Good morning all,
My mom is 87, gets around, very slowly, with her walker. Insists on doing dishes. She lives with me. Yesterday she fell backwards in the kitchen, fell on butt and back, hit her head going down. Had about a one inch gash on her head. Spent 9 hours in ER yesterday and they finally stapled her wound. Took tons of CT and X-ray of spine, head, etc. Everything seems ok, no broken bones or brain injury.
They did an ambulatory test when they were deciding at 10 pm whether to admit her or not. They gave her a walker and we stood her up and she almost seemed to have a seizure or a stroke and was not responding to the nurses questions. We got her back into bed and doc came in did a bunch of tests determined it was not a stroke or seizure. He figured it was maybe low blood count because of so much blood loss (while we waited about 6 hours to get her stapled up). So they checked her blood which was a bit lower than when initially taken 9 hours earlier but not enough to justify transfusion (which was discussed).
At this point I am heading over to hospital soon and I am looking for pointers to discuss with caseworker possiblity of her recouping at a rehab facility instead of coming home. She has great insurance and Medicare. She hasn't been to rehab since April 2020. Is this feasible? I would just like her to be more solid before she comes back home.
thanks for any advice you have for me,
Grace
Not responding to the nurses' questions, indeed. I wouldn't have blamed her if she'd responded with a sock to the eye.
I should see how she is today before you make any decisions. Myself, I'd have thought that a few days' rehab, to rebuild confidence with her balance and mobility, might be a very good idea; but you know her best.
After ten days on the CORRECT dose of the CORRECT replacement tablet, I feel MUCH BETTER than previously.
OT trying to be the crepe hanger, but a “temporary” placement in rehab can be a helpful “time out” for both of you.
Ask questions if they occur to you, and see what the social worker recommends as alternatives.
You could start researching rehabs and visiting to narrow down the choices as if she is discharged to rehab, you may have only a day or less to select a rehab place.
Consider home care after any in house rehab would be over. It would help her adapt more at home, and extend the amount and time of care. If she hasn't had home rehab, the staff who visit may offer insights on safety at home, and the home care nurse may have insights as well into what's happening.
On another issue, and this isn't a criticism of using a walker to stand up at the hospital, but it's not the most stable assistive platform. After we discovered rollators, my father rarely ever used his walker.
What got me is she fell backwards. This happens in people with Parkinson's. Here is what I found. You may want to ask the doctor about this. Walkers do not help people who tend to fall backwards. A woman I knew had a special one for her Parkinson's.
"Backward disequilibrium (BD) is a postural disorder which is characterized by a posterior position of the centre of mass with respect to the base of support in the standing and sitting position predisposing subjects to backward falls. This postural disorder is defined by a posterior body tilt"
My mom did the revolving door thing, fall* hospitalization* rehab* a few times. A lot will depend on the facility you want mom to go to, if you have one in mind. Some want the patient to have been admitted to the hospital for at least 3 days. If you know the facility, I would first call them and ask them about admittance, especially since Covid has made admissions a whole new ballgame.
Do you know how long mom is expected to remain in the hospital? I would think they will want a better handle on why she fell before they talk about releasing her, whether to rehab or home.
That said, in my experience, it's never to early to pick the hospital CW's brain about the possibility of placement in rehab, if it's deemed that mom will need it. In my mom's case, that decision was usually *mostly* in the hands of the hospital PT people who would do a little work with her. They had to make sure she could, at the very least, get up and down a flight of steps, since that's what she would have to do in order to get into my house. If she couldn't handle that, then she would have to go to rehab in order to get her strength back.
Don't forget, at 87, a few days in the hospital is going to set mom back a bit, especially if they encourage her to stay in bed unless there's someone right next to her to keep her safe, as they often did with my mom. While my mom had PT and OT come to the house after her release from rehab, I knew my mom, and she would not have progressed as well as she did if she ONLY did at home rehab; she had a tendency to do the exercises willingly while the therapist was at the house with her, but not so much on her own, as she was supposed to. If you're mom is more compliant than my was, that might not be a consideration like it was in my case.
How was your mom's last experience in rehab? That should give you a good place to push off from, so to speak.
Good luck!
Good luck. Let us know.