My husband is 92 and suffered a stroke. He went from the hospital to rehab but rehab now says he has too many problems for them to deal with. Any advice?
They said he has 2 BIG Problems: 1) Short-term Memory - he can't remember from one day to the next what they taught him to do. 2) They say he is spitting out his medications or refusing to take them. Where does that leave us, what can I do??
Apparently your hubby cannot now participate in rehab to the extent he can be helped by it. What does the rehab advise? At some point rehab will level with you that this level of care is impossible for your husband now, and that he will have to return home or to his long term care facility. Medicare will not cover rehab when the notes by therapists for OT and PT show that the patient is not capable of participating. They can get by with fudging things for a WHILE, simply getting patient up and around and doing strengthening exercises, which will help even with memory care issues, but at some point medicare will send a refusal letter, which will be passed to you. Do, when you speak with the facility, stress that whether hubby takes his meds or does not, whether hubby can remember to do exercises or not, you still expect rehab, ordered by his MD, to work on STRENGTHENING him so that he can be more safe when he returns to his regular environment. Speak with Social Services about all this today.
I agree, at 92 your DH may not fully recover. He has to be willing to do the work. He does need to remember his exercises. He can't progress if they have to keep teaching him every day. And because he can't progress, Medicare will not pay for his Rehab.
Rehab is not skilled nursing. Your husband will now need a lot of care. If Longterm care is provided at the same place u may want to transition him there. He will get PT there, too. If you go this route, I suggest going to a lawyer to split your assets. Husbands split will go towards his care and when gone you apply for Medicaid. You get the home and a car and enough or all of your combined monthly income to live on.
im thinking staff / social worker will be working with you towards what’s next. Unfortunately your husband has had a life altering event that he probably will not recover from.
keep in mind, while trying to decide how to help him best… things do not get better. Your age, your abilities, and impact on yourself .. you also need to take care of yourself.
You can encourage your DH to eat, drink & take his meds, but this is all. He can still refuse. It is up to his body how he recovers. Very hard for both of you.
If rehab is not able to proceed due to the memory problems, it leaves you looking at somewhere for him to be cared for instead.
Ask for a medical update meeting with his medical team (Dr, PT, RN) to discuss his progress, treatment options & listen to their suggestions.
Don't be surprised if LTC is suggested as a location to provide his care going forward.
Home can be an option IF safe for both him & you. If you could hire sufficient help to manage & hire/buy any equipment needed. This is able to done for some people. Definately not right for others - as their care needs are too high - the spouse/carer also has health issues or care needs, living very rural or up many stairs. Or that the burden of care would simply be just too great in a home setting.
In those cases, finding an acceptable care facility close to home is next.
Your DH being a physician, hopefully had made his wishes known to you regarding invasive or burdonsome treatment. What measures he would take regarding active treatments or comfort care.
Let us know how you get on with a medical update meeting. My sympathies to you.
From your profile I agree with your son to not do more testing - I believe in letting nature take it's course at some point and 92 seems appropriate to think that way.
Talk to people at rehab as to what would be an appropriate setting for him. I strongly suggest NOT taking him home or you will suffer mentally and physically. I doubt it would be safe for either of you. Maybe Medicare will cover X days in a nursing home after his hospitalization? I would take advantage of this.
There is nothing you can do, because he seems to have suffered enough brain damage that is affecting his cognitive functions and his judgement. Most likely his rehabilitation will be a failure and he could suffer another stroke, more lethal. Not everything in life has a satisfactory solution.
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What does the rehab advise?
At some point rehab will level with you that this level of care is impossible for your husband now, and that he will have to return home or to his long term care facility. Medicare will not cover rehab when the notes by therapists for OT and PT show that the patient is not capable of participating. They can get by with fudging things for a WHILE, simply getting patient up and around and doing strengthening exercises, which will help even with memory care issues, but at some point medicare will send a refusal letter, which will be passed to you.
Do, when you speak with the facility, stress that whether hubby takes his meds or does not, whether hubby can remember to do exercises or not, you still expect rehab, ordered by his MD, to work on STRENGTHENING him so that he can be more safe when he returns to his regular environment.
Speak with Social Services about all this today.
Rehab is not skilled nursing. Your husband will now need a lot of care. If Longterm care is provided at the same place u may want to transition him there. He will get PT there, too. If you go this route, I suggest going to a lawyer to split your assets. Husbands split will go towards his care and when gone you apply for Medicaid. You get the home and a car and enough or all of your combined monthly income to live on.
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keep in mind, while trying to decide how to help him best… things do not get better. Your age, your abilities, and impact on yourself .. you also need to take care of yourself.
I wish you peace as this works out..
You can encourage your DH to eat, drink & take his meds, but this is all. He can still refuse. It is up to his body how he recovers. Very hard for both of you.
If rehab is not able to proceed due to the memory problems, it leaves you looking at somewhere for him to be cared for instead.
Ask for a medical update meeting with his medical team (Dr, PT, RN) to discuss his progress, treatment options & listen to their suggestions.
Don't be surprised if LTC is suggested as a location to provide his care going forward.
Home can be an option IF safe for both him & you. If you could hire sufficient help to manage & hire/buy any equipment needed. This is able to done for some people. Definately not right for others - as their care needs are too high - the spouse/carer also has health issues or care needs, living very rural or up many stairs. Or that the burden of care would simply be just too great in a home setting.
In those cases, finding an acceptable care facility close to home is next.
Your DH being a physician, hopefully had made his wishes known to you regarding invasive or burdonsome treatment. What measures he would take regarding active treatments or comfort care.
Let us know how you get on with a medical update meeting.
My sympathies to you.
Also, stroke victims are usually on a puréed or soft food diet. Why can’t they just hide his pills in the applesauce? Have you asked?
Talk to people at rehab as to what would be an appropriate setting for him. I strongly suggest NOT taking him home or you will suffer mentally and physically. I doubt it would be safe for either of you. Maybe Medicare will cover X days in a nursing home after his hospitalization? I would take advantage of this.