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Mother is being released from a hospital after breaking her hip. They say she can't go to rehab has to go to nursing home w/post acute care? The hospital says she is too weak for a rehab center.

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The difference is that a rehab center which is normally hospital based reqiures 3 hrs of therapy/day and to be honest, the majority of their patient are very high level patients and.or complex. This might include a young person with a CVA, a motor vehicle accident, spinal cord injury. Very specialized. Nursing homes with skilled beds for rehab normally have full service rehabs which is all three disciplines. Pays to do a tour. I have worked as an OT in this environment in many places/states. Most of these facilities are very well managed and the rehab is great with very skilled therapists. Where I work our average length of stay is 21 days to home. We do home assessments, work with families and are very motivating environment. Again, do your homework. Across the country, many hospitals are closing their rehab centers as insurance companies are making decisions to send people out and unfortunately, this has to do with reimbursement to hospitals. Yes, it is still about the bottom line!!
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To be honest, it sounds like they are saying that they are recommending comfort care. Please clarify with her doctors if they are recommending any rehab at all, or for her to be kept comfortable and pain free. You might inquire if calling Hospice is the right move at this point.
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My mother is in a long term care facilitie... They also have a few beds that are for short term rehab as well. The care is amazing and all the safety procedures are in place.. Before my mother was long term she was in two other times for short term rehab .. I was very happy with the care she got and when I had to make the decision for long term it made it a little easier with knowing the staff already. Good luck!!!
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My mother was in the hospital for five weeks, during which she received minimal P.T. at her bedside. She is now going into her third week of P.T. through a Nursing/Rehab facility. I've learned a lot about the process. (One thing I've learned, it pays to have good insurance). She needed to be able to participate in 3 hours of day of P.T. and to demonstrate to Medicare she was making progress or they would not pay beyond 20 days. She will be discharged on Monday and now, with the assistance of the social worker, we are learning about in-home health care and more about Medicare/Medicaid benefits. Thank God for this forum. It helps to have a list of questions each day for the doctors, nurses and social worker. They were tremendous resources, even to the point of calling me at home to discuss her proposed treatment, improvements and goals.
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Rehab in a hospital is more intents and rehape in nursing homes are in some cases almost none when my husband was 8n hospital rehab it was from when he got up to afternoon with 5 pt s when he went to nursing home he got 15 minutes with 30 people no one on one like hospital at nursing home I could never find a pt they closed there room at 9am and had all there people done in hafe hr the as worker was also done by noon and always never had time to talk to you about your loved one he became a living dron there he ate slept ate slept ate slept that was his day with TV running day and night no water by his bed as they don't want to be taking them to tolit all day so plants you bring die as your lobed one wilts not to give them a bad rep there are also great ones but its best to visit frit and often and don't except your loved one to tell you there unhappy with the place because they are glad to be with you and are worried where they will go next could be worst hope I did you some good
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To follow OTJenn (I'm at OT too!). Rehab in the hospital is more intense for a shorter period of time. The person does need to be able to tolerate 3 hours a day of therapy, but not consecutively. There also needs to be a solid plan after discharge- someone to care for the person if needed etc.
Subacute rehab in a nursing home is less intense therapy for a longer period. Some facilities are very good but some are awful. You definitely need to do your homework and visit the facilites.
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In mom's case, the measure they used was a patient's ability to work for three hours daily at serious rehab. A rehab center would be a wasted resource for your mom right now. A broken hip means maximum of toe touch on that side for weeks. Most older seniors aren't even going to be on their feet walking because they can't effectively hitch their step.
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I agree with cattgoodness. My Mom is currently in a rehab health center in Newark, NJ and I don't think in most days she does 5 minutes of real Rehab. My Mom suffers from dementia and she is just a # there. She gets told to do some leg pushes and Mom does one push they walk away to instruct someone else what they need to do, and my Mom stops her leg pushing because there's no one near her to direct her to continue the therapy. to me that is a waste of state funds. Luckily for my Mom she has family that visits her through out the day to make sure she eats all her meals and to keep her somewhat entertained otherwise she would go downhill instead of getting better..There are a few very caring nurses that I could only wish my Mom had them at all times but I also have seen some real rude ones and the rude ones could care less about their patients and don't like to be questioned about anything. All I can say from my own experience is watch and absorb the staff and within a day or two you will see if it's a good fit for your love one or not. I learned that you can't address the rude nurses yourself because of fear that they will take it out on your love one. But you should let the social worker make notes of any bad treatment. Best of luck to all caregivers and your love ones.
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Full fledged rehab hospitals have a three hour active therapy participation rule that they typicaly can't break if they want to get paid and not dinged for fraud. Subacute, typically the level of rehab in a skilled nursing facility, is lower intensity and accomodates a slower rate of progress; in my experience the team coordination of all services may not be quite at the same level either. But I have had friends in subacute settings do really well and get back home, though many people run out of covered rehab days and/or stop making progress and have to transition to long term care. Some therapy may still be provided in long-term care depending on specific goals, but they are more likely to delegate it to nursing staff and maybe a therapeutic rec person to keep a resident mobile and active.
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Cattgoodness: Could you kindly retype your story with punctuation marks? It's difficult to follow.
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