Mom refuses to do exercises twice a day as advised by home health PT. How can I motivate her?

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.

my mom did the same thing right down saying she was in pain with her arthritis. Sadly I have no answer for you other than to suggest she take what ever she takes 30 min or so before she does the exercises.

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.

Oh, boy.
Here we go. My brother was SOOOO helped by his one month in rehab after his car accident incidentally got him a diagnosis of probable early Lewy's dementia. He got a diagnosis of probably early Lewy's dementia at that time, and his balance had been poor for some time. And after doing and practicing exercises he was so much more steady on his feet.
But would he do them when he was released.
We talked. He said that there was just so little he felt in control of after all he went through, and in the middle of selling his last home, moving to ALF, getting me POA and Trustee of Trust and management of his finances, that he just had to take control of some few things, one being when and if he exercised.
I do those same balance exercises now, and I don't do them faithfully enough nor often enough no matter I know they make a difference.
I think you may be fighting a losing battle. I wish it were not so, but often the more we advocate for something the more our loved ones move away from hearing what we say. Not good. Not right. But it IS word.
I sure wish you luck. Let us know if something works.

I know two ladies who did this - either they refused therapy outright or they refused to practice the exercises in between sessions. One of them seemed to think that if she only worked on exercises when the therapist was there... that the therapist would come more often. Not true. The other lady I will speculate was a genuine pain management problem and a case of refusing to exercise until pain was under control - which it never was.

One lady was bedbound within a year. The other went 4 years still being able to transfer, toilet, and minimal walking but is currently a hoyer lift to a geri chair every day and it's been that way for quite a while.

Both had all the proper encouragement and resources to complete the exercises as prescribed. Neither was given any exercise that they literally couldn't do. They simply did not comply with what was prescribed and all the encouragement and explaining in the world wasn't going to change them.

My mom had home PT for awhile. If I hadn't worked with her to do her exercises, she wouldn't have done them.

My mom's the same way. She's had PT/OT many times over the years and does good then slacks off.

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.

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.

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.

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.

From your profile: " I recently took FMLA to care for my aging mom who has limited mobility."

Are you living with your mother now? Or vice versa? What happens when your FMLA time runs out?

Are you the caregiving plan for your mother, or is this temporary?

Is this through home health? Why is it only one time a week? Is she also doing occupational therapy along with physical therapy? They work best together.

My mom did very well in PT and OT and she was in her 90’s. Mom had Parkinson’s disease. She also did rehabilitation at a skilled nursing facility. She worked incredibly hard. I was amazed at what they had her doing.

My mom used a walker too.

It does work for some people and others it doesn’t.

My mother did do some of the additional exercises that they referred to as homework. I found that she always did more with the home health staff than with me.

Is she in pain? Sometimes aqua therapy is recommended. It’s done in a pool, they work out in indoor pools and don’t experience as much discomfort in the water. Is that an option for her?

Moving vs sitting if able is better for your joints. If I sit longer than 30-40 minutes my rear end, back & knees hurt.

You cannot reason with a person suffering from Dementia. The best thing for arthritis is to move.

Really, IMO, the 1x a week isn't doing a thing if she is not doing her exercises daily. She wasting the PTs time. She could be seeing a patient who is willing to do the work. If Mom shows no progress, Medicare will stop paying. Plus, she probably doesn't remember them. So you have to start all over working with her.

Your family leave will be over soon. What are your plans? Mom can't live on her own and with a family and a job, you don't want to care for someone with Dementia. With my Mom, we got PT into her AL. When she went to Long-term care, shevwas given therapy there.

OT is for occupational therapy. Usually for someone who needs to relearn or a different way of doing something. With my Mom there was nothing the OT could really do. She was beyond dressing herself, bathing herself, toileting herself, cooking, cleaning ect. So he discharged her.

Thanks everyone with your answers, suggestions and even your sympathy. It’s encouraging to know that other people have experienced this and I am not alone.

Do them with her. Empathize with her that the exercises are boring but schedule times each day for the PT session. Set a timer for the session and tell her "this is what we are doing until the timer goes off."
You may not like taking time for the PT sessions, and you may not like the exercises, but your mother is not going to them on her own just b/c you are nagging her to do so.

Try music during exercises. You can do hand over hand if she won’t do them independently. Otherwise tell the PT and there’s nothing you can do. Best of luck

Let's be honest and say that I (who also is on PT) and even my PT (who also is on PT) don't always do our exercises daily or twice daily. I do think that 2x/day is a lot for an elderly person. Mom (who'll be 99), has PT sessions to strengthen her legs and back. She doesn't do any PT exercises outside of the 2 days the PT is there, but she enjoys going out with her wheelchair to go around the block for 20 minutes. If your mom enjoys walking outside or at a store, maybe you can consider this exercise.

Force her to do her PT exercizes. It's for her own good. She's going to complain and gripe anyway. If not about the exercize, then it will be something else.
Maybe twice a day is too hard for her? It's too much for me. Maybe once a day.
If PT wants her to be walking, would she like to walk in a store or the mall? Sometimes a change of scenery really helps.

Should you? IMO that's up to you.

You already know that most of the effort is coming from you. As long as you're willing to listen to the griping and complaining then carry on.

I've never seen someone like your mother all of a sudden become motivated to exercise on their own.

You've got to pick your battles.

I have the same problem with my mom. Her mobility has been declining since a hospital stay/rehab/multiple UTIs last summer. For a while after rehab she could still get around with her walker and use the toilet. But since a bout of Covid and yet another UTI over the holidays, she has been bed bound. Home health has been coming all this time, and physical therapy's goal was to get her out of bed and able to walk a little with her walker. Sometimes she was compliant and would do what the therapist asked, but lately she just refuses. Flat out says, "I don't want to" sometimes with an accompanying growl or cuss word.

At this point we are just trying to get her to stand on her feet long enough to transfer into the wheelchair so she can at least sit up part of the day, and have been able to do that. But every day it gets harder for me, alone without the physical therapist there, to get her out of bed and into the wheelchair. She just refuses to help or use her muscles in any way, and I find myself feeling angry at her "laziness." But I know what's really going on is her dementia. It's so sad to see that she's lost all desire to move, or even get out of bed.

The therapist assigned her exercises to do twice a day, but those exercises are all up to me, Mom can't remember that she even has exercises. So when I can (which isn't all that often) I try to go and take her through her exercises in her bed. It's just me lifting up her leg for her, pretty much. She won't do it at all, and it seems pointless.

It's also hard to have to keep arguing and cajoling and begging and bribing every time I want her to just help me out and stand up!

Leave her alone . Most Older people dont Like PT . Did you Like highschool Gym Class ? The only Motivaters are Long walks and or swimming if your near a Pool . The brain is Tired . I Take My Dad Out to eat after a Doctors appointment and we take Our time home and sit on a Bench , walk , get a ice cream , people watch. His walking is very slow so we have a lot of breaks . Thats about all I Can do . 3 years ago he rode His Bicycle everywhere so he isn't Lazy . His brain is Tired .

I don’t know when you find out tell me because I need more exercise too.

Even those these won't match up to the PT exercises, put on a YouTube video of seniors doing goup exercises. If she has a group her age to do exercises with, she might just want to join in. Who likes exercising alone? Blah.

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.

Same frustrating concern with my husband.

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."

Wow.

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.

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 exercising....no 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!

Endeavor: Sadly, as your mother suffers from dementia, she does not possess the capacity to recall the cues to DO the physical therapy. Hugs sent for this most difficult of times for you AND your mother.