86 year old Dad came to rehab today. He will start PT and OT tomorrow. Our goal is to get him back to his home (with a care team in place).
I was here most of the day to help get him settled. He is confused about why he is here etc and I am explaining it often. I would like to hear from this wise group about what should I be doing. How long should my visits be? I am feeling like two separate visits (shorter) to book end the day might be a good idea. I am already worried I'm going to burnout quick since I also work full time and have a family. I just don’t know what I don’t know. This is my first time around with a rehab situation like this and being a caregiver for a parent with dementia. My heart is slowly breaking. Thanks ❤️
Keep explaining to your loved one that he/she is there to get better and that means doing the work they ask. Since every person in skilled nursing is respected as an individual with rights and free will, every person has the right to say yes or no to treatment. Help your dad to say yes as often as possible.
Start preparing now for your loved one's return to home. Get input from the staff about what kinds of assistance your loved one needs. PT can help direct you to mobility aids and safety aids. The nursing aides can clue you in to what works for bathing, eating, night time routines... The nurse can let you know when/if your loved one needs medication for specific issues: constipation, anxiety, agitation... Social services, aka as case management, can point you to resources your loved one qualifies for.
There are really bad experiences you’ll read on here & some really good. Most in reality fall somewhere in the middle & change as staff changes or our loved ones conditions change.
My dad has adjusted well so I’m fortunate with that, but I know that could change over time too. Even if you don’t keep him there after rehab, consider it a trial run. The experience can help you later.
Wish the best for you & your father.
Tell them concerns regarding dad's confusion and ability to participate working hard at PT and OT which will be a requirement for coverage. Tell them you wish to be included in all care conferences even if by phone. Tell them you would like to be informed and ask if you can attend some PT and OT sessions, or whether this is prohibited. Introduce yourself at the desk, in the offices and with nursing staff. Be available to them and cooperative. Help in getting his clothing marked for safety. Work with them to form an initial care plan (what should they watch for especially?).
Good luck. Just be a KNOWN presence will help so much. My brother was in Palm Springs and I at the other end of our state, but a week staying there, showing up, speaking with everyone about care, medications, conferences, PT, helped enormously to make solid relationships and foster communication. And to let them know someone in family is engaged.
You need to watch for your own purposes carefully to see if going back home will remain possible, advocate for all the time he can get in care, and let discharge planning know if it appears he may not be able to return home. Let them know what in home care is and is not available for him when he is discharged.
You may be explaining too much. You don't mention dementia, but in his confused state, even without dementia he's not going to retain your explanations. Your instinct will be to explain more each time, like you would with a child. But a child will retain more than an 86-year-old. I suggest you stop explaining so much. Instead of the long version, say "You're here so they can help you get stronger." No more. No less. Don't change the wording. Repeat it over and over. Same way each time.
Don't expect much from him. Let the PT and OT do their jobs. He may not cooperate. On the other hand, maybe they'll motivate him to do his best, and then it's up to him. They'll advise about his progress and prognosis. Believe them. Then plan. My husband is in memory care and the wife of one of the other men there objects and questions EVERYTHING. She comes across as insufferably pushy. This doesn't help him. It makes his medical team want to avoid her. As dad's advocate, stay calm and smile, emphasize that you're all a team, and insist that they keep in touch or send you reports or whatever you need to understand the situation.
The care team you expect to have in place in his home - I'd advise against his going home unless his progress is spectacular, and maybe not even then. Managing caregivers at home is a huge job that you do not want! I've done it for both parents and my husband. You already have a job and a family. Concentrate on them and arrange for dad to go to assisted living where he'll have a social life and a team of professionals to look after him.
I wish you luck! It's quite a learning curve, isn't it?
Don't expect alot from a man who is 86 yrs old with Dementia. 86 yr olds don't always bounce back to what was their normal. As said, you may want to consider placing him. Unless he is living with someone, trying to have round the clock care is a lot of work.
