next step, baby steps

So Mom went into rehab Monday afternoon.  My initial impression was "This place is so depressing!"

True, but so limited.  Mom shares a room with a pleasant woman who was hit by an ambulance(!), but she's sharing a room!  I said to myself.

She's in the bed by the door, with just enough space between the bed and the wall for a chair.  There's a television mounted on the wall up near the ceiling, above an expanse of blank white wall, on which I taped up big color prints of photos of her birthday flowers, because staring at a blank wall is depressing, I said. Out loud.  And she really misses her flowers, because she does.

Everyone -- every single person -- has been kind and professional. She has physical therapy and occupational therapy and gets washed and dressed and fed.  She is cared for much better than she allowed us to care for her at home.

That's still surprising me: what she allows.  At the hospital Mom became confused and disoriented, sometimes thinking she was at home to the point of arguing about it. (hospital delirium) The delirium has continued at rehab, but she is still on the steroids and will be until July 3.  We are all hoping that she recovers once she's fully off the steroids, but I'm worried that she won't.

Still, she has walked more in the past 2 days than she had in the previous week, but she has lost so much function through inactivity.  She developed pressure blisters on her heels and now they've popped, and with her bad circulation they represent a huge infection risk.  Plus lying in bed for most of the day (everything leaves her exhausted) puts her at risk for pneumonia.

Her nephrologist sent along her lab results, noting that her kidney function is at 12%.  Dialysis is recommended when it hits 15%, but she absolutely will not consider it.  It might make her feel better, but with the arthritis, diabetes, kidney disease, neuropathy, spinal stenosis and degenerative disc disease, it's doubtful whether anything really can make her feel better at this point.

Mom's compliance at this point is creepy, knowing how strongly she felt about doing any of this before she went to the hospital.  She's playing - being - the good girl and doing a fine job of at least going through the motions.  Her level of fitness is so low that even going through the motions will improve her capabilities, at least at first.

The staff at the rehab center have a policy of 2 weeks of observations before recommending a care plan to the family, so they can really see how the patient is responding to nursing and therapy.  By that point Mom will be off the steroids, so we'll have a much better idea of what she's capable of in the longer term.  In the meantime, we just have to take it day by day.