Rehab at home or a facility?

[Anonymous]

We’d have to hire private caregivers for the home option but obviously he wants to go home. He has a hip fracture that got surgically repaired after fall

[Anonymous]

Home if you can swing the cost and don’t mind overseeing the caregivers. But you’re also justified in telling him he needs rehab until he’s a bit stronger.

[Anonymous]

Depends on a lot of factors. Is he medically fragile? If so then maybe home is better. Is he going to be compliant? Are you going to be able to manage his care? Can you get him to the bathroom and bathe him? How much pain is he having? How deconditioned is he?

I used to work in rehab and my spouse still does. My observations is that some hip fractures can easily rehab and others are really tough. Just saw a really bad one recently where the inpatient rehab was months. So just knowing it’s a hip fracture doesn’t give people much to go on to help you with this.

Personally though, I would rehab in a facility because performing self care and helping toilet a family member is something I wouldn’t want to do unless there were no other options.

[Anonymous]

Personally I’d say facility. You can’t replicate that level of care and monitoring.

[Anonymous]

Facility. He will be safest there. And it gives you 24/7 care to give yourself a break. This is a marathon not a sprint.

[Anonymous]

Anonymous wrote:Personally I’d say facility. You can’t replicate that level of care and monitoring.

This

[Anonymous]

Anonymous wrote:Facility. He will be safest there. And it gives you 24/7 care to give yourself a break. This is a marathon not a sprint.

+1

[Anonymous]

I made the mistake of letting my mom rehab at home and swore never again. I couldn't make her do the exercises she was told to do...she simply would not listen to me. Facility all the way.

[Anonymous]

There will be much more intensive and hopefully effective rehab in a facility. You have to be able to do 3 hours a day to qualify for inpatient under Medicare—realistically, is he going to receive this level of care at home?

[Anonymous]

Rehab facility and be prepared for lots of complaints. They get much more intensive intervention so better long term results. It's so hard because your parent may guilt trip you and resent you, but it's easier on you as well to have the professionals manage it. If you do oversight at home there will like be pushback from your parent on the amount of intervention and doing the assigned exercise on his/her own. So you will likely deal with a disappointment parent either way, but in terms of actual results that last rehabilitation center is much, much better. Plus you can visit and when the parent starts guilting and shaming you, leave and take care yourself knowing that this is the best hope for actual results.

[Anonymous]

I am an OT, I work in a hospital. Snfs are notorious for being understaffed because they are extremely difficult working conditions. Therapists have to see up to 10-12 patients in an 8 hour work day and have to document and discuss w co workers. And nurses have way too many patients assigned. Just giving you perspective so these employees aren’t coming across as lazy or uncaring if they don’t spend a ton of time with your loved on. Burn out levels are high. But if you can’t provide the assistance needed for transfers and daily activities, they need to be in a facility. I find many family members underestimate how much strength it will take to get their loved ones out of bed, to a toilet, dress them, etc. a hip fx is very high risk of falling again if not monitored and assisted

[Anonymous]

Anonymous wrote:There will be much more intensive and hopefully effective rehab in a facility. You have to be able to do 3 hours a day to qualify for inpatient under Medicare—realistically, is he going to receive this level of care at home?

That’s impatient rehab , not subacute rehab. Many older adults with hip fractures cannot tolerate 3 hours of therapy a day realistically

[Anonymous]

My mom tried the at home option with CNA level live-in caregiver and then PT and OT came to her. Cost was equivalent to being in a facility It really could have been great for the right person. It wasn’t great for my mom, in fact it was terrible, but that really is more about her than than the set up and she kind of blew the whole thing up. When she ended up back in a facility, she was just kind of miserable all the time and also not in her own space. So if you can handle Home, do it.

[Anonymous]

Unless he can afford a 24/7 caregiver, a good facility 100%. Do your research on the quality of the facilities in your area and request ones that are good. It will be a battle to get the hospital to approve rehab, though. Many hire a patient advocate for this. It’s based on the PT and OT assessment, and they will always assess the patient as ready to go home.

[Anonymous]

Anonymous wrote:

Anonymous wrote:There will be much more intensive and hopefully effective rehab in a facility. You have to be able to do 3 hours a day to qualify for inpatient under Medicare—realistically, is he going to receive this level of care at home?

That’s impatient rehab , not subacute rehab. Many older adults with hip fractures cannot tolerate 3 hours of therapy a day realistically

Can you explain how it's determined what the patient can handle in terms of therapy hours? I'm curious because when my parent had a different condition, the whole "they may not be able to handle 3 hours" thing definitely seemed more like an excuse the hospital gave in case there was no available bed in inpatient rehab. They acted like because they had mobility issues in the hospital maybe they wouldn't qualify, but once I pushed for impatient rehab over SNF, they easily qualified.

If they didn't need mobility help due to the issue they were hospitalized for, they wouldn't have needed the rehab in the first place. Plus by nature hospitals don't have time to test anyone out on how they handle 3 hours of therapy.

My personal opinion is anyone who can handle inpatient rehabilitation should do that over SNF because they will likely get home faster.