My 76 year-old mom has been diagnosed with PSP and is showing early signs of balance and memory issues.

Yesterday she fell and broke 4 ribs. For the life of me I cannot envision how she fell so hard to actually break ribs, but she did.

Questions are these:

Hospital wants to release her, as they should, but she cannot take care of herself in this much pain and there is no one local available to be her ‘nurse’. Is there a way to convince the docs to put her in some type of rehab nursing home for a week, just to give us a chance to catch our breath and figure out what to next?

The Internet talks about pneumonia being a PSP cause of death, I’m concerned about the broken ribs and if there are specific things we should be looking for or doing to help prevent her coming down with pneumonia.

Bone strength decreases as we get older so falls from standing frequently lead to rib fractures in the elderly. She will be assessed by physical therapy and occupational therapy and their recommendations will guide the discharge plan in terms of discharge home vs rehab etc. Pain control in rib fractures is difficult and multiple therapies combined is the preferred approach. This includes typical pain medication, a low dose muscle relaxant, lidocaine patch etc. In the hospital we sometimes use epidurals for pain control as well.

Pneumonia is her worst enemy at this point. To avoid it she must push through the pain to take deep breaths. Hence the incentive spirometer, the plastic blow toy. Actually moving around works well too. Occasional breathing treatments can help sometimes.

I hope this helps. It’s never a good time to be in the hospital but in this current pandemic it’s the worst. All facilities are at max capacity based on staff. Factor in the virus presence itself and rehab facilities are less appealing.

If she has no assets Medicare might be able to do something

^^^^^^^^^^^^^
You mean Medicaid.

Even if she has Medicare and not Medicaid, she'll only be on the hook for $1,556 if her stay is inside of 60 days. $1,556 is the 2022 costs instead of the $1,408 mentioned below. But it gives you the idea of how it works. Talk to a hospital ombudsman or a social worker to help get the hospital to sign off that she needs a skilled nursing facility to recuperate and get her back on her feet. Someone in the hospital with a brain and some compassion just needs to understand what you explained in this thread.

Medicare Costs Link

Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
• Premium: Free
• Deductible
○ $1,408 for each benefit period
○ A benefit period begins the day of admission as an inpatient in a hospital of Skilled Nursing Facility.
○ It ends day of discharge plus 60 days.
• Coinsurance
○ Days 1-60: $0 coinsurance for each benefit period
○ Days 61-90: $356 coinsurance per day of each benefit period
○ Day 91 and beyond: $704 per each "lifetime reserve day." Each person has a total of 60 reserve days over their lifetime.
○ Beyond lifetime reserve days: all costs

You can deny discharge and ask for a medical review by Medicare/Medicaid.

We did it several times with my Dad.

The hospital should have given you a case manager to help you through all this. If not, ask for one.

Tell them exactly what you want for a discharge plan…one that includes placement in a inpatient rehab.

Definitely talk to a case manager/SW. I’m surprised they did not plan for a 20 day short term disability or in-home shone health aide; I don’t think she would need skilled nursing care, so would ask about those two.

Great information and direction in this thread, thank you we are putting it to use! To add…

We looked through the results of the CT Scan, there are also slight fractures to the L1 and L2 vertebrae.

That was some fall she took.

You may want to inquire about home health services, nurses coming o the home and cna overnight?

I work in health care, and have had many patients come in with balance issues. In all the elderly patients, and some of the middle aged patients, there has been large amounts of plaque built up inside the arteries. This was visible on x-ray and/or MRI.

One case, a 63 yo male, was having memory and learning problems. I supplied him with protolytic enzymes which eat up plaque. In two months he was slightly better, in 6 months he was 90% better. Now is 100%. In my opinion, most elderly persons with balance or memory issues could be returned to normal with these enzymes.

Generic name is Natto Kinase, but 3/4 of the product on the market comes from China and has no therapeutic value.
I use Natto-Serazime from Designs for Health. Have numerous patients who are extremely satisfied with the results.