Mom's mobility has been declining since September 2022. She is now at the point where she has to use a walker to maneuver around the house. The home health Physical Therapist comes once a week to do exercises with her which, even though she complains and gripes about it, she still performs the exercises. However, when the therapist leaves, she refuses to do the exercises that the therapist recommends she do twice a day. Should I force her to do them and listen to her gripe and complain? I usually remind her of them and offer my help but most of the time she will say that she is in pain from arthritis and doesn't feel like doing them today.

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It's nearly impossible to get an elder with Alzheimers/dementia to do PT exercises; they can't remember them, or follow cues, etc, so it's basically an exercise in futility to try to 'force' this issue. Leave your mother alone. If she becomes wheelchair bound as a result, so be it. That's what happened to my mother eventually, due to neuropathy in her legs and feet, and her inability to do the PT/OT exercises she was supposed to do. She lived in Memory Care Assisted Living and had help with everything she did.

Best of luck with a difficult situation.
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Reply to lealonnie1
KNance72 Feb 4, 2023
exactly my opinion
This isn't all that unusual. I recall my cousin, who was 80 years old at the time, saying that her orthopedist told her that many patients refused to do therapy as prescribed and that's why they didn't fully recover from rotator cuff surgery. My cousin was a former Marine, WW2. She pressed on through the pain and recovered as fully as possible. But she was a Marine.
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Reply to Fawnby

Your mother has a host of health issues and pain. I don't think "forcing" her, however you plan on doing that. is a good solution. Encouraging her and working with her may help.

Twice a day is a lot for an unhealthy senior in pain. Once a week is not enough to keep her mobile. Anything more that once a week in better than nothing. Once a day, once every two days...may be more realistic.

Let's face it. Old age is a downhill experience and she will continue to lose mobility. That's inevitable. PTs tried to get my mother to exercise when she was progressing with vascular dementia. They thought she could. She had exercised all her life. As her daughter I knew that. She couldn't do it at that point. She would have if she could have.

It's hard to see them decline, I'm 85. It's hard to be declining.
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Reply to golden23

If you take the time to do them with her as the therapist does it may help. And I think twice a day is asking a lot, getting her to do them once a day is going to be difficult enough.
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Reply to cwillie
Chestershaba3 Feb 4, 2023
Wishful thinking my mom even fought the pt. Even when in a $300 a day facility. When they give up that's it. And mom used to yell at my dad "use it or lose it"...ended up in care home wheelchair bound. I'm afraid that's too common, and when you add aunt used to say she thinks she's lived too long. Died at 98.
There is a fine line with enabling bad behavior. Asking and bribes are not always enough. The person who was in my house did not like to do therapy either. The whining and crying over the pain was insane but she always wanted to be served her snackies. I had to put my foot down...if you cannot walk to the kitchen, you cant get snackies. I heard alot of I am in pain and my response was due your exercises. After a battle of wills, weeks long, she would walk to the kitchen with a gait belt to get her snackies. I have been told I am mean for doing that.
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Reply to Stacy122
BurntCaregiver Feb 4, 2023

You are not wrong for doing that. You're doing the person a favor by making them get up and go to the kitchen if they want snacks.
Babying an adult never helps or improves anything. It's easy to baby someone and you're not mean for refusing to. It shows that you care and anyone who doesn't get that clearly was never a caregiver to an adult or they're just ignorant. It would be way easier for you to just have delivered the snacks on a tray with a smile to your person, but it wouldn't be right. It wouldn't help the person in your house who needs to be up and walking fo their own good.
Tough love is hard. It's hard on a caregiver, but many times it's what a person needs.
Good luck with that.

If she's motivated by anything at all, you could point out that if she doesn't get stronger she'll be in a wheelchair and out of her house.

My mom wouldn't do PT, and my poor dad tried everything to motivate her. He knew that she'd have to move to a facility if she became wheelchair-bound, but there was nothing to do about it.

As it was, she ended up wheelchair bound after a fall, but only after she'd been moved into a facility for other reasons. It was too bad, because she could have probably still walked again, but her room at the facility was too far from the common area/dining room, and she just didn't have the stamina to walk that far.
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Reply to MJ1929

Mom quit in-home PT the last day the PT came to her home.

Nobody could encourage her to do anything to stay mobile. I'm not even talking mildly flexible, I'm talking just being able to walk partially upright!

This is a common problem. On the last day of the last PT she recieved, I walked the PT out to his car. Asked him if she would be able to conitnue to improve and remain able to walk upright and pehaps ditch the walker one day. He looked at me and said "She will never do a single exercise again in her life. Those exercise bands will rot away in the sun. Don't expect anything, she won't even maintain the level she's at now."


