Nursing home or not?

  1. My dad is having a total hip replacement this month and the doctor said that many of his patients go to a NH for about a wk after the procedure. My dad and the rest of the family are dead set against it. Should we do what the doctor says "everyone" else does or should we hire a part time home health nurse to help me out with his recovery at home.

    My question is this: If it was your father, would you want him in a NH for rehab, or would you hire a private nurse (part time) and take care of him at home.

    I'm worried about infection, not enough care (due to poor staffing, etc), etc. Am I being crazy or to over protected.

    TIA
    Erin
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  2. 22 Comments

  3. by   Insurance RN
    Mnay people I know of who have had joint replacement surgery go to a SNF or rehabiliation facility for a short time. There are many factors to consider, are there enough family members to assist yuor loved one, what about physical therapy, who can assit when he has to go to the bathroom in the middle of the night? Most of the facilities where I am provide fantastic rehabiliation, my suggestion is...........don't write it off without considering it.
  4. by   AuntieRN
    I have always been dead set against SNFs too since I used to work in one. But now that I am working more with total hips etc I see that they really need some good rehab and pt to get better. You want him to be at his best after the surgery. Taking care of him at home will be really tough. He will need assistance to do just about everything. I agree with InsuranceRN I would not totally discard the idea. You can go and check them out first find out what pts there think etc. It is only short term. We have a rehab floor in our hospital and most pts stay 7-14 days. It is always full. Perhaps you could find something like that for your dad.
  5. by   CoffeeRTC
    Hey....what they both said. Def check all the places out first.
  6. by   TazziRN
    My mom was in a short term care facility for 3 weeks after her CVA. If we had had her at home we would have babied her rather than pushed her in rehab. I would not have her in a LTC if I had any choice, but short term for therapy? You bet!!
  7. by   hikernurse
    My mom went into rehab for a few weeks after her knee replacements and it was the best thing for her. It would've been much harder to take care of her than we thought initially; Tazzi--we'd have babied her, too. They definitely practiced tougher love than we could have.

    More importantly, my mom felt it was a good experience. Not so much the food, but she liked the staff :-).

    I think it's a good idea.
  8. by   CaseManager1947
    This is a discharge planner's dream question--- first of all, how old is your dad, is he mentally alert, able to cooperate with therapies??? Secondly, his doc will order PT/OT after his procedure, and they will make recommendations based upon their assessment of what he will need or require in the way of post-acute services. Depending upon his age and payor source (medicare, private i nsurance, state aid), he will have to meet skilled criteria to be in SNF/SNU. He may be more suitable for Rehab, IF,and this is a big if, the rehab in your community is able to take any more straight medicare clients. They have to meet medicare's MIX of cord injury, head injury, stroke, etc. Some patients even go home with home health, believe it or not. Total knees going to rehab, very rare anymore. Hope this info helps to clarify some of your concerns and questions PM me if you want any other info. Oh, also, typical stay for Total Hips in our area is about what it is for Fx hips, 4-5 days , so you won't have lots of time to pick a SNF, unless you have your research done ahead of time. Make sure you make friends early with your CM or SW responsible for discharge planning in the facility where he will be treated. Oh, and Rehab under medicare requires the patient to be able to do 3 hours of rehab per day.
  9. by   WOLFE
    Think about the rehab...last year I had to have a total hip replacement and I went to rehab for three days..not alot of time, but it helps. After that I had outpatient rehab three times a week for four weeks...but the initial three days at rehab helped.
  10. by   meownsmile
    Doesnt the hospital hes having the replacement at have a stepdown or transitional care unit? If not that is real surprising. I definately wouldnt look at a NH. It would be just as easy and probly cheaper to hire someone in home and use VNA/ home Physical Thereapy the first couple weeks.
  11. by   judy ann
    Although I don't have personal experience with a hip relacement, I do have experience with a very severe fractured ankle. I am so glad that I had the opportunity to use a local LTC/rehab facility. I was so very well looked after, and fed. And, more important, I had full access to physical therapy--both equiptment and personnel. This was very important as I would have become a couch potatoe if allowed to do so by friends/family, and there was someone awake all of the time if I needed something. I highly recommend the "rest home" type of care over the part time care taker at home. Even taking a shower is much easier in the huge walk in showers and the hand spray that is available. Then, there is always the activities to keep you busy!
    As has been said, check out the local facilities, but remember that there are many very satisfied customers! (It was also good for me as a nurse, to be "on the other end of the needle")umpiron: :chuckle :angel2: Can you tell that I really enjoy the smileys?
  12. by   mommy2boys
    To answer so of your questions, my dad is 56 yrs old with VERY good private insurance that is backed up by Champus (military). He is alert and able to cooperate with therapies. In our town there are no "traditional" rehab hospitals, just 2 "nursing/LTC" homes.

    The doctors say that he will have to stay in the hospital for a little longer than most patients because he has been on coumadin since 1987 (he has a rare clotting disorder) and they will have re-regulate his coumadin level after the surgery (he will stop taking the meds 5 days prior to the surgery). So he has the "joy" of hip surgery and dealing with heprine/coumadin medications.

    He sees his surgens (a orthopedic surgen and vascular surgen will be doing his surgery because he has vascular issues as well) tomarrow and we will get more information tomarrow. I'm going to ask about PT/OT, what his specfic needs will be, if PT will come to the house in the beginning, etc.

    Thanks for all the info and I will keep you posted on what our final decission will be.
  13. by   santhony44
    My MIL broke her hip a few years ago and was put into a nursing home for rehab.

    She refused to stay after a day or so and was taken home. She never got out of the wheelchair and began a pretty rapid decline.

    I really think she would have done much better and lived longer if she had stayed in rehab for a while and been pushed to get back on her feet.

    Your dad is young and cognizant enough to make sure he gets taken care of properly. I'd ask around for recommendations from friends and co-workers and also ask the doctor what his experience has been with the local facilities. There are some good ones out there.

    Have you asked your dad what he thinks? Some people are actually more comfortable with other people taking care of them than they are with family- they feel that they're being a burden, disrupting your life, etc.

    I hope he does really well no matter where he goes!
  14. by   IndyGal
    I think it also depends on whether he's strongly self-disciplined and will push himself to recover or whether he's someone who needs more structure and outside motivation. My grandmother had hip replacement and declined to go to a rehab facility afterward. She went home and refused to do any of her rehab exercises, wouldn't walk, used a scooter everywhere, and generally had family wait on her hand and foot. It's been years since her surgery and she STILL walks with a cane and limp. If she'd gone somewhere with a tough love approach and been forced to do her rehab, she'd be back to normal.

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