Surgery Recovery - Is geriatric rehab out of the question?

Hi -  
My Mom is 72 years old and was diagnosed with Stage 4 ovarian cancer in March 09.  She had a hystorectomy in 1980, and was under the impression that both of her ovaries were removed at that time.  After she discovered a lump on her neck in February and several tests were run, it was determined that she did still have her left ovary and it was cancerous.  

Over the past several years she has spent the majority of the time in bed complaining of back and leg pain and extreme fatigue.  She was prescribed several medications to treat those symtoms (symptoms) including Gabapentin and Vicodine.  I had noticed that she was occasionally confused about situations and more easily irratated over the past year and a half.  She came to stay with me when she had the lymph node biopsy.  It became obvious that her level of confusion was more series than I orginally thought.  She was not aware of what medicines she was supposed to be taking, when she should take them, or how often.  I discovered late one night she had taken all of the medication for the following day in a 4 hour time span.  She was very confused and having hullucination.  I took her to the emergency room for treatment where they pumped her with fluids only for two days to get the medication out of her system.  Her primary care doctor suggested at that time that she appeared to be exihibiting signs of dementia or early alzhiemers.

After taking my Mom home, I strictly regulated her medication and the confusion cleared up significantly.  Then we went to the first oncologist.  He suggested that we treat her with pallative care only using gemzar and carbo to prevent her from suffering pain in the short amount of time she has left.  We agreed and opted not to get a second opinion.  As the treatment progressed her confusion and aggitation returned.  We had noticed a pattern of the symtoms (symptoms) getting bad right after chemo and clearing up by the time the next cycle started.  The oncologist said it was not related to the chemo, but solely caused by her "organic brain disease", and we should stop chemo and send her to in patient hospice.  We chose to get a second opinion instead at the local university hospital.

The new oncologist informed us the medications she was being given to do cause the confusion and aggitation, and he calls it chemo brain.  He feels like there is hope in getting her cancer under control - but probably never into remission.  He has continued to treat her with another 3 cycles of taxol and carbo.  At the beginning of each session, they started with benadryl and prilosec to prevent a reaction to the taxol.  Within 15 minutes of started, she starts getting loopy and stays that way for the next week and a half.

Her CA 125 has gone from 480 to 128.  Now he would like to do surgury to remove the ovary and any tumors in the abdomin (abdomen) he can.  She is being evaluated by the pre-procedure group at the hospital to detemine is she can handle being under anthesia, and all of those tests are coming back good.

She is very clear minded right now and is wanting to do everything she can to fight the cancer.  It seems to me that she has some mind altering reactions to some medications.  I have a feeling the surgery is going to have the same effect.  But I still want her to have the surgery.  My only concern is being able to take care of her after surgery.  Do you think it is out of line to ask the doctor if she can be sent to a rehab center after the surgery to help her build her strength back up?  It would really help me to have some help while she is loopy while she is recovering.  I also think she would benefit from some physical and occupational therapy to recover some of the muscle and motor skills she has lost due to inactivity over the past couple of years.

Thank you in advance!

[shewrites]

I'm sorry to learn of your mother's troubles -- and yours.  I really don't like hearing that the original doctor was so quick to give up.  72 is not that old.  You need to get a realistic assessment from the new oncologist and then try to meet your mother's needs.  If she has dementia, it will complicate things, but she probably can still tell you and her doctors what she wants.  Keep in mind that you'll feel guilty later if you push her into painful treatments that she doesn't want -- and guilty if you don't support her if she wants to fight.  So try to do it her way.  

Talk to the doctor before any surgery.  Lots of times a Medicare patient it entitled to 30 days of nursing/rehab after hospitalization.  If not, she may be entitled to home health visits, which will relieve your mind but really won't relieve your duties.  IF the doctor doesn't know, the hospital probably has a social worker assigned to this who can help you a lot.  My local hospital has lists of nursing homes, home health services, etc. that are available as well.  

Beyond Medicare, there are home health care services (a couple hundred dollars a 24-hour day --less if you can manage with less hours) which you can purchase.  If she has the money, that would be an alternative for a short time.  You may need such a service for a few hours a week anyway, so it's worth doing the research.  (I'm assuming you do have a life of your own.  Keep in mind that caregivers need to take care of themselves as well.)  

Please keep in touch.  There are lots of people on here with more experience than I have who I hope will weigh in with ideas for you.  Good luck!