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I am the caregiver of my mom. She has Dementia and 4 weeks ago she fell and broke her shoulder. She has started therapy and does really good when home heath come and helps her, but that is only twice a week. The rest of the time she is to do it with me but she won't. I have tried everything I can think of. Her arm and hand are getting stiff because she won't use them at all. Before this she feed and dressed her self. I know when first happen she couldn't because it was her right shoulder and she is right handed but now she won't even try. She wants me to do everything. Any ideas how to get her to do therapy and help herself more?

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Hi Auntkiki,
What is that phrase - "the mother of all invention is necessity" or something like that. Meaning, I think, if one is forced to do something they will figure out a way to do it. In other words, if you don't help Mom get dressed and feed herself she will figure out a way to do it. With in reason, of course. I wouldn't let her sit in filth and starve BUT I would make it harder for her. When she realizes that it is hard to do on her own you can remind her that is what her therapy workouts are for. Just a suggestion. Good luck! (also - have you thought of rewarding her with a treat after each work out? - a little candy or something? If she is at that stage where she needs it?)
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Thank you, MishkaM. I am going to try that. Put her food in front of her and let it sit there. If she don't eat I will feed her but not as soon a I place the food in front of her. I have been trying to bribe her. Her brother and sister live in Ohio and I told her if she wants to go see them like we planed she has to start using her hand and also walking more to build her strength. All she does is lay on couch or in bed. I thank I have been babying her to much. Thanks again!
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It is easy to fall into babying them too much. For one thing, we love them and don't want them to suffer. For another, it is just easier to do it ourselves and get it over with than to encourage them to do it themselves.

I think your planned trip is great to use as a motivator. My husband was far more interested in doing his therapy when it was to get ready for a cruise. For some elders a trip in the future may be too far off to be very motivating. You may also want to come up with more immediate rewards. Something fun to do or a treat after the exercise session is done.

Another thing that motivated my husband is having someone do the exercises with him. His PCA was wonderful with that, doing everything along with him. (And I think that was more effective than just me doing them along with him.) You could do them with her, or perhaps even better, hire someone to help. If there is a college with a physical therapy program in your area, perhaps you could hire a student to come in for a half an hour each day. Or even a responsible high school student could come in and follow the printed exercise directions. Then you could say, "Mom, Jill will be here in a half an hour to do exercises with you. Let me help you to the bathroom first."

I sure don't always do the things I know are good for me. Do you? I suspect Mom is no better or worse than most of us. But when the therapy can have such an obvious impact on her well-being it is worth some effort to try to help her to do it.
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Tell her that you are taking the trip, whether she is able to go or not.
For 10 years, my Mother said that her shoulder was broken. It had, of course, healed. But, she refused to do the therapy. My sister babied her and it was not a good thing. That said, shoulder therapy is worse than child birth. I have done it.
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Auntkiki- Since your mom does great with the therapist, then you know she is physically and mentally able to do the work, but since she won't do it with you, then she is probably resisting because "you're just her daughter, who are you to tell her what to do?" (At least, that has been my mom's attitude when I have tried to get her to do any kind of exercise or therapy. I hear it is a pretty common problem for family caregivers). So, you might need to do things that get her to do the work she needs to do, without her knowing that that's what you're doing.

Here's an approach that follows along the lines of what MishkaM was saying. It's a therapy that was developed for patients who had lost the use of an arm and hand from a stroke that left it lifeless and limp, or paralyzed. Now, your mom isn't paralyzed, but she has a shoulder that was injured and she doesn't want to use the arm. The principles of this therapy might work for her.

This therapy is called "constraint-induced therapy", in which the patient is positioned in bed or on their chair, and desired items are placed on the patient's weak side, so that the "bad" arm and hand is the only one available to reach for their food, phone, pager, remote, etc., so they are forced to try to use the weak or paralyzed limb. Sounds cruel, but even after an injury that leaves the limb paralyzed, there are still nerves available to make the limb work again, but they won't do any good if the uninjured or "good" limb takes over and does everything that needs to be done and the nerves in the weak limb are never called on by the person's own motivation (hunger, boredom, wanting to do something enough), which is more powerful than a therapist or caregiver prodding them to do something that is difficult or seems impossible. An even more intensive form of the therapy involves immobilizing the "good" limb in a sling or even a splint and securing it so it can't move at all, and giving the patient simple tasks to do such as just nudging an item to move it a tiny distance, and building up to more movement and more control of the arm and hand. It is very intensive and difficult work, but it's amazing- people who have had no movement in a paralyzed arm for years have been able to regain normal use of the arm with this therapy.

I'm saying all this to confirm and to build on what Mishkam said. Now, your mom isn't paralyzed, but the principles can still apply. Don't do anything that puts her in danger or is neglectful, of course, but try to apply the principles to your mom's activities of daily living and concrete, simple things that are motivating to her. Put her plate (comb, hairbrush, remote control, purse, -anything that she is mentally capable of doing but just reluctant to use the injured arm for) on her "bad" side, close enough that she has to move her arm just a little bit in order to reach it, then think of a reason to leave the room and tell her you'll be back in a little bit. Don't tell her what to do or say anything about using the injured arm, or about trying to do something difficult, because she might feel like you are trying to force her to do it, which you are, but she doesn't need to know that ;-) which would make her resist doing it, because "you are just her daughter, who are you to tell her what to do?". Let her own desires or needs be her motivation. Stay out of the room long enough that she'll get tired of waiting and she'll try to do it for herself (If you stay in the room, she'll think you should be doing it for her). Check in on her once in a while, but don't let her see you, and if she eventually does the thing for herself, come back in the room and say something like, "Hey, you did it for yourself! That's great!" and then change the subject so she doesn't get wise to it being a setup and that she just did something that you wanted her to do. If she tries but is not successful, or only gets halfway done, but gets too fatigued to finish, you can say, "Hey, that was a good start, do you want me to help you finish?" If this approach seems to be working, use it throughout the day with anything she wants to do, and keep letting the task be just a little bit more difficult than the time before by placing items a little further away, or the activity a little bit more complicated or the objects a little bit heavier.

I hope this approach works for you. If it does, your mom gets her therapy without even knowing it, and you don't have to beg or bribe or lecture her to get her to do it. Good luck!
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Thanks everyone for you help. It is so hard not to try to do everything for her but this morning she had her cup of tea, I sat it there and acted like I had to go do something came back and she was drinking it. I acted like I didn't noticed and after awhile I ask if she was done and she nodded yes and that was it. Also she did try to feed herself last night but she has tremors in her hand so I helped her then. Take her to her neurologist next week and hope he can give her something for that. Thanks again!
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Auntkiki- Great to hear about such good results already! Bless you!
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