A hospital visit for UTI lead to my father being sent to a nursing and rehabilitation center, which resulted in a rapid decline and loss of mobility. I was hopeful sending my father to a rehab facility would help him build up strength, but it did nothing but degrade his health. They then discharged him early with little notice and the memory care/assisted living facility we planned to take him to then refused to take him due to the rapid decline. A month earlier, he was still able to stand and take steps. Now he’s completely bedridden, not eating and starting to get bed sores. Why do they call it rehab when all they do is make it worse? The system and care for elderly patients is broken, breaks my heart. Rehab for elderly patients is a joke and now we are left with no good options for his care.
The physio he received was, in fact, quite a joke - trying to direct multiple instructions with where to place hands, look, and manage a stick at the same time for one with Vascular dementia was nonsensical (added to the therapy being conducted in a busy and noisy environment).
I was advised that he would not be able to climb 5 steps safely and needed placement in a facility. I asked if I could have a go and, before they could answer condescendingly, I asked my dad to get my bag (which I had placed at the top of the stairs) - he went up with ease! No stick or distracting instructions, he just held the rail and up he went. This was his 'automatic' response kicking in.
The funny thing with dementia is that sufferers are not 'stupid', just easily confused by new or different situations/purposes. Of course, supervision is key and not making assumptions is common sense, but seeing things through their eyes helps a lot to remember they are not 'broken' as I have read (certainly impaired, and some more than others), but dealing with things the best they can even when it feels to us like they are doing the complete opposite.
Since then, my dad has navigated stairs confidently (with supervision) and this is part of his regular 'exercise' routine (even though we don't call it as such!).
Rehab is, at best, anything but a joke. My brother had a serious car accident and after a week in hospital was all but bedbound. He spent a full month in rehab and they brought him back completely, in fact better than he was when he went had the accident in term of balance and strength. I still do balance exercises they taught him and it has helped my own balance.
So we are down to Dad and his general condition, and whether or not his rehab was a good one.
Did you attend sessions with your father for PT? Were you included in careplan if you are responsible for Dad's health care and wished to be there? A good rehab will reach out to at least one family member to be involved if that person is willing.
I am so sorry Dad didn't improve. But you honestly aren't qualified to judge all rehabs by your Dad's sad experience. Keep working, and hopefully Dad will have home PT. He may take a long time to get better, and in fact now you cannot really know if he WILL get better. I hope for the best for him.
I can understand that you're frustrated and angered about your father's lack of progress, But you're not considering other factors:
1. What was the diagnosis for which he was placed in rehab?
2. How much research did you do about this particular place before your father was placed there? I.e., did you interview other rehabs, ask about patient:staff ratios, take a look at the menus as well as the rooms, shower areas, etc.?
3. Did you research this particular facility, checking as much as you could about its background? Or was it one that a discharge planner recommended?
4. What kind of active role did you play while your father was in rehab? How many care conferences did you attend? What intervention did you initiate to speak specifically with rehab staff, DON, or other staffers?
5. How many times did you either speak or meet with staff to address your grievances and work out solutions?
It's easy to understand that someone unfamiliar with rehab and its benefits as well as limitations has her own expectations, that may not materialize. And it's also easy to understand that many people aren't familiar with rehab, its benefits and its limitations.
In addition, it's easy to understand that it can seem overwhelming to challenge staff - you're out numbered. Caring for someone requires development of tactful as well as politely aggressive skills, of negotiating skills, of research skills, and of the skill to know when to compromise and to know when to stand your ground.
I don't know how involved you were, but if you weren't, this is a hard lesson to learn.
Going forward: if your father is still in this facility, list all your concerns as well as goals anticipated, ask for a sit-down meeting with at least the DON, an OT, and a PT. Be polite, but express your concerns and disappointments. Don't condemn or criticize, but ask how WE (i.e., you and the staff) can address your father's decline and accomplish reasonable goals on which you and the staff can agree.
Good luck; this isn't easy. We went through this with my mother's first rehab, I also experienced some problems along the way in my father's rehab journeys, and learned to be politely and sweetly insistent if not aggressive to accomplish our goals.
If you change your mindset from negative to positive (i.e., "this isn't working", to "how can WE make this work?"), I think you'll find that staff are more cooperative. If they're not, it's time to look to other options, such as a different rehab.
You should be equally careful with any post discharge home rehab. I had to replace a few companies that didn't meet standards.
One thing that I have learned, the older the body, the more catastrophic a simple issue can be, it takes longer to heal and it doesn't always return to pre-illness abilities.
90 is old and his body is worn out, you must prepare yourself for the inevitable. Maybe not this week or month or even year but, eventually he isn't going to recover from any illness and it won't be anyone's fault, it is just the cycle of life.
Get those complaints filed and get him moved to a different facility if needed but, don't just be mad.
It doesn't matter how intelligent a person is when it comes to Dementia. It effects everyone the same way. Your Dad has or is losing his short-term memory. It does not matter if they tell him over and over how to do something, he is not going to remember it. There is no conditioning. They have to remember so they can get to the next level. Medicare will not pay if Dad is not making progress.
Maybe "broken" is not a right word, but dying is. The brain dies little by little as the Dementia travels to different parts. When it gets to the part that controls the heart and lungs, you die. There does come a time when Dad will no longer to be able to read or comprehend what he reads. My Mom was an avid reader but she lost the ability to follow a book. I would find her bookmark towards the end one day and the next back to the beginning. No Dad is not stupid the brain just does not cooperate.
You are going to find as time goes on Dad is not going to be able to take simple commands. Or be able to tell u what he needs. He will use one word when he should have used another. It goes beyond just a little confusion. When we took Mom to a restaurant I could tell the menu was confusing so I gave her 3 choices. As time went on 2 choices, then one. I just picked what I knew she liked.
I agree, I found Rehab for Mom a joke. She was in her last stages if Dementia so of course she had no idea what she was suppose to do. I was told 14 days into her therapy that she would not walk again unless assisted with her walker. That rehab really had not done much because she couldn't follow instructions or remember from day to day her excercises. But, they kept her 18 of the 20days that Medicare pays 100%. Got her back to the AL and within 24yrs was walking all over the place with her walker.
Rehab for elderly patients is not a joke, it is the progress of the disease that makes rehab difficult. With dementia there is a constant cognitive decline. With rehab many dementia patients find grasping, retaining what is expected difficult. And it takes more time and patience to work with dementia patients I am not sure a lot of PT and OT take the extra time they are limited as to how long they can work with a patient. When my Husband was in rehab I was there every day and worked with him as far as I could tell I was the only spouse or loved one that participated in rehab.
With rehab it is often trying to get someone to relearn how to do something. With dementia there is a loss of cognition and function so being able to retain what is supposed to be done is almost impossible.
Many Memory Care facilities will keep a resident when they are no longer mobile and require "equipment" and more help to move and transfer. But they are unable to accept a new resident if certain criteria is not met.
Your option now would be to find a Skilled Nursing facility that can take him. Skilled Nursing facilities are allowed to use equipment that Memory Care facilities can not use.
You might want to look into Hospice and see if he would qualify for Hospice, often a Hospice Social Worker can arrange placement that he might otherwise not qualify for.