My husband had knee replacement surgery on 6/21. He came home yesterday (even though I felt he should have stayed another night). He’s been on the sofa since. He has no upper body strength and cannot stand. He’s too big for me to lift. Our insurance declined in-home therapy and the hospital never got back to us on outpatient therapy. I’m so frustrated that he won’t try. I know it hurts. He was so much in agreement and willing with the PT at the hospital but since he got home he thinks laying around will eventually help him get up and walk. Help!
Why didn't I know about this during our extended lockdowns? I could be shaped like that now 🤣🤣🤣
Bloodflow promotes healing. Blood clots are a real threat.
What reasons does he give to not move?
My ideas start with;
* Pain? Take the meds prescribed (many don't).
* Stiffness? Gentle bending.
* Swollen? Ice.
* Tired? Take a nap.
It's awful to be 'The Nag' 😣
What solutions can HE come up with to overcome HIS obstacles HIMSELF? (It is HIS new knee afterall)
I don't know your Husband's age, other medical issues or pain tolerance of course. But my next ideas would be;
Today - Him: Walk to & sit at the table for all meals. Physio exercises as prescribed then ice & rest. On repeat.
Today - yourself: Call the hospital. Explain. He will not be the 1st patient to only have motivation for a 'professional'. If instay rehab is not an option, ask to get home visits PT set up. (See if your health insurance covers this or pay if possible). Then he can move to outpatient rehab sessions when he is a little more recovered.
Good luck!
Please don't injure yourself attempting to help him stand!
the hospital lied to us. My insurance does cover inhome PT. They recommended not to take hospital staff at their word. It’s been a whirlwind of a day.
1. Appeal the insurance denial. Send it by certified or registered mail, return receipt requested, and document everything, including any phone calls although I would try to avoid phone calls though and stick to contact that can be documented (i.e., via mail).
2. Ask his treating physician to prescribe home PT.
3. Ask also if he can script for a home hand/foot "bicycler." Your husband can use it sitting down, and "biking", or weight it down on a table and use it for his arms. It's a comfortable and easy way to work out arms and legs.
Nova Medical Portable Hand and Foot Pedal Exerciser - 6002-R (senior.com)
4. He may be depressed or just overwhelmed. Try to cheer him up by playing his favorite CDs, listening to music channels on tv, going through old photo albums, discussions of his interests, etc. If you can get him to exercise, provide a reward, something special to eat, or something that makes him feel good about himself.
He wouldn't. He would say he would and then wouldn't. I had to relearn that lesson I tried always to reinforce for others. We just are powerless to make people do anything. I agree with appealing the decision on home PT.
You can call Adult Protective Services who can send professionals to help him envision the future of being totally disabled. As Dr. Phil says, "Every choice has a consequence."
On the off chance that there is a problem If he can not get up and you can not help him this is a potential problem for blood clots.
I might be inclined to call 911 for a "Lift Assist" the paramedics will come and lift him off the sofa. If you do not want him back in the hospital they can place him where you want him, in bed, on a chair...but if he will not move I would be inclined to send him back to the hospital.
When is his follow up appointment with his doctor?
*I can tell you from experience (at least my sisters experience) her husband also did not do the PT that he was supposed to do and his knees are no where near what they should be range of motion wise. The adage Use it or Lose it is true!
another snag has been no staffing for inhome PT. That’s really sad.
This Aerobic Video Wins Everything (480p Extended)
Glad to see he's getting into outpatient PT. I agree with other poster about hiring someone to do his exercises with him at home on the non-PT days. That is the ONLY way my mom will do her exercises. She does not listen to me but makes excuses and whines. Too difficult and annoying for me to handle. They ALWAYS behave better for someone else. He may not like it but too bad. Tell him when he's better and consistently doing exercise on his own without you begging him, etc. then maybe the extra aids can be dismissed.
It is crucial that he get his range of motion back or he will have ongoing issues.
If you are waiting on him and catering to him, allowing him to sit, you are going to have to take a deep breath and set some boundaries and stick to them. Like meals are served at the kitchen table. He needs to get himself there to eat them.
As long as he is cognitively capable, ask him to take responsibility for his own recovery. He's an adult and should care about getting better. Tell him YOU need him to be independent and do what he should be doing to get the most out of his operation. That you are not going to do more for him because he is choosing to do less than he should be. Time for some tough love. It may not be easy but it's necessary at this point.
I am surprised you did not come home with home health, I thought it was standard for at least a couple of weeks after major surgery. It is scary how tight insurance companies are getting... the money they save on this puts them at risk of higher claims if he falls. You may want to contact your provider to be sure the proper code was used when the order was made because something as simple as that can get care rejected.
If he is a veteran, there may be options there. Contact me privately if you are not sure where to start.
Give him rewards for completing his therapy. Try different things to see what works for him. Watching a movie together on Netflix? Serving his favorite food for dinner? Give better or more rewards for more reps/greater participation/more attempts. These rewards don’t have to be expensive or difficult. Positivity is encouraging.
Be creative and use what works for him. Don’t scold or hold anything over his head. You don’t even have to let him know this plan.
