So my father has been in a SNF at a nursing home for what we hope will be short term rehab since September 22. So he's still under the Day 1-20 of the Medicare pays for it thing. I went to a 'care meeting' with my mother today and... I am more confused and upset and anxious and scared than I was two days ago when he seemed out of it. Has anybody been through this sort of thing?
I don't really know the point of the meeting. A Social Services coordinator was there, someone from Dietary, a Nursing Coordinator, an Activities Director, and (briefly) his primary physical therapist. The therapist said he's walking 60-80 feet and more or less getting used to a walker (he has issues with contracture on his left hand and needs help gripping it, I guess). The therapist says some days are better than others and that there are still problems with stability and turning and shuffling and walking... all of which led the the fall that landed him there (on top of a host of other problems). Anyway, this seems sort of like progress.
Anyway, the Nursing Coordinator said when the 20 days ends and that his supplemental insurance will cover the rest for days 21-100 but... it'll be up to physical therapy when he's strong and stable enough to come home.
But... they talked around him, saying "if he can" when the sign-in sheet was passed around, talked about "do you hold his hand when he's walking around?" and when my mother said she wanted him to be able to be independent enough to get up and around the house on his own (neither she nor I is big enough to trained enough to do physical lifting and care safely... as we were doing before he got hurt) and somebody said "you can get a lift chair" as if that was the only chair he'd ever have to sit in.
Shouldn't that be when they start saying "maybe consider long term care"?
So... I walked away kind of terrified they're about to say "he's fine, you have 48 hours to take him home."
Is that bad of me?
How long do people usual spend in short term rehab at SNFs?
Do other ones have the 48 hour notice rule?
My mother and I (I live with my parents) have a lot of fears about how life was before and how it could be again (he won't do exercise or move around much at home)... which of these people who were at the meeting (and seemed very scripted) do we tell about these fears?
Should we have a meeting without my father there so we can feel more free to say them?
How do I talk to my father, even to my mother about them?
How can anyone at a nursing home having a meeting about this sort of thing, asking if someone will be there 'most of the time' to help him and if we've walked him around my the hand, even suggest that's a good way for anyone... him or us... to live?
Am I overreacting? Panicking for no reason?
Am I awful for asking these questions?
I adore you for having read this far in my panicked post and appreciate all words of advice, experience... that you might have.
I really feel for the situation you and your parents are in. It sounds like you are not panicked about financial issues involved in your father's care but about how you and your mother will manage to care for him if they release him before he's fully mobile.
Unfortunately, I think you're right to be worried. I believe these meetings are called to make sure the patient will have the support they need when they go home. Generally they want to release the person as soon as possible. I honestly don't know if the fact that your father has supplemental insurance will play into how long they will keep him. The one time my mother was in rehab, they required her to pay the patient's share for days 21-42 up front (estimating her rehab would be 6 weeks) and released her when that time was up.
I believe when you're in for rehab, they have to release you when you're not continuing to improve (AlvaDeer, please correct me if I'm wrong). So that will figure into when they decide to release him. He may still need a lot of help. He may always need a lot of help from this point on. If he doesn't want to exercise or move around at home, it's likely he won't want to do it at the rehab, either, and that may put a cap on how much progress he's actually able to make.
No, they don't think this is a good way for anyone to live. Unfortunately, they don't concern themselves with that. They want to make sure the patient has support at home, even if that means someone helping him walk, get up from a chair, bathe, eat, and everything else. If you don't think your mother and you can provide the assistance he needs, now is the time to apply for a permanent nursing home spot.
A private meeting without your father there might be a good idea. In your place, I'd want to know how much independence they think he will ultimately attain. Unfortunately, they probably won't be able to tell you that, because a lot depends on him and his motivation. There's only so long that a rehab can and will keep him, though. And given his lack of self-motivation and the fact that he landed there to begin with, he probably will never be better than he was when he went in. If I were you, I would assume that and start making plans accordingly.
My mother and I do have things we want to be more of less sure of... like him being able to get up from a chair on his own... when/if he comes home. We didn't get a chance to ask today, not even just because he was there but because it was so rushed.
We probably do need to start making plans. Just don't know how to start... or even if it is time to start... I just hate the idea of waiting for another injury at home.