Mom broke right ankle, right femur, and left ankle. Any advice about 24/7 bed care?

Thanks for the update!

update 2: mom is home! Care is pretty much as normal, just a little more difficulty rolling in bed to get peri cares done/change briefs.

If discharge is unsafe, the hospital is obliged to keep her until s bed is available. They don't like it but I have seen it before.

Update. Not a single bed open the entire state. Going on 5 weeks in the hospital.

By 'home', do you mean hers or yours; and are you intending on being her carer or just directing the care?

Get carers in twice a day (or more) if mom has funds - you will need to keep up your own strength/nutrition/rest to manage in between times. Learn from them by assisting a little so you can cope by yourself if necessary.

Purchase some 'slide sheets' to save your back, install a baby monitor, and create a space (or nearby room, cupboard, etc.) as makeshift kitchen and for cleaning supplies so you aren't running around all the time.
Continence pads might be advisable, at least in the short term.

Over and above her injuries, this is a precarious situation requiring considerable attention and vigilance for the physical and mental impacts (for both of you) from being bedridden. Some physio might also help (if funds extend that far) to maintain condition of the unbroken bits as well as monitor rehabilitation/healing as muscles will atrophy, joints stiffen...

Hope she is patient and cooperative/understanding.

Sounds like quite a fall and also sounds like your mom may have brittle bones. If she doesn't have osteoporosis, her fractures should be healed in 8-12 weeks. If she does have thinning of her bones, the fractures will heal very, very slowly. She should have splints or casts to help stabilize the fractures. A hospital bed with an overhead frame can help with mobility - if she can use her upper body strength to move. Extra pillows and foam wedges can help to change her position in bed and keep her from developing "bed sores." If she can not move well, you will have to turn her every 2-3 hours or rent a bed that can gently move her from side to side. The other option, in this case, is to continue care in a rehab center until her fractures heal.

aj6044: Your mother needs to be housed in a rehabilitation facility after the SNF in order for her bones to heal. Please let medical professionals manage her care as if you attempted this in the home setting, you may find it EXTREMELY challenging.

Don’t take her home. This is a nightmare and professionals can figure out better how to handle it.

It took a while to put all the pieces together. My wife fell and broke her hand and went into a care facility. She also needed rehab from a broken hip a year prior. It was a miserable experience for her it was the worst place (another story) when she returned home she got dementia. It took a couple of months to diagnose. Traumatic experiences like these can bring on dementia. “They” say it may go away but it has only gotten worse. So my advice is to be careful with putting someone in a care facility if their mental state is fragile.

aj6044, I would think that given her injuries, she would be sent to a rehab facility for the maximum amount of time payable by Medicare (if I remember correctly, it's 3 or 4 weeks, but that was some few years ago). She could stay longer if privately paid.

To me that's the best and safest way to recover from those kinds of injuries. When my father broke one hip, then the other one a few years later, those were always the routes we took.

During the last days before discharge, we worked with the social worker(s) at rehab to get home care. It wasn't as thorough, but it was adaptable, and very helpful.

A social worker in rehab can also work with you and then arrange for in home equipment that might be needed. During our first go around, the PT and OT folks came to the house, did a visual assessment, and made suggestions on what else could be done to increase safety.

You do not mention Moms age. I think you are putting the cart before the horse. This is all a shock to Moms system for one thing. Being in a strange place with strange people may worsen her Dementia. Like said, you need to see how she progresses. You may no longer be able to care for her. She can transition right from Rehab to LTC. In my area, they are in the same building.

Being on Medicaid was mentioned but that is health and in home care, right. A LTC stay may need to be applied for. This you can run by Moms caseworker.

Rehab and Medicare. Riverdale's Mom's secondary insurance must have been very good and covered what Medicare didn't. First, the 100 days that Medicare allows is not guaranteed. The length of Rehab is determined by how the person is progressing. If the person hits a plateau, Medicare will have them discharged.

