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My dad had knee surgery a year ago. He fell a couple of times and got an infection that led him to a second knee replacement surgery and time in a post acute center. He was in a leg cast for over a month, with IV antibiotics for 6 weeks. He got Covid there and a bad UTI, so he had really bad dementia. He fell in the post acute center and dislocated his shoulder. It could not be put back into place. Instead of the hospital doing the psych exam per me and my sister (she is POA) so that we could sign for my dad to have surgery (he was refusing the surgery because he was very confused and disoriented and combative), they released him with back to the post acute center. That center decided to release my dad and a hospice group swooped in. We had never been involved with hospice. We didn't know what it was, it was not explained to us. They just told us they would help my dad find a place since he was getting kicked out of the post acute center (they said he wasn't progressing, which he wasn't due to the Covid he contracted there and the UTI and the fall - and a hernia and virus). He was supposed to be getting physical therapy for his leg, but hospice stopped that (we did not know this was the case). Dad was put into a crappy group home. Finally I talked to some people in the health care network and was referred to someone who hooked us up with Hospice of the West, so that they could help us get him moved out of the bad group home and into a better one. We got him off of hospice and tried for months to get physical therapy to get him walking (his muscles were so atrophied from being in bed for 4 months, he couldn't walk). Insurance kept denying the PT because he was in a group home. I would fight for weeks, get a couple PT appts then it would stop. We finally started to try to get his shoulder taken care of after the dementia and hospice help, that has taken 5 months and 3 different surgeons and he FINALLY got the surgery on Monday. My dad was an alcoholic growing up, disconnected from us kids. 7 years ago he fabricated a fight over my younger sister having my mom's diaries and cut all 3 of us out of his life. I finally got him to talk to me last May (pretty sure it was just to get me to sign off as a family member so he could get his knee surgery), and I have given up the last year of my life taking care of him. Getting his prescriptions, taking care of his house/cars, paying his bills, making all of the doctors appts and making all of the phone calls to the doctors/surgeons/home health/insurance/etc, getting personal items, calling him every night to make sure he is OK, coordinating everything with the group home and on top of that, taking him to doctor's appts. He is bed ridden and 6 feet tall. It is physically grueling to get him out of the group home bed, into the wheelchair, out of the wheelchair, into the car, out of the car, into the wheelchair, into the doctor's office and then all of that again to get him back to the group home. Both my husband and I have bad backs, and between him and getting the heavy wheelchair in and out of the car, it really messes us up. I need help getting him to these appts. It would be just one less thing to worry about and deal with, on top of everything else (taxes, his sister, his narcissism on top of everything else). If you have any suggestions for help with transport, please let me know. I know this is a lot - thanks for letting me vent.

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I’m sorry about your father. When my LO became wheelchair bound, I switched her care to a doctor who came to the facility every week. The PA or doctor examined her in her own room. It was less stressful on her. Before that, the facility transported her in their van. With her condition she was not able to participate in physical therapy. As she went to comfort care only, then hospice, tests were stopped. If a UTI was suspected, her doctor or hospice prescribed antibiotics for her comfort. I hope you can find some help.
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Sounds like he needs to be in a LTC facility where they can use a Hoyer lift to safely transfer him from bed to wheelchair, and then you'd need to hire a transport company to come get him, wheelchair and all, to his appointments.

PT won't continue if they feel he is either uncooperative or not progressing. I tried everything to get my MIL to do more PT and learned this the hard way. He'll only get it if he falls again and then goes back to the hospital and then back into rehab.

My personal philosophy is that the caregiving arrangement is only working if it works for both the receiver and giver. It's definitely not working in your case. I respectfully ask that you step back and assess the "why" of what you're doing. To what end? What do you think will change for your dad if he gets some physical abilities back but then you both screw up your backs for the rest of your lives? Your spouse is a saint for enduring and participating in your dad's care and honestly it's not fair to him. You and he are your first priorities, not your dad. Take care of yourselves so that you can take care of each other in your own senior years. Wishing you clarity, wisdom and peace in your hearts as you ponder your situation.
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There are some medical doctors that have returned to doing house calls. In most cases, they charge more. Have you considered hospice care?
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It sounds like the transport problems are just the tip of the iceberg?

For car transport the person needs to be able to transfer themself in & out of the car, either independently or with minimal assistance + also have a wheelchair light enough to be packed by the accompanying support person.

If mobility is limited or wheelchair exceeds support person's limit, wheelchair taxi is required.

So Dad is currently getting your gift of free car transport. But if he now needs a wheelchair taxi, unless you own one, he will need to pay for this service until he can mobilise better.

Yes it will cost more. But injuries to yourself or husband will cost YOU both more: physio treatments, time of work or other activities, loss of function, pain, risk of permanent damage.

Don't let 'but it's family' overrule plain common sense.
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Contact your local senior center, county elder care division, and state elder care agency, if there is one.    Any of these might have either suggestions or options.

E.g., my father's senior center had leased 2 point to point (small) buses for shopping and medical appointments.   Cost was very reasonable.

When I had cataract surgery, I learned of and hired one of the local ambulance services which also provides nonemergency transit.    It was costly, but safe.   

These kinds of senior oriented transit vehicles in my experience typically have lifts, so that your father would be wheeled out to the vehicle, onto the platform, and raised to the passenger area.
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