Stay at home instead of rehab facility? What can we do to make it work?

If you think your Mom should be using a walker but she resists, consider a 3-wheeled rollater (Winnie Walker). The PT folks aren't crazy about them, but it has been wonderful for my Dad who insists that walkers are only for old folks (he's 96).

Hi Espolsa
You're talking spinal compression fracture yes?
My mom had 3 at the same time last October. It took 4 weeks for her to start to feel better. Her PMD told me she was better off resting at home. There was nothing to be done but to wait for her to heal. Home therapy came after. Honestly the biggest challenge was the pain management. The pain was constant. Tramadol was used but it made her confused and hallucinate and constipated. Tylenol was helpful. She never slept more than 3 or 4 hours those first 4 weeks. Not to mention the risk of falling from the tramadol and also Ativan.
The most useful things we bought for her were: the toilet bowl arm supports, so she could get up from the seat. We also installed grab bars in the shower ( had to have a handyman do that) and a bed support grab bar that slid under the bed so she could pull herself up in bed and get in and out of it easier. Most of it was purchased on Amazon. The doctor ordered lidocaine patches, they did help, they were expensive though.
I hope you are managing ok. I wouldn't wish that on anyone!
It was horrible to see someone go through so much pain.

Mom has been visited by PT and working thru exercises. She is using the theraband and seemed to enjoy it. Someone is always there with her when she has the PT. She is coming along and has walked without the walker. [she never liked it, but I wouldn't mind keeping it around forever and I think secretly she knows it might be with her forever]. I did see the exercycle and heard about it from my Uncle. We may get it for them. Thank you for the advice :)

Esposla, first, thanks for the frequent updates. It helps posters offer additional recommendations, but for me it's a sign of interaction and appreciation for responses. Many posters never reappear after the first post. It's helpful to know which answers helped, and how the suggestions were implemented.

I'm glad that in home therapy seems to be working out well. I had a few more thoughts after rereading the posts.

It's a good idea if either you or your siblings can be present at the PT sessions, not necessarily all, but enough to write and diagram the exercises your mother is being given so she can continue them after PT ends. Good therapists will generally provide print outs though.

The best ever therapy I had was through a local hospital system. The therapist gave me a packet of exercises drawings and instructions to follow at home. I'm partial to hospital affiliated therapy facilities as well because they used to offer 2 months of self directed therapy (based on the exercises recommended by the therapists) at a reduced cost. It used to be $25/month, compared to well over $100 for a private therapy facility. But this was back in the mid 2000s.

The PT'ist might use therabands, which look like giant open ended rubber bands. They're colored coded for strength. Typically the lower strength band is used for starting, and changed to higher strength as the patient is able to handle a stronger band.

These are easy exercises to do with family, and can be continued even after the care agency therapist is through and won't be coming again.

Another exercise my father decided to do on his own, and has been supported by therapists, is with an exercycle. It's essentially the pedal configuration of a bike, but can be put on a table (and clamped to it) to strengthen hands, or placed on the floor and used as a bike pedal, for leg strengthening.

Google "arm exercycle". There are 2 series of photos; the second set shows the kind to use at home in the 3rd and 5th photos. My father's was only $14.99 when he bought it several years ago. It's probably twice that now.

It's a good way to get leg exercises while sitting down, especially if someone has limited leg strength, back problems, or weak arms. Playing a favorite CD helps create relaxation while working out.

As to good and bad rehab places, it's not much different (other than purpose) from any profession - there are good an bad doctors, car repair shops, plumbers, ...whatever.

Our first experience was when my mother broke her leg; there were problems, but they were resolved. Still, it wasn't the best. A different facility within the same chain was the best, by far, but it was in an area of teaching hospitals and standards were much higher than in our area.

So it depends on the area, the facility's individual management, whether there's a chef or meals brought in....that's why I developed a checklist and did some pre-placement interviewing.

Thank you. Mom has and RN and PT every other day. We also got an aide to assist with bathroom and companionship(although dad is there we need other eyes on her)

If you're going to do it at home, here are a couple tips. Make sure she gets out of bed and walks up and down the hall as frequently as her doc allows. Many folks prefer bed rest, but the walking will keep her from developing a DVT and it's the only way for her to begin to gain her strength.

Also, make sure she has a home care RN visiting at least once per week. A good nurse will give you details on what to watch for. If the nurse isn't helpful, change home health companies.

Make sure she has the equipment that she needs. Gait belt, toilet riser with hand holds, walker, etc. The PT person can recommend.

Watch her diet. Make sure she is getting enough fluids and protein. And enough calories.

Correction: * "so it's not to say they aren't good."

Thank you for your replies. One of my siblings had a bad experience with the rehab; so it's not say they are good. I'm sure many are , but research would be necessary. My brother opted to have the PT in my moms home. Unless 2 of us want to search for a rehab, we are likely to use the home care....at least as long as it's working. I've checked out an assisted living facility and don't like it, but I'm the only one searching or considering it, *thanks CTTN55. Only one of us can't be the decision maker for a big step like that.

