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My brother has not shown interest in my father for years. I have posted earlier about him taking over his finances and not allowing him to go home. My dad is in a rehab facility but I found out today that he barely gets any physical therapy. He suppose to get 2 hours in a.m. and 2 hours in p.m. He barely gets 30-40 minutes a day. I suspect my brother has something to do with this. I am trying to get someone there to give me information why, but since I a third as medical POA I am not getting any answers. Also, they recently give my Dad Ativan and he nearly went crazy. I asked them to DC it and my brother overrode me and told them to give it to him. When a night time nurse saw how my Dad was acting she DC it. I have been the one taking my Dad to all doctor appointments, managing medications, research medications, etc. My brother has done nothing and I fear him. I do not believe he has my dad's best interest. It scares me! I do not have money to fight this in court.

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His O2 is 98 almost 100% of the time. I am called a medical dictionary at work because of all the research on have done on my mother's and father's health issues. The Ativan made him very agitated. It is not recommended for the elderly. I researched it for hours on the internet and came to the conclusion it was the Ativan. He is no longer taking it and he is 100% better. When my mother was alive she was in a University Hospital and they were giving her Haldol. He Co2 became quite elevated. I asked them to stop the Haldol....they said that it was not causing her Co2 to be elevated. It took me weeks to finally convince them to take her off of it. They gave it to her to sedate her at night. I was told she would pass in a week. My request was to get her home ASAP so she could pass in her own home. My other request was to discontinue the Haldol. 48 hours after they discontinued the Haldol her Co2 dropped drastically and she lived another 4 years. All the drs. had egg on their face! Only a nurse would admit I was right all along. She put in my mother's chart never to be given Haldol again! I always try to be as informed as I can....my brother could care less. My father's CHF is classified as mild to moderate. The therapy he is given is not at all challenging.
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KTR, Thank you for the additional information. Your poor father, what a rough time he's having! Try to learn all you can about his condition. Maybe the medical and therapeutic decisions will seem less arbitrary. If he is suffering from CHF, there's a lot of information about it on the Internet.
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20 Lasix is not a lot. The disorientation was probably not the Ativan, but very possibly a low saturated oxygen level. He will need to sleep with his head elevated to keep fluid from filling the lungs. Some CHF patients need a 45-60 degree elevation. Get yourself a pocket 02 sensor. If exercise makes the 02 fall rapidly, STOP.
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I know he takes lasix 20 mg a day....I will check to see if he is taking anything else. I have been the one monitoring his medications until my father went into the hospital and then rehab. My brother has medical POA but never had anything to do with him medically. Never took him to a dr. appointment and has had no interest in him in years. Now he is taking over everything and it is scary.
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You mentioned fluid in his lungs, an indicator of congestive heart failure. Usually CHF patients take some heavy-duty diuretics like furosemide and metolazone, which can result in serious fatigue. Check that out and see if the diuretics are at proper doses and his potassium levels are OK
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I did mention it today to the therapist and they sort of ignored me. I plan on attending more sessions and try to get them to do more.

Unfortunately my father has not been much of a reader (my mother was) and he only likes to read the newspaper...but now not so much.
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Have you discussed directly with the occupational and physical therapists your desire and feeling that your father can do more therapy? This would be the first step, as they determine how much OT and PT he'll get, regardless of what you feel (and you may be right - just saying, it's their call).

Does your father read? If so, bring him some books, or magazines.
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My father has NOT had a stroke or heart attack. He was hospitalized a few days for some fluid on his lungs (first time). He went to a physical rehabilitation center because he became increasingly weak at home due to lack of activity over about a year's time. He is 86 years old and about a year ago my sister demanded that he not go upstairs to his bedroom but rather sleep on the first floor. He spent three weeks sleeping in a chair (or barely sleeping). He had to wait three weeks for his three sons to move the mattress from his bed upstairs. During that time he was so tired he hardly did anything all day. Also, he could no longer wash- up in the bathroom because it is too small. He washed bedside and starting using a urinal next to his chair. My siblings told him he would fall and hit his head and it would be all over if he walked to the bathroom. I had a PT come to the house and she got him to go upstairs when she was there. She told me there was no reason why he could not go back up because he did just fine and needed to walk more. She thought it best that he go upstairs when I was with him. Well my siblings disagreed so he never went back up. Unfortunately, the inactivity caused more muscle loss and he became less active. By February of this year he was no longer walking and spending a few days in the hospital in April he could no longer bare weight. Before he was forbidden to go upstairs he took care of himself and exercised in the bed each morning and rode a stationary bike twice a day...that all ended. I told my siblings that he would be an invalid if they did not stop scaring him and telling him not to move... I was right. Anyways, I went to his PT/OT session this morning and he got 20 minutes OT and 20 minutes PT - that's it for the day. It was not at all difficult for him, he was not short of breath and certainly could have done more. I was told by a nurse aid that they get an hour of PT and an hour of OT in the A.M. and the same in the PM. I think he should get a least and hour of each a day. He hates being there and it seems like he just sits most of day when he should get more movement. He does interact with the nurses and therapist but like all of patients there he wants to go home. I think he gets agitated because he spends so much time sitting in his room alone. Yes, they do have a few activities and he does join in sometimes but most of them are geared toward the females (there are so many more of them than males there). He does do some singing and chair dancing but that is usually only once a week. He does show some confusion especially in the evenings since he has been there. I have heard that could clear up when he gets home. This is his seventh week in rehab and I think it is time to step it up! He does not have a room mate so it gets boring for him. The nurses and aides do really like him so he is friendly and does interact.
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KTR, it would help to understand the situation if we knew more about your father's condition. Let's see if I have this right: he had a heart attack about two months ago, presumably was hospitalized for a couple of weeks while he was treated, and then, 45 days ago, was moved to rehab.

