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I’ve already posted very long accounts of situation on here already, and received very thoughtful advice—so I will TRY to be brief. Dad (gaining on 95), is currently two weeks into rehab/SNF after a week and a half in hospital. It was facility opinion that he would be too high functioning to stay long term after rehab (which is projected for sixty days), and they referred to sister ALF. BUT, as I see it, Dads abilities are declining. He seems to really struggle with ADLs every time I do them with him. He falls asleep most of the day, and it’s futile to try to keep him awake—which may impact abilities because he is always confused for a while after waking. According to him, He is restless and wakeful at night. None of this is new, he was like this at home for a duration before hospital, like this in hospital. Lack of ADL ability is somewhat new. Intermittent confusion and unclear thinking seems more frequent in hospital and SNF, but was also happening at home. I’ve asked doc to look into a couple of possible medical issues that may be effecting. Because he is a fall risk, he hasn’t been allowed to ambulate except in therapy. (In hospital was allowed to use walker to bathroom with aid.). Here they wheel him into bathroom and help him transition. He does feel that his vision and hearing are worse since hospital (vision checked and acuity hasn’t changed).So this could definitely effect ADL and cognition… He isn’t eating well (same at home, ate well in hospital and initially in SNF). Even bringing favs from outside doesn’t help.
When I express concern over declines, his usual CNA (who is wonderful), responds “he can do that”! Is it possible that I approach ADLs in a way other than they do and maybe it confuses him? I get the feeling that they have the impression that I am trying to look for ways to leave him here (or maybe that’s my guilt talking). I am trying to see the best, but I’d be lying if I didn’t admit that these declines make me more concerned that ALF may be too much for him, and home as well. (I literally had to feed him last night because he couldn’t figure out how to move the spoon. Normal dad would not have tolerated that.)
Of course, he has six weeks to go before expected discharge. Just keep my mouth shut except at care meetings (first one is tomorrow)? Keep being there and encouraging his independence for all he could still do (like dressing, etc—OT is working with him)? Be more hands off and let them have more opportunities to gauge his abilities ?( I no longer stay all day, but go in at different times late morning, afternoon, dinner, etc). Relax a bit and recognize the man is almost 95 and is displaying same stuff he was at home and all docs knew about, and just support him in any way I can? Sorry, just trying to get my mind and emotions wrapped around all this…

I think you need to stop being so present at rehab. They won’t be able to really assess his condition and abilities if you are there constantly as his crutch. Spend more time away doing some things just for yourself. Start to think about your future. No matter what you do, you can’t stop his decline. Even just losing so much vision and hearing can be very depressing for someone his age. There is only so much you can do to have a meaningful life when you have lost so much. Sometimes people just decide they are done, and that’s ok. The PT/OT is probably a bright spot bc it breaks the monotony of his day, but it won’t last.
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Reply to ShirleyDot
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Hope, I’m sorry you seem twisted in a knot over this. Doesn’t seem so long ago I was there too. I so well remember visiting my dad in rehab encouraging him to “try harder” and “do one more” of whatever it was. I had many conversations with family members where it was pointed out he was “being stubborn” or “refusing to cooperate” He has tired and frustrated. We were frustrated, he’d always been such a determined man. Finally his doctor kindly said if this was his dad, he’d begin hospice and stop all the therapies and treatments. We were stunned. Dad chose it for himself, actually rallied for a few weeks, had a great time with family and friends, then had a sharp decline, and died peacefully. None of it was what I saw coming, but proved exactly what he wanted. He was so very tired of it all. I have no idea if this is anything like your dad. I likely related this to you before. All I do know is that this is out of your hands. All your efforts to get dad to recover are admirable but it’s truly not up to you. Give him the grace to know how tired he has to be after such a long life. Know he’s now not the same man you’ve known for so long. It’s impossibly hard to realize this, I know. Our dads are our first protectors and heroes. We can’t picture them differently. He just needs you to give him a smile, hold his hand, and say it’s going to be okay. Leave all the rehab to the staff, let them decide things about recovery and next steps. Just be the daughter, nothing more. I wish you and dad much peace
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Reply to Daughterof1930
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Hope21 14 hours ago
Thank you from my heart for your generous and kind vulnerability in relating your experience. I do not know for sure if that is my dad’s experience yet or not. But it well may be. You have given me a lot to digest, with a measure of peace that I need to try to rest in the fact that it’s time to quit the hyper vigilance and make the most of the time there is. Thank you.
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Rehab is not a permanent solution. Medicare only pays up to 100days and 80 of them Medicare only pays 50%. Rehab only works on why he is there. Lets say its to get his strength back. If he gets to the point there is no more progress, Medicare will have him discharged. Rehab is not responsible for his decline. He is 95 yrs old and has been thru a lot. They are good, till there not. Things can literally happen over night.

