My mom (93) had a stroke this morning and is in the nearby hospital. My dad (94) is there with her. I am unable to go be with them because of health issues, but my husband is on point for respite for my dad. We don't know how severe Mom's stroke was (either they haven't told Dad yet or he couldn't hear). They are keeping her for now for "some rehab" and observation.
My SIL, who is a retired nurse, said they may push for a rehab facility, but she says she's seen what "rehab" facilities do for 90+-year-olds, she thinks they're too harsh and that they don't take their frailty into account. She thinks we should all weigh the benefits of rehab vs Mom going home and having home healthcare and not being forced into anything strenuous and "pretty pointless".
I'm not sure what to think of her advice. From conversations my mom and I have had in the past, she's not a fan of rehab homes. She thinks the one her mother was in at age 95 (she fell and broke her pelvis) was awful, and for mom that means all rehab facilities are awful. My grandmother also contracted pneumonia there, from which she ultimately died (in a hospital).
So this is all super premature, but I'm just trying to get my head around what next steps might need to be. Both Mom and Dad are okay cognitively, so ultimately it's their decision, but I feel like my husband, brother and I should be able to help give them all the information they need.
What do y'all think? Should we listen to my sister-in-law and add her counsel to the mix of deciding factors, or are there other ideas than "rehab or go home and be impaired"?
For context, Mom is mostly bed-bound already (she gets up once a day to go to the living room to watch TV with my dad, needs a walker), she has had several compression fractures, a couple of years ago fell and broke two bones in her arm, and she has a slew of chronic health conditions. She's pretty miserable, but also conflicted about letting go of this life. (She's a Christian so not afraid of what happens after, just of letting go.) Dad has been her full-time caregiver for about 2 years, and I am unable to take on that role due to my own health issues.
If the hospital doctor recommends rehab, it could be for speech and occupational therapy. I don't know if you can request that they don't subject her to strenuous physical therapy.
Yes, there other options besides rehab or going home and be impaired; it could be time for her to move to a nursing home. Your father can visit and spend time with her there without the demands of being her caregiver.
You could encourage your father to hire a full time caregiver, if they choose to stay home.
If your family is clear in stating your goals, I don't think the rehab therapists will work your mother to pieces.
I think answers will depend upon what impact the stroke had on her. I agree that rehabs/PT can do more harm than good for someone very elderly (been there, done that with my Mom when she went for PT to strengthen her core -- a young PT injured her).
In rehab someone will still need to tend to your Mom, since she is only there for rehab and not custodial care. Is she cognitively willing and able to participate in the PT?
Maybe consider a hospice assessment instead?
My dad is so used to the "doctor is always right" mentality of people who've not had to deal with the medical community beyond normal healthcare (yes, as he's gotten older he's had to have more appointments, and even had a TIA last year, but that was easily managed by traditional med treatment, i.e. blood thinner and BP med). I, OTOH, have extensive personal experience with doctors who did NOT, in fact, know what was best for me as an individual.
They want to help Mom "get her strength back". She's been bed-bound for so long, I don't think that's a good goal. If they mean get as much use of her arm and leg back as possible, that's reasonable, but I am afraid they're going to harm her by being too rough. I'm surprised she's even considering saying yes, given her fear and loathing of rehab/skilled nursing facilities. But she's also a rule-follower, so...
Trying to get my dad to listen and not just accept the doctor's plan without consideration. Trying to get my brother on board with pushing back a little. Trying not to have my own stroke over it all.
It's wise advice, though, to be wary of others' intentions.
Instead it may just be best to let her come home when she's able, with in-home health care aides coming in to assist her as needed so her care doesn't all fall on your dad.
Or if she really is now more compromised after the stroke, it may be best to move her into a skilled nursing facility where she will be looked after 24/7 and her husband and family can just be her loving family and advocates and not her burned out caregivers.