My Father (80) has decided he is quitting PT. Any advice?

What's your dad doing in place of PT? Sitting in a recliner watching TV? If he's not up and moving regularly and doing his exercises he will grow weaker. You're not blowing this out of proportion, you have a legitimate reason to be concerned. In time the burden of his care will fall to your mom. It's the old adage of "use it or lose it". When elderly people just sit all day they atrophy and get sick.

When your dad says, "It's not doing any good" remind him that he's not in a nursing home, he's at home and he's at home because of the progress he's made in physical and occupational therapy.

If it makes you feel any better your dad's attitude is not uncommon. I'm in healthcare and I've worked in rehab and I've seen many, many elderly people give up on PT and OT. They tend to decline without it. I also saw an elderly lady in her 90's religiously do her PT and OT exercises everyday. It took her the entire morning to do them but she did them and the last I saw her she was still living alone and doing well. I think the fact that she had a daily task to do everyday was almost as important as the exercises themselves.

Since you can't force him to participate, I might discuss plans with him and mom for when he is not able to stay at home. Look at the options so you have a backup plan.

Eyerish is right - if your father doesn't continue with PT, he'll decline and pull your mother down with him. You're wise and right to address this now.

The problem is that he doesn't seem to be realistic or even considerate about what to expect from his family. You might have to be a bit harsh, discuss the situation with your mother, and draw up a list of what can and can't be done in the home by either of you. And stick to it so he realizes that unless he continues to improve, he can't expect either you or your mother to compensate.

I don't intend this to be a cruel or punitive measure, but you're right that neither of you can be expected to compromise your own health if your father is not cooperating.

I am adamantly in support of in-home PT and OT, which to me is just as valuable in its own way as therapy in a facility because the home is where the real world is - it's where he'll eat and sleep, and he needs to be able to adapt to it.

The other suggestion that might work is a "come to reality" lecture by his doctor, advising your father specifically that if he deteriorates, loses strength and mobility, he might eventually find himself back in a facility on a long term basis. I don't believe in scaring people, but sometimes it's necessary to get through to someone who is intent on making less than wise decisions.

Thank you so very much to the 3 caring souls who responded to my question. It was very affirming. An appointment is scheduled for dad with the director of the PT program next week. I am hoping for a "come to reality" lecture from her and maybe that will bring him back to therapy. I also hope she will emphasize that if he resumes PT it is VERY IMPORTANT that HE provide feedback to the therapists. Let them make adjustments if something is really hurting him or wiping him out. This "throw the baby out with the bath water" approach is the worst! I am going to hold out hope...but his life patterns don't support my hope. I will keep the thread updated and welcome any other feedback, comments or information.

I might also offer that as my parents have gotten older and pushing 80, I think that they don't really appreciate some things. Maybe it's mild cognitive decline.....I don't know, but I wonder if they really have the capacity to fully appreciate certain things.

I'll also add that it took all I had to push myself to PT when I had two frozen shoulders and I was in my 40's! It was painful! lol I can't imagine enduring long term PT in my 80's! He's done pretty well.

I hope they offer some helpful suggestions when you meet.

Thinking it over, perhaps he's just "had enough" right now and needs a break. Maybe a few days of R & R at home might help him view continuing PT more differently.

GardenArtist - I had the same revelation today!!!! He needs to get his pain under control (he has been on a fentanyl patch for over 2 years) which he let the prescription run out 2 weeks ago. He used to take vicodin, but can't get it anymore on an ongoing basis without being in a pain management program. It wasn't helping much anymore. To Sunnygirl's point, I know it's very difficult for him...I have not endured what he has and I give him all credit (and mom too for being by his side). I will keep the cognitive decline issue in mind as well. It kind of makes sense when I think about how he didn't call his PCP for a refill on the pain medication that he needs. Mom was doing all of this kind of thing for him, but has been letting him have responsibility for the things he can do (he can hold a phone and dial now - couldn't over the summer). She still handles most of his meds, but he has to participate in his own care in whatever way he can - but maybe he is challenged still with even this.
I CAN'T TELL ALL OF YOU HOW GLAD I AM TO HAVE PEOPLE TO TALK TO ABOUT THIS...my husband is so tired of hearing me :)

Dawners, sounds like he's got a lot going on. Maybe he just wants to focus on getting the paid issue under control, especially if he needs pain meds for PT. Sometimes we all just need a break.

