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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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The hospital has social workers who can explain and arrange such things. You should also discuss with her doctor - not the aides or the nurses - about what to expect next.
I doubt that mom will be able to live alone anymore, though she might think it's possible. This fall is probably not an isolated incident. She may have fallen various times and not told you about it, and she can be expected to fall again. Four hours a day with Home Instead isn't enough help and observation when elders reach this stage.
Taking her into your own home should not happen! Becoming burnt out is the reason. Once they get in, it's hard to move them out, so realize the situation before it happens. Start checking out assisted living places where she will have a social life, activities, friends, and more safety than you can provide.
Before mom can be discharged, the hospital will assign a social worker to her case. (One hopes) They will assess the home situation and the available resources and care she needs.
I cannot imagine them discharging her to home with only 4 hrs of an aide once a day. More likely a rehab facility.
In fact, if you yourself don't want this burden (and it will be one, no matter how you feel about mom) you need to advocate for her care loud and clear.
Is she right or left handed and is the break on her dominant side? I can do a LOT with my right hand, if my left arm/shoulder is in a sling, or whatever. If she broke her dominant arm-she's going to need a lot of help.
Also, at age 92--you are probably in your late 60's yourself. And, due to age, her recovery might be slowed down.
My Dh took care of his 93 yo mom for almost 2 years--he was in his early 70's (middle child, with older brother and younger sister--but they were still 68, 71 and 74)..they were chronically exhausted and depressed by keeping that promise to keep her home forever.
By the time they gave up and moved MIL to a lovely ALF, she said to the, "Oh this place is so much nicer than the one you used to have me in" (she'd been HOME!!!!!!!!!!!) She lived a week in this ALF and died 2 years ago today--Valentine's Day and my Dh's 72nd birthday.
The kids have said over and over again that they should have moved her to care years earlier.
Don't try to be a hero. Do what is BEST for mom and visit her, but don't make yourself be her one and only. It will kill you.
Talk to the social worker, and if you have to the Orthopedic Doctor and the Primary Care Physician.
My neighbor age 78 broke her right shoulder and left hand tripping over a parking lot bumper.
She had a really poor quality Medicare Advantage policy. Her break was bad enough that Orthopedic Doctor did a shoulder replacement. After the shoulder replacement the Medicare Advantage insurance company wanted her discharged to her home immediately after surgery. She had no family in town, no one in the house, and no CNA's.
It took the combined efforts of the Orthopedic Doctor, Primary Care Physician and the Social Worker to get her discharged to a rehab. My neighbor wanted the lux rehab in town. Only one rehab in town would accept her insurance so that is where she went.
The neighbor wanted to be in rehab for 8 weeks. Again, she had the shoulder replacement and a cast on the opposing hand. Insurance company discharged her in 4 weeks.
She came home. No aids. Neighbors helped her get dressed for the first week. I felt like it was pretty dangerous not having someone in the house. She had friends drive her to her PT appointments.
At 6 weeks she was driving but she still had a lot of shoulder pain. RN told her she could not take the oxy if she was going to be driving. Her biggest problem with driving is she does not have a push button starter in her car. She has pain when she turns the key in the ignition.
She has been doing outpatient PT at the surgeons PT office now for 8 months. She goes twice a week for shoulder PT and twice a week for hand PT. Her shoulder PT just stopped last week but she will continue with hand PT for awhile.
Also, if your Mom can afford it and likes the home help she has I'd route the 4 hour people to the hospital and then to the rehab in the mornings. She will feel better having people around she knows and they can assist her with dressing etc.
So.....if you live in Florida and have Medicare Advantage be prepared to get the Orthopedic doctor and Primary Care Doc to fight the Advantage plan to get her to a rehab.
If she has CNA's for 4-6 or 8 hours a day she after discharge from the rehab she is probably fine to return to her home. Plus they can drive her to her PT appointments. For the first 2 weeks after rehab discharge I'd have CNA's for 10 or 12 hours at the home. You should be able to reduce the hours after that.
It was dangerous for my neighbor not to have anyone in the house the first 2 weeks after she was discharged from rehab.
