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My 81 year old mom fell off her bike 2 weeks ago. She broke her pelvis in 2 places in addition to her elbow. After surgery on the elbow, she was moved to rehab center. After 2 rounds of PT, she was in severe pain. She now refuses PT because of the pain, is on heavy pain meds, and has been given more exrays. She has not seen one exray. The doctor managing the case hasn't given us any answers but says they may need to move her to another facility i.e. nursing home, if she doesn't progress. The insurance may run out as well. Two weeks ago Mom was a vibrant active individual living on her own. Now she's depressed, in pain, and is bedridden. Only one sibling lives nearby. The other 3 live out of state. Besides this physical disability, my mom functions cognitively and is sharp as a tack. What can we do? What options do we have if mom can't have PT or refuses PT due to her pain?

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Freefalling, I'm so sorry to hear about your mother. Reading this thread I see a theme on our elderly parents, mostly mothers. My mom was not taking care of her diabetes which landed her in the ER with a sugar level of over 500. While there they found out she had appendicitis. Then she got blood clots in her lungs. After 3 weeks (and the hospital was pretty crappy on top of all this) she was discharged. She has EXTREME lethargy and I think she's depressed. I lost my older sister last year so now it's just me with all this stress. She can't walk without a walker and assistance.

We live in a building and my aunt is on the first floor. She went into her place in her spare bedroom because it was the closer than getting to her place. She doesn't want to do anything but lay in bed. She eats only bites of food. I think mentally she has given up. I feel like she thinks she will just live in her sisters spare room forever. I'm hoping to get her into a SNF using Medicare. I'm so stressed. I KNOW without intervention she will become bedbound and just die. She is satisfied just laying in bed 24/7 and letting me clean her. I'm also not working and can't even think about job searching with all this. It's all on me. I'm scared she will refuse PT because she doesn't even want to sit up against pillows let alone stand. She wants to eat, drink, talk, watch tv all while laying down. I think she will lose what little mobility she has if she doesn't get into rehab fast. The hospital has set up home PT and she are moving at a snails pace. I'm happy she can still stand and move with a walker and think with PT she can become more mobile. I think she wants to get back to her old self but doesn't want to do the work to get it. She was lazy before, now it's 1,000 times worse. She's 74 and was able bodied before the hospital. This is terrible and so stressful.
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My mother had a knee replacement three years ago at the age of 70. She refused the PT and ended up immobile in a wheelchair. She developed diabetes and various ongoing infections as a result of being immobile. She passed away July 4 at the age of 73 of septic shock. She was in excellent health before the knee replacement.
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Teresa, is your mom in rehab? Has her hip been repaired by surgery?
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my mom is withering away after she broke her hip. I don't think she will be coming home. What can I do to motivate her?
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Medicare will not pay for inpatient rehab services if the patient is not progressing or refusing pt. Is that what you're asking?
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Can a SNF refuse the care of a patient if he refuses PT?
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My mother fell broke her hip, had surgery and has been in a physical rehab center for a couple of months. Her medicare is about to run out and we would like her to stay at the rehab center for a few more weeks. Can we pay the rehab center ourselves? my mother has the money to cover it.
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Do EVERYTHING you can to help your Mom or she will become bedbound, immobile and die. I know because my mom was this way. She broke her hip in 2004, has had another hip replacement, a spinal fusion and back surgery. Now she cant even sit up and continually gets infections, the last one nearly cost her her life. I am going to try faucet joint injections to block the nerve signals of pain that go to the brain so she can hopefully tolerate some physical therapy. I also googled what to do when physical therapy is too painful and found out about a different type of therapy called myofascial therapy.I am in the process of setting all of this up. I pray it works, or she will die.
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I have answered many pain related problems with the same answer to use "Anodyne Therapy". ( Infrared Light Therapy.) It works. She will have less pain when they use this device so she can rehab faster as a result of having diminished pain. Some rehab centers have this device or one like it. Perhaps it is in their closet not being used. Get them to use it. One story I have of a therapy group not willing to use it (Anodyne) but were challenged by the Dr's written order to use it and finally did. Had they used it 3 weeks sooner the patient would have shown evidence to have regained 90% use of a flaccid arm post CVA (stroke). Again... This works.... look on PubMed.org (Medical publication Gov.. site) and look up the topic "nitric oxide".This is the most written subject with interesting outcomes to boot.. Anodyne Therapy helps generate nitric oxide in the blood. THis is the science behind this device. Go for it.
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I assume that either you or your sister have medical POA for your mother? It sounds to me like you need an elder lawyer to resolve this situation and possibly file a complaint if necessary along with find another nursing home for your mother if you can. I'm sorry that your mom is willing to work on getting back to walking but the PT are not. My mother has the opposite problem of not being willing to work with PT, but the PT people are willing and have tried to work with her. Let us know how this turn out.
