Yesterday, family members were given day-long training in how to care for my mother when she returns home. We were taught the proper way to move her from bed to wheelchair and back, wheelchair to toilet and back, wheelchair to car and back. We didn't use a dummy - we moved my mom each time, as it is as important for her to know what to do as it us for us.
After a while of this, any remaining bubbles imagining my mother strolling home, or confidently using a walker to reenter the house burst. Walking at discharge means "often using her own walker to get to the bathroom" if she is very fortunate. There were other demonstrations, hands-on activities, examples of how to make things at home more wheelchair-friendly and the like, but the wheelchair activities hit home.
A few nights ago, about 7PM, my mom fell while being moved between the bathroom and her bed. This was not due to negligence - her arthritic knee that should have been replaced years ago "gave out." They promptly called my dad at home: "Is this her husband? Well, sir, we dropped your wife. She's alright but we're going to have x-rays done just to make sure. Would you like to talk to her?" (My dad is hard of hearing and uses a speakerphone so I hear all his conversations.) You have to give them credit for full and prompt disclosure, and some unintentional levity. The x-rays showed everything was fine. Her knee has given out a couple of times since. Now, there's no question that the knee gives out. Also, no question that once wrapped in a bandage to "give support" (it doesn't really) after that happens, it works fine.
The first wheelchair demonstration was by the physical therapist who has been working with my mom since the day she arrived. My mom's initial reaction to his requests was so much like the nights we struggled to get her to the bathroom before she was admitted to the hospital that I wanted to flee the room. If he couldn't convince her, how could we? He did gain her cooperation, and everything went pretty smoothly after that. (In the midst of this, my sister-in-law had a great idea: she moved my brother from wheelchair to toilet and back while my mom watched. I think that helped my mom's confidence, in herself and us, tremendously.)
At the end of the day, a meeting with the medical staff was arranged for the family. All the hospital people who attended are working directly with my mom, and the crowd was pretty impressive: her attending physician (a woman whose mere presence tells you who is in charge without asking), a social worker, the lead nurse, the lead physical therapist, the lead occupational therapist, a neuro-"something I can't remember" (who I am pretty sure is a psychiatrist in a bit of disguise), the nutritionist, and one or two others. The family present included my mom, brother and his wife, sister, and myself. (My brother-in-law stayed behind to take care of my dad.)
Each department gave a report including what had been done and an evaluation of my mom's progress. They were forthright and did not pull many punches that we noticed. We were actively encouraged to ask questions. We did. It was a long meeting.
The great good news was never actually spoken: my mom was able to sit in a regular wheelchair for the first time, and not a special, adjustable reclining one. And not just for a moment but all day long, albeit on-and-off. She was sitting in that chair (a carbon copy of the one ordered for her to take home) for the entire meeting. All of us kids thought this was an impressive achievement. The other good news is that the anticipated discharge date has not changed.
That said, the only time a punch may have been pulled during the evaluations was during a discussion of the support needed to accomplish the various tasks my mom engages in during therapy. During the first week, only minimal support was ever needed. IIRC, this means that no more than 25% of the effort was supplied by a therapist. However, the last few days have required moderate support (25-50%). They readily admitted that they were at something of a loss to explain the change.