Rehabbing Is Good But You Can Go Home Again

That poet who said “you can’t go home again” doesn’t know what he is talking about. On July 16, Ma returned to the house Dad and she bought in August 1968 after spending the previous seven weeks at a rehab facility. For close to two months, her life was regimented by health care professionals who told her when to wake up each morning, what to do in twice daily therapy sessions and barged into her room whenever they felt like it to give her medicine and check her condition.

After Ma had two weeks earlier seen the surgeon who repaired her broken hip, she felt frustrated when he told her that she still could not put sufficient full pressure on her left foot to warrant walking stairs.

He said that she needed another 10 days of boring repetition of what she had already mastered in order to give more time to the fused bones and pins to secure themselves.

Two days earlier on July 14, we did a dry run where we wheeled her to my car in the facility parking lot and she rehearsed getting out of the chair and into the front seat of the four door sedan. Just as the therapist had told her earlier in the day regarding her first effort to climb stairs, once again she did it “like a pro.”

That Friday she took the ride home and back to her house that she had not seen in weeks and readily climbed the stairs to the front door. She even walked up the stairs inside to the second floor to sleep in her own bed that first night.

This is what doctors, nurses and other healthcare professionals hope to see and hear. They want their patients to be success stories. But it comes with a price. People live longer now and expect to live it as healthfully as possible even into their 90’s. Most people with few exceptions would go into the poorhouse to be able to pay back the cost of surgery and recovery. The Federal Government is at a crossroads because the cost that they are underwriting for seniors is out-pacing the ability to fund it.

However, there is no alternative. The Feds must continue to finance senior care or there will be a lot of seniors lying and dying on street curbs.

Physical Rehabbing is another Way of Saying “Hurry Up and Wait”

Everyone wants to be healthy and wealthy. If not wealthy, then have enough to at least stay even with the crowd. If not totally healthy, then at least enough to maintain a level of dignity and self-support as much as possible. Such are the dreams of those sleeping the night through in rehab facilities. “Hurry up and Wait” pretty much describes what goes on during physical rehabilitation as a result of injuries or surgery.

The rehab therapist sends an assistant to the patient’s room and rushes him or her via wheelchair to the exercise room despite whatever the beneficiary of the said workout is doing at that moment. Once there, the patient is told to wait while the therapist works with someone else.

The therapist finally focuses his or her attention to the said patient. He or she demonstrates for a moment or two what the patient is expected to do for the next few minutes but runs off to help someone else. After a wait of another few minutes, attention is again returned to quickly demonstrate another task to perform but off goes the therapist once more. Eventually the patient is wheeled out into the hall and told to wait until someone can wheel him or her back to his or her room.

Another type of ‘hurry up and wait’ is for the healing process itself. It can be a long duration depending on the injury to a broken bone and surgery to repair the damage. In Ma’s case, she fell and broke her left hip. That same night she had surgery and six weeks later, she sits in frustration at the rehabilitation facility. The other day she met with her surgeon who told her she was progressing fine but that six weeks was not enough time to heal back to her old self.

For one, older people have an issue with osteoporosis, which is a polite way of saying they suffer from soft bone tissue. Simply put, Ma’s bones break too easily and if she rushes the mending earlier than it should be, she runs the risk of re-breaking the left hip. Seven years prior, she fell and broke her right hip, had surgery and was back to her normal self- whatever that means- after two months. However, the break was not as thorough as this time and she was seven years younger and stronger.

The doctor also said magic words. “Look, Medicare gives you 100 days to get better on their checkbook. Take advantage of it as much as you need.” For her it means two weeks of putting at least 50% pressure down on her left foot whereas up until now it was four weeks of no pressure. She has used a walker during exercise time with the left heel down and her toes up. It is up to Ma to go about her business of proving that this next phase is a piece of cake.

After two weeks, it will be the sixty day mark from the time of the surgery. She will be able to try 100% weighted pressure on her left foot as well as walk stairs. The surgeon said that when she can put 100% pressure down, she can go home but that it would not be wise to do so if she cannot master going up and down stairs.

This obviously generates lots of frustration. She feels better than she did six weeks earlier and can do some things again but she wants total freedom. Who doesn’t? Healthy people take for granted that they can take care of themselves.

When I was sixteen and a half, I did a stupid thing- one of just many in my lifetime- and jumped over a fence that I knew had an eight foot drop to a cement floor. Naturally, I broke a metatarsal bone in my left foot which has never healed properly ’til this day. But, being 16, I was also young and strong enough to ignore the fact that I had done damage. Other than wearing a shoe with a wooden sole to act as a splint and cushion the pounding that walking did to the sensitive break, I went about my normal business. I even went to my high school graduation with that stupid wooden shoe. No cane, walker or crutches. I probably would do the same today. But if this were to happen twenty years from now, I suspect I would be grounded for several days as well as using a walker for a while.

That magic word- Medicare- helps soothe some of the pain for those in the same boat as Ma. American society decided that the age of 65 (or whatever it will be in the future) is the special passport to government financed medical care. The first twenty days after surgery, Medicare pays 100% for her recovery provided she is able to show an effort in cooperating with said recovery. After twenty days, Medicare pays 80% and the Medicare Part B co-insurer pays the other 20%. Ma has up to 100 days in a calendar year from the time of surgery to take advantage of all that Medicare will finance. If Ma stays in a rehab place for sixty days and then goes home, she can still return and use the other 40 days up to the anniversary of the surgery.

Once upon a time- sounds almost like a fairy tale, huh?- retired social security recipients were not asked to pay much at all for Medicare benefits. Now, each monthly payment they receive automatically withholds Medicare Insurance premiums. For some people this can be over $300 per month. That is a lot of money to take away from someone who is ending up with anywhere from $1400 to $2000 a month in social security money. And there are those like Ma who saw their social security money drop 40 percent when Dad passed away as well as lost Dad’s pension. The biggest slap in the face to senior citizens is that for the past couple of years there has been no increase in social security benefits due to the “Economy”. But there has been an increase in Medicare premiums withheld. Beneficiaries in 2010 are receiving less social security money in 2011 than in 2010. The situation does not look any better for 2012.

Is Social Security a Silver-Haired Lining?

The Economy is on everyone’s mind more so than ever. We read and hear how things are getting better but Unemployment is still way too high and many are working jobs below their skill level and collecting pay that does not keep up with the Joneses. I have it on good word, though, that Mr. Jones has been out of a job for the last eighteen months as his wife tries to hold the fort down with her meager salary. Jonesy is thinking of asking about that greeter’s job opening at Walmart.

Around the beginning of this century, baby boomers figured we would continue to hold our own in eking out enough of a living to pay current expenses even if we were not putting much away for the future. We also figured that Social Security benefits at age 65 would help when we retired and that Medicare would take care of health payments for our old age ailments and drug prescriptions. But, of course, that all changed.
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