My mom, 86, fell and is now in rehab. Any advice?

My 88 mother in law has fallen & broken her femur 3 times in the past 2 years. Each time she’s had surgery it’s brought her overall condition a little lower physically & mentally. After surgery #2 we brought her home. She spent the next 2 months in a hospital bed. She was completely out of it mentally, but after 2 months she regained her mental abilities & was basically herself again. Home health did rehab, and she learned to walk with the support of a Walker. My father in law was her primary caregiver. But he had a lot of help! During the first 6 weeks post-surgery #2, my husband lived with his parents. He is strong & did the heavy lifting. We also had a wonderful caregiver who came in about 20 hrs. per week. For fall #3 it was more of the same, except everyone knew how to handle it better. My husband & I didn’t have to stay more than the first week. The others who’ve pointed out the effects of hospitalizations on the elderly are 100% right. After each surgery she reacts poorly. We wish she could have stayed in rehab at the care facility, but it soon became clear to our family that we’d lose her mentality if she stayed the recommended 6 weeks. So she came home. One day at a time. Now, 5 months later she is basically herself again, although with each accident she becomes less able to walk. I am glad to say that with a lot of love, prayers, and persistence, she is better. She says, “I don’t remember what happened to me, but I am feeling like myself again.” The best thing that cheered her up during the darkest days was getting 2 kittens. Their purring, cuddling & comic relief helped so much! My MIL is now in outpatient physical therapy & is willing to work hard to become as active as possible. She is an inspiration to me! Don’t give up hope, but be realistic about the intense level of care needed.

Your mother is in Rehab for a reason. Rehab placement implies an expectation of imrovement, so her doctors may be expecting some amount of recovery. She is being taken care of and the Rehab facility should be guarding agains her falling. If Rehab helps her regain strength and condfidence, she will be less afraid of falling as time goes on. The trauma of the fall, and the hosptial if she was hospitalized, may be contributring to her confusion and anxiety.
Don't think too far ahead. Be glad she is being taken care of for now and give Rehab a little time to watch for improvement. Don't plan on your sister's help. You do not need to visit your mother every day. Do the things that have to be done one day at a time. If your mother is participating in rehap and showing progress, he stay will probably be paid for for 20 or 30 days. You can re-assess the stiruation during that time.

Since your mom is having anxiety, please talk to her doctor about medications to help calm her. She may only need these medications until she recovers enough to go home or gets settled into a new living arrangement (depends on her progress and doctor's recommendations). Also, decide on which day(s) and time(s) you can visit your mom. Stick to those day(s) and time(s) and "remind" her frequently of when you will come to visit.

Get sister to see her psychiatrist to evaluate and treat her own mental health issues. If sister is not competent to live on her own, she may need new living arrangements - based on doctor's recommendations. Be supportive of the plan of care set out for her. Decide on which types of help you are able to give her. Communicate this to her and stick to your decisions.

Make sure to connect with loving, supportive people on a regular basis. A listening ear, a compassionate heart, and the occasional shoulder will help relieve some of this stress.

Oh my, you have your hands full. However, you can do this...

First, put away your fears about your Mom. This is so that you can concentrate on the here and now. Listen to your Mom, really listen. Keep her focused on her recovery. Talk to her about what will be happening the next day. Talk about the future. Ask her about her expectations. Do not dismiss them. Talk to her and remind her of what she needs to do to get to those goals. (If she has a lot of pain, get the pain managed. It is very hard to concentrate or remember about getting well if you are constantly in severe pain.)

Talk to the PT to see if there are any exercises you can do with her to speed her recovery. I totally get that your Mom is afraid of falling (that is normal). Exercise with her to improve her core and her balance. Learn to use the gait belt. Don't think about the short term memory loss. If you are going through a traumatic event, you wouldn't behave rationally all the time either. Work with her so that you can transfer her to/from the wheelchair and the car so that YOU feel safe doing so. The PT/OT at the rehab hospital should be showing you this. Watch the PT/OT person work with your Mom. Watch how they handle her. Watch what they are teaching her. Try to reinforce those movements while you are there with her. Bring her some nutritious food from the outside. Foods high in Vitamin C are good.

