Constant dilemma. What would my position be if they flat out refuse regardless of my willingness to pay?

My question is this. Where is this P.T. located? Part of the nursing home? What about seeking an opinion from an outside independent P.T.? You really need many more facts before you make a final judgment what to do. Have your doctors given input on this. Sometimes there is nothing that can be done via P.T. I am an example - tried and tried, nothing works so no more rehab.

Ask you family doctor
for auggestions.
maybe he can recommend some “exercises” that will help her where she is. Maybe something with balance and just overall better wellness. I know you don’t want her to lose hope but you want to be able to get some benefit if you pay for some sort of service. Good luck and wish you well.

Ask her to start doing upper body (wheelchair) exercises to build up her arm strength and chest strength. If she complies with that and can hold herself up with her upper body, then PT would be worthwhile. It would at least give her something to shoot for.

Imho, there may be another reason as to why the physical therapy company is not returning your calls.

I just wanted to update and thank all of you. I bought the foot pedaler. PT had tried it with her but not to the extent my husband and I did.

We braced it against a wall and made sure her wheelchair was locked. After much effort she was finally able to pedal on her own. This is the most movement her legs have had in 7 months. I am hoping it will continue. It requires her to be in her socks as the shoes she needs don't fit in the pedals. I will just have to be sure she spends some time in her socks and gets help with shoes when she wants to pedal herself out of the room.

It was so gratifying to see her able to move her legs. We positioned the table for her food and phone near her and also had all this placed within access to the TV.

I am somewhat annoyed PT could not have cared enough to figure this out but such can be life in a NH. I just hope this routine can continue. As I mentioned it took us at least 10 minutes of moving her legs ourselves before she could do it on her own. Thanks again for that suggestion.

Riverdale, I am so happy you are having success!

Please check to see if the footstraps are adjustable. I was on a recumbent bike at my gym the other day and realized that the pedal straps could be adjusted. If not, perhaps the company can provide a larger strap.

This post and its answers have been very helpful. I'm 71 and my spouse is 68. I've had constant experience with resistance and non-communication with some of the staff on my spouse's PACE program (Program for All Inclusive Care of the Elderly) in my state. While the overall program is a Godsend in terms of comprehensive medical care for my spouse, a stroke survivor of normal weight for his height with many ongoing health issues, the PT segment depends largely on the interest and motivation of individual staffers. The head of PT in our program consistently refused to communicate with our outside and out-of-pocket PT for years and I have kept the records on that. The out of pocket expense was significant enough to be a medical tax deduction but we gladly paid it until the outside PT retired. Then, a PT staffer for the PACE program advocated successfully for a tendon-lengthening foot and heel surgery that has eliminated spouse's need for strong painkillers, i.e. Tramadol, and he is able to place weight on the foot without pain. When COVID hit, our PACE program allowed in home PT, but our advocate staffer left when (apparently) management over-scheduled the in home PT staff to the point where our advocate felt she could not do a good job and she left the PACE program. Many of the exercises she had my spouse do at home with me alongside, I did not feel safe doing with just me, because he has balance problems and if he isn't caught before losing his center of gravity, he's on the floor, with a high risk of head injury or other trauma. We've been thru that a few times on our own. We do stretching and resistance exercise but beyond a certain point I have to nag. I feel as if early on I transitioned from wife to caregiver, not to mention losing my ability to work and my freedom to leave the house for more than an hour without having a sitter come by. Despite the ruling of Jimmo vs. Sebelius, it's the availability of PT staff to deal with patients who may not be fit enough or motivated enough to accept and do PT, that may be a damper on the availability of PT services.

The reason why PT doesn't want to continue with your mother isn't because she's overweight or because PT can't be beneficial to her.
They're not continuing with her because they aren't interested in private-pay clients because they can't collect enough.
Whereas if it's insurance paying, especially Medicare or Medicaid, the sky's the limit on what they can charge for the service and insurance will pay it. Then they send a second bill to the patient for what insurance didn't "cover". This is why they don't want to deal with your mother who insurance isn't paying for. The same with a nursing home. They like to get the private cash-paying out of the way as fast as they can to make way for the real money - Medicaid.
When my father was in the nursing home on private pay the cost was ten thousand a month. For the first two months he was there Medicare and his secondary insurance was paying. The nursing home collected $80,000 which comes out to ten thousand a week.
If you want your mom to continue with PT, see if her doctor or maybe some other will order it. Once they find out insurance is paying, they will open mom back into PT with open arms.