns we might have. It was really helpful. Your rehab facility should offer both physical therapy and occupational therapy. The physical therapy is to get your mother stronger. The occupational therapy is to teach your mother how to do those things that she will need to do in everyday life SAFELY, without hurting her new hip until it heals. Things like putting on socks and shoes (she's not allowed to bend over), getting out of bed, showering, if she's going to continue living alone (and they will evaluate her ability to do this), safely cooking for herself (they have kitchen set ups) when they can't reach, bend or twist. They may advise that she go to an assisted living facility for awhile after rehab, or have someone come in and stay for awhile to help out with cooking and cleaning.
Hope this was helpful.

Hi Bonnie, I hope your Mom's surgery goes well. My Mom had hip surgery when she was 96. Things I learned. Ask your sibs (near Mom) to check out the rehab places. They REALLY do vary! The one I picked fro my Mom had 75 minutes /day for physical therapy and 75/day for occupational. In addition, there were 'activities' during the rest of the day that kept her busy. A year later when my husband's aunt needed rehab, his family chose a place 'near to one niece'. They offered 30 minutes of therapy a day! Frequent visits are important for your sibs to follow up with the therapists. And to see how your Mom is doing. I know this sounds trite, but while my Mom had a pitcher of water in her room each day, she couldn't reach it. Surprise Surprise when she wound up totally dehydrated! And, the rapid set of changes can cause your mom to get mixed up as to where she is, etc. Someone will have to keep her on an even keel. Keep us posted.

Thanks so much. Your mother's experience sure made me feel better! Mom does have ap Personal Assistant who is beside her all of the time...and loves mom dearly. But, she only works M-F and mom is alone over the weekends. Right now I'm just worried about her ability to rebound from this hospitalization. My brothers thought a chair lift thing would be good, but I'm thinking the elevator would be better as she may need a wheelchair and the chair lift thing wouldn't really work. The house is set up in a way that the stairway is in a straight shaft.
No worry on the funding. Not only does mom have money of her own (although she much prefers us kids to pay for things) but my brothers are all multi-millionaires and eager to do whatever then can for mom. (note, brothers, not me!) Thank the good lord we have a healthy and loving family!
Does the doctor/rehab person have the "say" about returning to her home? Two of the grandchildren have MSW, one right in the state of Maryland...I called her and she is going to work with the hospital SW to identify recovery places. That makes me feel ever so much better as she knows her grandmother and what she will and will not do.
I'm worried about the bending over part...and the showering part. She has hand grips in the tub but still has to step over the tub edge and ususally sits on a chair while showering. Will that work or will we finally make Mom accept a new walk-in tub? I really appreciate your help with clueing me in on the changes she will be facing. Thanks so much. Bonnie

Okay...check out the time the rehab place has for the pt and ot...what about the MRSA issue? Anyway to find out if the institution has had any problems with that?

She will need to sit down while showering. We have a walk in shower, so not sure how they handle people that only have step in tubs. I'm sure they probably have a method of having you sit on the edge of the tub and then get in, but not sure about that. If you wanted to press the issue of the walk in tub/shower, now might be the time, though, if you could get it done in time. Sorry about the previous duplicate message.

Eve

Thanks Eve,
I think it is a good idea to do a walk in shower. Get rid of the tub. She thinks these changes to her house would lower the value...such a child of the Depression!
I talked to her PA, Andrea a few minutes ago. Mom still hasn't had the surgery which was due to start two hours ago. I really dislike this hospital and wish Mom had been moved to Suburban Hospital in Bethesda, MD. It is a Johns Hopkins hospital and I've heard great things about it (including my own birth was there!). Mom is in a great deal of pain and tries not to even move! Scale of pain 1-10 she's a 9. Poor thing.
Although I did research on elevators for her zip code and found 4 companies that would do the work, we need to wait until we find out if she will be moving home (which we all hope for, of course). The Social worker came in earlier this afternoon with a list of 4 places for rehab. She/he talked about the time spent on therapy...and some other issues you told me about. It is important to find a fit that has well trained therapists in her needs field. Won't know that until she is evaluated by the doctors in the next few days.
I can see a possible clash in opinions about Mom even moving back home but I really doubt any of us kids are going to press her but the grandchildren are very opinionated about her moving out of the house.
There are walk in tubs that only take a day to install so if that makes sense, we can get that done. My brothers have wonderful contacts as they have had loads of work done on mom's house to make it better for her to live there. One brother put in an extensive security system only to find Mom didn't like it one bit and made him take it all out!!!
You have really helped me, I do appreciate it, Eve. Funny, a in one of mom's books the leading lady is named Eve.

