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My dad has always had issues with back and knee pain. He was recently discharged from the hospital and is now in a nursing home rehab because he cannot walk. He has been using a walker for a few years now and has been slow getting around, but could always walk around the house. Now he cannot even take two steps and with the help of others. Therapists have little hope for a full recovery and are telling us that he may stay like this. It has been two weeks.
Dad says that he has no strength in his legs. He stands there and cannot move his legs to walk. He ends up falling. But when he lays in bed, he can move them and do his rehab exercise without any help or difficulty.
We have been told that this is from all the medications he is taking. Pain meds, high blood pressure, etc... We are also being told that it is due to his age and medical condition, COPD, asthma, diabetes, etc.. This has happened before when he has had pneumonia. He comes out of it weak, but eventually, after rehab, is back to walking like he did before.
Therapists have little hope for a full recovery. I am not satisfied with the answers they give us. If it is meds, then how about changing them around? If it is muscles or nerve issues, then what exactly is the prognosis?
Is anyone else going through something similar? Thanks for any help or advice.

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Love the responses. Ferqflyer, you mentioned about the young therapists having an effect on your dad. My dad has always been a flirt and still is. He showers all the nurses and therapists with kindness and compliments them constantly. Then he shits on mom and calls her stupid, doesn't know what she is doing, etc... I have told him that he should be worshiping the ground mom walks on because SHE is the one that cares for him when the others are not around. And what would he do if something happens to her because it won't be me that will wipe his ass when she is gone.

cdnreader; Thanks for your response. I will check on his meds and see if the combination may be taking a toll on him. We are hoping that the doctors would be doing this. But we will remind them.

GardenArtist; Unfortunately, dad has always had a complex about his limping and always tried to hide his deformity. For YEARS I have been telling him to get it fixed. He was given the opportunity to get a new hip and have his leg back to the correct length, but he has always been skeptical when it came to surgery. He was also told to wear the shoe, but he refused. He only started using a platform shoe within the last ten years but does not use them in the house now. There has been a lot of damage done to his spine, knees, and hips because of how he walks. And he has been given the opportunity to get them fixed over the years, but because of his skepticism, he has chosen not to do it, so here we are. NOW, he wants to get new knees, but as you can see, this may be difficult. One doctor said he would do at least one knee and his PCP says it is OK, so we are waiting.
Right now we are focusing on him getting back on his feet.
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With one leg shorter than another, hasn't anyone suggested an orthopedic shoe with a higher heel to even out the disparity? This should have been raised years ago.

A friend had to have such a shoe after being immobile for a few days after falling down the stairs. The damage to her leg resulted in a permanent shortness. But her orthopedic shoe evened out the shortness.

You write that your mother is an enabler. That may take away his motivation right there, since he has someone who will cater to him even if he's not very mobile. She needs to wean off her compensation for him, but that probably will not happen without some drastic change.
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It sounds like you are carrying a lot of resentment about your father giving in to his chronic illnesses. You may have had a legitimate beef years ago, but it could really be true that each episode of acute illness has gradually brought him to a point where he can't recover fully. Today when are bombarded with images of so many elders living vibrant, full lives into their late 80's and 90's it is easy to forget that life expectancy for an American man is still less than 80 years, and that many suffer with several years of debilitating illness in their final few years.
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Dear thesarge,

I'm glad you are trying to advocate for your dad and seeking out more information.

I am a strong believer there is an answer and that something can be done. I know its hard being the advocate because it feels like every question you ask is a giant roadblock!

I do believe doctors and nurses underestimate the cumulative side effects of medications. There are forums about how statins used to treat cholesterol have devastating side effects for some seniors - causing muscle weakness to the point people cannot walk anymore!

My own father once we changed his medications was able to walk again! I know its a delicate balance but finding the right dosage and the meds with the minimum side effects will be worth it in improving your dad's quality of life. I thought the doctors and nurses knew best, but sometimes it is not worth it to go with the program. Seek out second and third opinions if necessary. I hope you can get the help your dad needs.
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thesarge, thank you for the information, it gives us a better understand what your Dad is going through.

