My husband recently fell and broke his hip (upper part of femur) and had a half hip replacement. Is currently in hospital but they are trying to get him into inpatient rehab. He also has Parkinsons and radiculopathy (nerve damage) in the same leg resulting from shingles, so recovery is not as simple. We aren't at all familiar with how rehab services (OT, PT) operate in skilled nursing facilities, nor who decides when enough function has been restored to allow a person to go home. With outpatient PT and OT, my husband's doctor has written a general order and then the PT and OT take over from there, and they do periodic evaluations to determine if their services are still needed (based on Medicare or insurance guidelines I'm sure). In a SNF, I presume there a doctor who writes the orders and oversees the patients medically? And would this doctor coordinate care with the patient's other doctor(s)? The hospital will be providing detailed notes to the SNF, including notes from the PTs who have seen my husband. How does the SNF know that a patient is safe to discharge to home? I know hospitals are bound by regulation to make sure it's a safe discharge. Does the SNF have a process to do a home evaluation to make sure it's safe? We are fortunate that my husband does have LTC insurance and we are already getting some home care aide services from an agency, so can get more when he's discharged as needed. We also have grab bars, shower chair, bed rail, and a lift chair, so I think home is pretty ready physically.
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Also, ask his current doctor if he is affiliated with any facilities to continue oversight of his care. If he's not, he may know a dr that does this sort of thing and is helpful in maintaining communication between current dr and the one who will see him at the facility.
From what I was told the therapists are the ones that provide the information that gets your rehab extended or you go home. I stayed in touch with them to find out the real progress, because the doctor is only reading notes not seeing the progress.
I know that being separated is difficult, but use this time for some self care and rest. Statics show that the better a person is on discharge the less likely they will have a recurrence. So trust the pros and encourage hubby to stay in rehab until they say he is ready to go home.
Our occupational therapist was the one that walked through the house and made suggestions about what to do for safety. The hardest thing for me was NO throw rugs. I have almost white carpet and throw rugs save my sanity, so be prepared for some changes that you might not like.
Be sure and ask for in home therapies, that will help your husband know how and what to do in his environment versus a facility setting.
May God give him a speedy recovery and you some self care and rest while the pros care for your hubby.
There are plateaus that people meet and no amt of therapy is going to make them better. Sometimes the legs just give out. Once a plateau is met PT stops. Then the decision of bring them home has to be considered. Can a family member physically take care of the person. Can they afford aides to come in. Is the house safe. Does the caregiver have support?
If no to these questions, then LTC maybe needed. Private pay, if u can, Medicaid if u can't.
Medicare determines how long a person stays in rehab from what the therapist reports. If they hit a plateau, they are usually discharged. Therapy can continue at home. The first 20 days is fully paid by Medicare. The next 21 to 100 only 50%. Some suppliments may pick up the rest. With my Mom she pd $150 a day. This can mount up. So, if you can't afford it tell them. U may be able to get help from Medicaid.