my boyfriend is in an acute care rehab hospital?

Question

he had 2 failed hip replacement surgeries, and got a really bad staph infection. he has no right hip at present. the acute care facility wants to discharge him to my house. he needs antibiotic injections every 4 hrs, is in much pain, cannot use right foot at all (right hip will be out until infection is cured (about another 4 weeks) and then another 6 weeks of strengthening physical therapy exercises. then he will get the new (3rd) hip replacement put in. after that, he will need physical therapy.
i am afraid to have him at home now, because i do not think it is safe. he outweighs me by more than 100 lbs, and the iv antibiotic injections must be given every 4 hrs., round the clock. he dreads going to a nursing home, where the care is very poor, the physical therapy is minimal, the homes are very understaffed.
much as i would love to have him at home, i do not think i am capable of caring for him. i'm not strong (can lift a max of 10 lbs. and have a torn meniscus in my right knee.
i think i am going to have to tell him i can not let him come home until the antibiotic injections are finished and the infection is totally cured. i think i could handle it if he then came home....with wheelchair and walker. (he cannot put any pressure on his right leg because he has no hip). but he cries when i mention the nursing home. i am trying to get the acute care rehab hospital to keep him till the infection is completely gone. that makes sense to me. it takes 2 attendants to move him from bed to walker to bathroom, or to wheelchair. in our local nursing homes, instead of taking patients to the bathroom when they need to go, they prefer that they soil themselves in bed and then get changed. it's an ugly situation.
any ideas on how to convince the acute care hospital to keep him at least till the infection is cured???
this is heartbreaking. i don't want to disappoint him. he cries, and he's NOT a whiner. but i don't think he will be same at home yet.
DOES ANYONE HAVE ANY IDEAS ON WHAT I SHOULD DO????
thank you for any and all ideas.

mistify · Accepted Answer

The acute care rehabhospital will NOT keep him until the IV antibiotics are done.  The function of this level of care is to prepare the patient for discharge home and to meet their rehabilitation needs. At this level of care, average stay is 7-10 days, and these types of facilities are not "long term" (it's rare for anyone to stay in one longer than 4 weeks). Since he is currently without the hip the best you can likely hope for at this stage is to have him to the point where you can help him get out of bed, and he can walk short distances with the walker maintaining the non-weightbearing status....or that he can transfer into a wheelchair by using a sliding board.   It will be a different story when he has the new prosthesis and there is more potential for his mobility to improve...THEN, he will require another stay at this level of care.  

However, we NEVER want to send someone home unless it is safe to do so.  The goal of his current rehab stay is to get him as safe as possible to do these basic transfers. As part of that process, they will need to complete family training with you...to see if the discharge goal is possible.  IF it's found that you cannot manage his care by yourself, discharge to the nursing home is a likely scenario.   

So don't give up yet, remember, that he will likely improve during his stay in rehab and this should become a very manageable situation.  It's essentailly like someone with a broken leg who cannot put any weight on it. With practice, I anticipate he will improve.  

I've actually known many people who had this exact procedure done...many are able to go home after a 1-2 week stay in rehab.  You should be involved in family training which will help as well.

Anonymous · Answer

Home health will come to the home if he has insurance, medicaid, or medicare.  The visits include a nurse, bath aid, and physical therapy.  It must be prescribed by a doctor.  With him needing antibiotic injections every 4 hours, I would suggest you put him in the nursing home until they are finished.  They have a nurse on staff who can do this for him.  He can also get PT at the nursing home.  BE THERE when he gets physical therapy because they have a tendency to slack off on patients who don't have a care giver standing right there to check them out.  All nursing homes are understaffed.  That is why they don't take patients to the bathroom as often. The executive suits at the top keep all the money and the CNA staff is often underpaid.  If you can get him to an acute care facility, that would be the best option.   You don't say how old he is.  If you are Catholic, call Catholic services.  If he is over 65, call the local elderly care services.  If neither of these work, consult with an elder law attorney.  It will be worth the fee to know exactly what your legal options are.  With a torn meniscus you could end up in the bed next to him if you aren't very careful when caring for him and that wouldn't do either one of you any good.

Amaretta · Answer

Have you actually visited the nursing homes yourself and talked to the staff about his possible care there?  Don't rely on rumors and secondhand information for others.  Go see the places for yourself.  You can also look for the top nursing homes here:

http://health.usnews.com/senior-housing

And check the ratings for your local nursing homes here:

http://www.medicare.gov/nhcompare/include/datasection/questions/proximitysearch.asp?bhcp=1

You're right to be concerned about your boyfriend's care at home if it takes two nurses to lift in the hospital.  Plus who will take care of him while you are at work?  I've spent time in a nursing home twice after joint replacement surgery (the rehab wing at the operating hospital was full both times) and, while it wasn't home and it wasn't perfect, it was okay.  It allowed me to heal and do rehab with nursing care available.  Sometimes you just do what you have to do to get better.

Anonymous · Answer

Does his insurance cover home rehab where a skilled nurse could come to your house for a while for him? Or are his finances able to pay for a home care/rehab program? Check into that. He doesn't want to me in a place full of strangers =( And if he had to go wouldn't you be able to visit him a lot and pester the nurses?

Pooky™ · Answer

He needs home health nurse - has that been discussed with him?

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my boyfriend is in an acute care rehab hospital?

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