Get a book and start a diary. Record her mood. Record what you see. Record what PT/OT did today. Record what happened today. With the entries, you can see if there are any correlations, and it is a great way to be able to see what has worked in the past and what hasn't worked. (BTW, don't expect "instant" changes...it might take 2-3 days or more before you see some improvement in an area.)

At the 2 rehab hospitals that my Mom attended, they both had social workers and patient coordinators (advocates?). These were the people who were non-medical, who could assist you in getting help and future assistance for your Mom. Record in the diary any pointers they have and use the diary to help you follow up on any actions you need to take. Don't rely on your memory. You may need to remember these things days, weeks or months later.

Do you have to do anything for your sister? If so, get a diary and record everything you need to do, or have done. If anything, this diary will be good if you need to get outside help.

And yes, a therapist to help you through this stressful time of your life is a good idea. The social worker or patient coordinator at the rehab hospital might have some names to try.

Diaper is good for now. However, if getting out of a diaper is a realistic goal for her, she will need to learn how to get from bed to toilet quickly and without falling. Remind your Mom of that.

Don't accept what the internet says as the absolute truth. What you read on the internet can limit your thoughts. Your Mom is a unique person. You are a unique person. Between the 2 of you, you can be part of the 5% that is the exception to the rule....but only if you listen closely and don't limit your thinking.

Don't pick up on her anxiety. You need to be the steady, rational person.

At 97, my Mom fell and had 2 screws put into her upper leg. Statistics would have had her dead within 1 year. After I got a different PT, she was able to walk with a walker without a gait belt, and she celebrates her 101 birthday this year. One year after the fall, she didn't remember much of her time in the rehab hospital except that the food was good (while she was in the hospital, she complained a lot about how bad the food was).

You can do this....one day at a time, one foot in front of the other....concentrate on your Mom. Put aside your own fears and limitations and work toward getting her back to where you and she want to be.

So you have your hands full, and thats just the tip of the ice cream! I know its Ice burg but I think you should have an ice cream as a small reward for yourself. My mom who was 77 fell little over a year ago at a local hospital, she was hurt so bad and your post brought back all those memories. So fresh I could write a manuscript of the events. I am just a simple girl in NW GA with no formal medical knowledge , no physical therapy training, I might qualify as a bad CNA. but after her discharge from the hospital, I was thrown into all the above as well as dietary, laundry and housekeeping. I'm so sorry, as I'm writing I realize I dont have any real advice. Yet I feel compelled to say something. My mom doesn't remember any of the events, due to brain injury and still struggles with pockets of memory loss. I too was informed how these type injuries could bring the onset of dememtia. I quit my job to take care of her. We made it thru living on her SSI check, yes times were lean but we had each other. I know she was so tired of me and my ignorance but somehow she survived. And I'm a better person for having to go through it all. I know she was hurt but those events were very traumatizing to me. I would wake up in the night running through the house crying. only to realize I had to be dreaming. Yes ma'am, buckets o tears indeed but we come thru and you will as well. Just know down the road there's a light, and each day the darkness will give way a little more. Thats not anything that my feeble brain tumbled out but omage to one of my favorite songs. BLACK GIVES WAY TO BLUE by LILY CORNELL SILVER. My dad had passed away just months before her accident to make our situation even more eventful, and that song seems to have healing properties. anyway I've rambled enough with no real advice. I hope you and your family come out in the light. I wish for you only to take one day at a time, lifes details have a way of filling each day. Months will have passed before you know it. I hope you can find a song that will lift and carry you through. Your stronger than you know.
With Love Sheila S
P.S. and some ice cream

mamadrama: Perhaps you could benefit from a therapist. It is IMPERATIVE that you take care of yourself, else you cannot care for someone else successfully.

It sounds to me like you need the help of a therapist to get through this. It's a very difficult situation with your sis having mental illness and your mum having mood swigs and calling constantly. It's the old "put your oxygen on first before trying to help others".

