Rehab–Attitude and Reality

A broken hip makes one helpless.  Can’t move, can’t get up and do what you and I take for granted daily.  Excellent doctor, successful surgery, excellent rehab facility selected. Yet as R lay flat on her back in a hospital bed after admission to the rehab center, we realized there would be “down days” and physically-challenging work ahead.

The importance of attitude: loomed front and center.  First concern–whether a proud, successfully independent 97-year-old woman would have the will to endure, and recover from, almost complete dependency accompanied by the pain remaining after surgery and accompanying the physical therapy.

Control and Empowering: We couldn’t control much, but wanted R to feel empowered, not like a helpless little old lady.  She’d never considered herself that way, that would be so undermining. To this end, we immediately requested that the staff call her by her first name, never “honey” or “sweety” (or any other too familiar or what she might consider a diminishing pet name so commonly used in care facilities).

Next, we asked R to give us orders–where to put things, what things she wanted us to bring her from home, what we could do to make the room more user friendly for her etc. etc. That gave her a smidge of control. Within a week, she also tried to control what little she could.  “Pick the dead leaves off that plant, she would instruct.  “I don’t want to look at dead leaves,” she’d emphasize.” “I don’t want clutter in this room,” she’d say. We complied with any “orders”.  Her mind worked, we didn’t question even seemingly unnecessary (to us) “orders.”

Adjustment: The first week in an institutional setting is similar to a child’s going to school for the first time: unfamiliar routines, new people, different food, expectations, and disappointments. When we don’t feel good, we’re weak, we lack energy and we’re not mobile, we may not feel much like adjusting.  We may be cranky or worse.  Understandable, isn’t it? Here’s where focusing on the big picture helps.

What’s the goal? Always keeping the goal in mind applies equally to helping aging parents and their children. This helps ward off the disappointments, insults, and temporary setbacks. The goal in R’s case was to be able to walk again, regain independence and not need a wheelchair. But R had an intermediate goal because of her surgeon’s instructions to the rehab center: “no weight on the left leg for 90 days,” then an x-ray to be certain the hip was healed, before weight-bearing exercises could begin on that leg.

Patience: Unbeknownst to us, until she told us she had passed the 45 day, half-way mark, R was mentally crossing off the days until her return to the surgeon and an x-ray showing the femur had healed…..    To be continued on next post 1/22/11.

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Note: An RN in the family was emphatic that once R began the weight-bearing exercises on the leg with the broken femur, she should never use a wheel chair. Why? Because the unused leg needed every chance to strengthen and using the wheel chair eliminated precious time exercising that leg. Indeed she said using a wheel chair instead of making oneself walk at every opportunity while doing rehab, is a reason old people who break a hip will become confined to a wheel chair, never to walk normally again

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