Follow
Share

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.

Find Care & Housing
My fear for her going home would be that her needs are going to be more than your father can manage.
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.
Helpful Answer (0)
Reply to CaringWifeAZ
Report

When my 80yr old mom had an ischemic stroke a couple weeks ago, the doctor recommended she go to a rehab hospital for at least a week. When we checked in, one of the questions the intake person asked was "What are your goals? What do you want to accomplish with therapy?" I imagine this is a standard question on rehab forms. Since this was a recurrent stroke, and since mom has suffered from dementia for over 8 years, I said that we wanted her to be able to return to her memory care facility with the ability to use her walker to go back and forth to the dining room, to be able to use utensils to feed herself, to swallow her food, and to be able to use the toilet and dress herself. After a week and a half, she left the rehab able to do those things. When she went in, she let her right arm drop and she couldn't get herself out of bed. They are visiting her twice a week with PT and OT. She still has trouble completing sentences, and her anxiety and dementia confusion is worse. But that's where we are now.

If your family is clear in stating your goals, I don't think the rehab therapists will work your mother to pieces.
Helpful Answer (0)
Reply to BlueHeron
Report

Any realistic gains in rehab will be made in the first 21 days thst Medicare pays for. I would go ahead and see what happens. After that you’ll have an answer about what her new needs are.
Helpful Answer (0)
Reply to PeggySue2020
Report

UPDATE ON MOM'S CONDITION: She had a "small stroke" and the doctor is definitely recommending rehab. Now we're in the process of evaluating that necessity "for real" as opposed to just a possibility. Lots to consider. Advice still very much welcomed.
Helpful Answer (0)
Reply to StacyAa
Report

"We don't know how severe Mom's stroke was..."

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?
Helpful Answer (1)
Reply to Geaton777
Report
StacyAa Aug 19, 2025
Those are good points. We now know she had a "small stroke" and is already regaining use of her paralyzed arm and leg and speaking clearly.

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.
(0)
Report
You cannot care for her. You will soon find out if dad can care for her. I ask you if SIL contributes to her care. If not then maybe she is just offering lip service with no intentions other than to meddle....caution.
Helpful Answer (0)
Reply to MACinCT
Report
StacyAa Aug 19, 2025
SIL lives in Norway (though she did her nursing here in the States and is a dual citizen, having grown up in the US to Norwegian parents), so is just offering her "professional" opinion out of concern for my mom. I kind-of wish she WAS here, so we'd have an advocate and an extra on-point person since I can only give advice and offer to look into the safety record of the facility being recommended (affiliated with the hospital she's in).

It's wise advice, though, to be wary of others' intentions.
(0)
Report
If your mom is already pretty much bedbound, I'm not sure how much help rehab would be anyway especially after now having a stroke, so not sure that I would put her through that.
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.
Helpful Answer (4)
Reply to funkygrandma59
Report
StacyAa Aug 17, 2025
Thank you. I think we'd have a fight getting her into skilled nursing, but it may just have to be that way. I'm not looking forward to the upcoming discussions, but we have to be realistic, and that's what you're saying. I appreciate that wisdom.
(0)
Report
Ask a Question
Subscribe to
Our Newsletter