It sounds like your mother belongs in a facility with 24/7 professional care. Ask the rehab people for an evaluation as to where she should go. Obviously your sister is not the right person to care for her, and, I believe her care is beyond you too.

Do either of you have POA?

Many will tell you to bring your mother home as soon as you possibly can. From my experience, that should not be considered. You say she is constantly calling you from her bed? Just imagine having that go on during your sleep times. Sleep deprivation is a classic modern-day form of torture. I have been dealing with this for two years now. By dealing with it, I mean I have not had uninterrupted sleep now for more than two hours in two years. I am now a zombie, as you will be. Yes, there is a good chance there will be some abuse in any institution but you will find yourself to be called an abuser by her in short order too. I have outside help for 6 hrs per day for three days per week. Trust me, it's not near enough. You are facing the hardest time of your life, I understand. You also must protect your well-being if there is any way you can afford it.

Hi, first of all I am so sorry for You and your family. I went threw something like this with my Mother. So check the rating of the facility she’s in. Reviews, state ect. Know that the squeaky wheel gets the oil here! Be known to everyone at that facility! Yes when someone who has been Independant , in there own home , goes into a facility it’s an institution no matter how pretty they look it is what it is. When you have a large population of people/ patients it’s the way it’s done. Most important ( and I can not stress this enough!) take care of YOU! Because don’t forget, if you go down then you will be NO help at all to them! Make sure also ALL paperwork’s are in order! ( Wills, trusts ect) No one wants to think about it but if your Mother becomes unable to cognitively sign things there will be heartache like you won’t want to belive! I wish there was a magic answer I could provide. Visit your Mom encourage, support, validate her feelings and live her. Same with Sibling. Seek out as much help as you can there are people that will even visit . You must be exhausted. I know it is absolutely heart breaking know that as difficult as this is you are doing the right thing it doesn’t feel like it because it hurts so. Keep asking for assistance and reaching out for support, I hope You , your Mom and Sister are able to get healthy and back home. God bless to You all.

Try to get her out of there ASAP!!! There is so much neglect and abuse in these places. Look into home therapy and care while she is recovering.

Hi there, sorry to hear about your mom. I agree with those saying to have your mom come home. My dad went in to the hospital and then a SNF (declined tremendously w/in a short amount of time). I pulled him out. If I had to do over again, i would have brought him straight home. Not all SNFs are a bad experience but ours was, sadly. I would put her palliative & hire caregivers to monitor her well being. Dementia does unveil itself & it is a journey. I recommend this site. Everyone on here has been of great support! & the articles are great resources. Wishing you well.

Extremely difficult to see our parents suffer. Unfortunately, nothing you can do at this point but just go with the flow. Everyone has their own path, remember that. If this is happening right it's cause your both supposed to be going thru this experience. Self care the best way you can so you can deal with seeing her suffer. Get rest, get a massage, get manicures and pedicures for your well being and strength to deal with family members emotions and suffering.

Let the rehab address her needs, including a neuropsychological evaluation. Meet with them to plan a safe discharge after recovery. Emphasize safe. It sounds like she should not go back to living with your sister. She needs either AL or SNF going forward, to see that she gets good, round-the-clock care. Do you have DPOA? Does your sister? If not, someone needs to have this and that someone is probably you. Meet with a gerontologist to plan for mom's care after discharge, then follow that plan. You will have done your best. You cannot control everything and right now Mom's recovery is the problem. After she is stable and safe, find out who is legally responsible for your sister. If it isn't you, don't offer. Help her to get social services to support her or adult children if she has them. Then take a vacation!

I would keep a close eye on things and get your mom out of there as soon as possible. During Covid my mom fell and broke her wrist. She was in rehab for 10 weeks with very limited visiting at first due to pandemic. She left there incontinent and a very small part of the strong, independent woman she went in there as. It is heartbreaking and almost two years to the date we are still trying to cope with the aftermath. I am afraid the isolation and having absolutely no control over anything for that long caused my mom's decline and delirium.

