aside from all of the logistics advice, I would make sure you seek a second opinion from the best surgeon you can find to make sure the surgery and treatment plan are exactly what she needs. Even if you like your surgeon, get a second opinion to be sure.

I'm sorry, OP - elder care is really tough! As someone with an elder parent in CT who did a stint of direct elder care in CT (with my other parent who died) and now is down in VA, there are advantages and disadvantages of her staying in CT vs. VA.

In general, CT has a much more robust social services system for elders, and there are more programs available if your MIL needs financial assistance beyond Medicare. Some states have opted to use Medicaid waivers to design unique elder-care programs like Home Care for Elders, which uses Medicaid funds to provide in-home care providers for elders who can be somewhat independent and don't need full nursing care. Virginia happens to be much more stingy with that stuff.

Of course, the main advantage of having her down here is it will make it easier for your DH to coordinate her care and provide her with direct support. Trying to do it from a distance is exponentially more difficult. In my case, I have opted to keep my mom in CT because we got her accepted into a program that provides Medicaid (Title 19 in CT) funds for her placement in an assisted living facility, which is incredibly good and perfect for her needs. When I talked to VA folks about a similar program, they said there are like 100 spots for the entire state for this kind of a program, so the chances my mom would be accepted are pretty much nil.

Of course, if she has the funds to completely self-pay for assisted living ($3-6,000/month) then you have lots of flexibility and I would say bring her down stat. But if you think she'll need some more financial support, start with CT. Each region of CT has a Council on Aging that coordinates care -- in SW CT where we're from, it's called SWCAA (Southwest Connecticut Agency on Aging)...the social workers will guide you through all of the options and can evaluate your mom to see if it would be appropriate for her to be part of the Home Care Program for Elders, which could retrofit her home for assisted walking and provide her with things like home based occupational and physical therapy once she gets out of rehab.

Her rehab facility's social worker will be able to connect you to this agency to get the evaluation done. It takes a couple of weeks for the appointment, and it's in person (they come to you). You should also start getting all of her financial paperwork together...you'll need tax papers, bank statements going back 5 years, etc....if you think you'll want to see if she qualifies for some state aid beyond Medicare.

Good luck! I know how hard it is!

Talk to a social worker through the hospital/facility where she is now.

What is MIL's take on all this? I would guess that she would prefer to continue to live on her own. Many seniors are reluctant to move into a retirement community, but they're a great source of social support and activities to keep people active. It sounds like she will probably need pretty minimal assistance--just driving--and somewhere to live without any stairs. If she really wants to remain in her house in CT, she could get chair lifts installed. I think whether she should live in CT or VA depends on how strong her support network is in CT.

It's really hard to say what her long-term prognosis is at this point. I would be concerned if she was a couch potato before that this knee injury could be the start of a real decline in mobility and independence--mobility in the elderly can be a use it or lose it thing.

If she is in a facility now, there are social workers who can help you. Finances are going to play a major role in how you proceed and a social worker will be able to help you with understanding your options given your MIL's insurance and finances.

I'm at that stage in life where I've seen a lot of friends go through similar things. It does depend on how much your MIL will want to live independently, how much she can cope with on her own and her and your finances. Options:

One just recently finished a big renovation of her house where she converted a dining room and then added an addition to the house to create a small in-law suite for her mother. Her mother has a bedroom, a sitting/living room and a small kitchenette and bathroom. If she needs more than the mini kitchenette (I didn't see it, but it sounds like a small sink, mini-fridge, microwave and maybe a hotplate), then she can come into the main house and use the main kitchen.

If she's pretty capable of living independently but just needs some help, I've seen several friends who have hired daily help anywhere from 1-6 hours per day where a nurse or attendant comes in, helps do household chores, gets meals ready and sets them out so the person can make their dinner when ready, run errands or take the person on errands, etc. Each situation is tailored to the individual needing assistance, so it's hard to generalize too much.

If she's not so capable, then perhaps an assisted living facility is the right place. There are many different types, ranging from institutions where you have a room to yourself with share common space and dining facilities plus round-the-clock attendants to ones where you essentially have your own apartment or even home and there are nurse/attendents in the facility available both for drop-in or on-all support as needed.

If she insists on staying in her own home, does she have a downstairs room like a dining room or den that can be converted to a first-floor bedroom? If so, you can convert and perhaps hire someone to come in an help. How much help you will need for her will depend on how able she is to care for herself and how much you can afford.

If she is willing to relocate, what type of living arrangements is she open to?

These days, elder care is a huge industry and there are many, many options. You need to have a frank discussion with her about what she wants before you can whittle down the options to a manageable number to review and consider or you could be spending months and months just figuring out what you should consider.

Does she have financial resources? A friend of my parents sold her house and moved into an elder living community that provides different levels of support based on their needs. I visited her and was really impressed. She lives alone in a small apartment, but everything she'd need is onsite, including dining facilities. This was in NJ, but I'd imagine you could find something similar in CT or VA.

I've heard ads on the radio for a service called "A Place for Mom" that connects people with care facilities. I don't know anything about them personally, but could be worth researching. How old is she? I imagine this is all a big shock to her as well as you guys.

Can you move her down to stay with you until she recovers? Her prognosis might be significantly better than what you were thinking.

You need to get busy investigating her options, including her finances as well as her preferences about continuing to live alone. There are all kinds of short-term fixes you can find for temporary nursing care in the home, but if her mobility is permanently compromised, you need to start thinking hard about alternative arrangements. We had a similar experience when our parent flunked a competency test for driving. It took 6 months of patchwork arrangements (we found an agency that provided drivers and support thru the local council on the aging) but eventually we moved him to a continuing care retirement facility. He lives independently, but has a massive array of on-site services (including meals) and activities. His needs were mental, but there are plenty of people there who are very sharp but have physical limitations.

My MIL had a serious knee injury when visiting us just before Thanksgiving. LOOOOng story short, she is in a rehab facility now locally and will be there for the next six weeks and then (possibly) will need surgery (they need for the swelling to go down), then recovery for like 8 weeks after surgery and then we are at a loss. The prognosis is that she won't be able to be fully independent anymore and will always need a walker or cane, most likely won't be able to drive, her house in CT is full of stairs, etc. So we are really thinking through what needs to happen long term and just don't know where you go from here. Do we move her down to Virginia permanently? What type of facility? She isn't mentally impaired, it would all be for mobility and she is very overweight. My DH and I are literally sitting there after her orthopedic doctors appt yesterday with our mouths open - we have no plan & no idea where to start. Bonus, Medicare might kick her out of rehab sooner rather than later at which point we'd need to hire a full-time nurse and pay for it ourselves. Any ideas??