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Ok, My mom had a stroke on Monday of this past week. This is her second one in about two years, however this one is more severe than her last one. This stroke has left her with a lot of physical issues, including extreme weakness on her right side and fatigue. She isn't able to feed herself, walk without assistance or do much of anything involving her right arm or leg. Her speech is extremely difficult to understand (very slurred, no aphasia just issues with physically moving her mouth to speak).

My father is disabled as well, requiring help bathing, walking, as well as having dialysis 3x per week (and being unable to drive himself). I am their sole caregiver, and I simply can not do it all at this point. She absolutely refuses to allow me to help with some tasks (eating, bathroom, bathing), preferring instead to go without rather than actually ask for assistance (I offer, I try to help, she will refuse to let me).

She was released to an Acute Therapy Hospital in a large town nearby (about an hours drive from home). She did not want to go and refuses to believe that being at home is not the best thing for her right now. She was at the hospital for less than an hour by herself before she called me insisting that I be there at 10am tomorrow (Saturday) morning to pick her up and "bring her home". She doesn't like the way the nurse handled her shower tonight (basically gave too much assistance, didn't let her do enough on her own), so she says that she will not stay there and that if someone is not there to pick her up, she will call a taxi to do it.

I'm at a complete loss on what to do here. She *needs* the therapy that they can give, and 'at home' therapists isn't an option due to the severity of her condition at the moment. They offer intensive therapy (speech, occupational and physical therapies) in a setting that is not available locally. There *is* a care hospital locally, but they are not as intensive, and would require her to stay longer in the facility.

Has anyone had to deal with a similar situation? I'm really not sure how to handle this situation, especially with it being over the weekend. Do I bring her back to our hometown? Can she be transferred to the rehab center locally or would I have to take her back to the hospital? Is it even possible to have her transferred at this point?

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Thank you all for your answers!

I called first thing when I woke up and spoke with both the Patient Advocate (in hospital social worker) and the charge nurse for my mother. They are aware of how she is, and both went to talk to her. It seems that the *MAIN* problem she had last night was that the nurse was difficult to understand (she was very sweet but had a very heavy accent), and that she was having trouble understanding Mom, so there was some miscommunication that got her very, very upset. That combined with the 2 hour drive (in horrible traffic) and her not sleeping much, and just nerves at being in a new place was just a bad combination that led to her panicking.

She is doing better this morning, she's met her speech therapist and the physical therapist (occupational therapy won't be in to see her til later this afternoon), and my brother will be going up there first thing tomorrow to spend the day with her (and take her a few things she needs to be more comfortable, her own pillows, a nightshirt, things like that). She's agreed to stay there for now, and actually told me that she was just upset because the nurse was rough in handling her (during the shower). That nurse won't be dealing with mom anymore (the one with the accent), so there's little chance of that becoming an issue again. They've all been made aware of her mental issues, and they have been very understanding about everything.

She has agreed to stay the minimum of 2 weeks for now, after that time they might recommend that she stay a bit longer or they might transfer her closer to home (or discharge her to home).

So for now, all is good.
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Boy, you've got your hands full. I see from your profile your mother has Alzheimers and bi-polar disorder. With those two diagnoses, her ability to be rational is very limited. So I think you need to protect yourself and your father and try to do the best thing for your mother's health (mental and physical). And that is certainly for her to remain where she is.

You've gotten good advice above, so I'd go with that. Stick to your guns and do NOT bring your mom home or move her until she's done with her more extensive rehab in her current facility. You're too young to be dealing with this all by yourself! Get as much help as you can, because given your parents' assumed ages (since you're only 34), you could be doing this for a long time.
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Post stroke, my mom was in acute rehab for about 10 days. Then they transfer you to sub-acute, which can be closer to home. To my mind, your approach depends upon whether this is typical behavior for her, i.e., she's the type that ALWAYS signs herself out of hospitals ama, switches docs every 6 months or when they tell her something she doesn't want to hear, or if she's a generally reasonable, smart person who can be reasoned with. If it's the second, reasoning, pointing out the benefits of staying, yes. But if she's the hard headed type, I'd pull out the bug guns and go toe to toe with her. Alerting the staff is the first thing to do
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Tardis, do NOT show up and pick up your Mom. She really does need the care and the best thing you can do for her is to get her the BEST care and chance to rehabilitate. When she calls at 10 am (or before) be firm but loving. 'Mom, I know you want to get your health back to where it was before you had to go to the hospital. I already spoke with the nursing staff and they will ask the aides to allow you to do more. BUT they have to be sure of your capabilities so you don't get hurt. If you break your hip (or whatever) you would be back in the hospital. No one wants that to happen. Let's give this a chance.'

Most rehabs have no therapy on Sundays and at the most very limited therapy on Saturday. This will give her a chance to rest. Then she will be more ready for the real therapy on Monday.

Your info doesn't have any background on your Mom. Her age and anyhealth issues for example. But truly, her meltdown doesn't mean you should cave from what you know is right for her. No one at the rehab will allow her to 'hail a cab'. And as Eyerishlass said, how would she ever do that? Keep us posted.
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Have a nurse put you in touch with a social worker at the hospital.

Because she's so physically disabled from the stroke I doubt that she'd be able to drag her half-paralyzed body to the entrance to hail a taxi but you certainly don't want her to try.

Alert the staff about her desire to leave.

After her hospitalization and rehab what's next? I hope you don't plan on taking care of both of your parents.
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"For giving any assistance to her or your father"
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If this was my mom, it would make me really angry. I would tell her that she has to do rehab where she is or you will no longer be responsible for giving any assisted center to her or your father. They will have to hire outside drivers and household help. This is your mom blackmailing you into indentured servitude. Call the facility first thing tomorrow and talk both to the director of nursing and social work. Advise them that if your mom leaves Against Medical Advice, your are in no way going to be responsible for her care. Remind your mom that she'll be on the hook for the services already provided, Medicare will not pay. Get the psychiatrist at the facility to see your mom as well. There is a brief window of opportunity for successful rehab after a stroke. Once that train leaves the station, there is no going back your mom is acting like a petulant 2 year old. Don't enable her tantrum, and don't sacrifice your mental and physical health to her idiocy. Stand up to her now. Or sweet talk her. But don't allow her to come home.
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