Emotionally she is still struggling and came home wearing incontinence briefs, using a walker and needing constant care, feeling helpless and sometimes, hopeless. I have tried everything but we just can't get back where she was.

My mom also fixates on things, has OCD behaviors and is getting to the point that she can't do anything for herself. This happens more often than you would imagine. I hope that your mom recovers. If I could do things over I certainly would never allowed her to stay in the TCU for so long.  I would have brought her home and had the PT, OT done there.

That happen to my dad 6 months ago .Rehab only lasted for a month if there is progress they will keep longer

Sounds like mom is ready for memory care. Please get her evaluated. Please consider some therapy for yourself, so that you can come to terms with this horrific disease and the damage it does to all concerned. After she's appropriately placed, plan a nice vacation for yourself.

Aloha!

Take to heart what janicemeyer18 said. Good advice.

When my mom broke her hip she was in rehab for a couple of weeks after surgery, but they didn't keep her long enough because of medicare limits. She was not ready to leave. She had two bedsores, was very unsteady even with the walker, and was afraid like your mom is. She also had memory issues that were much worse than normal. Part of that was from the medications after surgery, which take a long time to get out of the system, and part of it was the extreme stress. It gets better as they improve physically! After rehab, because she wasn't ready even if they said she could leave, we moved her to a very nice assisted living place for a couple of months. She could get continual care there if needed, and she could heal more before leaving. We didn't tell the staff that she might be leaving, as we didn't know ourselves, but it turned out to be the best thing. It gave me time to recover from my own trauma over the situation, and time to think and plan for the next steps. Because of the lack of good home care staff, we ended up moving her out of assisted living into an independent living apartment. She likes it there (it took a while), she helped choose it for herself, and the social life helps take the burden off of my to be her "everything." I struggled with a lot of guilt, but then I learned to tell myself, "I did the best I could." Which I did. It has all turned out very well, and we don't have nearly the worries about her safety. Best of luck to all of you who are going through this. It's really hard, but you will get through it.
P.S., Mom doesn't remember most of what happened during rehab.

And also.... Don't argue with her or correct her on what she thinks is real or anything like that. It's their reality and although it's wrong you don't want to upset them. Asking about where possibly a loved one is who has passed or something like that. Just say they went to the store or on vacation or are at work or they are coming tomorrow. She might ask one time and that's it. Just keep it going. You don't want to upset them. My family did that and got my mom upset. I asked him why would you do that... He apologized and said he didn't know but his mom had dementia and he should have known you can't do that. You can't get them upset. Keep her as calm as you can if possible. Maybe pictures or anything that makes her happy. Early on when I was just getting back I would argue some with my mom but didn't know how bad or what stage the dementia was in because she was still talking and walking at that time. So be careful with words and things she may not remember as to not upset her. And share that with family members who visit her....

Been there and living the fallout. Wife fell and broke arm and was in short term care. Unfortunately it was the worst place and she got worse. Now home she is bed bound. Still deteriorating. She gets home healthcare. Just taking one day at a time. The whole story could be a book. But to sum it up the healthcare system is broken. Even if I wanted her in a facility there are no good ones with space. So we are on our own surviving.

