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She has had a few falls, refuses to use walker. A few years ago after a fall that broke her hip, she was discharged from SNF and refused to let the PT person in her apartment. She worked as a nurse so she thinks she KNOWS what is best. She is constantly saying she needs to go home, get her out of here! She has been here 1 week after a fall that made her go to hospital with broken ribs. She also fell TWICE in one day in September of last year!

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Your profile says your mother is 96 and has dementia. Is this your opinion or an actual diagnosis?

Are you her PoA? If not, and she doesn't have one, and she doesn't have a medical diagnosis of dementia, she may be able to check herself out, but don't enable her by bringing her anywhere. Tell the facililty she is an "unsafe discharge".

Also, wishing to "go home" can be part of "sundowning", a common dementia behavior.

If you are her PoA you tell her that when she can perform her ADLs for her doctor, then he/she will discharge her.

If she has diagnosed dementia, then redirect her conversation to something else to get her unfocused on her obsession to leave. You don't have to argue with her if her brain is broken. You won't convince her or reason with her or be able to employ logic. That part of her mind is going, or gone.
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You posted this under Alzheimer's and Dementia so I am assuming that your Mom is suffering from dementia and that you are her POA. Otherwise, no SNF is a prison, and she could sign herself out and go home.
You understand that she cannot go home because she will not do her exercises and you already have evidence of that from the past.
So basically the answer is no.
When there is dementia we are beholden as the POA to act in the best interest of the elder we assume the care for. So just say "no".
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Sorry this is a hard one. Most people in those places want to go home. BUT they can not do so. I would keep it vague - not right now mom. I understand you'd like to go home and I can't blame you, etc. Just give the same response every time, don't get upset (well, try not to!) and change the subject. The weather works?
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Don’t worry. If she refuses to do PT (usually 3 times) they will discharge her. Otherwise it is fraud for them to keep her. Use this time to have her seen by a geriatric psychiatrist if possible to see if a Med adjustment would help her be more cooperative.
She can’t go home but she will have to leave the rehab if she doesn’t cooperate so also use this time to make meaningful changes. Depending on her cognition, you can explain that to her. You can be moved mom…but it won’t be home unless you can x,y and z or hire help. Settle in for now while we figure this out.
If she will need Medicaid for a SNF, then realize that it is easier to get her in following a hospitalization. If SNF bed is available where she is and you feel it is a good place for her, speak with their admissions person. Also look into other viable choices.
If she thinks all she has to do is command you to take her home and to take care of her you need to really sit with that a minute and understand what that can mean for both you and her. There are two people here to consider the needs of. Not just mom. Especially if she has dementia.
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katlovesdogs, welcome to the forum.

I remember back after my Dad had a heart attack it was recommended he go to Rehab, but my Mom refused to let him do that as she didn't want to be alone. Instead physical therapy came to the house. It was a very slow process as my Dad only did the exercises when the therapy person was there.

Couple years later, after surgery, it was recommended Dad go to Rehab, this time he went. Dad stayed the required amount of time, then came home. What a huge difference in Dad's physical recovery. Dad enjoyed using the machines in the Rehab gym, which he didn't have at home.

I also had purchased my Dad [mid 90's] one of those rolling walkers which has hand brakes, a seat, and basket. He was so happy, he was walking everywhere he could with that thing. My Mom [late 90's], on the other hand, refused to used a walker. She felt it made her look old..... [sigh]
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Tell her she's stuck in that SNF for rehab and isn't getting released or going home until she's REHABBED. We all know these elders are fully non compliant with doing the PT exercises at home! That's just manipulation techniques to support her case for going home. Sorry ma.
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I swore the last time Mom was in rehab, it would be her last. She was 89 and in late Stage of Dementia. I requested they not leave her in her wheelchair all day. I asked for a cushion for her back, got it, next day gone. She cried because she was lonely. Therapy was maybe 2x a day and she was just sitting around after that. When I finally had a care meeting after 2 wks I found her thyroid med had not been given her because their doctor felt she didn't need it. The therapist said Mom was not able to follow instructions or remember her excercises from day to day. I said SHE HAS DEMENTIA! Then she would never walk again unassisted. Within 24 hrs back at her AL she was walking all over with her walker. I could have gotten therapy in the AL.

Really you can't blame your Mom and at 96 her legs are probably going to give out anyway. They did with my Aunt. That last time Mom was in I was pinching pennies to keep her in the AL. I told them to inform therapy that there was no money and they better do what needed to be done in 20 days. She was discharged in 18. I would ask that your Mom be discharged and therapy done in her home.
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