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My mother has been in a nursing facility with a crack pelvic and started to make good progress in PT. She had to go back to the hospital for an infection and then came back to the nursing facility. She cannot get out of bed on her own. She wants PT, but they now are refusing it, saying that she has plateaued. The PT say she is going ok, but in front of the doctor they change their story. They want my Mom to go home. She has a bed sore, they have torn her skin recently just above the ankle and below the knee. (one cut is 12-inches long, like a Z) They said it happened in trasnport to the hospital. My sister and I both ask for information and they tell us that they will only talk to one of us, not both. What can I do. A few months ago she was walking with a walker and very sharp. She is 91. They refuse PT now. What can I do about this situation. I feel helpless.
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Often times Physical Therapy has devices such as ultrasound, E stem (tens) EMS, Heat pads. The more progressive companies have infrared light. If you want my thoughts on it is the best available modality. The unfortunate thing is that Medicare will not pay for it. That is the reason why Dr's will not order it and therapists won't request it. The irony is; it works better than any other type of "heat therapy" and alternate treatments I mentioned earlier. Look into it www.AnodyneTherapy.com is the leader in the industry. There are other infrared devices too. Anodyne Therapy is the industry leader. The important thing is ask for infrared treatments.... in fact demand it....The FDA cleared it for pain management poor circulation swelling and muscle spasms. Your loved one will respond to the treatments and be able to tolerate the physical therapy because she will have less pain in the long run. Good luck.
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I wonder how much of the success in rehab for these seniors, comes from their personalities in the first place. My mother-in-law broke her hip, went to rehab and did great. She was 85 at the time. She said it hurt, but she was absolutely DETERMINED to walk again. So does the personality of being a stubborn, determined, resolute person make the difference?
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I, too, had problems with my mom while she was in rehab for a knee replacement. She was supposed to get PT 3 times/day on weekdays and once a day on weekends. Mom refused PT b/c she said it hurt (plus I think she was a bit lazy and didn't want to make the effort). I told the nurses that mom was there for PT and to take her for PT whether mom wanted to go or not. Well---they didn't make her go to PT and she went home with a contracture in her knee, which meant another surgery to fix the contracture and then more PT!!! She would have been better off if she'd done the PT the first time. I also wish the nursing team would have consulted w/ me about options to make the PT more painless.
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I can empathise with you. Also, I can undestand her pain doing the PT. I had a total knee replacement and the PT was painful. I have been doing SWIM therapy 3 times a week and it is absolutely wonderful. Not only does it not hurt, the water is theraputic both mentally and physically. There are also many nice people who are in pain that I swim with. They have helped with ideas on how to allieviate pain, sharing their own stories and have brightened my day. Some are much worse off than me which makes me humble. I plan my days around swimming and I look forward to sociaizing with the others. Try to find a place that has a heated pool and doesn't cost much. The pool I go to is a state run faciliy for the handicapped. One needs a dr. note and the cost is only a dollar. There should be more facilities like this available....not just the local YMCA (which also has senior prices). I learned what exercises to do for my knees from the physical therapists at the dr. office. If she is able to find a pool...it isn't necessary for her to be able to swim...they have swim aids and may have a ramp with railings or a chair to assist getting in and out of the pool. Hope this helps!
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My mom broke her back from falling. She also resisted rehab and almost went into a nursing home. They did an evaluation and found that she was depressed.
Gave her something for depression...she started doing rehab and got to come home soon.
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My mom is 87 and did great at physical therapy in the rehab. When she is home she does nothing. I am tired of fighting with her. I have given in.
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I had the same experience with my aunt - She broke her hip, was operated . She geve up on the rehab . She was unable to walk and in a wheel chair until she passed away . It was really sad.
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My mom is just like her mom. Following the broken hip, she gave up and so has my mother. Thus, mom has made herself stuck in the nursing home because she is totally immobile. Plus, my mom likes for someone to beg her to be helped.
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My mother was also in a lot of pain during rehab and was refusing to go. The nursing staff and I had a conference and decided to give her an extra dose of pain meds shortly before her rehab session to help her relax and to enable her to be more comfortable. Once she was in less pain she was more willing to work at her recovery and be less anxious about rehab.
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My Mom had a hairline facture of the pelvis. It was very painful and she had a hard time recovering from it. She had in-home PT...ask if this is possible with your Mom. Perhaps the PT at the rehab is pushing her too hard or is not as experienced. Go with her during one of her sessions. Also, it is your mother's right to see her x-rays and/or speak to her doc.
They can remove her from rehab is she refuses to do the work, however, if she is in that much pain, perhaps she needs to be back in the hospital for evaluation. She should have a "care team" at the rehab. Speak with the leader of this group and ask about your options. The "squeakier" you are, the better care your mother will get. Do not let them move her until you are clear about her condition and their plan seems reasonable to you. Talking to the doctor directly is best...so they can't hide behind their nurse or front office staff. And don't be afraid to ask the important questions.
Factures, at this age, are really painful and take a long time to heal. I hope your Mom gets the most appropriate care.
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