Glad I've been of help! I just got home from one of Mom's dr's appt's followed by dinner out. It was the first time she'd tried to go out to dinner in quite awhile, and she's exhausted. We didn't go anywhere fancy, just the Fisherman's Marketplace, but it's one of Mom's favorite's - she loves the fresh seafood.

I know it's hard when surgeries start late, but they very seldom on time. Oftentimes, emergency surgeries knock the scheduled surgeries into a later time, or a routine surgery with your doctor that was scheduled earlier in the day can take longer than anticipated. I've seen this in just about every hospital I've been to all across the country - it's the nature of the beast.

I don't know about walk in tubs. Your mother may not be able to sit down in a tub for a very long time, and I would concerned about her standing up on a slick surface. She for sure will not be able to bend her body to get her feet under her for at least 3 months, probably longer. I would think a walk in shower would be a better option. You can tell your Mom that walk in showers are all the rage now - just look at HGTV - hardly anyone has a bath, and if they do, it's in addition to a large walk in shower.

Hi Bonnie - She should have a walk in tub ideally, My mother had a hip repair last year at 99 and got through it fine, went to a rehab hospital and discharged herself early. She is a physiotherapist and she didn't agree with their treatment!!! But that is mother. She lives in an ALF and returned there, and manages fine with home care 4 x a day and uses a cane sometimes. She has a tub and knows how to get into it, but uses the walk in shower, and a stool. It has taken her longer to recover from this hip op than the last one 15 years ago. She is basically healthy though has some stomach issues. Good luck. I am sure she will do fine.

WOW! 94 and still at home. That is great. Good luck to your Mom and to you finding the best facilty to recover.

Thanks all...Mom finally went into surgery after midnight. Needless to say, I was upset as she had been in that hospital for 36 hours in great pain. I called a few minutes ago and she was in her room. The PT and SW were there deciding if she was up for the PT or whatever. I'm waiting for a call back. No doubt Mom just wants to get some rest before charging forward. I shared the information you all so generously offered with my brother who is near Mom. Hope he finds this site and can read all the great comments himself.
And thanks emjo for the upbeat shower idea. I'll let you know how this turns out! Thanks again, Bonnie

Hi friends,

Just a brief catch up on Mom. She had the hip surgery about 12midnight and back to her room around 4:40 AM.
She had a sip of the hospital coffee and declared it "bitter" then had a sip of PA's Starbucks coffee with cream...and said "better". Mom really likes instant coffee with the flavored non-dairy creamers. (go figure).
The good news is she did get up and sit this morning! She is such a sweet person yet hates PT or any exercise. However, my guess is she will do it with the carrott being able to get back to her house!
Someplace I said the brothers are meeting on Monday with contractors for the elevator/chair lift...also built in "disabled" shower and replacement of all 4 toilets with appropriate higher stools. I just hope my brothers are sensitive to Mom's taste and they do not choose something too comercial or ugly. She loves her house and feels so good being in it. The goal is to get it all done before she checks out of the rehab. "They" say she will be in rehab about 20 days. Our aim is to get her back into her normal/comfortable/happy routine as soon as possible. Older brother (I've two older brothers) says he is totally on top of it and not to worry. I gave him this website and log in information last night. He said he learned a great deal and appreciates all of the hints and suggestions from all of you. Mom has made a point of saying she gets worn out easily and for all of us and friends NOT to come see her. She says she has more than enough people watching every move! I understand Mom and will go to visit when she says to come. For those who would like to look at her book of poetry you can find it on Amazon. The title is : Poems of Love and Hate. Are we allowed to give real names? Here is her poem she wrote for this book.