Sorry I'm late and sorry your having these issues. First, don't listen to anyone who says unfortunately falls happen. No!! They happen when someone is not paying attention or thinks they can do something really fast and they can't. Once the first or 2nd fall happens there shouldn't be anymore. 1st fall you might not know their situation or it could have been an honest slip or they had something come over them really quick at the wrong time. 2nd time that's it. At this point they cannot walk by themselves or stand by themselves, you can't leave them for a second, they need a walker, rollator, wheelchair, or human assistance. I took care of my mom for almost 14yrs before her recent passing in Jan. Falls can be prevented if you at the time of the fall let that be it for them walking and standing or doing certain things by themselves. I had caregivers. And she fell with one of of them. You just have to asses the situation and once the balance goes that's it. They have to have assistance. Preferably a person not a apparatus. My mom had dementia as well. Sounds like yours has early onset or is in the early stages. Look... you need help. If the place she's in doesn't want to help or is not helping the way you think is helping her or you, get her out. Possibly take her home and do private or in home care. I had my mom in our home. She was fine and better because it was home. At her rehab facility and stints at the hospital she did not get good care. Not all are bad. Some people that work there are. Which is why I was there everyday she was in the hospital and hospice and had my caregiver there when I had to work. Nobody could take better care of her than me and it was a lot at times but, she was taken care of and I found a great caregiver that was a God's sent. That relieved a lot of stress off me. I still worried but that's natural. Trust me, now that she's gone I'm glad I did everything I could for her. I feel better rather than hoping someone else is doing the right thing. My mother was incontinent as well and I believe fell with one of the earlier caregivers so she was scared at times until with me. She may forget your name but won't forget your face or her routine. Routines are important. They do remember them. You need to find a facility or caregiver for home or someone in the facility you trust that is going to do right by your mom. It will help you and make her feel safe. Things will calm at some point but you have to get things in place at home or a facility that will make her feel at ease and that in turn will help you. You will need a support system. You're unfortunately in the beginning stages. Find family or people you trust or interview that will treat her like it's their mother or loved one. There are people out there that care. Once you do that things will fall into place. Also, make sure you have P.O.A. and make sure her finances and any will or trust, and insurance policy/s are in place so you won't have to worry about that later. I didn't have that advice. And also if possible take time in the morning or at night before you deal with her and after to relax and clear your mind. Find something you love to do whether hobby, or walking, or meditation, yoga, or something to unwind and release your tension and stress. Find a block of time before you start and after you visit her or put her in bed to de-stress It is paramount you do that. I wish you well in your journey with your mom and finding peace throughout this unfortunate situation. If your religious or spiritual use that. Find the tools to help you help her. Good Luck!! Better yet you'll be fine. Find the strength. Hang in there!!! You don't need luck. You just need to find the strength and fight for the both of you. You all will make it. One day at a time..... I've been there...

My mother broke two hips and went through hospital, rehab, and then nursing care (all in two months). I decided to take her out of nursing care because she was declining mentally; not eating much and losing weight, too. She either would not or could not cooperate with the rehabilitation-exercises, and what not. The only fear I had for bringing her home was learning to change her diaper. So. I overcame the fear and decided to bring her home. The doctor and nurses must have thought I was incompetent as they tried to talk me out of it, practically. Then they said she was not safe at home which I had trouble believing since she would not step her foot out of bed. Anyhow, after some persistence they allowed her to come home on Hospice so they could basically oversee her safety and the doctor would feel comfortable (lol!). She has been here for 5 months and all is well except the normal decline of dementia. She doesnt get out of bed and I can change a diaper! She eats very well now for her age and condition. Although it is exhausting and I have had to hire part time help it is working out and we are saving thousands monthly with this situation. Plus, she is happier at home--and off most of the meds they had her on! (Sometimes I wonder about the medical establishment!) Anyhow, I thought Id share our story if it would help. God bless you in your day to day journey.

So sorry for all of this distress, grief for both you and your mother...
Be sure to get support for yourself via pastor, chaplain, other professional support; practice good self care, see your PCP, stay hydrated, eat nutrition conscious, exercise and get outside some each day..... Your mother is receiving care at the facility; so take care of yourself while she is there to build your own endurance.
1. Speak with her case manager and pcp re present concerns, and going forward options/prognosis...
This can change in a moments time...
2. Attend the " care planning" meeting most facilities have for pts. Get date and time from staff, case mgr
3. Be sure that she is being seen by facility social worker and chaplain
Speak with them about your mother's behaviors and changes you are noting.
4. Establish some manageable visit schedule, keep visits short and quality focused:. speak with your mother ( if she is able cognitively) about limiting phone calls.
* If she has dementia or other cognitive impairment, she will most likely not remember calling you, hence the repeat repeat repeat calls.

