She is recovering from a hairline Fracture in the upper neck of her femur. she had 3 pins placed in an inverted triangle. After 3 day delay for surgery and 3 days without food and too much heavy narcotics mom was moved to a rehab facility. Everyone is super nice but they are running at state minimum requirements. Today, when I showed up my mom was combative and was holding her fists tightly to her chest, wouldn't let me hold her hand. After talking with the nurses she had not had any Tylenol for pain over the past 22 hours. She would say that she was fine and not in pain because she hadn't moved in bed. As soon as they try to change her brief she is screaming in pain. Because she is in so much pain she isn't able to participate in the PT activities and emotionally shuts down and is beginning to not want to try to get better. What steps could we take to bring her home and get PT to come to the home and provide in-home caregiving by myself, CNA family, and private nurses without having Medicare cut her off from future rehab needs or cover her current stay?
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Ask about lidocaine patches in addition to pain meds. They really helped my mom. Make sure she isn’t running a fever and has no infection.
Ask about ice packs. She needs the pain meds ordered at the right time to take affect before therapy and to be given the ice pack afterwards. Ice helps some, while heat helps others. Discuss it with the therapist.
Speak to the doctor about having it on her chart that she be given the Tylenol on a regular basis until she gets over the worst of it so she doesn’t refuse it. She probably isn’t able/won’t request it on her own.
Speak to the therapist for them to partner with you on making sure she has had the Med early enough. Speak to the DON. Make sure she is eating, hydrating and don’t let her get constipated.
My mom had a similar experience. Did not hurt as long as she stayed still.
Do not take her home yet. As little help as they appear to have, you need to take a deep breath.
If she is being changed, fed, her pain managed and some therapy done then be cautiously optimistic that she will get better. Be very visible.
Medicare doesn’t care if you take her home. But truly, you will have plenty of opportunity to help her when she does come home. Right now they need time to get the meds straight and get her comfortable to move.
All that you mentioned, home health etc., cna, therapy can all be ordered when you do take her home.
I agree with getting a meeting with the top dog at the facility and ask for some help. I have a caregiver that helps someone at a facility because they can never provide enough care for the patient. Maybe you could hire someone a few hours a day to help things?
Your mom should obviously not be on PRN tylenol but on a regular schedule at this time. Talk to the doctor and get that arranged. I even doubt that tylenol will even touch the kind of pain you are describing so will need something stronger.
Are you able to spend time there to help make sure she is being better cared for and somehow sweet talk her into doing her PT? If she thinks she is going back to your house and this is what she wants I would very firmly tell her that it is NOT possible until she can do X, Y, Z. I did this with my mom - said she had to be able to get into the house on her own (3 stairs) and walk without my assistance from her bedroom to the bathroom.
Good luck!
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