My mom “hated” exercise. But she loved going shopping at the mall and her favorite thing was jewelry. When she was recovering from spinal surgery I thought she might never get better. Although she could still walk, her doctors said she might never transition out of a wheelchair. We took her to the shopping mall. One of my children was on one side and I was on the other, holding her hands snd walking, kind of like a human rollator. Mom could only make it from one bench to the next. (In those days there were lots of benches, positioned less than a block apart.) We would go to one bench and sit. Go to another and sit. And then to the next. At every bench we would take a short break. She wanted to go into the jewelry store and look. “Great idea! We will go after 10 benches.” The next day it was a different store after more benches. Within a relatively short time she was asking us to walk two benches without a rest, and then to just walk with no benches. (We made it to two miles, with no breaks after two weeks of this). If we would have said “let’s go exercise” (or even “let’s go to PT”) we would have never made it out the door. The idea of shopping is what made her happy, and we never even needed to even buy anything.
Make sure he doesn’t spend too much time on the couch or sleeping, or taking more painkillers than he needs.
He could be feeling depressed snd defeated. Take this positive approach to help him lift himself back up.
Any update on how the Outpatient PT went?
Hopefully he is feeling better and is doing some of the PT that he needs to do.
Or, of equal value, go to a great bakery, buy two eclairs, flash 'em from 5 feet away from the sofa and while you take a bite out of one tell him the other one will be waiting for him in a cooler on the other side of the yard.
Would he consider doing the exercises with you…if you did them too? Could it be a challenge or a game to pass the time? That’s a stretch, but I thought I’d throw it out there.
If not, you must contact the Dr regarding the outpatient therapy. There are PT places all over most cities (not sure where you live).
Sorry to be so harsh, but the way you phrased it ‘the hospital never got back to us on outpatient therapy’. Is sooo passive. They probably should have, but this is on you guys…contact the Dr who did the surgery and explain your husband flat refuses to to home exercises and tell him you want him to sched PT for your husband. Please do this ASAP. Be sure to tell the Dr all your husband is doing is laying on the couch complaining about the pain.
Sounds like this will be one of those situations where your husband will bellyache to people….”oh I had surgery and I’m worse then ever…” He will leave out the part he refused to follow Drs orders for post surgery PT.
with PT - I did my PT before surgery and after surgery knowing that PT is the key to no pain after about 2 weeks I had no pain and my PT was done regularly. I was released from the doctor and back to work in 6 weeks. I used a cane for the next two weeks and BAM! Walkin' great since. I have no pain and I have done a 5K since.
without PT - My two friends had same surgery as me. One has pain not a lot but enough that she walks for a bit and the needs to sit. My other friend says her knees burn. Both did the least amount of PT they were asked to do. None before barely any after.
Also - if the knee is not moved scar tissue WILL build up where the scar is and another surgery will needed. I took a massage tool I purchased at the dollar store and rubbed it along the scar and I could bend my knee more than 90 degrees within 6 weeks!
PT is the key yes pain now no pain later!
Prayers for you and yours
"Build off something they like to do." In clinical terms, this is called high-p or behavioral momentum. You nailed it, and it works.
My wife after her stroke 3 yrs ago wont lift a finger to accomplish prescribed home therapy , unless I'm dragging ber by the hand the whole way. I've concluded she likes it on the couch all day watching me cook, clean, manage the house and acreage.
Our insurance approved another round of outpatient PT and that helped until I finally started planning her day for her full of manageable tasks and refuse to do it for her. This is where it seems you'll need help getting started. Any kids, neighbors or friends that can stop by a couple times a week and get him up and started? Or look at home assistance products such as pull bars, ropes or even a lift chair? Let him know the consequences of letting the procedure heal in one place, meaning another surgery.
Have you explained your situation to a outpaitent thearpy center to see if they had a service to come pick him up?
She put him in a nursing home. Not sure how long. A week or 2? My dad liked it there. He told me, he had a cna give him a shower/shave. I said your arms didn't get operated on. I put a stop to that, and everyone worked on getting him moving again. Took away his wheel chair. Made him get up. He didn't like the pain, but he elected to get the surg. It's surg, it's gonna hurt rehabbing.
My dad started looking in to sev surgies as well. We think he enjoyed the pain meds a little to much. He never drank/smoke. So my mom put a stop to that. Said they couldn't afford it. Luckily he didn't try to seek it out elsewhere. Call the soc worker at the hospital. Maybe they can help set it up. Good luck.
She put him in a nursing home. Not sure how long. A week or 2? My dad liked it there. He told me, he had a cna give him a shower/shave. I said your arms didn't get operated on. I put a stop to that, and everyone worked on getting him moving again. Took away his wheel chair. Made him get up. He didn't like the pain, but he elected to get the surg. It's surg, it's gonna hurt rehabbing.
My dad started looking in to sev surgies as well. We think he enjoyed the pain meds a little to much. He never drank/smoke. So my mom put a stop to that. Said they couldn't afford it. Luckily he didn't try to seek it out elsewhere. You also have to stop with the urinal and food. Otherwise, he's king on the couch. He's got no reason to move. You can take the remote away, turn off tv. He's got to get up to get it lol. Good luck.
it's a battle hate to say it - how do you make a person do something they refuse to do. you talk to the dr and try to scare them that doesn't work, you say you won't listen when they complain, that doesn't work. so short of leaving him, forget it - he is on his own if he is a stubborn man, maybe start goin out see what he says