I'll come at it from a slightly different perspective, since you've gotten very good answers so far about "should he/shouldn't he" continue PT. Whatever the decision is, if your mom and dad are like my mom and dad were, they're a unit and it's virtually impossible to split them apart to get one (mom) to act reasonably (bring in outside home health) if dad isn't cooperating either. You can set up scenarios and try to get them both to be reasonable, but at the end of the day, you can only do so much. So set reasonable expectations about how much you can do in this situation to make things better. It's tougher when our folks have some cognitive decline and may not be able to fully reason, but it is what it is. And yes, please keep us updated!

Sunnygirl1, I had a frozen shoulder, too and you are so right, it was painful big time. One time with physical therapy I thought 3x a week was way too much so I cut it back to 2x a week... then I realized my shoulder/arm was hurting me more, so I went back to 3x a week and it was easier to deal with. Now I am on a break, due to the continuing saga of my aging parents.

Dawners, so your Dad just might need a break for awhile. But don't have him take too much time off. My Dad was lazy about doing exercises unless the physical therapist was a cute gal, then he was enthused :) But between visits my Mom couldn't get him to practice. Yet my Mom was doing exercises she was shown by a PT 20 years prior and was still doing them faithfully every day. Each of us is different.

Great answers here. As an OT, I feel that people are motivated by what is important to them. A good interview by OT to determine that can get to the root of his fears, as well as what is important to him, and to your mother. Once you know what is important, you can then look at barriers and start to address these. Pain is a big one, as you mention. Best of luck!

My mom did all her rehab and the place was awful shes dead now so what good was the rehab.leave him alone rehabs dont do anything but draw out money from the insurence.

Dawners I feel for you and I resonated with your comment about your husband being tired of hearing about it. Been there too! It is good to have a sounding board of like individuals who have been there!! My dad is 94 and always did everything around his home til he moved into independent living and no longer had to. He thought he earned the right to just sit and do nothing and I saw my once physically capable dad lose strength and balance because of it. Sit, sit, sit all day and maybe walk to get the mail and to eat. He got PT exercises to do at home and did them for a while and then quit. Two weeks ago he got a mild case of pneumonia and now he will begin PT next week. He got very de conditioned to the point he needed a scooter for the long ride to the dining room. Something we fought against for years. I only hope and pray he will continue or he will end up in assisted living. I think at his age he'd rather watch TV and die...it's so sad.
Yes PT can hurt...I've had two frozen shoulders and have a rotator cuff tear now but I'm intrinsically motivated to be mobile and strong. Some people are extrinsic ally motivated and those are the ones who usually don't make it. If the external reward isn't worth it and they don't have the inner drive, it just ain't gonna happen. Aging can change so many things....things I too will deal with as I age along. I hope all goes well for you, but you aren't responsible for his choices and can't make his decisions for him unless it's to help move him into ALF at some point.

Hi, sounds like good suggestions already - my idea of taking a break however, is that any more than 2 weeks, the person will start to decline. That should be enough of a break, if he was feeling stressed. My other thought is to try to sit with him sometime, over usual conversation, relaxed, and bring up the PT, and be ready to agree with him, in order to hear what it was that he disliked. Then agree, and say that's easy to change, that part, since it did so much good for you. Sometimes we look at things from the big picture view, but don't listen closely enough to hear of sometimes legitimate complaints. Another thing would be to have mom or anyone, do the exercises with him and with the PT - creating a positive bond to support the value of the exercises to him. Sometimes PTs may arrive with their own ideas and not make time to ease him into exercise gradually, so he could look forward to their bonding and encouragement.

Remember, in this age range physical therapy was working on the farm, coal mines, etc. Paying someone to teach you how to exercise is pretty silly to them. (I know, I have an 89 yr. old husband). You can just support his decision and your mother's and let the chips fall where they may. Perhaps if you stop nagging, he will figure it out on his own, and you may not know what exercise routine he may already have on his own (mine does). Stay out of it, it is his life and your mother's to decide what they are going to do in their marriage.

My Dad refused to accept the fact that he wasn't able to walk, and refused to use a walker or get PT, etc. He lived with my Mom & they were a single unit as well; married for 68 years. I had to let it go, and made the decision to wait for the phone to ring with bad news. That's exactly what happened. My Dad fell on 7/24/14 and broke his hip; Mom called from the ER with the news. Long story short, Rehab refused to release him back into independent living, and I had to get both of them into an Assisted Living Facility (ALF). The decision was made FOR me, and for them, once he fell. I believe that the PT Dad had in the ALF is what kept him alive for 11 months following his fall. The PT gave him hope that he would walk independently again, and get back into his former apartment (believe it or not). He passed on 6/23/15 at the ALF but had physical therapy until 3 weeks before his death.

