Very helpful to hear this, @aekmom! My thoughts are with you as you continue to work within a very difficult situation with your beloved father.
Aekmom, we are on parallel course for a bit here, though hip fracture is much worse than stable pelvic. I just wanted to mention that I am having serious doubts about the kind of PT offered by rehab. I was chatting with our AL director and mentioned my intuitive feeling that the rigorous one hour session was too much too early after a fracture (and causing pain) and the AL director said that rehabs have to provide that to earn/justify Medicare funding.
Maybe our parents are smart to resist! (I also googled and found that pelvic fractures should first be treated with rest and that weight-bearing should be avoided, which is certainly not the approach of the rehab PT.
I am pursuing this question tomorrow. I attended the hour long PT today and I found it distressing and a bit over the top. In fact, for half of it, the PT thought she was treating a hip replacement!
Granted, they do need to be able to get to a bathroom, or at least a commode…
Glad the delirium was from the hospital and that he is better mentally, such as it is.
I called the hospital floor where my mother was last Friday and the nurse there agrees with me about the PT after recent fracture. Someone there had mentioned that I could talk to an ortho person today. She looked in the record and found the name of an orthopedic PA I can talk to. This gave me the strength to call the rehab and say please no PT until I have talked with them.
I feel like you can never sit back and just trust. I think that the vigilance required is one of the hardest things about taking care of our elders.
@compmom, exactly right about the vigilance. No, I don’t have a medical degree, but knowing the patient is pretty important sometimes. Pressing the red button and getting help is important sometimes. Kudos to you for continuing to advocate and care for your mother.
Amen about vigilance. Being “on” all the time, especially for those of you with elders in fragile states, must be so taxing. Hugs and wine / chocolate / kittens to all of you.
" I was chatting with our AL director and mentioned my intuitive feeling that the rigorous one hour session was too much too early after a fracture (and causing pain) and the AL director said that rehabs have to provide that to earn/justify Medicare funding."
Check into the Medicare rules about PT. I read (wish I could remember where) that PT can be started later after healing time and still be covered. Thought I read about a class action suit that has changed the rules about the time limits on starting PT. My dad has refused PT recently because he was too weak after being discharged from hospital and the PT people just said they could sign him back up when he was ready for it and Medicare would still cover him. But he’s at home and not in a rehab–there are different rules I’m sure.
@Aekmom – My dad was in the hospital for at least a week and got no sleep whatsoever. It was like torture. Literally. They wanted to send him to rehab (which in any other circumstance would be a good idea) but my sister and I brought him home (it took two of us literally to manage and we had our doubts even then). We knew that being in rehab would not allow any sleep either and that he’d probably die as a result. I truly believe that. Plus he lost 15 pounds.
I wanted him to do PT (home) but he cancelled nearly every appt. It might have worked but he was in such a depleted state that unless they came on HIS schedule there was just no way. I argued with him quite a bit but now I’m sorry I did. He was right. The body needs time to heal. Especially as we age. My dad is 96–he’s not 22–there is a huge difference. The body doesn’t care about Medicare rules and how many papers need to be signed.
Just recently he’s gaining some strength and getting a “routine” of sorts. We’ve benefited from a prior PT experience so we know exercises and have some equipment around that we can utilize on his terms.
PT did come though while he was really not ready to even move out of bed and they were helpful even then.
PT gave instruction on what he CAN do no matter how limited (our PT professionals had a TON of suggestions for bed exercises just to get the blood flowing!) that were very valuable. Not everything has to be a huge jog around the block to maintain some semblance of physical health.
Great helpful posts above. @gouf78 the course you took with your Dad sounds just right and I hope he continues to gain strength.
I managed to get the PT toned way down and targeted at the few things she has to be able to do, like get into the wheelchair from bed. No long tortured walks. Geez! The OT came in and talked to me about how he overheard the conversation and agreed. He was fantastic and brought the grabber to help her get dressed. We will go to orthopedist tomorrow and get guidelines. I really don’t think that ambulation is a good goal for PT right now.
I’ll have to look up Medicare rules. Doing PT later makes a lot of sense. Seems like we end up reading regulations a lot!
Unspeakable poopy scenes the last two days because the rehab aides aren’t sealing the bags on!!! Getting use to these things. Thank God for gloves.
I think something like a walk is more about muscle strength and lung power than the occupational aspects of dressing or getting out of bed. But you know what she can tolerate and priorities.
@compmom, I silently say “bless you” every time I put on those gloves, several times a day. I’m so sorry the staff hasn’t been sealing those bags correctly!!
My mother qualified for PT last spring, but she was so exhausted, I guess by life and her condition, that there was no way I could drive her 20 minutes to the place, have her do PT, and then drive her home and have any hope of getting her out of the car and safely walking. I got a referral for a local gal who is actually a personal trainer, but she specializes in doing PT homework with old people, She has been coming about twice a week for a year, nope, not covered by Medicare, but she charges $30/hour and comes for 1/2 hour twice a week so $30 a week. It’s worth it. She now is very comfortable and familiar to my mother. Plus she has referred to me several shower aides in the past year and it’s great to have another set of eyes on my mother, someone removed from the personal, someone who pretty well understands the body.
Ladies, I have a question for you.
My dad’s eyesight is really deteriorating. He can no longer read the newpaper or magazines. I seem to remember seeing a device that can take the image of a page and show it on a large screen. We recently got him a large computer screen, so I"m thinking that we could find this device and then he could read it on the computer screen - where it would be much larger.
Anyone know what I’m talking about? Thanks in advance.
What about just getting a digital subscription to the papers and magazines and increasing the font size on his computer?
He can read just fine on his computer since we got him a large monitor and enlarged the font size. But not everything he wants to read is available online.
https://www.loc.gov/nls/resources/blindness-and-vision-impairment/devices-aids/assistive-technology-products-information-access/. There is a section on portable video magnifiers that might work. Good luck finding the right tech!
@bookreader we ended up using a plain old magnifying glass for my dad. Getting other gadgets involved became too complicated.
The orthopedist agreed that rigorous PT was not indicated and might even harm healing for now. He also wrote an order that said she could return to assisted living. The goal is not to walk asap. She will be in a wheelchair for 4-5 weeks for healing and the at home PT will come three times a week and we will continue more natural maintenance of strength. It is bursitis as well as fracture, from the fall, and time will heal.
Thank you @momofsenior1 and @GTalum . Research to commence.
@bookreader my mom has had one of these “readers” enhanced imaging system for the last 10 years. She has macular degeneration and can’t read.
It has been the best thing for her- not cheap- about $3000.
Maybe they are more reasonable with advances in technology
On a related note- previously I would download BARD audio books from the library for my mom to listen to on portable audio device from the association for the blind- she always had problems remembering how to use the controls -
but today at our library I discovered small ( palm size) easy to use all in one audio book called “playaway” - all I do is attach some ear pods.
PLAYAWAY- from our library for anyone to borrow !!!
hopefully with her reader she can manipulate
http://www.playaway.com/audiobooks/
@compmom kudos to you for advocating for your mom. I did the same when my little mother was blown over by a wind gust resulting in severe pelvic breaks.
Rehab commenced and there was no way for her to do it. The PTs and OTs would come to her room when she was in rehab and then to our house where she was non weightbearing for another 7 weeks!
This was 6 years ago, and she recovered well, and moves amazing for 89 year old.
So kudos to you for enlisting the orthopedist in your quest.
(That being said I contacted some PTs who did tell me that pelvic rehab is extremely painful- and the need to move soon after the injury - )
We were very careful about pain meds and falls----- luckily as non weight bearing patient she was able to wean off meds and once she walked was quite stable)