As a hospital social worker/discharge planner myself, this is definitely the most accurate description of the likely outcome here. If someone has a Medicare Advantage plan instead of straight Medicare, we are totally at the mercy of the insurance company to decide if they will pay to send someone to rehab. Even with straight Medicare, the patient must be in an inpatient status, not observation, in order to qualify. The hospital team will always work hard to convince insurance companies to approve rehab - we know that is usually the best-case scenario for people! Even if we do end up convincing the insurance to approve, it's usually only for a few weeks unless the injury is very extensive. Anything else beyond that insurance time (unless Medicaid is involved) is a private expense. Unfortunate for sure, especially when the patient's loved ones and care team can all see that they would benefit from more rehab!
My mom had the same injury. The Ortho doctor treating her in the hospital ordered PT and located an inpatient rehab facility, that was inside a nursing home, for her PT. It was approved by insurance, she transferred there and continued for as long as insurance would pay. Appeal when you need to if they decide she should leave early. My mom is still there with private pay. Those kind of fractures heal very slowly.
This willbe something that should be discussed by tge discharge nurse before Mom is discharged. If there will be no one home to care for her, then its an "unsafe" discharge. Falls at Moms age may mean 24/7 care now. They are good until the aren't. May need to place her if you can't take care of her.
Falls are often a game changer in the very elderly. The hospital social worker or discharge planner will help with rehab placement. If you have knowledge of local nursing homes you can request one and they will see if it has availability. You can also ask on your local Nextdoor for recommendations of places local people have had good success using, you will get answers of the good and not so good. Wishing mom the best in recovery from such a hard situation
Talk to her doctor. The doctor should make a recommendation for rehab.
Thankfully, it's not her hip! At that age, a broken hip or leg can really impact the rest of her life, as it affects mobility.
If she is becoming unstable on her feet, and a fall risk, it doesn't matter how many hours of home help she has, she will fall again. It is time to talk about mobility aids. If she can get by with a walker, that's fine. If she is too weak (her arm may not be able to support her on a walker) then she should be in a wheelchair to prevent falling. Rehab can help provide exercises to keep strength in her legs, and she should have help when standing to go to the toilet or go to bed. If it is no longer safe for her to live alone in her home, it is an easy transition from Rehab to long term care facility.
This actually just happened to my Dad last November; he is 95. He refused rehab care after the hospital, so we went the PT/Nurse route at home. My mom is home as well, 91, but she went into the hospital a week after he had gotten home so it was interesting. I ended up staying with him for awhile. The PT is still coming to the house but I believe this is ending this week.
You need to push the doctor and staff at the hospital HARD to get her into rehab. When my mom (age 89) broke her wrist and bones IN HER FACE, the doctor in the ER initially wanted to discharge her home. She had a concussion, and after the trauma of the fall, her face was swelling on one side to the size and shape of a football by the end of the day. I said there is no way she can go back to her independent living apartment and she needed rehab. She needed to be taken care of, build back her strength (she was weak and dehydrated), and learn how to do ADLs with one hand. And no, we could not take her home with us. But I was told you only get inpatient rehab if you've been admitted to the hospital. The Dr. took sympathy on us and shortly after this conversation came back and said they were going to admit her for observation and that paved the path for rehab a few days later. While she was in the hospital the staff was concerned she was sleeping so much, but that's always how she deals with trauma. It was what she needed to start healing and she would not have gotten that if she was sent home.
If you do get her into rehab, please remember that they are not elder care facilities. They will not make sure she's eating, drinking, staying in bed, getting her hygiene attended to, etc. That will still be a family member's job or a hired aid. Your Mom may need a SNF.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
I doubt that mom will be able to live alone anymore, though she might think it's possible. This fall is probably not an isolated incident. She may have fallen various times and not told you about it, and she can be expected to fall again. Four hours a day with Home Instead isn't enough help and observation when elders reach this stage.
Taking her into your own home should not happen! Becoming burnt out is the reason. Once they get in, it's hard to move them out, so realize the situation before it happens. Start checking out assisted living places where she will have a social life, activities, friends, and more safety than you can provide.
