How to follow through on physical therapy?

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My mom (vascular dementia, in AL) has an order in for physical therapy to improve her walking and balance. Wonderfully, they can do it right in the AL. She had PT earlier this year also, and because of her dementia never did the exercises except when the therapist was there. She just forgets. How have people here handled that. We are thinking of asking for (and paying for) an additional aide to be there to ensure she does the exercises 2-3 times a week. I haven't had a chance to talk to the AL yet, and wonder if having an aide will be sufficient, or whether they will want an actual therapist to be with her. Just looking for ideas on how to improve the follow through. Without the follow through the physical therapy doesn't do much good. Thanks

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You might also mention that the 'doctor says you have to do this" That generation things the physician's are the almighty and therefore will do anything attached t them.
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Reply to geewiz
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Thanks for all the feedback, and it is nice to know we are not alone with this problem.

I'm going to be talking to Mom today, to see how receptive she is to having somebody meet with her regularly to follow through on the physical therapy. If she is willing to give it a try, I will call the AL to see what they suggest. Mom is still with-it enough to be able to do the exercises (they leave diagrams for her), so I think just an aide to help would be enough. Just somebody to help her remember.
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Reply to chdottir
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Every day coming here helps me to know I'm not alone in my frustration. I'm nodding while reading all your responses. We also have the tension bands, ankle weights,tiny 1-2 lb hand weights all in the front room. I dust them once a month . 4 th year in a row -- septic hospital stay( UTI).. month in rehab... home with me staying with her with OT and PT.. same exact exercises ( toes up.. knee lifts ... repeat)... she does them while therapy is here.

I encourage her to do them after breakfast.. after Price is right ... etc.
Like my children I try to bribe , cajole .. nothing. Then I overhear her tell my aunt on phone .. therapy only comes twice a week to "fix my legs--- not doing their job well"
Then again ... from her recliner nobody is doing there job well.

This site has been a literal life saver for me. I found it late one very very dark night for me emotionally. I haven't been able to make any real changes yet but I guess all the details don't matter to anyone but me... I just wanted to express my gratitude for all the wonderful people here... just knowing I'm not completely alone in my situation( and sometimes frustration) enables me to face another day !

Blessings all !
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Reply to Mimi-of-2
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So important to use it or lose it!
Mother has had many surgeries with the requisite follow up PT at home.
Not ONCE did she continue the PT past the last PT's visit. NOT ONCE. The rubber bands are still lying on the kitchen counter, from 4 years ago hip replacement. I think if you tried to stretch them, they'd break, for sure.

Mother walks with her walker--I should say she "chases it"--it's an arm's length away and she's bent over in half shuffling along--yet 6 weeks after hip replacement, she was standing straight and in "proper" position for walker use. (sigh)

DEFINITELY we/she should have been more aggressive as per the PT. Found out much too late that she could have qualified for in home PT for life under her LTC policy, nobody bothered to check and see. She wasn't motivated without a PT there, none of us kids could get her to do anything.

Many elderly will be much more compliant with a "stranger" than with family. Just sayin'. We're not unusual in this.
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Reply to Midkid58
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I took the same course of action as GeeWiz, initially asking for handouts on the exercises to be done, then doing them with Dad if he was up to it. (In fact, I was sorting through some files in my "studio" and found so many exercises from Dad's therapy that I actually had more for him than from my own therapies.)

As Skypuncher mentioned, there might be an issue if an outsider comes in to assist with PT - liability issues specifically. So discuss that first with one of the admins, or SW, or DON to make sure that they're comfortable with a nonstaff member participating in PT.

An alternative might to offer to pay one of the existing PT staffers for "extra duty".


The only concern I would have with a staff aide is that they're trained to assist in various ways, but I don't believe they're specifically trained in PT. That would be something to ask if the facility agrees with bringing someone in.

When we did workouts at home, sometimes I'd put on a favorite CD for musical inspiration, and typically followed with a treat, for both of us!
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Reply to GardenArtist
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For what it is worth, here is what I did with my mom's PT. She too had dementia. I went and watched the PT work with my Mom. Then on other days, I would take my Mom through the same steps (or at least those I felt comfortable doing). Ditto with MIL (I had more luck there than her 5 kids!)
The AL wasn't always thrilled that I had my Mom walking after her hip surgery, but watching her in rehab, I knew she could do it. Keeping seniors as mobile as they can be aids in sleeping, digestion, etc etc.
I had my MIL march in place to keep her legs moving. After all, she needed those legs to transfer to toilets and get into/out of bed. Every visitor can do something. It may not be perfect but movement is movement. Good luck
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Reply to geewiz
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Where I work, we will often get requests for exactly this. While some individuals despise a stranger telling them what to do, we find that most people react extremely well to having an outside "aide" (in our case a nurse) involved in their PT. Not only does it simply help them remember to do their exercises, they seem to view the aide as a trustworthy figure (at least within the context of PT). They are much more willing to work with someone they see as an expert.

Depending on the actual facility, you may get a bit of push back about bringing in some sort of outside aide. Personally, I would give it a try. The upsides much outweigh the downsides. The worst case is you get told no and you're back to square one.
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Reply to SkyPuncher
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