So my mother, 65yr old , just had a partial hip replacement after a fall. She is doing well and is going to go to inpatient rehab once released. How ever they told us they only care for the patient 7-14 days. Which I know will not be enough for her to be able to get back on her feet. What do we do? Can we transfer her to another facility? We can't allow her to go home by herself again if she isn't ready. We are hoping to move her closer to either me or my sister once she is healed and ready enough to handle a long drive. I guess I am just looking for advice. She does has Medicare part A and B.
I had a full hip replacement at the age of 58, and they had me up the same day walking and had me go home the very next day, where I had my daughter stay with me for about 10 days. I also had to go to outpatient PT a couple times a week for a couple months. I too was still caring for my husband at that time(at home)who was in the throes of his decline from vascular dementia, and about a week after my daughter left, my husband ended up in the hospital for a week, and because his speech was so limited, I felt I needed to be with him to be his voice, despite the fact that I couldn't drive yet(due to my surgery, so depended on my friends to take and pick me up)and had to walk extremely slow using my walker to get to his room and back.
It was a crazy time, and looking back on it, it's amazing what we humans can do when push comes to shove, so I wouldn't worry too much about your mom. She's very young and will do just fine. I think you may be over thinking things and underestimating the strength and determination of your mom. Us humans(and women in particular)are quite resilient.
Wishing your mom a quick recovery and the very best.
Ask the hospital if they are sending her to ACUTE rehab, which may be why the short time frame. She would then be transferred to sub-acute for longer term therapy.
After Mom is in for about a week there will be care conferences with all at the rehab. The MPOA for Mom can be included. This will help explain meals, meds, PT, OT and how measurements of need and progress are made.
It should be made clear to Social Workers that Mom needs to be self caring on discharge and lives alone.
You may need for Mom to get some home help and home visits from medicare for PT/OT in home. Some of this will be self care cost. Expect to pay upward of 30.00 hour if using an agency and most have minimums, say four hours three times a week for simple cleaning, walks, simple meal prep; ask agency at that time.
Try to take this a day at a time while still staying ahead of it (I know, makes no sense) but know much depends on her progress, some in home hired help may be needed on discharge, discharge planning will help explain the rules and work with Mom's unique situation. If Mom does spectacularly well they will want earlier discharge, but if she does very poorly they may "give up" so steady as it goes and contact Social Worker on day one to stay in contact on Mom's case.
Good luck.
Even on Medicare A and B and Medex supplement, rehab departments sometimes quote a time frame a bit shorter than the 21 days of skilled rehab that Medicare can cover fully. Leaves time for family to appeal the decision...I think Medicare gets3 days to decide...and patient ends up leaving just before or on day 21.
A referral to skilled home health care agency (Medicare certified) should be made before discharge, so that she is seen within a couple of days of discharge for PT(gross motor/lower body work) and OT(upper body, activities of daily living, like cooking, shampooing. They also do home safety assessment, can show you or sister how to get her in/out of car, and advise on safety rails, raised toilet seat, etc.
Hiring some non medical home care will get caregivers who are helpers, but there are some limits to what they do. Can be very helpful in the first couple of weeks.
Mom needs to know to do her very best at rehab...if she refuses 2x in a row, she is determined to have reach her potential and no longer qualifies for rehab in nursing home.
At home, tolerating the helpers can be hard...but helpers can go in another room so not staring at her every minute...as long as you work this out with the agency. Then she can do more on her own while still having a helper right there if she needs one.
A safety alert pendant is also a good idea for any elder who lives alone...