What I had noticed is that your Dad is taking Xanax and blood pressure meds. Xanax can make someone feel very tired depending on the dosage, then throw in blood pressure medicine which can also make one feel very tired, no wonder your Dad doesn't have the energy. Have Dad's primary doctor review the medicine list.

Ah ha, your Mom is enabling your Dad. And she will continue to do so as that is the norm of their relationship.

Most parents won't take advice from us, we are just the "kid" and what do we know :P

I noticed whenever my own Dad was doing physical therapy, if the therapist was an attractive young woman he would follow her directions, with a really big smile. Once she left, Dad was back into his recliner not doing the exercises until she came back for his next session.... [sigh].
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Thank you for all the responses. I did not elaborate on dad's condition. He went to the hospital because he could not stand and was in a state of confusion. He normally stands, walks a little, gets in and out of bed with an aid of a trapeze bar and is alert.
In the hospital, they said it was the meds. He takes Gabapentine, morphine pills, Xanax and other blood pressure meds. He has been on these meds for many years. The hospital gave him oxygen, fluids and some therapy. In a few days, he became more alert and regained "some" of his strength, although he still could not walk on his own. The hospital sent him to a nursing home rehab where he is now.
Dad's history includes a "fused" hip which limits his mobility drastically. He cannot bend his leg or sit the way normal people do. He has walked with a limp for more than 55 years because one leg is about 2" shorter than the other. This has caused his back issues, which includes a curved spine and nerve damage. This has also put a lot of stress on his knees, which are both shot. He has been in need of knee replacements for several years, but he had decided against it. We won't get into the many arguments that I have had with him because of his selfish decisions. I knew that his current condition was imminent.
His other problems are COPD, asthma, high blood pressure and diabetes. He got asbestos from his work which added his breathing problems. He is on oxygen 24 hours and sleeps with a bi-pap machine.
Mom has been an enabler pretty much all of their marriage. Mom has always said that because of dad's "condition" and "deformity" he cannot do a lot of things, like getting dressed, washing, etc.. This is nothing new and dad has accepted this "gratitude" thus making himself helpless. Now that he is older and weaker, she does a lot more for him including wiping his ass.
He has been in and out of the hospital and rehabs for the last 2 - 3 years. Each time he recovers and is able to dress, bathe and wipe. Therapy at home has also helped out, but as soon as they stop, he gets right back into his recliner and within a few weeks, mom is at it again, and he "can't do the things he once did." Mom has also refused to change her cooking and eating habits, so they eat high fat and high caloric foods.
OK, so that is his history, Can you sense a little frustration? I am an only child. Both my parents are 75 years old. I do not live at home, in fact, I live in a different country. But I return every year to see what is going on, and usually, it ends up being very stressful and frustrating. They think that I am picking on them, but I tell it how I see it.
The reports I am getting from home is that his progress is very slow and that he still cannot take more than 2 steps without any help. They usually have two therapists to help and they tell mom that "it doesn't look good". But I take that with a grain of salt because this has happened before, I have heard the same thing and he comes out OK.
Mom says that he is alert and does his therapy while in bed but he says he feels weak and cannot move his legs. I "think" that he is just sad and is giving up. I tell them that he needs to continue with the rehab and to do it often. No need to wait for the therapists to show up. I tell him to do his exercises once every hour. Why not? He is laying around doing nothing anyways.
No one has given us any offical prognosis. The nurses say it could be the meds, which I don't think it is, or it could be his condition and because this has happned so many times before that he is getting weaker. Also, not enough for me.
He will be seeing his PCP on Tuesday and I told mom that they need to ask to go see a specialist. I also think that although it may take a little longer than last time, he will recover somewhat. At least he will be able to walk again. I really think so and I keep telling dad that.
I wish that he would follow through with his therapy and eat a little better. This has helped him stay out of the hospital. This happened every time I visit. I push him on his activities and I make him get away from the TV and move around. But as soon as I leave, and there is no therapists around, he ends up back in the hospital.
Sorry for the long response and sorry for the venting.
I would like to hear from others that go through the same thing and find out what you have been doing about it.
I think that these steps are all that can be done for now. Keep up the therapy and ask for a specialist.
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I would tend to agree that the conclusion that he can't walk is premature, but it depends on who's drawing that conclusion. Do you have an orthopedic doctor who's seen him for years, and can make determinations on progression or reversal of his walking ability?

