Being Present For Your Aging Parent During Rehab
[ photo by Askar Abayev ]
Acute inpatient rehabilitation is where my heart lies.
Why do I love it so much?
I really believe I love it because I cannot think of any other area of medicine in which the team approach is more utilized. The team includes the rehabilitation physician, the nurses, nurse aides, physical therapist, occupational therapist, speech therapist, recreation therapist, neuropsychologist, chaplain, dietician and THE FAMILY!
Yes, the family is a part of the rehabilitation team. I say this because my most successful rehabilitation stories are of patients with involved family members. So how can you as a family member be a part of the rehabilitation team for your loved one?
The main way to be a part of the team is to be present. Being present does not necessarily mean you have to be there all day every day, but if at all possible, try to be there regularly. In this time of COVID-19, things are a bit different in terms of visitation, however, the majority of rehabilitation hospitals are allowing for 1-2 visitors each day. If the number of visitors each day are limited, I would advise that the people who will be the primary caregivers upon discharge to home be the ones to be present as these are the people who need to be most up to par in the knowledge of how to manage your loved one once he/she gets home.
(Related blog post: What To Expect When Visiting A Nursing Home During COVID-19)
There are multiple facets to being present for your loved one’s rehabilitation stay.
The first way to be present is to be there when the rehabilitation physician rounds. This might not be possible everyday, which is fine, but I would recommend being there at least a few times a week. I talked about this in last week’s blog post. This allows you to know of any new changes in medications, new test results and any possible change in the treatment plan.
The next way to be present is to be there for the therapy sessions. When I first meet the family members of my patients, I encourage them to be present for at least some of the therapy sessions. With three hours of therapy five days a week, it is not realistic to expect the loved one to be there for every therapy session. It is wonderful to have at least one loved one present on a fairly routine basis, however, because you are able to see the progress your loved one is making during the therapy sessions.
Many people feel like they might be a distraction to their family member if they are there for the therapy sessions, but this is usually not the case. There might be times when a therapist feels a particular session might be best done with just the therapist and the patient, but the therapist will let you as the caregiver know when that needs to happen.
Rehabilitation involves regaining strength and function that was lost during due to stroke, accident or illness. In many cases of acute inpatient rehabilitation, a patient must learn a new way of functioning in terms of mobility and performing activities of daily living. Oftentimes, this new way of life will require assistance from a caregiver. Beyond just the patient regaining strength and endurance is the training the caregiver receives during the rehabilitation stay.
(Related blog post: Acute Versus Subacute Rehabilitation: What Is The Difference?)
The caregivers/loved ones are encouraged to actively participate in the therapy session as the therapist sees fit. How much hands-on care you give to your loved one is usually dictated by the physical, occupational or speech therapist. The amount of help a loved one is able to provide to the patient is best to be done in a gradual manner.
The therapists are not just providing rehabilitation to the patient but also training the loved one how to most safely provide care to the patient. This training is going to be absolutely necessary for a patient to return home after rehabilitation. In my experience, when this training is done in a gradual manner as opposed to a crash course just before discharge, the discharge to home is much smoother and often less overwhelming.
(Related blog post: Taking Care Of Elderly Parents At Home)
Sometimes, as the training moves in a gradual manner, it becomes apparent to the family members that caring for the loved one at home might not be possible without additional assistance. This may mean obtaining extra help at home and sometimes it means alternate discharge locations for additional therapies. Whatever the case might be, if this realization occurs early on in the acute rehabilitation stay, it allows for a longer time to make additional arrangements for care once the acute rehabilitation stay is completed.
(Related blog post: Mom Needs 24/7 Care…)
The next facet of being present is to be there during medication passes by the nurse to your loved one. Depending on how many medications are being received, these medication passes are likely to occur multiple times during the day. Have a conversation with your loved one’s nurse to determine when the medication passes will occur and try to be present intermittently for these. This will be when you learn what your loved one is taking and how he or she is taking the medication. Sometimes, there might be difficulty with swallowing, so modifications to the medication taking process have to be made. This will allow you to be educated on this process.
(Related blog post: Options For Medication Management)
Finally, it is also important to be present with the case manager. The case manager will usually try to coordinate a time to meet with the family members when they are present for therapy sessions or physician rounds. The case managers are also willing to have these discussions over the phone, as well. These meetings are important because it allows for early planning for the needs of your loved one once he or she is discharged from acute rehabilitation.
Feeling overwhelmed with the process?
Afraid you may not make the right decision at the right time? This stage of life for you and your aging parent often brings more questions than answers. Reading information from a trusted source like me can help guide you in the process. However, if you still feel overwhelmed, don’t hesitate to reach out to me. I am happy to help with a personalized plan for your unique situation.
© 2021 Jessica Kluetz, DO