What was his physical and mental condition before the heart attack? You mention home PT, so I suppose he already had some physical impairment. Was he mobile? Was he able to perform all the "activities of daily living"? Was he able to engage in conversation, did he have interests of his own?

How did things change after he had his heart attack? What can he do for himself now, if anything? Does he have conversations with people, does he interact with the nurses, therapists and other patients?

You mention that he can't bear weight alone. Is there something wrong with his legs, or is it his general weakness?

You mentioned in your other thread that he's frequently agitated. Do you blame his medications or does he suffer from dementia? (Or both) In other words, what is his cognitive state?

We can be more useful to you if we know more about your father.
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shakingdustoff - our situations are very similar!! I have been told by a few attorneys that since my brother is POA I have no power at all. It would cost me big time to try and fight it. I have been the only one in a family of five children that has been there for my parents on a daily basis. I have made many sacrifices for them and made my siblings lives very easy. My mother is now deceased and my oldest brother (POA) is married to one of the most jealous people you would ever meet. In fact, my second oldest brother ended up divorced because my former sister-in-law could no longer take her nastiness toward her and my brother did not try and stop it. After my second oldest brother got divorced my oldest brother's wife started in on me. I like you live with my father (sold my condo) to help him and my mother. Because I do not currently have a mortgage they think I am rich (I am not). I tell you all of this because this is what I believe is the motivation behind everything. I do not trust my brother at all because he has shown no real concern for my father or my mother when she was alive for years. I do not believe he wants my father to get better so he can put him away for good. My father does have cardiac issue but he has NOT had a stroke. I have talked to many people who have or who have had their parents in a similar or same facility and they have had much more therapy than my father. My father has been there for 45 day and he still cannot bare weight on his own. Also, when he was given Ativan he became sleepy and missed out in about 4 days of therapy. I have gone to a few of my father's sessions and I know for a fact that my father can do much more. When my father was first admitted I was told I was not allowed to come to his sessions....I put a stop to that! This is an example of one of his recent sessions - had him walk (with assistance and using bars) about 6 ft - 3 times and then stand for about 5 minutes with a machine holding him up - that's it. That was a OT/PT combination session. I know my father can do much more. My father's o2 is 98 and his blood pressure is good. He does not exhibit any shortness of breath. I think they need to pick it up. A co-worker of mine whose father just had a heart attack and a stent put in is in the same facility in another city and he told me he is getting a lot more therapy than my father. He is only 3 years younger than my father. This facility is not a nursing home it is strictly physical rehabilitation. My father had done more with home PT.
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A guardianship may cost only several thousand dollars, but if it is contested, which my guess is your brother would not hesitate. So, you would be looking at tens of thousands of dollars. I suggest you call Adult Protective Services to check in to things. They will conduct an investigation, prepare a report, which nobody will see unless you end up in court. The advantage of APS is it will not cost you anything. They will be impartial observer and possibly recommend guardianship be assigned to an impartial third party. Some situations dictate that.
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In my experience with rehab for my mom, even in acute rehab, the most she hot was each therapy (speech, ot and pt) twice a day, 45 mins each session) why do you think dad is supposed to be getting 4 hours a day? Perhaps it's 4 hours per week? Perhaps the rehab center can have the sw dit down with you and your brother and help reconcile your differences about this so that you can work together for dad's benefit.
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KTR, I just checked your profile and see that your father has a heart condition and has had a stroke. I doubt if there's any way that any facility would agree to administer 4 hours of therapy a day to someone with a cardiac condition. Even supervised cardiac rehab in a hospital setting, from my experience, was significantly less.
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Four hours daily of PT is a lot of PT for an older person. There are some facilities that do have accelerated PT for patients who can tolerate it, but this would more likely be someone younger and stronger.

Think of what 4 hours of therapy a day would mean - I couldn't do 4 hours of workouts and I doubt many people could, let alone an elderly person with compromised mobility and energy.

45 min. to an hour of PT and another 45 min. of OT is more like what I've seen in the several rehab facilities we've used.
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Is your Dad "in his right mind"? If he is still competent (in the legal sense) he can easily change the POA. If he is no longer competent, then I think Pam's suggestion of becoming his Guardian is the only option.
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No, he does not refuse PT....they do not schedule him for 4 hours a day. I have been to his PT/OT sessions and they are only about 40 minutes makes and they combine them. I am going to go there tomorrow and start asking more questions. My brother chose himself....my Dad did not understand what it all meant. Ativan is not recommended for the elderly. It increase dementia risk and also can do the opposite on the elderly (cause agitation not mellow them out). My Dad's brother was given that same medication and they had to take him off it for the same reason. I was there the two times he was give Ativan and I never ever saw him act like that before. The nurse who is usually with him at night was so shocked to see him act like that she ordered it discontinued. My brother does not know anything about his health so it is crazy they he controls it. I would like I should be able to revoke it.
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Is dad refusing the PT? If he is, the rehab will discharge him because they can't do any more for him. Ask to see the PT logs, maybe dad can't remember. Ativan is an anxiety reliever, I've seen it mellow people out and even stop seizures, but not make them crazy. What other meds does he take?
If you want to be a Guardian, you will need a lawyer and several thousand dollars to make it happen. Your father chose his POA's and only he can UN choose them, unless somehow there is a Guardian.
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