For my Loved Ones
My neighbor leaned across the garden gate
and watched me working.
I was on my knees amoung the peonies.

"There's so much left to do, " I said.
"The garden's nowhere nearly ready yet
for the killing frost."


"These golden days," she murmured, "why not
just enjoy them? Your garden's never looked
so beautiful. There's lots of time--"

"But not for me," I said, and looked at her. She
gazed into my eyes, where all my secrets are;
she saw, and caught her breath.

I said, "I do not dread the winter;
just want it not to come
before I'm ready."
==
So in my waning years of life
I've gathered up my little songs
to have them ready,
and I've brought them here, for you.
_____________________________________________________________
That is probably as best a description of Mom as I can offer up. She is a beautiful women inside and out. In one review of a book the commentator said she was the image of a wonderful "fairy godmother". She did not appreciate the implication that she was old...but there you go. I think Mom is very brave, terribly shy, and a truly loving person.
Well anyway friends (and Mom is from a long line of Quakers/Friends) I so appreciate your compassion and spot on suggestions for her well being. Maybe you never knew your experiences would help others who need them!
Thanks and loads of appreciation. She's not out of the danger zone but we all have hopes of a "full recovery" (we think 90% will be fabulous). Bonnie

What a beautiful poem!

It is!

Thanks for reading it!
Took our little niece and nephew to church for Easter egg hunt and games this morning. It is such a breautiful day here, sunny and bright...67 degrees. Just a perfect time for Easter activities.
Mom actually stood today! Yeah!! Now listen to this...Mom's PA (Personal Assistant, Andrea) brought the following to the hospital: favorite china, coffee cup and spoon, mashed potatoes, green beans, pudding, IPad, hot water bottle, toiletries including her special toothbrush, blanket and I don't know what else. Those little homey things are making her feel more comfortable and reminding her of home. Everyone says she is having a great deal of pain, something about spasims in the hip area. Her right shoulder went out of socket, too, so that is really a painful event making it unable for her to use her right hand. that will get better as all these things heal.
Mom understands that she must coorperate with the PT and says she will inspite of hating exercise. And she is going along with modifications to her house (just make sure I have a white floor in my bathroom). So, let's hope for the best but be prepared for the worst. Thanks ladies, I so appreciate your concern. Bonnie

It is absolutely imperative that she do all of her physical therapy. Even after she gets home - the more she exercises, the better off she will be. My Mom has no issues with her hip at all 5 months post op, but she is one of the most compliant patients you will ever meet. If she is told to do exercises 5x/day, she will, religiously!

My mother broke her hip and went straight home. She did fairly well, but it was a small house. Then, when she broke her shoulder we chose a private pay facility. It was much nicer than anything that medicare would pay for.

Personally, I think the house is too much for her and that should be discussed as soon as possible.

My Mother turned 94, today and lived at home up until a month ago. Good luck.

It is good to see your experience with pt and returnng to life. Mom intends to do whatever they tell her to do. And again, the family is looking at all possible options for staying in her home...but...So glad $$ isn't an issue but having someone with her 24/7 may be a problem. Andrea, her PA does a wonderful job but has her own life, too. All I know right now is my brothers and Andrea say the are on top of it. Good! If you read her poem I posted earlier, you can see she isn't afraid to die. However, she is afraid of "lingering".
I was pretty upbeat this morning but feel some gloom now.Not sure why but I've always been very psyic when it comes to Mom.
Thanks again. Bonnie

Further update...well, Mom has to have a blood transfusion due to low iron (?) and anemia before the hospital releases her to rehab what was to be today.
A CAT scan will also be done as she did complain of fuzzy vision and such.
Also to be done, today.
No elevator as the structure of her town house won't support it inside and it would have to be on the outside which requires loads of permits, 6-9 months work, and $75,000.
The chair thing can be done in 5 -6 weeks, inside and $20,000.
Chair lift won.
Next to the bathroom!
Bonnie

One more note from what we went through recently. My 90 yo MIL, thought that if they put in a walk in shower in her home, she would be able to live there. I knew it sounded like wishful thinking, but it is her money. She got to use it about 5 times and now is in AL, for the next year (lease). Good luck. I hope your mom feels better soon.

