A friend has been in a rehab facility for nearly two weeks. No discussion yet on what's expected of her care. She hasn't received PT (someone helpfully brought up a sheet of exercises she could do in bed) and just started OT, apparently also in her bed.
I keep pressing my friend's husband to ask for one. He's been busy putting out fires - they let her glucose drop dangerously low, only monitoring her once a day, the onsite dialysis center flubbed transporting her to vascular access... Today he says the dialysis center director told him he was running ahead, rushing ahead instead of waiting for them to get to know the patient (SMH LOL SERIOUSLY??)
I thought the POINT of a care conference was to get to know the patient and discuss a plan of action for their stay.
Has the huspand spoken to her doctor? He also needs to talk to the head administrator there and TELL them -- not ask -- what time he'll be there for his meeting.
We get the hospital discharge recommendations. We get sight of the hospital discharge summary (if we're lucky). We then do our own assessment, and write the support plan which is reviewed - in theory - twice a week.
Trust me, there is a care plan in place because everyone who comes into contact with your friend is working to it. But it isn't necessarily in a presentable or long-term format, and more to the point if your friend is not medically stable then the care plan has to remain a work in progress until she is.
What took her to rehab?
My mother was sent to a dreadful SNF for 'rehab' once in 2019 and had no PT or OT for over a week plus her care was outrageously horrible; her oxygen cannula was hanging in the air and hooked up to NOTHING, for one! I had a fit and went out looking for a better SNF myself, found one, and had the admissions director help me get the Medicare secondary insurance company to approve the transfer. The new SNF sent a mini van out to the SNF-from-hell to pick mom up and get her over to the new place where the red carpet was rolled out for her right away. She immediately got PT & OT for the remainder of the 21 day stay that Medicare pays for.
If your friend has been in rehab for 2 weeks with no PT, she's only got 7 days left before her time is officially over according to Medicare (unless she's approved for 100 days). Occupational therapy does not occur 'in bed'.........real OT is therapy that is taught to a patient on how to function outside of the hospital or SNF once they get home; like in the bathroom or the kitchen, etc. How does OT 'occur in BED' exactly???
This woman and her DH will be lucky if this SNF doesn't kill your friend before it's all said and done, by letting her glucose drop so low and ignoring her need for dialysis, etc. It sounds like a great place to get OUT of, imo. Her DH needs to speak to the admin immediately to see exactly what's going on here, what her care plan is, and go from there. To be in 'rehab' for 2 weeks with nothing happening is ludicrous, in my mind.
Best of luck.
Yes, there is a problem if she has not started PT. OT are they teaching her how to get out of bed safely? OTs job is to help with ADLs. Her husband needs to ask the Director of Nursing why his wife has not started therapy. They are wasting her 20days that Medicare pays 100%. After that DH may be responsible for 50% that Medicare does not pay for the 21 to 100 days.
Rehabs are not skilled nursing. I am not a diabetic but I thought diabetics checked their levels more than 1x a day. I would say to transfer her.
Can you go with him and be a set of ears? That's what I recommend.