My husband, who has dementia, had CHF and developed pneumonia in the hospital. He was in ICU intubated for three days under anesthesia. It took him two and a half days to wake up. After two weeks in the hospital, he had to go to skilled nursing for rehab. He has been here two weeks. He's getting physically stronger, but mentally deteriorating. It's not just the dementia, its depression, anxiety, delusions, and paranoia. HE IS SO MISERABLE THERE. I want him home at the end of the week. They say he'd be leaving AMA, and Medicare might not pay. Is that true? I feel his mental health depends on coming home and having some in home care. He'll always have dementia and I know it will worsen. I can deal. He deserves what little quality of life he has. I think it is their interest to keep him there. MONEY. 😪
But sometimes they are necessary in spite of risks. Sometimes the potential benefits outweigh to downside.
Can you spend a lot of time with him in the facility? Can you rotate your visits with other family members or friends? How much longer does the staff think he will benefit from additional therapy? What will he gain from this, in their opinion?
As others have said, I doubt very much there is a financial motivation in recommending that he stay. TCU and Rehab places can very easily fill their beds.That doesn't mean they are always right, but please at least give them credit for having your husband's best interests in mind.
I really do understand your frustration. If you think he would in fact be better at home (and there is the possibility that he's so overwhelmed he won't want to participate in home therapy), talk to his pulmonary or cardio doctor and ask if they'll script for home care, as the rehab facility might refuse to do so.
My Dad had a choice of a Rehab over-night type facility and he choose home care where a physical therapist, occupational therapist, a nurse would stop by to visit him a couple times a week. In the mean time, my Mom [who was in her 90's] said she could take care of my Dad. Oh dear, no way my Mom could help Dad walk, so she was calling me frequently because Dad fell.
Dad would do the exercises only while the therapist was there. Other then that, he sat in his recliner. If he was at a facility, an Aide would be making him get up and do some walking with his/her help.
One other thing, do research on home care. These same facilities will try to make the decision for you, why? Money. Home health will pay a referral fee to the facility because of being grateful to have a new patient/customer.
Many people don't know, those on Medicare have the right to choose Home health care as well as, Skilled nursing facilities, though again, some medical folks try to make the choice for you,
It is normal for someone who has dementia to feel depression, anxiety, delusions and paranoia when they are "living" in a new environment. That happens to 90% of our senior citizens, and 20% to much younger people recovering from a serious surgery or illness. Once you bring hubby home, it might take 2 or 3 days before he feels he is back at home.
If hubby leaves early, that bed will be filled within hours with another patient, thus money isn't the issue.
And whatever you do, do not say anything in front of hubby about how rehab is keeping him there without reason, etc. That would only depress him more. Ask the rehab director how is hubby doing, and what do they think is the time line for his discharge. Then put a wall calendar in hubby's room and mark off the days and show the day of leaving. Counting the days might help hubby look forward to returning home.