Start exploring with her PCP and facility staff your limitations in caring for her at home and your sisters illness;. Start to consider options for possible placement for your mother and/ or other choices that will accommodate her " safety" and well being as well as your own well being.
Practice deep breathing.....
Do not feel guilty about decisions that may need to be made. Be sure that POA status is in place.

My wife passed away in August 2020 she was 76. She fell out of bed and broke her back. Tough decision to have her go thru a 9 hour operation. She went thru operation, and I got her home, but she passed away two months later. It really comes down to age and care if you can afford it and condition of the patient. I went thru all of what you are going thru, and it really takes it's toll on your mind and body. My mother had dementia for 11 years and thank GOD we had long term care insurance. I can understand crying just stay strong and take one problem at a time. Good Luck

I am glad you asked this question. The answers are very helpful and probably predictive for my mom’s situation. The hospice plan is what I would choose for my mom due to her extreme fearfulness of change and that just breaks my heart. She was a very caring compassionate woman and to see her fearful and anxious is what prompted me to get her a private caregiver 4 hours a day every day. They have bonded and initially mom didn’t like it but I asked her to do it for me, please try. She trusts me and did try and in a few days she was used to having a cheerful face seeing her 1-5 p.m. Sometimes I think she likes Mona more than me! Lol. Seriously, it was good to have company for mom and someone to help her with “daily tasks”. Eating, brushing, showers, lotions, hair, walking, warm compresses on her eyes, talking/reading to mom or watching Golden Girls on TV. Mom will never get better but she has someone for the journey.

Hi, so sorry to hear about your mom’s fall. I can tell you I have been through the same thing with my mother - she fell and broke her arm and was in two rehabs and the hospital. I experienced the same kind of confusion and phone calls with her. Come to find out she was on some pain medication that was causing this confusion… Norco. Check to see what drugs they are giving her for her pain sometimes that has something to do with it. Also, my mother had a UTI and that definitely affects the cognitive abilities so have them check her urine.

I know it’s not easy but hang in there. I did also find that my mindset affected her mindset. In other words, if I was calm, she was calm. It is an overwhelming situation, but it will get better. My mom is now more herself, and we are planning on getting her home as soon as she is able to. Much luck to you.

It is hard. I have not dealt with this but would like to comfort you. Keep in touch with her Dr and caretakers- nurses, physiotherapists, social worker in the rehab for discussion/support. Share your woes with them.
If you believe in God hear some good words. YouTube has so many talks which will strengthen you.
Depending on your schedule generously share time with Mom. Puzzle/cards any board games or groom her if she is interested or listening to songs together. Just be there.
Take time for yourself too. Trust caretakers to do their job. Communicate with whoever is available. May God bless you and strengthen you. Anything is possible though God.

This is the new reality of your Mom. Remember her cognitive ability changes at times so one day she is more “with it”, perhaps than the day before. Don’t fear the worst. Just meet her needs one day at a time and try to keep a positive outlook.

Go there and assess your Mother. If nothing is broken and she can walk, then she can have rehab at home. Rehab facilities will keep her as long as her insurance will pay but they cannot keep her against her will. Go with your gut - and don't make anyone guilt you for it.

I’m going through the same thing with my 90yo mother. Her dementia has gotten much worse since she has been in the hospital and now rehab, but I’m hopeful she will go home eventually. She called me 3 times late last night. She apparently had forgotten where she is. I have no solution or wonderful advice to share, all I can say is ‘Just try to hang in there and take care of yourself .’

In 2021, we had a really hard time with my mother. She broke her back, went to rehab and it really showed her memory problems and cognitive decline. She was released, went back home then fell again breaking her back and ribs. Again, she was in rehab, then went to my sisters for a short time. She is back home by herself as she refuses to consider assisted living, and not bad enough for us to make her. I take care of her financials, I got a machine to manage her medicines, my sister takes her to her appointments and another tries to do her handyman work and grocery shopping.

I will say that my mother has improved, compared to where she was right after her accidents. Enough that she's living by herself, but she needs a lot of help. It took about a year and lots of doctors appointments to get her here. We are also aware that we can't do much until the next time she ends up in rehab and we can only hope the next time won't kill her.