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?
I'm hoping that your father will recognize that his lack of cooperation isn't helping him, but that's probably not going to happen for some times, if it does happen at all.
You've done all you can; know that you've tried.
Today mom and dad had an appointment with the doctor who is the director of the PT program he was in at Ohio State University.
1. According to mom, he said (quietly) in the waiting room that he was only going to tell the doctor about how he didn't like the treadmill part of PT. Mom suspected he wasn't planning to tell the doctor that he doesn't intend to continue--and she was right.
2. So the appointment was mostly about him becoming able to cath himself (he still has urinary incontinence that gets worse and then better - urologist thinks it will get better as the cervical spine heals and recovers). Dad doesn't think he will ever be able to cath himself even though the OTs and doctor assure him he can and tell him that he will be more independent.
3. Because dad didn't cop to his decision to quit therapy and diverted her question about why he hasn't been in 2 weeks by saying they are in the middle of a bathroom remodel and it was too much for mom to drive him to PT 3x a week. THERE WAS NO DISCUSSION OF HIS DISCONTINUING PT! The doctor doesn't know he is quitting. Mom didn't say anything (she never does - this is her survival technique).
3. On the way home, dad said he was going to get PT at the VA. Along with that he wants to go to the VA to have someone look at his hip, get MRI's, x-rays, etc.
This is significant because when he fell apart last January, I spent a great deal of time, blood, sweat and tears untangling his health care (he was going to VA for some things and going to private doctors for others and not telling the doctors full information about what was going on. He literally had 2 doctors lists with 2 different med lists and instructions about what to tell which doctor and what not to tell another doctor. So, when he fell apart - of course, the health care team had to be narrowed and they had to know what was going on - and no one really knew! Anyhoo, long story short - I sidelined the VA in order to advocate and get care for him in the private hospital system he was in. There is no VA hospital in our area - only outpatient center.
CONCLUSIONS: Both of them are in denial. She is in denial because she has to be to live with what is going on everyday. I told her that he will spend the rest of his days seeking this doctor and that doctor and he is using VA because we (meaning me) won't really know what he doing and not doing. I told her that's fine and dandy until it all hits the fan again and we are left to figure out what he was doing.
Regarding the PT - It is like when I say "I will start my diet on Monday" and Monday never comes. I told her that he is probably just saying that to "benefit" her, me and my sister. As of now...he hasn't even called to get an appointment for a PCP or geriatric assessment (this assessment has a waiting list of up to 3 months) in order to get going.
BOTTOM LINE: I know and have known I can do nothing in this situation, except be there for mom when she melts down. I must work through my disappointment in my dad's behaviors and realize he is a "do as I say - not as I do" kinda guy. I promised my mom that I will be kind and loving the next time I see him and I will move heaven and earth to support her - but I will refuse to discuss anything medical or health related with him. Also, I told her that when he declines (because he will sit in a chair all winter), becomes ill or falls - I am not going to stand on my head to advocate for him. She is okay with this.
Sorry for the eternal post....I have no one else to talk to about this. Sister is an "ostrich" and rarely talks with me about dad, hubby is kind and listens the best he can.
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.
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.
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 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 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.