He needs PT to stay strong enough to stay home. Dad is 80 years old w/spinal stenosis, diabetes, chronic pain and severe mobility problems. 3 months ago he had neuro surgery and is recovering (earlier this year, he lost complete use of his hands and became incontinent). He had serious surgery, did 3 weeks in-hospital intense PT and has had 5-6 weeks of PT since he got home in late August. He has made so much progress! But now, he decided to focus on one aspect of the PT he hates - won't talk to the therapists about his concerns - and decided that "its not doing any good." I could honor his decision - except Mom (70 w/no health issues) is taking care of him and, quite frankly, it's killing her (not being dramatic - literally). His response to my concerns about how his decision affects his family is "Oh well, that's okay. I won't go downhill, not me." We have already done 5 months of the hospital, nursing home cycle earlier this year. I can't help but to feel that I am left to wait until he gets so weak that Mom can no longer take care of him at home (she is refusing home health services) and/or he ends up in hospital. He says that PT isn't that important and I am blowing it out of proportion. Am I?
When your dad says, "It's not doing any good" remind him that he's not in a nursing home, he's at home and he's at home because of the progress he's made in physical and occupational therapy.
If it makes you feel any better your dad's attitude is not uncommon. I'm in healthcare and I've worked in rehab and I've seen many, many elderly people give up on PT and OT. They tend to decline without it. I also saw an elderly lady in her 90's religiously do her PT and OT exercises everyday. It took her the entire morning to do them but she did them and the last I saw her she was still living alone and doing well. I think the fact that she had a daily task to do everyday was almost as important as the exercises themselves.
The problem is that he doesn't seem to be realistic or even considerate about what to expect from his family. You might have to be a bit harsh, discuss the situation with your mother, and draw up a list of what can and can't be done in the home by either of you. And stick to it so he realizes that unless he continues to improve, he can't expect either you or your mother to compensate.
I don't intend this to be a cruel or punitive measure, but you're right that neither of you can be expected to compromise your own health if your father is not cooperating.
I am adamantly in support of in-home PT and OT, which to me is just as valuable in its own way as therapy in a facility because the home is where the real world is - it's where he'll eat and sleep, and he needs to be able to adapt to it.
The other suggestion that might work is a "come to reality" lecture by his doctor, advising your father specifically that if he deteriorates, loses strength and mobility, he might eventually find himself back in a facility on a long term basis. I don't believe in scaring people, but sometimes it's necessary to get through to someone who is intent on making less than wise decisions.
I'll also add that it took all I had to push myself to PT when I had two frozen shoulders and I was in my 40's! It was painful! lol I can't imagine enduring long term PT in my 80's! He's done pretty well.
I hope they offer some helpful suggestions when you meet.
I CAN'T TELL ALL OF YOU HOW GLAD I AM TO HAVE PEOPLE TO TALK TO ABOUT THIS...my husband is so tired of hearing me :)
Dawners, so your Dad just might need a break for awhile. But don't have him take too much time off. My Dad was lazy about doing exercises unless the physical therapist was a cute gal, then he was enthused :) But between visits my Mom couldn't get him to practice. Yet my Mom was doing exercises she was shown by a PT 20 years prior and was still doing them faithfully every day. Each of us is different.
Yes PT can hurt...I've had two frozen shoulders and have a rotator cuff tear now but I'm intrinsically motivated to be mobile and strong. Some people are extrinsic ally motivated and those are the ones who usually don't make it. If the external reward isn't worth it and they don't have the inner drive, it just ain't gonna happen. Aging can change so many things....things I too will deal with as I age along. I hope all goes well for you, but you aren't responsible for his choices and can't make his decisions for him unless it's to help move him into ALF at some point.
I have no words of wisdom for you Dawners, except to say that there is only SO much you can do here. Sometimes a disaster has to happen before the old folks can see the light. Sending you a big hug today, and a prayer that your Dad will see the burden he's placing upon your Mom & yourself.
I wonder if, when it comes to how important continuing the PT is, it may be not so much that your father doesn't understand as that he doesn't agree - doesn't agree that it's worth the effort it costs him to do it, that is. You may believe (you may well be right) that he will be sorry later, if God forbid he experiences a decline that could potentially have been delayed or prevented. But then it isn't you who's having to find the motivation and energy to carry on with maybe painful, tiring exercise. If it is the case, literally, that he can't be bothered, that's teeth-clenchingly frustrating for you - but it is up to him. It's not a small thing he's being asked to do, when you put yourself in his very tired old shoes.
The other point is a bit of a tangent - you say your mother is refusing home help. But when the choice is between your father's moving in to long term care or her having more help with him at home, won't she change her mind about that?
I got his antidepressant upped, and he tried again, with me buying bike pedals and stretch bands, etc. They are just gathering dust.
I am wondering if an antidepressant at his age - and if he is in good shape - might help to perk him up enough to keep up with the P/T for a while longer. You might also have a geriatric specialist take a look at him and/or any other meds he is taking to see if anything could be causing pain or problems.
Everyone has made fantastic suggestions. I think you need to look into all of them. You can't force him to do anything he doesn't want to - and people always telling him what to do could be adding to his belligerence. But to protect your mother and your family, and to limit his suffering later, you need to have a plan for what will happen. He will not miraculously get better. He will likely decline.
Do you have power of attorney? At least for health decisions? You might try talking to his doctors to see if he can get any home health care that might give Mom even a little break. She may argue, but perhaps if "the doctor ordered it", both she and he might go along with it. It won't necessarily fix him, but be a distraction for both of them.
I used to work out in the house, didn't really mind it when I had music on, but it was never as pleasurable as working in the garden.
So maybe you can find something your father can do that's healthy exercise but also is something he enjoys doing and used to do earlier and isn't PT per se.
So, alas..I will wait to see how the appointment goes on November 5th with the PT program director. If he decides he isn't going to continue to do what he can to stay strong enough for mom to take care of him (i.e., transferring and being able to ambulate), then I will have no choice but wait in the wings and see what happens. I could go on and on.. Again, I APPRECIATE every post and comment - I feel cared for and thank you for that.