I think my mother would try to opt for in-home rehab, if it became necessary. My father died in a rehab facility. While I wouldn't make her go to that particular one, I would refuse to have anything to do with in-home rehab. I will not become her personal care attendant and stay at her condo.

I will probably make at least one of my (all out of state) brothers participate in the "which rehab facility?" discussion (and make the ultimate decision), because I do not want to get constant complaints about the facility if I am the one to make the decision.

We've used rehab after a fall with surgery and and illness. There's no way I could have done at home what their staff was able to do. Dad was not happy staying there 24/7, but he liked the therapy staff, and I thought they were very good with him. They allowed me to come and watch too.

You heard that rehab facilities aren't effective...from whom?

Is mom going to do exercise at home after PT leaves? PT is effective in good facilities in part because they have a variety of equipment on site as well as supervisors you can go to if things aren't going well.

I'd check if admission to rehab is allowed after discharge home. I'd also start researching rehab now for "the next time".

I so recall running around Connecticut one afternoon with my brother, visiting 4 rehab before picking one for mom. Do you and your siblings have the ability to do that sort of thing?

Thank you garden artist, my mom has my brother sleeping there. Also an aide daily 9-3, and PT daily. I will share all this great information . This forum is very helpful to inexperienced like myself. I wish my siblings would do some research too though. We had heard the rehab facilities aren’t that effective , but checking them out first would have been a good idea. Although, mom was released so fast-I wonder, should we have kept her in hospital until we searched for one?

One of the drawbacks to home care directly from a hospital is that there's no step down (intermediary) care as would be available in a rehab facility.

If you're not comfortable with the rehab facility recommended by the discharge planner at the hospital (and by all means interview there, do a walk through, particularly at dinner time, ask many questions, including staff to patient ratio, whether meals are prepared on site or trucked in, etc.) search, and find your own. There are ones out there that are much better than the ones often recommended by hospitals. That's been my experience for 14 years.

Rehab facilities at least have some machines, which are like "force multipliers" and can leverage the therapy to make it more effective. You won't have those machines and equipment at home. Nor will you have as much therapy time at home; progress will be slower.

Care will be more difficult, so be prepared for that. A hospital bed would definitely be helpful, as would care for (sponge) bathing.

How many people would there be to offer help?

To make home therapy work, again, interview a number of companies before selecting one. Also discuss with the doctor the possibility of returning to a rehab center ( usually requires 3 days of hospitalization for Medicare to cover) and whether or not Medicare would in fact cover if she comes home first, then goes to rehab. This would be a major concern.

Thank you jjariz. We thought mom wouldn't like the rehab facility. It may be the better way to go if it doesn't work out this week. I hope it is permitted to switch from their home to a rehab facility if it becomes a nightmare.

If your Mom has medicare, the insurance will pay for rehab at a facility. Are you sure that you don't want her to go to the facility? I found with my Dad that it really helped him gain strength and recover.

thank you freqflyer. i'm becoming a freq flyer myself these days. It's my mom and dad at independent facility. they do have options in-house ,but we've been using a different agency. She does have a walker and seems ok using it. was your dads' physical therapy for back issues or something else? my dad seems to get in the way , but not on purpose, just wants to try helping and it's too much for him.

esposla, twice my Dad had 2 choices, one was living at a Rehab for a couple of weeks, the other was having physical therapy at home.

The first time around, it was my who choose that Dad stay at home and she would take care of him. It wasn't easy as both of them were in their late 80's, early 90's. Mom found out she bit off much more than she could chew.

Physical therapy came to the house, but Mom wasn't user friend, she would glare if the PT was a pretty young woman. The Mom found there was no way she could help Dad up the stairs, she was frail herself, so Dad slept in his recliner and Mom slept on the sofa, either of which was good for either of them. Plus Dad didn't practice his exercise when the PT wasn't there. Recovery took a very long time.

The second time around, Dad choose the Rehab facility. Mom agreed. Dad liked physical therapy especially using all the machines. He couldn't wait for his time in the gym. Plus where his room was located and the dining hall, he got a workout walking back and forth. The food was very good, and Dad enjoyed talking to all the new people.

It depends on the person with what they are comfortable with.

Your profile says that your parents or is it your Mom and her brother or son are living at Independent Living.... or did you mean they are still living in their own home? Usually Independent Living facilities have their own physically therapy, plus options that your Mom can order to help your Mom until she is back feeling better. These options come with a fee.

If your Mom is still living at home, like my parents were, I remember they had to bring in a plumber to add grab-bars in the bathroom. A hospital bed would be nice, I think you can rent one instead of buying. Yes, a TV in the bedroom would be great for those days when Mom just can't get around. Depending on where the fracture happened, maybe a really nice rollor walker, but ask PT first.