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My Dad's Dr. ordered physical therapy for him due to his fall risk. The therapist does a great job of showing the exercises, but after he leaves, Dad won't do anything. He "knows" he won't be walking for much longer without enough muscle tone and he says he is fine with that. At the same time, he says he can stay in his home as long as he wishes. I am responsible for his care (advanced directive) and this just isn't the case. If he can't walk, he can't stay in his home. His wife is in her mid 80s too and cannot take care of him. I have sacrificed enough in my personal life and I cannot do more. I don't know how to explain this to him in a way he understands. He continues to say he is fine. He can't remember 5 minutes at a time! Sigh . . .

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I like what you said about why he needs to do the exercises, and how you and his wife can't care for him in a wheelchair. Write it out twice, give him a copy, and leave the other copy where he can see it. We did this for my aunt, with clear choices. She got to decide. My mother-in-law was told bluntly that she would never leave the nursing home (after surgery) if she didn't get up, do the exercises, and walk again. She did not have dementia, and she decided to walk rather than face that consequence. Sometimes blunt is kinder.
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Yes, geo123, you are right. There is a cap. I forget what it is but you're right. The number of visits is limited. As for the patient compliance/noncompliance thing, that came from a PT I spoke with a couple years ago who was telling me the extent to which they had to document everything.
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I'm not sure that's true. I think there's a cap on the medicare payments, period. I'm not clear if more PT can be added in a fiscal year if there's some true need, but there's some limited number of visits, is my understanding.

Actually, it's not the number of visits, but a dollar amount cap, is what our PT said. And, it's not easy to extend, according to them (they're an entire PT practice - not just coming from one person).

But I'm not saying that if the person doesn't comply that it couldn't stop, sooner.
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One thing to think about is that Medicare pays for therapy so long as progress is being made. In their notes, PTs/OTs/doctors are obliged to note whether the patient is complying with their recommendations, doing the home exercises assigned, etc. So if the patient is not doing their bit, Medicare can pull the plug. Medicare scrutinizes patient records like you would not believe. They have teams of people devoted to finding ways not to pay for things. That's another thing that I remind my mom about. When we see her doctors, I always tell her to make sure she does not blurt out that she is lackadaisical about doing her home exercises. God forbid the day comes that she needs rehab again and can't get it because of a track record of not complying, etc. Fortunately Mom has always given it her best shot when she has been in rehab. Third parties always make way more progress with her than I can, which is to be expected of course since it's way too easy to ignore family members (as others here have pointed out).
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My mom loves to mutter about how PT is "crap" and "worthless" and such. Still, muttering isn't the same as refusing, but I've known people who feel that way and totally refuse to do them.
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My Dad is also one who doesn't like to do exercises... my Mom is the opposite, she is still doing physical therapy exercises given to her 20 years ago.

We did notice that Dad took more of an interest in doing his exercises if the physical therapist was a young very attractive woman.... she would tell him she would be disappointed if she didn't see any improvement :)

Of course, Dad stopped doing the exercises once the program was through.... [sigh]
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Also, I wondered if there's a way to hire someone to come to do his exercises with him, separate from the PT. If he doesn't remember to do them and if you are already stretched to your limit, this is the only practical solution I can think to suggest.

One more thing - I find with my mom that if a stranger is having her do something that she does it, where, when I want her to do it, I'm always here so she knows she can put it off (and then just never do it!). So, if I were to hire someone to specifically come and do her exercises with her, she'd feel obligated to do it. If you think your dad would also participate if someone came, then that could be something to consider.
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Similar to others, I have this issue with my mom. She cannot remember the exercises her PT has her doing even with clear sheets on what they are and how many times to do them.

Because of her memory, she thinks she does them every day when, in fact, if I get her to do them a couple times a week, I feel I've accomplished something. Someone has to do them with her and that someone turns out to be me, in our case.

Every day, she complains that her back hurts. Every day I remind her that's because she doesn't do her exercises and doesn't get up, enough. There are more medical issues that are coming up because of her insistence on sitting and slouching all day, every day. Every day, I remind her about all this and she means well, wants to do it, but puts it off and doesn't.

I tried having her keep track of her exercise in a notebook so she'd see that she'd not doing them. I ended up having to keep the log and it only sort of worked.

So, what I'm trying to get across is that it's going to be a struggle. It requires nicely reminding your dad on a fairly consistent basis. Pick your message and repeat it. When there are negative consequences, remind him that it's because he hasn't been doing his exercises.

Maybe the simple message that you repeat is, "Do your exercises so that you can stay mobile; otherwise, you have to move to a nursing home. It's your choice and I'm not going to make you do it if you're okay with having to move to a nursing home."

Past that, I don't know that there's a lot you can do.
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Thanks, Helpforlife. I guess some days I just feel less suited for this role. You're right that you can't do what is beyond your control. Must take pleasure in the small stuff!
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PLEASE! No need to apologize. I am sure everyone on this site has had those days, caring for their loved ones! I gave up on the schedule thing. It is just too hard! I am at the point where I feel its a successful day if we are fed, bathed, safe and most of all, happy! For me, its more important that my Dad be happy than if he doesn't smell so fresh or doesn't care to do his exercises. After all, if he won't do them, what can I do? It is beyond my control and that of his Dr, so I am making the best of it. I too, am giving up my life (and financial success) to help my Dad in his last years. After all, I wouldn't wish for someone to be "mean" to me in my own last years. Our standards must be flexible, if for only our OWN sanity! Best of luck to you!
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I am exhausted from trying to cajole my mother into doing her PT, OT, and SLP exercises. Now I am thinking of paying a professional to come in 1-2 times a week to work with her, at least on the PT so she stays on her feet. I'm sure it's not cheap. Has anyone hired a PT privately? Can it be done privately, or does one have to get the doctor to request it? I've offered to take her to the local Parkinson's exercise class which meets 2 x weekly, but she keeps saying 'not today'. I've told her that if she wants to stay in her house she has to be able to walk around it. She spends her day eating, sleeping, and reading the newspaper, watching TV; I tried to create a schedule for her, but unless I stand next to her all day, she doesn't follow it. Today I blurted out that I don't want to feel like I am giving up my life for someone who does not want to make any effort to keep their mobility. And now I feel bad about that. Bad day here. Frustrated. Sorry to vent!
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Not exercising on his own is pretty common. And if he can't remember 5 minutes at a time, he is not likely to remember the purpose or how to do the exercises.

Can someone else do the exercises with him on the the days PT does not come? Our PCA did them with my husband. I did them once in a while with him, too, but he liked doing them with the pleasant young PCA better!

Maybe now would be a good time to introduce some in-home help. A few hours several days a week could give Mom a break and get Dad exercising. And also start the process of preparing for the future.

Maybe walking is too overwhelming a goal. But keeping enough strength to be able to transfer from bed to wheelchair to toilet will make his life so much easier going forward that it is worth really working on this issue.
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