Pops currently is 98 and fell as a result of a seizure (neurologist inexplicably had reduced his seizure med dosage by 2/3) leading to a partial hip replacement in 9/2021. Upon early release from hospital therapy, he fell again in 10/2021 as a result of low blood pressure from hospital prescribed Metoprolol. Since 10/2021 he has been immobile & in severe pain (10+) that numerous MDs have been unable to diagnose. Finally in 4/2022 a competent surgeon recognized the fall had damaged the partial hip replacement and repaired the damage (replaced femoral stem which had dropped ~6"). The surgery addressed the pain - 0 pain now - and pops has been in rehab in a nursing home since late July 2022. The plan was for him to regain mobility to the level of 1-person assist, then move back to his assisted living facility to continue therapy until he feels comfortable coming home. His nursing facility finally said he had used up his Medicare benefits and he was scheduled to move back to assisted living this past Wednesday, 10/5/2022. Unfortunately, the long delay in repairing the original hip replacement led to his developing a wound on the heel of his hip replacement leg from the need to mechanically move the leg. He would lift the leg by placing the foot of his good leg under the heel of his bad leg. The wound has developed a 3 cm eschar that has "gotten better" but basically remained unchanged since entering the nursing facility. His assisted living facility won't take him back with the wound, and the nursing facility said the eschar could "fall off" tomorrow or remain forever, totally unpredictable. The edges of the wound are dry with healthy tissue, so the hope is healthy tissue is growing under the eschar. But..... I am almost certain he had the wound or at least the beginnings of the wound while he was living in the same assisted living facility waiting on the repair of his hip. The question is should I continue to pay for the assisted living apt. hoping that the eschar will soon resolve? An ancillary question is, if his Medicare benefits have been exhausted for nursing facility therapy, do they continue for wound care? Given the protracted immobility (>9 mos.) he still needs daily therapy to regain his pre-fall levels of mobility and self-reliance. Any suggestions appreciated!
The AL is not a nursing facility. A wound is usually looked after by a specialized nurse. The AL nurse is pretty much more of a paper pusher not hands on. If there is an emergency, they call an ambulance. If you had brought this wound to the nurses attn at the AL she would have probably have had you take Dad to a foot Dr. She may have kept watch on it, put meds and bandaged but it would have been Dads responsibility to see a doctor if it worsened.
You say that Dad plans on returning home? Like I said, if his 100 days are over for rehab, he is now on Private pay. You need to find out if he will still be able to get rehab in the NH/rehab. You need to find out what type of care Dad will need at the AL. Maybe he can get in home care where a nurse is sent out to look at the wound and bandage it. In home could also do therapy. You need to run this all by the SW at the Rehab. When you get these answers, then you can talk to the Administrator at the AL. They maybe willing to bring him back if you get him outside help.
If ur Dad has exhausted his 100 days, then he may not be able to get in home therapy paid by Medicare. There is a lapse until a certain amt of days. If he is a 2 person assist, the AL does not have to take him.
BTW has he seen a wound specialist or can you get him out to see one? The doctor may pick the eschar off, something that rehab staff are not allowed to do, but the wound specialist can.