I found the staff would say wonderful and my dad would say terrible and the reality was in the middle.
I also went to watch a couple sessions of PT around the corner, my dad would engage the therapist and anyone else around in lively conversation and not be doing any actual PT. So I was able to speak with the therapist and ask that they encourage him to actually do the therapy while he talked.
Another thing I did to help him settle, I bought meal tickets from the business office and had dinner with him on occasion.
Anything you can do to help normalize the facility for him will be helpful.
I have found that an involved family member makes a lot of difference in the care that is provided. You should acknowledge his care staff with hellos, thank yous and maybe a nice tray of goodies, these people are under paid, over worked and unappreciated, for the most part, so just seeing them and acknowledging what they are doing for your loved one goes a long ways.
Prayers that his confusion lessons and that you find the right balance to be a helpful advocate and keep your own life on the rails. This is a marathon not a sprint.
Your dad has dementia, he may not be able to fully participate in rehab.
If he does not recover to his previous baseline (you do not indicate what your dad was in the hospital for) what are the plans? Will there be caregivers 24/7? Will family be able to provide the help that is needed if paid caregivers are not available?
While dad is in rehab there is no need for you to be there both morning and evening. find out when the PT and OT sessions will be and go before or after those. He will probably be tired after and will nap. Let him get used to the staff, allow the staff to help him where he needs help.
I think at this point you need to look at other options as well. Is Memory Care an Option? Does he need Skilled Nursing? Will you have to apply for Medicaid at some point? If so what needs to be done now so that will go smoothly? If he is a Veteran will the VA be of help?
Ask the therapist what their goal is for your dad. My DH aunt with dementia did fine. It depends on many factors as to how well they do. If he has a health condition that requires a special diet such as low salt, that will need to be stressed. Make sure they have his meds on hand, especially if he is in pain. Wishing him and you the best of luck.
I would also like to know what you mean by care team as it sounds that he will likely need 24 hour assistance.
The reason I ask is that if you need to move him to memory care or assisted living, it is much easier to do so from a hospital or rehab setting than from home. Be honest and realistic about whether you and whoever else in involved will be able to keep him safe at home and provide the care he needs.
When you say "our goal," who is there besides you? Will the other(s) step up and do their share? You have a full plate with your job and children.
And I'm sorry about the heart break. It is a transition, no matter what solution you choose.
If he does return home, is the care team prepared? Sometimes transferring from rehab to another facility or unit is a smoother move than back home and then to a facility due to needs being too great in the home.
The worst of rehab aimed at PT/OT is that they often give up too soon. He has had the insult of moves and changes and is going kind of in and out, will often refuse PT and say "Not now" as my own bro did. They need to push him to participate and improve which will improve him wanting to, his muscles, his adapting to the place, it turning into a wider world with the lobby, the PT and OT rooms.
Attend care conferences which should be with all the team, discharge planning and everyone. Let them know how invested you are in getting him home again and how THAT BEGINS WITH THEM. Beg, plead, bring donuts, do whatever you must. Stay in contact.
This will all lessen the tendency to say "he cannot progress" which means no more Medicare Coverage.
I was a "Loving pain in the bottom" to my bro's rehab facility. I made them know who he was. I dragged him out and about to see others. I attended OT with permission, I talked to social workers. Apparently I did such a good job that the Social Worker advocated for him to stay in his last home and not go into ALF. We had the big talk about support who lived there as I was flying back and forth and that So Cal boy wouldn't move where I am.
Your heart is in this. You will do the best you can. That's all you can.
But you also need to look realistically at how much he IS/CAN progress, because if he cannot come home again, it isn't fair to him or to anyone else to try.
Best of luck. You are thinking this out. You will do your best and I trust in that. Help him to stay oriented and motivated. Be HONEST with him about how he has to pull all the courage you KNOW he has forward to work hard so he can come home. Tell him you know he is tired. But beg him to try for himself.