Nursing Homes for Rehab... Horrible Idea.

[eveningsky339, LPN]

We have several rooms in our nursing home primarily used for rehab. These rooms are located on the SNF floor, right along with our dementia/alzheimer's residents. At first I thought it was neat, but now I think it's not so great. And here's why:

First, we had a married couple, both with hip replacements, share a rehab room. Everything was going well, they were getting ready to go home very soon, and then the husband got pneumonia. He went to the hospital, was treated, about ready to come back, then a full-blown heart attack. The MD said it was due to the stress on his body, thanks to the pneumonia he got in the NH. He came back to nursing home on comfort measures and died. His wife is devastated and does not want to go home without him, so she stays. They were married for 71 years.

Next, a stroke patient came in for rehab. She was in bad shape, but was making progress with physical therapy. Just as she was improving, bam-- pneumonia. She went to the hospital and came back as a different person. She is now total care and on the verge of going from rehab status to skilled nursing status.

After that, another stroke patient. She was actually doing great. About ready to go home, even. But then... yep, pneumonia. And of course, she comes back positive for airborne MRSA, and she will be with us for a very long time.

There are other rehab residents who were prevented from going home after being hit with infectious diseases, but I won't go into that.

The list could go on and on, but I think you get my point. And my I also point out that most of these pneumonia cases (there are more) are aspiration pneumonia? Our speech therapy department evidently isn't doing so great.

It's not all bad-- we just had a resident who left after seven days, going from two-assist to being completely independent and happy. But considering all the residents who come in and get stuck or die because of the disease-ridden air... I'm not too fond of the idea.

[fuzzywuzzy, CNA]

I don't think they would have been able to avoid the pneumonia just by going to a facility that's exclusively rehab, staying home, etc. Same with the heart attack. He would have gotten it anyway. Lots of people come down with lung infections after hip replacement because of their decreased mobility.

I do think that rehab and LTC should be kept separate though. They should not have rehab patients on the same unit and/or in the same rooms as long term people. I think it's stupid to do that because the routine is so different for both types of patients and it really throws a wrench in the works. On our mixed units the rehab people act needier and take longer to go home because they expect to be coddled like their long term neighbors.

[eveningsky339, LPN]

I don't think they would have been able to avoid the pneumonia just by going to a facility that's exclusively rehab, staying home, etc. Same with the heart attack. He would have gotten it anyway. Lots of people come down with lung infections after hip replacement because of their decreased mobility.

I understand that most, if not all, of our rehabber's have decreased mobility, thus increasing the chance for pneumonia. But they would probably be healthier swimming in samples from the viral pathology department at the local university. There are some nasty nasty bugs that wind up in a nursing home.

I do think that rehab and LTC should be kept separate though. They should not have rehab patients on the same unit and/or in the same rooms as long term people. I think it's stupid to do that because the routine is so different for both types of patients and it really throws a wrench in the works. On our mixed units the rehab people act needier and take longer to go home because they expect to be coddled like their long term neighbors.

This irks me as well... It's very complicated when you have six SNF residents and two skilled rehab residents.

[Misslady113]

I work in a nursing home that does rehab as well. I actually enjoy it. It's not the depressing, "they stay here till they die" environment. We have residents come and get better and go home. It's much more diverse and I get to see alot of different diagnoses, rather than the same thing all the time. The scene changes and I don't mind it at all. I will say that sometimes they bring in someone who really needs to be in a psych ward and it can present a danger for our permanent residents. But those people usualy go as quick as they come.

[fuzzywuzzy, CNA]

I like working with rehab patients too, just when they're on their own unit.

[nursel56]

Isn't there anything that can be done about disease-laden air? Seems like that would put everyone at risk. Having worked with people on waiver programs (home care in lieu of institutionalized care) I think it's far less expensive because of the far lower probability of infection.

[Poi Dog]

I work in a nursing home that does rehab as well. I actually enjoy it. It's not the depressing, "they stay here till they die" environment. We have residents come and get better and go home. It's much more diverse and I get to see alot of different diagnoses, rather than the same thing all the time. The scene changes and I don't mind it at all. I will say that sometimes they bring in someone who really needs to be in a psych ward and it can present a danger for our permanent residents. But those people usualy go as quick as they come.

Ain't that the truth?

We have 2 rehab residents who continually disrupt the quietness flow of the floor. It's not fair to the other residents who are peaceful and calm.

[CoffeemateCNA]

I work in a nursing home that does rehab as well. I actually enjoy it. It's not the depressing, "they stay here till they die" environment. We have residents come and get better and go home. It's much more diverse and I get to see alot of different diagnoses, rather than the same thing all the time. The scene changes and I don't mind it at all. I will say that sometimes they bring in someone who really needs to be in a psych ward and it can present a danger for our permanent residents. But those people usualy go as quick as they come.

Oh, yes, they can be quite a lot of fun.

I once had a gentleman last 2 days on my rehab hall before he screwed the top off of a bottle of Aloe Vesta perineal cleanser and drank the contents. Needless to say, we had to send him out to another facility that could... ahem ...better meet his needs. :)

People always say that LTC/rehab can be such a boring place to work. It's obvious they've never worked at any facility that I have.

[NM_CNA]

At the facility I work at they have SNF and LNF pods, but they rarely keep people in the pods they're supposed to be in. Almost every skilled person they move from the SNF pods to the LNF pods goes from doing all ADL s on their own to suddenly needing help reaching that kleenex box two inches away from them. Their constant calling makes it hard for us to even provide basic care to our long-term residents.