I have no words of wisdom for you Dawners, except to say that there is only SO much you can do here. Sometimes a disaster has to happen before the old folks can see the light. Sending you a big hug today, and a prayer that your Dad will see the burden he's placing upon your Mom & yourself.

I had to do my PT at a hospital, I had a main therapist but often got others depending on scheduling. The main one told me, and always emphasized at the start of a session, slightly uncomfortable is ok, anything you'd consider pain is not, say so immediately and we will stop. I only had that happen one time with a new exercise that was added in, it seemed to hurt a tendon in a different area. I spoke up, and it was stopped and removed from my routine. I mentioned it the following session to make sure, it was noted and they had no issue. I was shocked how much good it did me in my case, I've worked out most of my life and played many sports, didn't think I had anything left to learn. I didn't realize I'd been using other muscles wrong due to the injured back, leg, nerve. I didn't realize how much building and stretching other core muscles would help me be able to move in the new and safe ways my "new" body needed too, either. Two years later I still do the PT homework when I think I need it, and I always see an immediate increase in range of motion.

Dawners, I'm so sorry for how you must feel about your father's attitude. It must be extremely frustrating and worrying, and I sympathise. I just wanted to add a couple of comments.

I wonder if, when it comes to how important continuing the PT is, it may be not so much that your father doesn't understand as that he doesn't agree - doesn't agree that it's worth the effort it costs him to do it, that is. You may believe (you may well be right) that he will be sorry later, if God forbid he experiences a decline that could potentially have been delayed or prevented. But then it isn't you who's having to find the motivation and energy to carry on with maybe painful, tiring exercise. If it is the case, literally, that he can't be bothered, that's teeth-clenchingly frustrating for you - but it is up to him. It's not a small thing he's being asked to do, when you put yourself in his very tired old shoes.

The other point is a bit of a tangent - you say your mother is refusing home help. But when the choice is between your father's moving in to long term care or her having more help with him at home, won't she change her mind about that?

wow...sounds like he's been thru hell with his health issues!! i could understand that he would not want to do anything to challenging!! AND YES, your mom as his caretaker could kill her!!! I think that the only thing you can do...is get together and talk about going into a nursing home in the future. please let us know whats going on...take care of yourself and your healthy mom!

Yes, PT pushes to their limits. Maybe he is just tired. See what happens at the meeting. If he refuses PT 3x medicare will no longer pay. All in all, the decision is his.

I am so BLESSED by everyone's response! Even those who, at first read, I don't agree with - but I am soooo open to listen to all the views because I love my parents. Thanks everyone and all. I will keep you updated on the next step....they have an appointment with the physical therapy director next week. He is in a top notch program at THE Ohio State University, so I am hoping for good, balanced information which will bring him back around. I really, really, really could respect his decisions (I get it, I really do) - but I fighting for mom. Ultimately, though I know it's their life...they are a unit...but I will have my life in the meantime! I am so grateful for ALL of you.

Agree with Freqflyer - my Dad went through a month of home therapy after his stroke, followed by 2 months of outpatient therapy only because the girls were cute. He got stronger than before the stroke, but he doesn't remember that and refused to do it with us after a couple of weeks on our own. He can't remember the exercises to do them on his own. He has gone downhill since. He's 88.

Can you start a "group therapy"? Would he attend with his peers? We have silver sneakers here which incorporates some of the same moves as in PT.

Dana, they did not give your Dad print outs that depict the exercises along with his number of reps? That is too bad. They gave them to me at the hospital where I had my PT. Can you bug them for printouts, and reps? I am sure, each case is very much individualized. My experience with PT was super. It took a neurosurgeon to fix me, a surgery that sometimes does not go as planned, without it I was facing according to my MD, loss of lower right quadrant. He plainly stated I was about to lose bladder control, need a wheel chair. I am up walking and just great, part of it due to a good neurosurgeon, part of it due to the PT people. They are all only people just like you and I. Ask questions, be honest, don't be shy!

Yes, they did give print out but he lost them - I think on purpose. The PTs were great. Dad is just very tired at 88. I'm glad you have had success, New2this.