I think your best choice would be Longterm care. An Assisted Living is not designed to care for someone with his needs. Memory care, they usually can do most of their ADLs, just their cognitively is going.
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After I posted the above I researched your previous posts. The following was posted on Dec 4 2025. I found an early June post where the doctors were suggesting Hospice. Why did you not go that way? Your Dad has so much wrong with him. I am going to be blunt, your father is dying. If you can't care for him, he needs to be placed in LTC with Hospice. With Hospice there are no more hospitals, no more doctors. His last days should not be where he is poked and prodded. Made to do PT when he is confused and tired. You need to let him go.

https://www.agingcare.com/questions/time-for-placement-498028.htm
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Hope21 20 hours ago
Thank you for taking time to review everything. I understand where you are coming from. It is just that two of the docs that recommended considering hospice told him that in response to his stating he would avoid hospitalization in future, and wanted to avoid pain. After lengthy presentation about hospice by his PCP, he adamantly refused it—and was cognitively fully capable to at that time. He has even since stated that he does not agree with it, when I conveyed that a third doctor had recommended it or palliative care. So, I have been hoping to preserve his capabilities and some independence —especially since the SNF at least initially said they thought him possibly too high functioning for LTC…. But you are right, it could be time to reassess….(but I will say he has more than once voiced that PT is his bright spot, that it feels good and he really likes it so far. OT is helping him with strategies for dealing with the macular—seeing around the gray areas, etc. All valuable.)
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Now is actually the time to relax a bit. Dad's in rehab and being cared for and dealt with over there. He'll make whatever progress he's able to, at 95, and then you'll place him in the appropriate managed care facility afterwards. When my dad was in rehab, we'd bring him his favorite meals and I even made him a sweet potato pie because I knew his time on earth was limited. I wanted him to enjoy his favorite foods bc the rehab food left much to be desired. That's all you can really do Hope. Love him.
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Reply to lealonnie1
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Hope21 20 hours ago
I will work on the foods—thanks for the inspiration!
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He's 95 years old! Of course his abilities are declining. They'll continue to decline no matter what anyone does.

I'm for backing off and letting the professionals be in charge. Your role is supportive, to cheer for dad when there's nothing to cheer about, to show up with a bright smile, and to interact with his caregivers in a way that shows you aren't trying to do their job but trying to learn from them.

You recognize that you should relax a bit and seem to be looking for permission to do that. Go for it! Best of luck as you continue on this difficult journey with your dad.
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Reply to Fawnby
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Hope21 20 hours ago
Thank you. I have been caring for him for a long time and it is hard to let go of the reins.
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Yes, I think you should be more hands off and let them work with him and gauge his abilities over the next 6 weeks. Then, make a decision. You could be correct that he won't be a suitable candidate for Assisted Living, but the Rehab PTs and OTs have the responsibility of getting him to the highest level of independent functioning that he is capable of. They need to be able to show progress, or they will need to discharge him because insurance will not pay if he is not progressing.
Give yourself permission to breathe and relax. You don't need to figure it all out right now. It's good that you are thinking about his future care and formulating a plan. Go visit some skilled nursing facilities, if you haven't already, and get a sense of whether he belongs there. An admissions director will give you a tour and discuss the level of care he will need, although it is a little premature, as he is expected to continue rehab therapy for another 6 weeks.
From what you have described here, it sounds to me like he is just tired and kind of ready to give up. He maybe doesn't want to make the effort to be more independent. But for now, give the therapy team a chance to work with him and give him some encouragement, and see where it goes.
To address his restlessness at nights, and difficulty sleeping, ask if there is a doctor on staff who can prescribe a medication to help him sleep thru the night, or something to reduce agitation and restlessness. Trazodone worked like magic for my husband. He now sleeps all night and is awake all day.
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Reply to CaringWifeAZ
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Hope21 20 hours ago
Thank you for the good advice. He has repeatedly told me that his PT days are his bright spots—he really enjoys it and it feels good. But I do think he is getting tired and down. I have asked for something to help him rest at night. They did give him melatonin last night, and he was VERY sleepy this morning when I visited! I imagine it all takes adjusting. Thank you.
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