Rehabilitation - successes and failures

[rara67]

Long back story but Mil has got a place at a rehabilitation centre for 1-3 weeks following yet another fall and a hospital admission. When DH went to visit her a couple of days ago when she was still in hospital she couldn't even get herself to the toilet. She won't take her medication, doesn't eat and she drinks too much alcohol (hospital admission was based on the paramedics observation that she was intoxicated) I want to be really positive about the whole thing but to be honest I am just glad that she is safe and being cared for, if only for a few weeks. Has anyone else had experience of this? I know that the centre will be specialised in getting people back home after illness or operation but there just seems to be a mountain to climb.

[CMOTDibbler]

How was she before the fall? If she was doing OK, then they are pretty successful. But you can also regard her stay as a prolonged assessment of her care needs - so dh has to be brutally honest with the staff about her alcohol intake at home, eating/medication issues, and about what care you can offer her (note: I'd always recommend saying far less than you might actually manage as you need sustainability, not crisis response).
If you think she needs carers, then insist she is properly assessed for this before she's discharged, and don't accept discharge on a Friday afternoon or the weekend when if the promised care doesn't turn up you can't get hold of anyone (bitter experience).

[Marmitelover55]

My mum went into rehab following a fall and broken hip after a couple of weeks in hospital. It was s great place but unfortunately due to her Alzheimer's, she didn't progress very well and ended up going into a (lovely) nursing home.

[rara67]

Thanks for your replies. DH is hoping to speak to the centre manager today. We live about 50 miles away from MIL and DH works 70 miles away in the opposite direction. I work part time and DSs are 7 and 13 so there is a limit to what we can do. I need to remind DH to tell them, as people will assume that he has no/grown up children. Very good point about the Friday/weekend discharge. Marmite - so sorry things didn't work for your dm but sounds like you are pleased with the nursing home. I think the alcohol is a big problem, although dmil hasn't had a drink for over a week, so maybe if she goes for 3 weeks without a drink...or am I being unrealistic? I think DH doesn't want to say too much about her drinking for fear of her being kicked out the centre! I know that if she went into care she could have one drink per night but she currently has a lot more, although she is in complete denial. To be honest even if she does really well at the centre I can't see how she will come out and stay "on the wagon". She is very depressed although again, won't admit it so unless the Citalopram really works and she continues to take it, I fear she will soon be drinking again. It's so sad, she wasn't like this until about 5 years ago when Fil died. Even though she left him in 1983 they were good friends til the very end. It does get more complicated but I'll spare you the longer version!

[hatgirl]

They won't kick her out of the rehab centre for previously drinking.

Your DH needs to be upfront and honest with the staff involved in her rehab about what his concerns are about her returning home. If they don't know they can't help!

[CMOTDibbler]

You are the same sort of distance as I am then - I make it very clear that although I shop online for them, I have a FT job and a 10 year old and cannot physically be there to help out. It felt awful the first time, but I've realised that there is an expectation that family will be able to help out and you have to spell it out.

Your DH really needs to talk to them about the drinking. She won't get chucked out, and may be vit B12/ thiamin deficient which needs treating.

[rara67]

Thanks again. DH was speaking to the centre today but it would have been too obvious if I'd had tried to listen in. He was still on the phone when I left for school run and he's now our for the rest of the day. He's very articulate and sounds like he knows what he's talking about, so I think he may come across as very "hands on" but I know that he will tire of the situation if MiL doesn't cooperate. Part of me just wants to phone the centre myself and explain that she drinks and that she never grieved properly for her partner (although they were together for 30 years he never left his wife) or FIL who she never actually divorced despite leaving him over 30 years ago. The poor woman has been widowed twice but no one has ever acknowledged her as a widow. Thanks for reading, my DM has just arrived and she doesn't even know that mil is in the centre or been in hospital.....its gonna be a long afternoon....

[whataboutbob]

I agree with CMOT it would be best if the rehab place was told about the alcohol. As well as correcting any underlying vitamin deficiencies which tend to be more common in alcoholics, they might need to give her detoxing meds. If she is detoxing (ie withdrawing) she will come across as very anxious/ aggressive and it could give a skewed picture of her rehab potential. I've worked in hospitals for over 20 years and bizarrely it seems doctors are often not very good at picking up the signs of alcohol abuse.

[rara67]

Thanks Bob. I am drafting an email to the centre in my head as I feel that we are pussy footing around the alcohol issue. I heard DH say on the phone that she "likes a drink" but the reality is that she drinks a litre of 40% brandy a week, every week. This has been going on since her 80Th birthday bender when she was hospitalised for 9 days following a fall. Funnily enough they never found out the cause.....Brandy is possibly her main source of nutrition based on the amount of spore covered food we find in her fridge each time we visit. She came for Christmas and for three days the only non alcoholic drinks she had were three cups of coffee. I don't know if this means she is an alcoholic but I don't think you can drink that much without eating something to line your stomach and then rehydrating. She doesn't think she has a drink problem. To cap it all there is a bar at the centre! Don't want to go behind DHs back but fed up of this pussy footing and it is having a negative impact on our family life. Should I send the email? I kind of think it would save the NHS a lot of money rather than wait for weeks or months for the whole picture to be revealed.

[whataboutbob]

I understand your frustration and having had alcoholism in the family (although not my parents) I have also observed how relatives can be in denial about the extent of someone's drinking. I think the best approach might be to ask to speak to a doctor/ nurse in charge (don't just leave a message with a random) and be clear about how much she drinks, then leave it at that. It's not my area but I suspect that at your MIL's age they'd be aiming for damage limitation, not abstinence, but at least they'll have a more realistic picture of MIL's circumstances.

[rara67]

Thanks again. I phoned the centre and spoke to the occupational therapist. I explained about he drinking but it would seem that it is very clear from all the medical tests that there is a problem. It sounds as if they can't get on with the rehab and physio type activities until she is fit enough. I also took the opportunity to explain our family situation and the impact that this is having on all of us. The occupational therapist feels that a family conference might be a good idea to try and persuade mil that she is not making the best decisions etc and I have asked to be included in the meeting. I feel so much better, like a huge weight has been lifted and there is some acknowledgment of the strain that it is putting on our very small family. Thanks again for your support.

[M1ssunderstood]

Just wanted to add I have a similar thread and can see the future for us! Good to know there are others going through the same situation and can advise.

[whataboutbob]

Well done Rara a dependent elderly person sure can pile on the stress (unwittingly of course) and i am glad that you had the opportunity to express that and let the health care team know your position. My experience with my Dad who has Alzheimers was that health care professionals/ carers/ friends form church etc seemed to think that a daughter was an inexhaustible resource and it took me 2 years of counselling not to be ashamed to put my own needs forward sometimes.