Truer words were never spoken. She went downhil, mobility wise, slowly and surely.

He said this was the 'norm' and the patients who did well were far more motivated. Said that actually very few were on board with rehabbing.

Really sad. By the time she passed, she was bent into a tigh C- curve and couldn't lift her head to see anything about about the 4'8" mark.

A cautionary tale, for sure.
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Reply to Midkid58

This is so very common.

People can/will do their therapy with the therapist only. The uniform, name badge or professional manner works the magic.

Don't beat yourself up.

Decide if 1 x week with the therapist is ok or not. If not & you can afford it, have a therapist assistant visit 1-2 x week for a few weeks. Many community practices where I live employ assistants for this very reason.

Or if you want to be the therapy assistant yourself, make it an appointment. Today at X o'clock I will be helping you do your exercise program, per the Physio's plan. Ramp up the motivation with bribes. Big bribes! We will do X afterwards.

Or even better, can the exercises be snuck into her daily life? Eg Walk around the house twice before sitting down to lunch. 10 foot raises before putting shoes on.
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Reply to Beatty

I know a lot of younger people who won't do their PT/OT either. Some people just will not do exercises as abstract exercise even when they do understand the benefits and tradeoffs. My BIL is one of them. He will not do the exercises then complains that his replacement surgery did not give the benefits promised. He was like that at 30 and still the same way at 60. This is a fight that you will not win. Perhaps you can make some kind of a game of doing some subset of the exercises with her or get the therapist to help you find activities that will be fun and have some of the needed movements.

If she really is suffering from pain it may be helpful to giver her a pain reliever of some sort then wait half an hour and see if she is up to doing a few exercises. Follow up the exercises with something she really enjoys doing with you--playing cards or watching something on TV.

You might see if setting up a bird feeder outside a window she would need to walk to might give her something interesting to watch. (Bear in mind, though, that it will take you some time and money to maintain the bird feeder.) My husband and I started this kind of easy bird watching in our early retirement and have maintained it for more than 15 years, now. It has brought us much more joy than either of us expected. DH was against it at first, but now he is the chief caretaker of the feeders. We both make frequent trips to the feeder windows to see what is going on. There may be other attractions outside the windows to get her moving also, depending on where you live.

Ultimately, you need to decide whether it is more important to you to have friendly relations with your mother or keep trying to nag her into doing something that she just is not going to do. I would vote for a cheerful relationship and putting up with the walker if nothing can get her motivated to move more.
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Reply to LittleOrchid

See if you can address the pain. When my Mom is in pain from the arthritis, she is more unstable and doesn't want to move for fear of falling. So we addressed the arthritis and now the pain is more tolerable. For us, a combination of Tylenol and Advil (later Alleve instead of Advil) and she felt significantly better, but not quite, So then I added in CBD (no THC) and that took the edge off a little more and enough so that it is a dull ache that she can work around. We went to a pain doctor for guidance and validation.

Exercise is not something most of us enjoy doing. I have found that my Mom will only do some of the exercises. Others she wont even try. However, she needs to do the exercises to get the muscles to memorize the action. So I do 3 things: 1, I notice which ones she will/can do and which ones she cannot. Those that she doesn't want to do, I ask the PT guy for alternatives. 2. I do the exercises with her and give her my undivided attention while she is exercising. 3. I improvise.

For instance, I put the exercises into longer series. For instance, to do the sit to stand, she goes from one chair to another on opposite sides of the room, sitting in the chair on each end of the room. To make her lift her leg, I use a stepper board (her walker wheels fit around it) to make her legs lift her body up and down towards the middle of the walk on opposite sides of the room. When she could, instead of the "march", we used to try to get her to touch her knee to the bottom of the table. Her granddaughter used to hold her hand up and make her knee touch her hand. For agility and flexibility, we bought a small plastic ball (about 5 inches in diameter), then we take turns, with both of us sitting down, passing the ball back and forth (and I move my hands to give or receive the ball in different places, forcing the stretch and making her bend down, up and side to side).

One of the PTs suggested to me to make my Mom walk on top of folded towels to trigger her brain to automatically keep her balanced as she walks or stands.

...and yes, listen to her gripe and complain, however, make sure she is griping and complaining while she is griping and complaining before or after. My Mom gets my undivided attention when she is exercising. She's figured that out.

However, I'd address the pain first. After that, she probably will be more willing to do the exercises. That day that we got her pain under control was a huge step is getting her more mobile and stronger.

Good luck!
Helpful Answer (5)
Reply to ChoppedLiver
NeedHelpWithMom Feb 4, 2023
I absolutely agree with addressing the pain. It’s extremely difficult to work in pain.

Great post!
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