We also encountered a similar situation when my mother fell and broke her leg. I've written about this elsewhere but don't recall, so I'll just repeat myself. She was deemed uncooperative by the therapist b/c she couldn't walk with a balance bar.

We took her to back to see her orthopedic surgeon; he said he intended that she should be non-weight bearing on that leg for 6 weeks. Reporting back to the rehab center in a care meeting, we shared that information and challenged the therapist's conclusions. He was reassigned to another facility, Mom got a better therapist, and progressed well, all while non weight bearing on her broken leg.

I would NOT take the word of the therapists as gospel. Been there, won't do it again. My father's last rehab was at a facility where he's been 4 (maybe more) times previously. This last stay was definitely sub par, in treatment by the nurses, some of the aids (especially the older ones), and the therapists.

He was discharged prematurely, and it was clearly reflected when he got home. A friend who had seen him shared an observation that I think is on point. She noted that more younger people were there this time than before. There were patients recovering from knee surgery, replacements, but not from falls. (I'm not sure how she found this out, but patients often like to talk about themselves so I think she just engaged in conversations with them).

I think I realized I had seen more younger patients, but not made the connection. I did notice that the admin staff seemed to be a revolving door, with 30-somethings with not much business experience holding key positions.

I lost confidence in the therapists, and even challenged one when she forced Dad to stand while shaving. That goes against everything I've read, that as a person declines, adaptation should be to performing tasks while seated, SAFELY.

Something similar might be happening at the rehab where your father is. Make a checklist of what you want, start researching and calling, and contact the doctor or your PCP or whoever scripted for the rehab and explain the situation, that you feel the need to change facilities, and want to ensure continuing Medicare coverage. I got a letter to that effect, indicating that the then current facility was subpar. No problems occurred with Medicare.

Your father may in fact never recover fully, but there are interim steps between not walking and walking vs. fully recovery. He can do bed exercises, either laying down or sitting at the side of the bed. My parents both did these.

Blaming it on meds (unless he's literally comatose or very confused from them) sounds like a cop-out. However, I would get a list of meds they're given him, as I've found that rehab facilities pile on unnecessary meds just b'c "older people typically need these."

BTW, was this facility recommended by a hospital discharge planner?
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It is uber frustrating to watch a loved one decline like this. 5 years ago, my husband was using a cane. Today, he is bedridden. He’s had inpatient and outpatient therapy, MRI, CT, neurological testing of every kind. He’s seen 6 neurologists. We have never gotten a diagnosis or prognosis or a name to put on this. I haven’t quite given up, but I think he has. What I’m saying, I guess, is that sometimes there just isn’t any answer. What will be, will be. It’s disheartening and frustrating, but unfortunately beyond our control. I wish your dad the absolute best.
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thesarge, unless a person moves around a lot during the day, the muscles will become weaken. Has the rehab put Dad on an exercise bike to help build back up his muscles?

Related to age? Really? My parents were walking 2 miles a day when they were in their 90's. Today's newspaper had an article of a Flight Attendant for an airlines who is 81, celebrating 60 years of flying. Thus, something else must be going on with your Dad. How is his weight? Being heavy can be painful on one's knees.

I can't see where pain meds or blood pressure pills would be a cause. Those two are more opt to make one sleepy.

I wouldn't be satisfied with the answers, either, what the Rehab is telling you. Time for a second or even third option. None of what the rehab had told you makes any sense.

You mentioned that your Dad has back pain. There is always that pinch nerve that makes it very painful just to stand up from a sitting position. If that is the issue, ask the doctors about "traction". I had that 30 years ago, bingo the pain was gone. I do realize not every case is the same. Worth asking.
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There is obviously more going on here than back and knee pain, what is causing his weakness and why was he in the hospital?
Standing and walking involves much more than the legs and his ability to move in bed does not equate to the ability to be upright. Just keep encouraging him to try, hopefully with time he will regain a measure of strength and balance.
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