My mother (69) just had a partial foot amputation due to an infection. She has been sent to a rehab/nursing facility to receive additional care and PT. She has diabetes, osteoarthritis, and over weight. She lives alone and already has issues moving around on her own. She keeps talking about her getting out of the facility but this is where she needs to be. I'm looking for assisted living facilities to take her when or if she gets cleared by the rehab facility to leave. I'm wondering if the rehab facility will deem her unfit to return home and begin the process of admitting her to the facility indefinitely? Is that even a thing? What's the best way to find care for her when she's on medicare? I'm only 29 first time dealing with this. I needs lots of help.
At this point if you are your Mom's MR (medical representative) or MPoA I would make sure they know she lives alone and would need in-home help to stay there. You/your Mom needs to figure out where she should/can go from that point -- but it doesn't seem she's there yet.
If she doesn't have cognitive or memory issues, then she is still in control of her own decision-making. If you think she'll be discharged back to her home and it is unsafe for her to go back (and she intends to go back), I would talk to the discharge people at the rehab to make sure they know this. But again, she needs to have a place to land after discharge or the rehab facility will start charging her by the day and it won't be covered by her Medicare.
If she never regains mobility on her own again and is overweight, she may be beyond AL and need LTC instead, but this is a discussion with her/her doctor when she gets to this point in her recovery. The "good" news is that LTC is covered by Medicaid, if she also qualifies financially.
Your Mom will need to learn how to live as independently as possible after this surgery, and you will need to be careful not to enable her to depend on you for much. Just saying this because it's very easy to slide into this dependency and very difficult to get yourself out of it. You're too young and she may require too much help, even if you're willing. I wish you success in helping your Mom re-establish her independence going forward.
And it may well kill her.
See to it that you do attend any discharge planning. Talk to Social Workers at the facility where she is and let them know she should not return home alone and cannot do care or even keep herself clean if they come in and do wound care.
Tell them that you are working and that you cannot care for her and that you will not participate in nor enable an unsafe move home.
I advise you not to take on POA or guardianship of any kind. She is competent. SHE NEEDS TO BE THE ONE to work with discharge planning on placement and followup care. This is between her and her medical team if she is competent. These are life and death decisions you should not have to make for her.
For you, if they do an unsafe discharge (and tell them in those exact words--"unsafe discharge" because those words can rip their license right out from under them) you need to call EMS for transport back to a hospital or call APS if EMS won't transport her back. Don't enable this. Don't cook, shop, clean, attempt to heal this wound. It is very common for amputations to work this way with an inch at a time and surgery after surgery.
What you have now is an overweight, injured with open infected wound that can go septic in a diabetic who CANNOT CONCEIVABLY care for herself, and you cannot care for either!
You should not in any way enable your mother's return to her home.
If she insists on going there and insists on something this dangerous to her own well being then you should tell her the following IN FRONT OF a social worker:
"Mom, I love you, but I have my own life and am not capable of caring for you. You aren't capable of caring for yourself. If you infect again you could easily go septic and die. If you insist on going home and this facility unsafely discharges you there I cannot/will not enable this by taking on your care. You must get placement. If you return home unsafely I will call an ambulance to take you to hospital when needed, or call APS to assess your living circumstances, but I won't be a part of something that may well kill you."
If you can, put this in writing and ask that it be scanned into the chart.
Good luck. I hope you'll update us.
Since still in the hospital, I suggest discussing this ASAP with the social worker and/or discharge/ placement planner. If you think its impossible that she will be ok at home and manageable, then tell them this. There are a variety of options depending on need, from further short term skilled nursing facility, long term SNF, or assisted living. Payment/ coverage can vary and depends whether short term or long term and which place.....
Be aware AL is private pay. Medicaid rarely pays for it, something u need to check on with Medicaid. Medicaid will pay for care in a LTC facility but Mom has to only have so much income a month and so much in assets. You can make an appt with Medicaid to see what the limits are in your State and ask any questions you may have.