My parents recently were discharged from home health PT/OT. Since then they have done very little to do any follow up exercise as instructed
My mother continues to blame multiple reasons for not following through. She continues to point out that my father is weak and not doing his exercise. My father does use his walker to go to breakfast at their ALF, but again she has multiple excuses that she can't go?
I had a client who refused to get out of bed, refused to do the exercises the PT ordered and finally he was discharged from the services.
I must say, that this did not end well for him after four months of inactivity in the bed. He even refused to sit up while drinking fluids. He would turn his head to keep from choking, but eventually developed fluid in his lungs from lack of moving around. His mate enabled this behavior. They mainly used me for cleaning services.
1) PT doesn’t work
2) I don’t believe in PT
3) OT is stupid , she makes me hang up clothes hangers in the closet, which I don’t need because the laundry staff does that for me here ( in ALF).
4) I’m fine , I don’t need that cr4p
5) Leave me alone , I need to rest ( after a stroke ).
6) They are just wasting Medicare money.
7) I don’t want to
8) I’m tired .
9) They come too early .
10) I’m not old like the rest of these people .
It boils down to they either don’t understand , have no energy , or don’t care ( depressed) or all of the above .
Way, I'll add one more your list.
11) No-one ever told me I need to walk.
Do your parents have memory issues? Is it possible they aren't remembering to take any pain meds?
How old are your parents? Why were they in PT/OT?
Trying to get them to be people they aren't (and maybe never were) is like pushing a boulder up a hill.
If she is getting meals delivered to the apartment can you have them stop doing that? (See if you can request that they only have meals in the dining room, maybe it would help if it were a doctor's order)
That might take care of 1 aspect.
But only your parents can make the decision to follow through with what PT and OT has been doing.
I don't know if stressing that the next step will be from walking with a walker to a wheelchair then it is but a short move to Skilled Nursing when either one can not be transferred safely from the wheelchair. And if 1 needs Skilled Nursing and not the other they will not be together.
Maybe that might make a difference.
And if it does make a difference it might for just a short period of time, we all fall back into old habits.
Think about all the New Year's Resolutions that fall by the wayside by the February 1st.
So, who knows why? Could be she thinks hobbling around is good enough. Could be she’s ready for a wheelchair (I doubt this). I have decided to let it take its course. I fear she’s going to fall.
It may be a time when a move to assisted living is in order for this couple. Often the activities, even just the moving to the common areas for meals three times a day, will get people up and moving a bit more than the easy chair at home.
I wish you good luck.
After 2 years of refusing to stand or walk (she was an avid walker until the day she stopped) my mother (99) is still certain that, if she wants to, she can hop right out of bed, walk down the stairs and drive away in her car (which is long gone). She yelled at the physiotherapists to leave her alone. I think she truly believes that, when she feels like it, she’ll just pick up where she left off 2 years ago. Another dementia delusion.
Beatty, you made me snort. ‘11) No-one ever told me I need to walk.’
I asked my mother why she was being spoon fed instead of feeding herself. She informed me that nobody told her to feed herself. So I told her to pick up the cutlery and feed herself. She did. That was 2 years ago. She still feeds herself some days. Depends on her mood.
It is what it is. Accept it and don't ruin your relationship with mom by constantly nagging her. That's my suggestion.
I thought he was being facetious, but he was right. The exercise band sat on the kitchen counter until they rotted away. She never once did her exercises.
She was able to walk, but each successive surgery left her more and more unable to move about. Both my grandmothers walked without aids to the day they died--(both in their 90's).
Mom’s favorite singer was Frank Sinatra and her physical therapist played Sinatra for her while she exercised.
Her physical therapist was so kind and extremely handsome. My mom may have been old but she knew a good looking guy when she saw one! 😝
Somehow, even in her 90’s, with Parkinson’s disease, Mom managed to stay out of a wheelchair.
She did rely on her walker but wasn’t bed bound until shortly before her death (age 95) in an ‘end of life’ hospice care home.
I am sorry that your mom isn’t able to become motivated to do her exercises. Is she experiencing significant pain that could be preventing her from trying to do her best?
Wishing you and your family well.
Totally understand the difficulty to be motivated on your own to exercise .
A group with music and an instructor sounds great! I’m glad you are willing to go to clubs , events etc . You’ll socialize and meet friends .
So I goes no matter what we can't win.
Can't control them , all we can do is try to make there space as safe as we can , maybe some encouragement, but I gave up wishing mom would just sit, specially after a swelling ankle, so back, ext......
I tried to lead by example, if me back is sore I'm going to sit for a bit and rest, then I got grief for being lazy. Probably a no win situation with your mom too
My own mother, who was 94 years young, did participate in Physical Therapy on 5 consecutive occasions. It was not very strenuous at all since it was tailored to her age and she benefited from it.
Try to discover something she values that you can link to exercise as a reward or benefit. Is there a higher level of independence she would like to achieve? Help with sleep? Help manage pain? Improve appetite? Socialize?
Perhaps there is a walking club at her AL. Or, could you walk and talk when you visit? You can claim you need to stroll a bit because you've been sitting all day.
The therapist in me (retired) thinks perhaps a clue as to what is going on with mom lies in her focus on dad not exercising. She could be deflecting. Are your parents generally inseparable? She may be wrestling with grief over your dad's health status and her own. That may be another angle to consider. You might engage her in some way that you frame as beneficial her and your dad.
Best wishes. I think you will get some good advice here.
Aspects of resistance could include:
* Dementia
* Depression
* Feeling overwhelm
* Lack of will
* Anxiety
Best to talk with her about how she feels instead / not 'push' her.
She won't respond well to any pushing or most likely telling her the why she needs to do xxx for recovery and if she doesn't xxx will happen (i.e., go back to the way it was, worse, lose muscle mass). "This 'logic talk' doesn't help in my experience (although not a parent; it was a client).
I'd bet that this was your mom's MO for some or most of her life 'blaming others.' People do that when they aren't (able) / ready to take responsibility for their feelings and/or behavior. Ultimately, she will do what she wants and suffer the consequences of her actions or inactions.
I wonder if she'd benefit form someone doing them with her?
Not that that is easy to do / accomplish.
If there is a 'carrot on the stick' that will get her going, use it.
Along with this, I would try to relax / express calmness towards her.
She'll pick up on your stress and frustration which won't help either of you.
Take her hand, smile, look in her eyes. Just be with her.
Perhaps with this quality connection with you, she'll be more motivated to do what is in her best interest. She is likely suffering (tired, depressed, etc) If you can focus on this - a bit - perhaps she will respond. Although be careful to not over-do it... she may 'just' want the attention and be baiting you for that. I don't know. It is often a fine dance and we just have to try different approaches until something might click / work ... and then know when to rest / stop / accept what is. It isn't easy. We do what we can and then step back.
Gena / Touch Matters