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please help with questions about post therapy after knee replacement

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Posted 1/6/2011 2:23 PM (GMT 0)
hi. i need alot of help. dont know where to turn. my 67 yr. old father had knee replacement surgery dec. 28th. the doctor wants to discharge him this friday jan 7th. he lives alone and has not been successful in the therapy at the skilled rehab at the hospital where he is in patient now. we have told the doctor that we do not have the means for any family to live with him on a 24 hr basis until he has improved but this seems to have fallen on deaf ears. he is on medicare and has a supplemental insurance ( state of pa) but we are told he is not approved for additonal care at nursing home becuase he does not fit the criteria. our father is telling us he can't do all the therapy because he has no upper body strength. he is a big guy and is disabled from work because he has limited mobility in his shoulders. and his good knee is also bad and needing replacement and now he can't compsenate for the knee that had just been replaced. i feel we are in a mess with no one to turn to . i guess my question is in the state of Pa..will medicare pay for addtional time in a nursing home if they live alone and wont have the proper care. he will PT coming in 3x /week but thats it. the family can come in periodically and check on him but can't live there on a continual basis for the next month. some one please help friday will be here before we know it..
Posted 1/6/2011 6:59 PM (GMT 0)
My father had TKR a couple months ago and he was sent to a rehab/nursing home for 2wks when he left the hospital. (same situation, could not care for himself) After that, he had a Visiting nurse come everyday for 1 wk, and therapy at home until he could drive himself to therapy. This was in MA, so I don't know what the coverage is in PA?

(he is on Medicare, but has a supplemental INS he pays for himself) Sorry I couldn't be anymore help.

Posted 1/6/2011 7:12 PM (GMT 0)
JNO2 i appreciate any info i can get at this point. does your father live by himself? all dad will have is PT coming in 3x a week for 2-3 wks. he wants us to come live with him and take care of him and this isnt feasible. the hospital is telling us aside from bringing our dad meals he should be fine on his own at home. we are very concerned about this but have no choice really..thank you for replying 
Posted 1/6/2011 10:07 PM (GMT 0)
Yes, my mother passed 2yrs ago. My dad actually had knee replacements 10yrs ago and the one he just had done was to replace one that had loosened up. He really was okay by himself after the 2 wks in the rehab place. He used a walker to carry stuff around and a cane for just walking. He is 70yrs old, and the reason he went to the rehab place is because we couldn't be with him 24/7. Unlike your dad, he was walking with a walker by the time he came home. I live close by, so I helped him with meals and appts, but he really would have been okay by himself. The VNA came in and changed his bandages, and the therapy people came in a few times a week.
It does sound strange that the Dr is not advocating for longer term care for your Dad. Is there someone at the hospital that can help you? (just reaching, since I don't know if they offer this) I mean he can't be sent home alone, so why doesn't he meet the criteria? What else would he need to meet it? Sounds to me like it is just the Ins people not wanting to pay for more time in a rehab.
Posted 1/6/2011 10:25 PM (GMT 0)
i've talked to the discharge nurse, his doctor and his therapists and all say dad can do this by himself, he just won't. they have all assured me that dad can do this on his own at home and they just want to make sure someone can come and look in on him and make sure he has meals. i think after talking to you i feel alot more confident that dad will be ok. the hospital has basically said its not a question of dad not being able to do it its that he won't do it and going home and realzing that he has no one there will force him to try harder. i hope it works..thank you again for helping me...
Posted 1/7/2011 9:30 PM (GMT 0)
I was a few years younger than your dad, but I walked out of the hospital with my walker. He may just need to be reassured that he can do it, and make sure things are within easy reach for him.
Posted 1/7/2011 9:36 PM (GMT 0)
things are looking real good. dad came home and he is using a walker just fine. i think he just needed to get home and into his own environment. i won't neglect him but i feel a lot better seeiing what he can do and feel much better knowing that he will be ok if he is by himself..
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