Q:  My 93 year old mother just had surgery after falling and breaking the top of her femur. It was discovered the next day that she had a urinary tract infection and also required a blood transfusion. She has dementia but with all she has gone through the confusion has increased. The physical therapist who came in to evaluate her stated she felt my mother was too confused to go to a rehabilitation facility and would do better with a therapist coming to her home. I strongly disagree and think the assessment should have waited until my mother was medically stable. What can I do?

A: The first step is to speak directly with the care manager assigned to follow your mother’s progress. You can plead your case and request another assessment to take place. Be very clear that while your mother does have dementia what the physical therapist observed was very different from her usual demeanor and functional level. If for some reason this does not occur, the next action would be to contact the Patient Advocate or, in some hospitals, it could be the Quality Assurance Department. Their role is to listen to complaints and concerns and explore options to resolve the issue.

You obviously are advocating for an environment where your mother will have the highest opportunity to regain mobility and be able to return to her home. As hard as it may be, make every attempt not to turn this into an adversarial situation. If you continue to be dissatisfied with recommendations, you always have the right to file an appeal. The hospital will provide you with information on how to proceed.

In the meantime, it may be helpful to start looking into rehabilitation facilities located near where your mother resides. Log onto the Medicare website http://www.medicare.gov/nursinghomecompare to view the latest inspection results of each facility you might consider for your mother. If the final decision goes in your favor then you will have to wait to find out which facilities have openings and are willing to accept your mother as a patient.

Are you struggling caring for an older adult or having difficulty locating resources? Our staff is available for a no-cost consultation, set up at your convenience, to help guide you through your caregiving experience. For more details or to schedule an appointment, please call 800-892-0890.

Do you have a question? We encourage inquiries and comments from our readers. Please direct your correspondence to ageinfo@esmv.org or Elder Services of the Merrimack Valley, Inc., Age Information Department, 280 Merrimack Street, Suite 400, Lawrence, MA 01843. Joan Hatem-Roy is the Chief Executive Officer of Elder Services.

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