You receive an order in acute care to evaluate James, a 78yo…

Questions

Yоu receive аn оrder in аcute cаre tо evaluate James, a 78yo M who just had an elective L THA. He states he lives with his wife who can complete IADLs. However she is 76yo and unable to provide much physical assistance. James reports his adult children can alternate helping 24/7 with ADLs and IADLs for at least two weeks and then he can afford to pay for assistance as needed for a few more weeks. James has a two-story home (main bed and bath on 2nd floor, half bath and guest bedroom on ground level, no steps to enter -- just a threshold). He was independent without AE at PLOF with all ADLs and IADLs. During the evaluation he requires CGA + RW for balance for functional mobility. James could climb one step with minA and assistance to manage the RW but managing stairs multiple times a day would be extremely tiring. James requires CGA for sit to stand and or a toilet transfer. He has difficulty managing clothing so he requires minA for toileting. For LB dressing he requires minA for pulling up pants/underwear over hips and mod cues for use of AE. He is able to maintain balance with RW while someone else pulls his underwear/pants up over his hips. Of the following options, what is the most appropriate discharge setting recommendation?

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