Medicare pays 100% the first 20 days. The 21st to 100 is only 50%. Your secondary insurance may pick up the balance fully or partially. In my Moms instance, 6 yrs ago, she paid $150 a day. When admitting Mom to Rehab the financial office should have gone over this with you.

You may want to give this a little more time to see how Mom progresses. Taking care of someone bed bound is not easy.

A similar event happened to my mother almost a year ago. She very quickly developed a bedsore which became very large. At times it was treated twice a day. It is smaller but still there. It is treated once a day now.

You need to impress upon the staff that she be moved from side to side at various points of the day in order to attempt to avoid this happening. They can come on very quickly. You also should have a special mattress. It is extremely difficult for bedsores to heal in compromised patients.

I also question whether you should take this on should she become better. She should have the 90 to 100 days of Medicare in place. I forget which it is but it is around that. My mother had that and we had no bill for 3 months.

Observe the CNA's and other staff at the SNF where she is.
Ask them to teach you what to do.
And I bet you will notice that her care REQUIRES 2 people. So you will need another set of hands when/if she goes home.
There are ways to change a person in bed but it does require rolling them from one side to the other.

Side note the purchase of an alternating pressure mattress might not have been necessary. The doctor can order that it is considered DME and is covered. And depending on other conditions she has if she qualifies for Hospice then Hospice will provide all the equipment and supplies that you would need as well as having a CNA come to help several times a week. And the CNA is able to teach you the in's and out's of care.

Based solely upon what you’ve related, I’d stop buying things that you don’t really KNOW you’ll use that she’ll need, and devote a few hours to researching equipment, services, and extended care options that may or may not be useful.

Just managing toileting for a bed bound patient with NO recently broken bones is hard to plan for, and it may be completely new terrain after the pain of her injuries, the shock of treatments on the broken bones, and the initial incident.

Are you open to at least considering an “extended” stay in a care setting. Depending on the geographic area and the finances that you’re dealing with, that may be easier said than done, I realize.

In fairness to you both, though, you may need more information to face the circumstances you’ve got in the fairest way possible for you both going forward.

Is taking your mother to your home after rehab seriously your plan?

"No hoyer lift transfers until her femur heals"? What are you going to do?

From past posts, your mother is on Medicaid. Why isn't remaining in a SNF the plan post-rehab?

I think it is unrealistic for you to consider taking this on. Beatty has an excellent idea about doing this as a practice run while mom is still in rehab. This way you know what you are getting into and can make an informed decision about if this is realistically something you can handle in your own home.

Your intentions of care at home are loving & noble.

I'd suggest spending 24-48 hours rooming in at the NH (or spend 2 full days, depending on whatever visitor restrictions allow).

This will give you the opportunity to learn some tips from the staff re positioning, turning, clean-ups etc. To see what & how much will be involved.

Then you can gather what you need for home, equipment + set up home care aides - you will need respite break windows of time to run your own home/meals/bills/life.

Keep the skilled NH bed option open as long as you can (or ensure you can re-open it).

Remind yourself there is no shame at all in saying, No, I don't think this will work. Mother will need to stay.

Your profile says “my mother is a stroke victim, alcoholic, memory impaired, and incontinent. She has home health care”. You don’t say how old she is.

Two broken ankles and a broken femur will take a long time to heal, and surely she will be bed bound for a long time. My BIL broke a leg in the late stages of cancer, and he never left the bed again. You are making preparations for her coming home, but how long is she expected to be bed bound? Does she have the finances to pay for 24/7 home care long term?

Was the accident alcohol related? How stable will she be when she has healed as much as possible? Will she be able to avoid another fall, particularly if she wants to return to drinking?

Most people in your position (at least with an elderly mother) would decide that this is the time for a NH. It might be worth looking at the options for if the return home proves to be too difficult. Good facilities can have a long waiting list.

How on earth..?

Never mind. I'm so sorry to hear that this has happened - how doesn't really make much difference, unless she's likely God forbid to try that again!

I wouldn't buy anything or decide anything now. How many weeks is a few, and what's the plan for reviewing her progress/recovery?

Poor love, how is she?