There can be blood loss during the surgery which is one of the reasons they check the blood. I wouldn't worry about that too much. My mother has had tons of transfusions for other reasons (GI bleeds). At this point, I think they've replaced all of her blood :)

If it weren't for how intellectually active she is I'd say AL. She has all of her research notes and materials necessary for her book at home. She was telling us all how happy she was and how she just loved her home just days before the fall that broke her hip.
As I'm 3000 miles away, I have to go along with my sibs who all love and support mom in any way possible. I know the SW will do a walk through of the house before they release Mom from rehab.
Knowing mom as I do, she will just pass away gently when she is ready. She tells us her "expiration date" is coming soon but still hopes to hang on until her latest book is finished. I hope so too. Thanks for your help. Bonnie

One of the things that has happened to Mom since she has been unable to get out as much due to her declining health is a type of mental stagnation. She misses the stimulation that comes from daily interaction with friends and people her own age. In that way, I think AL would in some ways be better for her, and possibly for your mother as well. Seniors who still have their minds but have failing bodies need to keep their minds active, and just being around 1 or 2 people, no matter how loving, isn't enough. They need a social life. Assisted living can provide that.

When we were looking for rehab places when we toured we "sniff-tested" (one room isn't a problem, mutlitples or the halls smelling...nope!).

Sounds like you don't have to worry about the lion's share of the choosing, which is nice. One of the things that has helped in our family is that while my Mom (out of area) and Uncle do share their opinions, the Aunt who is DPA has the final say, and they support her decisions, even if it isn't how they would have done it (her attitude all along has been that if they want it done differently they are welcome to take over that part of the job and do it). Everyone working together has been great, and sooo much better than family members squabbling.

Be prepared that it DOES take awhile to get back to normal, so don't give up hope or get depressed if it seems she isn't snapping back right away. With my Grandmother the surgery went fine, but the rest of her system took time to recover (in her case it was the bladder not cooperating, so she ended up with a catheter for over 2 months -- fine now though).

Since she is (apparently) mentally competant & has funds would she have the option of a paid caregiver with in-home therapy if the rehab turns out to be unacceptable for some reason? Cost-wise may not be much more, and avoids some of the facility-aquired disease issues. Also, depending on how mobile your Mom is, does it make sense to look at having someone stay at nights? My (now 98) year old neighbor had assistants during the day for quite some time to help her, but at certain point it became necessary to have someone live there who's only job was to be there at night "in case something happened". There is even a non-profit here that matches older people with room up with folks (often middle-aged or older) looking for inexpensive housing (they do a background check & try to match personalities,etc., and make sure that everyone has reasonable expectations -- no free room just for living there, no expecting to charge rent AND get unlimited free 24 hr care)

What an excellent idea! I passed on your answer to my brother. There is a lovely lady (abt. 64) who is recently widowed (16 months) whom we met last summer when I was back visiting mom. Lovely Lady, Marti's son and family live next door to Mom. Son is a medical doctor doing research at NIH in Bethesda, his wife, J is a teacher but will be a stay at home teacher to her 2 kids. It would be a wonderful match if Marti would sleep at Mom's and Andrea during the day. So I sent all of this information to my brother and see what he tthinks.
So you get a really big hug for the suggestions!
Bonnie

Cool -- I hope it works out. I'm lucky enough to be living in a neighborhood with a lot of over-80 folks (and 90+...our local CVS even has a "100th birthday card" slot with two different styles of cards!!!). Getting to know some of them over the years has been fun (even if I have to hijack the waitress in order to pay the bill when I tag along with the 98 yr old to Denny's LOL!).

For all those who have been so kind to offer helpful suggestions about my mother.
She is HOME and feeling ever so glad to be there~
She is thinking she will get strong enough to climb the stairs again, so is not wanting the chair lift thing...yet.
The doctors and nursing staff, plus PT and OT have been amazed with Mom. So happy for her. and Proud of her, too.

It is so wonderful to have such a loving and strong mother! She appreciates all your prayers and support.
me, too.\
xxoo
Bonnie