Good luck in managing all this!
I cannot imagine them discharging her to home with only 4 hrs of an aide once a day. More likely a rehab facility.
In fact, if you yourself don't want this burden (and it will be one, no matter how you feel about mom) you need to advocate for her care loud and clear.
Is she right or left handed and is the break on her dominant side? I can do a LOT with my right hand, if my left arm/shoulder is in a sling, or whatever. If she broke her dominant arm-she's going to need a lot of help.
Also, at age 92--you are probably in your late 60's yourself. And, due to age, her recovery might be slowed down.
My Dh took care of his 93 yo mom for almost 2 years--he was in his early 70's (middle child, with older brother and younger sister--but they were still 68, 71 and 74)..they were chronically exhausted and depressed by keeping that promise to keep her home forever.
By the time they gave up and moved MIL to a lovely ALF, she said to the, "Oh this place is so much nicer than the one you used to have me in" (she'd been HOME!!!!!!!!!!!) She lived a week in this ALF and died 2 years ago today--Valentine's Day and my Dh's 72nd birthday.
The kids have said over and over again that they should have moved her to care years earlier.
Don't try to be a hero. Do what is BEST for mom and visit her, but don't make yourself be her one and only. It will kill you.
Talk to the social worker, and if you have to the Orthopedic Doctor and the Primary Care Physician.
My neighbor age 78 broke her right shoulder and left hand tripping over a parking lot bumper.
She had a really poor quality Medicare Advantage policy. Her break was bad enough that Orthopedic Doctor did a shoulder replacement. After the
shoulder replacement the Medicare Advantage insurance company wanted her discharged to her home immediately after surgery. She had no family in town, no one in the house, and no CNA's.
It took the combined efforts of the Orthopedic Doctor, Primary Care Physician and the Social Worker to get her discharged to a rehab. My neighbor wanted the lux rehab in town. Only one rehab in town would accept her insurance so that is where she went.
The neighbor wanted to be in rehab for 8 weeks. Again, she had the shoulder replacement and a cast on the opposing hand. Insurance company discharged her in 4 weeks.
She came home. No aids. Neighbors helped her get dressed for the first week. I felt like it was pretty dangerous not having someone in the house. She had friends drive her to her PT appointments.
At 6 weeks she was driving but she still had a lot of shoulder pain. RN told her she could not take the oxy if she was going to be driving. Her biggest problem with driving is she does not have a push button starter in her car.
She has pain when she turns the key in the ignition.
She has been doing outpatient PT at the surgeons PT office now for 8 months.
She goes twice a week for shoulder PT and twice a week for hand PT.
Her shoulder PT just stopped last week but she will continue with hand PT for awhile.
Also, if your Mom can afford it and likes the home help she has I'd route the 4 hour people to the hospital and then to the rehab in the mornings. She will feel better having people around she knows and they can assist her with dressing etc.
So.....if you live in Florida and have Medicare Advantage be prepared to get the Orthopedic doctor and Primary Care Doc to fight the Advantage plan to get her to a rehab.
If she has CNA's for 4-6 or 8 hours a day she after discharge from the
rehab she is probably fine to return to her home. Plus they can drive her to her PT appointments.
For the first 2 weeks after rehab discharge I'd have CNA's for 10 or 12 hours at the home. You should be able to reduce the hours after that.
It was dangerous for my neighbor not to have anyone in the house the first 2 weeks after she was discharged from rehab.
Thankfully, it's not her hip! At that age, a broken hip or leg can really impact the rest of her life, as it affects mobility.
If she is becoming unstable on her feet, and a fall risk, it doesn't matter how many hours of home help she has, she will fall again. It is time to talk about mobility aids. If she can get by with a walker, that's fine. If she is too weak (her arm may not be able to support her on a walker) then she should be in a wheelchair to prevent falling. Rehab can help provide exercises to keep strength in her legs, and she should have help when standing to go to the toilet or go to bed.
If it is no longer safe for her to live alone in her home, it is an easy transition from Rehab to long term care facility.
MD.
His personal physician.
Gena, Touch Matters