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My mom, in a rehab hospital, needed an IV for dehydration yesterday. I thought it was done. Tonight when I called her, she said it hasn’t been done. I called staff nurse, she seemed in no hurry to do this. “Maybe tomorrow” she said. She made excuses about a special IV nurse will have to come in. This is an elegant, and expensive rehab!


It sounds like shoddy care to me.


Of note, mother wants to be taken home ASAP! I firmly believe that she can not be cared for in her home yet. Too many acute needs. She is fully alert and in charge of her care. So it didn’t make sense when she told me she had no idea what they were doing about the IV all day today. I’m sure she was told something ! I suspect she’s building up reasons for why she can not stay there, or at any in patient setting. And she has been very manipulative, especially with me for many years.


I’m near crazy with this whole situation. She’s been moved to different facilities at least four times over last two months. Now I’m not sure if it’s manipulation on my mom’s end, or is it truly POOR health care at a well respected rehab unit. Or both ?


I’m just so tired…


Thanks in advance for any advice on this situation.

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Hi Nancy
Yes, IVs can be given in a Rehab. Especially if it is part of a SNF/NH. Nurses should be on hand who can start an IV. Reasons I have been given when something that should have happened and didn’t were doctors orders missing, medication not on hand, issues with delivery, billing issues, patient refusing. Does your mom usually have a difficult time with IVs? Could this be in her chart?
Are you sure a doctor ordered the IV? Being dehydrated can be very serious and someone who is supposed to be doing rehab might not be able to if dehydrated.
I am sorry you are having a difficult time getting this sorted at the Rehab. My moms first experience at a top rehab was dismal. She ended up back in the hospital.
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Nancymc Mar 2023
Thank you, @97yearoldmom AND others who answered !
It turns out there were multiple delays, of the EXACT type you mentioned. They just began it, BUT it was two full days later.
If this is skilled nursing care, I’d hate to think what a nursing home or any other lower (“less skilled”) level of care would do..!
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IV's can be given in rehab if they are ordered by her doctor.
It needs to be documented not just a "conversation"
And the facility has to have the IV that has been ordered. If it is not on site they would have to order it. (although I can not imagine a facility not having IV fluids on hand)
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Nancymc Mar 2023
Yes, it was verbal, by phone from a ANP, and the every-day staff nurses don’t start IVs, Thus delays…
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My 100-yr old Aunt was in rehab after a fall and broken hip. They did't give her IV fluids (which she could have used) and I assumed it was because of her advanced dementia (she'd pull it out) or they couldn't find a vein. But maybe it's because this requires more of a skill set than their staff has? I mean, the patients are there for PT, and needing an IV maybe means they shouldn't have been moved from the hospital yet? This may be due to the Medicare ccoverage (3 days in hospital covered then 20 days in rehab covered). I dunno. I'm stumped as well.
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Nancymc Mar 2023
Thanks. The hospital discharge was another MAJOR mix up ! With no notice to me, they wanted and planned to send her home with MANY issues. I had a fit, and I refused to pick her up ! It never should’ve gotten to this. What happened to quality health care ? Is it no longer accessible???
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I would ask to speak to the MD, medical officer in charge at the rehab. He can answer your questions about WHY your mother has become dehydrated, and about what will be/can be done in this particular rehab facility. Each facility is an entity until itself with its own rules. We wouldn't know what rules apply to this facility.

Sorry you and your Mom are going through this and hope that things right themselves.
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If she is not progressing for what she is there for, then Medicare will discharge her. You have a right to say you will not take her home and its an unsafe discharge. But that does not mean Medicare continues to pay. Now its transferring to the Nursing section, on her dime, till she improves well enough to be released if you think she should not go home. Or, she will never get better and it now means an Assisted living or LTC.

Really, if she still needs IVs maybe she should not be in Rehab. You have to be able to do the PT and OT. Maybe Mom will never do more than she does now. Therapy does not always help.

I just read Mom is 96. What are the problems she has? Like I said, Rehab is only suppose to work on what Mom is there for. If its just to get her strength back because she was in bed too long, then thats all they do. Prior problems she had are not their responsibility IMO.
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