He just was discharged from the hospital and cannot walk. Very weak. They recommend rehab. We are afraid they will make him a resident. Not sure if rehab is even possible since he is so weak. We will need 24-hour care, I believe, unless he can regain his strength. He has high blood pressure and AFIB. That is it. We are at a loss of what to do. We cannot lift him.
My dad was in a continuing care facility for rehab that focused on getting him back on his feet. They didn't try to keep him down so he could become a resident.
Find one that has a separate rehabilitation wing that allows him to utilize all the activities at the facility. These tend to be better rehabs then the ones that integrate rehab patients with long term care residents.
When my dad was in rehab they were able to tell me what he could and could not do. Because of that and a needs assessment done by the NP that was treating my dad, I was able to determine what type of facility would best meet his needs. Home care wasn't an option for multiple reasons.
I, highly, recommend that you meet with his PT and OT team upon admission, stay in touch regularly and let them guide you. Tell them what he needs to be able to do and they can customize his therapy to get him as good as it gets. Then you will have some idea of what is coming when he is released from rehab and can start making plans sooner then later.
I have a 91 year old friend that "lost her legs" as she puts it and now she is in and out of my 4x4, walking through stores, going to the gym and blowing my socks off. So, yes, I do believe that someone in their 90s can rehabilitate. But, they also fail quickly.
I would definitely get him rehab, if nothing else, it gives you time to get things set up.
As far a s rehabs that have a step up to SNFs they are more of an advantage since you go to the top of the wait list for a bed. My mom was in one of those 5 stage places that I was lucky to get her into. But she was on a 3 week wait list just to get in to MC. The reason I put her in that place was because I researched it as a great choice. You are fortunate to be close to Boston.
Dad needs to do the therapy. His stay there depends on how he progresses and if he hits a plateau, meaning he will not get better. Medicare will stop paying if he shows no improvement. This is where you will need to make a decision. You take him home or place him. IMO, 90 yr olds start having leg problems if they have not had them before. I would not look to him getting back to 100%. If he does then good for him.
I remember my Dad [in his 80's at the time] tried rehab at home with the physical therapist coming to the house. It did not work very well as Dad rarely did his exercises. Next time Dad decided to stay at the rehab facility [it had a nursing home] for the required number of days, and he did quite well, so for him it was a good choice, he was able to come home.
My Mom [now in her 90's], after a terrible fall at my parents' house, moved into a Rehab which had a nursing home. It was a good decision, as Mom could not learn how to walk or even stand. She was moved within the facility to the nursing home section. She needed a village to help her daily.
Also, the at home therapy people let her get away with "I can't/don't want to/am in too much pain to do such and such exercises", whereas the facility just told her "ok, we'll come back later to get you."
My mother did 3 stints of rehab in a facility that was attached to a nursing home, but it was an entirely different building, staff, kitchens, etc. The PT staff used the same space for both rehab and NH residents, but with different therapists and at different times of the day.
As far as "making" dad a resident, they can't keep him there against his will - or the family's will, should he not be able to make that decision for himself. My mom had the same concern when she first entered. I just told her "If they force you into the nursing home, just don't pay the bill. They'll kick you out in short order."
I think it's more important to find a good rehab facility rather than worry about where it's located. And the one my mom was in was excellent.
As far as whether he can successfully do therapy, you'll never know unless you try. The staff members where my mom was were excellent and she progressed far more that I had thought she would have been able. The battle was after she left, having her keep up with the exercises, which she immediately stopped as soon as she was home, and subsequently lost strength, but that had nothing to do with the rehab's staff members.
Look at it this way - if your dad doesn't try rehab PT, you KNOW you're going to have to arrange for 24/7 care one way or the other; but if he tries, maybe he can get back some of his mobility.
Good luck.
Where I live, there are freestanding rehab facilities, those connected to NHs and some connected to ALs.
Some rehabs cater to a younger crowd (think 40-50 year old marathoners getting knee or hip replacements) vs 90 stroke patients.
Look at several places. Why do you think it would be a bad idea for him to become a longterm resident?
At his age and with all of the assistance he needs, it may be time for NH care. But that would be a family decision. If you can't lift him that is a major issue with the amount of help he needs.
What was your father's living situation prior to hospitalization? Did he live alone? With you?
Can your father afford 24/7/365 care? If not, then can he qualify for Medicaid in a LTC facility? I know you don't want a NH, but what do you think the alternative could be?