My mom insists she can take care of herself when she goes home from post-stroke rehab. How can we explain reality to her?
How can we explain reality to her? My mom is on week 4 of post-stroke rehab. She has progressed, but she still can't walk or use her left arm. Her cognitive abilities are about 98 percent intact, so she is not demented. Even before the stroke, she was in major denial about being old and unable to care for herself in some ways. She lived alone and she seems to think she's going to go back to living alone. When I tell her she is going to need 24/7 care for the foreseeable future, she tells me that's ridiculous. When I point out that she can't walk or use her left (dominant) arm, she insists she will be able to recover all of that and live at home by herself. Furthermore, she needs 2 people or a lift to get her from bed to wheelchair.
I find this really upsetting, because I, as her only child, am going to have to either put her in a "home" or get her full time care in her own home. She is not going to accept either one of these options. I hate to feel like I'm forcing this on her and taking away her independence, but there's no other choice. How have you dealt with this siituation?
When is the discharge scheduled for?
There is a doctor, discharge planner (case manager of the rehab facility), reports that state the likelihood of mom going home or not.
They do discuss this with the patient, and preferably, when they see the need of a patient with continued issues, which will absolutely require assistance at any level. They hope to meet with person or persons that will care for patient.
When this is not possible, due to their demands, (lift, transfers, meds, mobility), they start looking for a PLACE TO SEND THEM TO.
Has anyone spoken to you about this yet, at the facility?
Ask them to help, for the love of God.
M88
Don't challenge her perception of her ability, but focus on the fact that you want to help her because of all she's done for you (I realize this may be a delicate approach and considered inappropriate by some posters, because there is also a train of thought that we really don't owe our parents as much as they feel we do). And segue into the discussion that finding assistance for her is your way of helping.
I agree to have the doctors break the bad news to her; they can take the heat, but hopefully will be as compassionate as possible.
I like Jessie's suggestion of couching the bad news in terms of needing it only until she gets well again.
Have in mind ways you can build up her confidence and allow her to still feel good about herself. Most people (including me!) have trouble accepting that our abilities are declining to the point that we can't care for ourselves.
Lean heavily on them. They also offer to place patients at the proper facility, since they have had full access to documentation, insurance, financials, etc.
M88
If you think you want to try and take her home at some point - which I doubt would happen if she requires two caregivers to transfer her then might you look for a caregiver now to spend a couple of hours a day with her while she's in rehab?
This way you can observe or get feedback from the Cg if your mom is going to accept a stranger into her home - they are clever when they want out and will agree to anything but then once back on their own turf they will kick the caregiver out
Since you're only on week 4 of rehab you will likely get Medicare to partially pay fora few more weeks if she's making progress with PT - if so keep her there awhile until you can make a plan
It takes a very willing easy going person to stay at home with strangers in their house taking over - my mm wouldn't accept it and as a result is now in a facility
Now is the time to find a trustworthy attorney to advise you.
https://www.medicaid.gov/medicaid-chip-program-information/by-topics/long-term-services-and-supports/integrating-care/program-of-all-inclusive-care-for-the-elderly-pace/program-of-all-inclusive-care-for-the-elderly-pace.html
It's an entirely different environment for therapy at home, more relaxed, and the therapists are often more experienced with older people in their own homes. The activities and exercises are easier as well.
You could prepare her focusing on the fact that they will help her find new ways to adapt to her own home, which they will do if they're good.
I'm surprised no one told you that Medicare would pay for limited home care.
And sometimes that's enough to spark and maintain motivation, while allowing the person to be more comfortable in his/her own surroundings.
There is one caveat though; too many people too close together can cause fatigue. Through experience, we limited home care to no more than 2 people daily.