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My mother had a stroke five months ago, she was paralyzed on the left side, she can speak but she is connected to a tube to eat. Since my mother has been admitted to a rehabilitation center for the elderly, she has been given little therapy, since she has gotten sick with pneumonia 4 times. It frustrates me to see that the therapy has been little, the therapists stopped the therapy for a while. month since according to them my mother is very aggressive with them so they decided to stop the therapy for a month, then she was given physical therapy, the therapist managed to sit her on the bed for a few minutes, but the sessions were few, I had to giving therapy to my mother based on videos that I saw on YouTube and in books, as a result of that my mother began to move her left arm and now moves the index finger and thumb of her left hand, she also already moves her left leg. As soon as my mother is going to receive therapy from the speech therapist again, the nurse says that my mother can now eat since she can now stick her tongue out. My point is that in that place they have been very slow in giving therapy to my mother who is by the way 83 years old. My plan is to bring my mother back home when she eats again since I don't trust the staff at the rehab center. A CNA even complained that my mother scratched her, as a result the Doctor prescribed her anxiety medicine and now she spends her time sleeping. That seems unfair to me, the Doctor didn't even tell me that they had prescribed that medicine for anxiety. I am frustrated because now that my mother will finally have therapy with the speech therapist, the Doctor prescribes her medicine for anxiety. It's unfair to my mother.

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Welcome, Grimaldo.

It seems like the prescribing doctor needs to adjust the dosage of the anti-anxirty meds.

Do you have POA for your mom?
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In my experience the side effects like excess sleep caused by new meds sometimes decrease once the body becomes accustomed to them, if they don't then you need to have the doctor adjust the dosage or try something else. As for them not keeping you in the loop - that was my experience as well, there was a lot of talk about being part of the care team but the reality was they never really walked the talk.
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In my experience with a 100-yr Aunt with dementia in a rehabe facility for a broken hip, rehab centers don't operate the same as NHs. The staff is not there to deal with issues other than their rehab. We had to keep on top of my Aunt's eating and drinking (because of her dementia and resistance). There staff may not be trained or experienced in dealing with people with dementia, agression, etc. They are there to move their rehabilitation along. It's difficult. I wish her all the best for her progress.
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Taking your mother home most likely will be more than you can handle. Then what would you do?
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Please meet with the rehab director or director of nursing before removing your mother. Voice your concerns and talk through possible solutions. My mother was also a stroke patient, with profound paralysis and a feeding tube. We found it easy to underestimate the extent of the damage and not see the hidden ways damage had occurred. It proved far more complex than we imagined. I wish you well in figuring it out, it’s not easy
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You are telling us what is happening here, and I believe every single word you say.
You don't ask us a question really, which is good, because I certainly don't have an answer.
When patients are in their mid 80s, and the spontaneous improvement from stroke has already gone so far as it can go (when the swelling injuries to the brain are gone) then you are down to consistent and involved hard work that is exceptionally time consuming. Often patients who are unable to cooperate with treatment are simply put down as "unable to cooperate" and are left while others more able, who are progressing more certainly, are addressed. It is sadly a kind of "triage" in which, given their staffing, they are forced to give the time where they believe it will make the most difference. I don't say this is done consciously. It simply happens. You are seeing the results of it.

I think the best you can do is contact social services or discharge planners and ask for a patient care conference with yourself (if you are POA and I assume you are) and with staff members from all walks of the place, nursing, PT, OT, Dietary.
Sounds they are at least assessing she may be able to eat soon, and this is a good thing.

I wish this went better, went easier, and I do recognize we lose people because there is not world and time enough to give the one on one devoted care that would be required. When Roald Dahl's wife , actress Patricia Neal, had a severe stroke he later wrote about his management of her care. Really it was ongoing and almost at times seemed bullying for want of a better word, but he made her whole and well again. Both have passed now, and wouldn't know name anymore of the book, but remember fascination with the story.
I wish you the best.
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Daughterof1930 Jan 26, 2024
Alva, you made me have a faint memory of the Roald Dahl and Patricia Neal story. I adored reading his books to my children when they were growing up. And I remember her as Olivia Walton in the original Waltons movie before the tv series. Now I’m going to explore what I can find of their story, you’ve piqued my interest for sure
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Is Mom now paying privately? Medicare would have stopped after 100 days. They needed to be doing therapy for Medicare to pay for it. If Mom is paying privately to get therapy then that's what they need to do? But realize that a stroke changes people personality wise. It effects the brain. So Mom may be more aggressive. Can't do therapy if the person is fighting you all the way. And when in a facility, the Doctor does not need permission to prescribe a med. Just make aware there was a change made. Your Mom may need anxiety meds.

It can take a long time to recover from a stroke. Maybe the staff thinks Mom is now living at the facility permantly? Because of this they have all the time in the world? Maybe you need to make it clear you are planning on taking her home. You need to have a meeting with the people in charge.
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strugglinson Feb 3, 2024
right - typically Medicare ends coverage at 100 days. But I believe one can appeal to medicare for a longer treatment, correct? Not sure how often they actually grant that.
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hopefully this is all getting covered on insurance and/or medicare.
If Medicare, there is the ability to appeal things, and do take advantage of that if you feel its needed.

Also, if you are not happy with this rehab place, and assuming there is insurance and/or medicare coverage, consider having her tranferred to another place. Unless you are in a very small town, usually there are a number of rehab places in most cities, and if there is insurance coverage, may be glad to take in a transfer.
U.S. News have annual rankings of rehab hospitals in each area.
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