Please be advised that for those in a skilked NH for rehab, that if there is no improvement, Medicare will only pay for 21 days. If, improved, and the person is discharged home, Medicare will pay for 2x/wk X 3 wks in-home PT/OT. If Medicare stops paying, private ins usually won't either. Who can afford $200+ for each PT session.

Dawners, my father has the same conditions as your father. He is 89 now, but started a pretty rapid decline about 5-6 years ago. He managed to keep up the therapy for a couple years, but "got tired". A few years ago, about a year after giving up on therapy, we almost lost him as he stopped eating and was getting increasingly confused. One thing that brought him back from the brink was an antidepressant. It perked him up enough to try home PT and helped to get some weight on. The PT didn't last but a few months though, and he started to do exactly what Dana's father did - "losing' the exercise sheets, phone numbers, etc.
I got his antidepressant upped, and he tried again, with me buying bike pedals and stretch bands, etc. They are just gathering dust.
I am wondering if an antidepressant at his age - and if he is in good shape - might help to perk him up enough to keep up with the P/T for a while longer. You might also have a geriatric specialist take a look at him and/or any other meds he is taking to see if anything could be causing pain or problems.
Everyone has made fantastic suggestions. I think you need to look into all of them. You can't force him to do anything he doesn't want to - and people always telling him what to do could be adding to his belligerence. But to protect your mother and your family, and to limit his suffering later, you need to have a plan for what will happen. He will not miraculously get better. He will likely decline.
Do you have power of attorney? At least for health decisions? You might try talking to his doctors to see if he can get any home health care that might give Mom even a little break. She may argue, but perhaps if "the doctor ordered it", both she and he might go along with it. It won't necessarily fix him, but be a distraction for both of them.

Haven't had a chance to read the posts subsequent to my last one, so hopefully I'm not suggesting something that someone else has. But I've been thinking about a PT regimen vs. PT naturally. Maybe something that's more akin to what he used to do before all the medical issues arose, such as limited walking or strolling along the street, short walks in a park...just natural, enjoyable exercise vs. planned PT.

I used to work out in the house, didn't really mind it when I had music on, but it was never as pleasurable as working in the garden.

So maybe you can find something your father can do that's healthy exercise but also is something he enjoys doing and used to do earlier and isn't PT per se.

i thinks it's really sad to make seniors, esp older sic ones do all this stuff they don't want to do anymore. if he's tired...let him rest...let him sleep, it's okay. can't live forever. just keep him clean, fed and comfortable...that's what i do for my parents.

I just wanted to respond to some of the new answers I have gotten to my question. Flstfrider, Dad has been taking Celexa since May. We are not sure it has helped much...he takes so many meds that it is hard to tell what is helping and what isn't. I definitely wanted to acknowledge your answer because mental health is so very important for all of us and oftentimes (especially in seniors) goes unrecognized and untreated. Yes, I am a healthcare POA (second to Mom) and on most of the HIPAA authorizations for the various doctors - because your sentiment echoes others - nothing to do now - but try to be ready for the inevitable. Right now, I have shut my trap and taking a "wait and see." To other posters who advocate to let him rest and take care of basic comfort needs - I do so wish I could do that. My nature is to be respectful of his decision and let him live his life as he sees fit. However, that's not our reality. I have a healthy mom who is busting her tail to take care of him. He has always been a needy man (she enabled it) and because he is so dominant in the household - his conditions and mood takes over. Dad's pattern does not involve proactively taking care of himself. Example, he doesn't and hasnt' managed his diabetes over the years (didn't even try), he would never take his medications correctly (when he was perfectly able to do so), he would never take a walk or even acknowledge the benefits of moving when he was in his 60's and 70's and still could. He constantly complains about his health, muddies the waters by not telling the truth to doctors along with many other behaviors. As his daughter, he instilled in me a "take care of your business - so others don't have to." mantra for life. Over the years, he has been very harsh and critical of others for behaving exactly has he is now! I know he sounds like a MONSTER - but he's not - he is actually a generous and funny man who provided for his family and has managed his finances well.
So, alas..I will wait to see how the appointment goes on November 5th with the PT program director. If he decides he isn't going to continue to do what he can to stay strong enough for mom to take care of him (i.e., transferring and being able to ambulate), then I will have no choice but wait in the wings and see what happens. I could go on and on.. Again, I APPRECIATE every post and comment - I feel cared for and thank you for that.