What's going on inside rehab? Reader Q&A Part II

KIRC issues a BOLO: What you should 'be on the lookout' for

Feb 23, 2022

In a recent Reader Q&A edition, we talked about some things you should know (and think about) if you or a loved one is prescribed a stay at a rehabilitation center (Skilled Nursing Facility, or SNF).

*KIRC is happy to report there is some GREAT news to share regarding the readers’ parent!*

This is PART II of that conversation.

1. Before hospital discharge

Before leaving the hospital ask the care coordinator to review any and all Durable Medical Equipment (DME) you might be eligible for through Medicare. Again, I recommend reading through the Medicare and You Handbook to learn what is available including items such as:

Home oxygen equipment
Hospital beds
Walkers
Wheelchairs

Once your loved one returns home from rehab these items are already in place.

I urge you to seriously consider a wheelchair and walker, as both can be vital while your loved one works to build back their strength.

Courtesy: Getty Images/SoumenNath

2. Facility food & meals

Ask a potential facility what the meal policy is, request to review the menu for details of portion sizes and nutritional value, and make sure meals are suited for your elders’ ability to chew and swallow.

You might be surprised to learn that while a facility may offer three meals a day plus snacks, it could be food items your elder is unable to manage. Or the menu items could be lacking in any viable nutritional value.

I urge you to be a pest when it comes to how food is being prepared and served. Also, consider this: does your elder need assistance eating? Quite often there simply are not enough staff members on hand for them to sit with your loved one and help them eat.

Yes, this is a generalization, but sadly that is more common than one might realize.

Ask the policy for visitors during meals so that you or a trusted loved one or friend can be on sight for meals.

Also, ask to see the kitchen. I did this when visiting locations and if they refused, I had to ask myself, ‘why?’

3. Privacy vs. interaction

If your loved one is given the option to eat in their room versus joining others in a dining area, I urge you to nudge your loved one to choose the group option. Why? Interaction!

If they are able to sit at a table upright, that simple action of going from the bed in their room, to a wheelchair, to a table, to engagement with others can be of benefit. Staying in the room means more isolation and the possibility for decline.

Courtesy: Getty Images/FG Trade

4. Regular movement (if possible)

Request care staff get your loved one up from their bed several times a day (if their condition permits). Even if it is just to move from bed to wheelchair for a short stroll down the hall, it means they are not static.

Plus, laying in bed increases the chances of developing bed sores. Once skin breaks in sensitive areas (buttocks, tailbone area, neck, arms, etc.) you can quickly face an entirely new set of problems with infection setting in.

5. Is there a doctor in the house?

Be sure to ask the procedure for the facility doctor. Many times, the doctor assigned is not on location and has not, or may never see any of the clients, yet they are now in charge of prescribing medications.

Be an advocate for your loved one’s medications. Review with staff and insist they remain on the same time routine for sensitive medications.

Also, ask what the procedure is if you need to make a visit to your own doctor. Do you drive them or does the facility do so? Who then is in charge of the medications? ASK QUESTIONS!!!

6. Better to look good

During any visit, make sure to wash your loved one’s face, comb their hair and spruce up their appearance. Do this every single day you can.

This isn’t about vanity. The more our elders appear disheveled and unkempt, the higher the chance they can be perceived as ‘on their way out.’

Keep current newspapers and/or magazines visible and handy. It can lend the appearance indicating your loved one is perfectly engaged, viable and in recovery, not decline.

7. Do your homework

Before making your final choice, make a search of the facility for past records to learn of any violations.

In California, The Department of Public Health oversees Skilled Nursing Facilities. It can take a bit of time to track it all down, but your loved one is worth the effort!

You can also turn to U.S. News & World Report as a starting point to view facility rankings. However, you still must do your own research and physical visits.

Now, that good news I promised - feedback from the reader who sought answers in this Q&A:

“Great call on the shower investigation. They have been washing her hair with washcloths. Pushed for the showers and finally it happened. I asked my mom if she got her shower. She smiled real big and said, 'It was heavenly.' She said her neighbor in her room had been there about a month and no shower. So now she’s getting one tomorrow!”

This feedback warms my heart and is exactly what KIRC is all about! Remember, 'We don't know what we don't know,' so sharing information with others can make all the difference!