My mom (91) fell and broke her pelvis. She is now refusing PT. Any advice?

In a different set of circumstances my dad was in a cycle of hospitalizations for CHF, often followed by rehab for weakness in walking, and back to a new, albeit lower baseline. We kept encouraging him to “try harder” in rehab and with home PT. What took us so long to grasp was that he simply had no no “try” left in him. Yes, some of it was depression as he’d experienced so many losses of people and abilities, but much more of it was being so very tired of the illness and hardships life had become. He chose to leave the final rehab place and come home on hospice. He died less 2 months later, with much sadness for us but with complete contentment for him. Sometimes life here just gets too hard, that’s what I learned. Not sure this is what’s happening with your mother, but something to consider. I wish you both peace

I would discuss with her doctor. She is getting quite a powerful pain medication, yet it seems not to be working for her. I can assure you that any break in the pelvis is notoriously painful, no matter even passive PT exercises (done with the therapist moving the limbs gently.

Just occasionally an injury with this level of acute pain can spell the beginning of the end. There may be medications that can be added that will boost the pain medication itself, and she may need more pain meds for a while, perhaps even a fentanyl patch.

Discuss with MD. This is a case of doing the best you can and hoping that the immobility doesn't create further, and worse problems, because it may. I am truly so sorry. Think of it as an injury in which the tiniest movement of any part of your body results in acute pain in the core. I wish you the best, but I think she needs better pain management.

Been there. My wife broke her hip 2 years ago. She refused the rehab. She has slowly declined over the last 2 years. She is Bed bound now and wears a diaper. She is now getting contracture in her legs. I am trying to force therapy on her but she plays the game she is not feeling well.
as with most things in life you can not force someone to do something they do not want to do.

Do they schedule the pain killers so that they kick in before they start rolling her?

Have you consulted with the surgeon about aggressive PT should be?

I would consider that hospice might be one of the things you consider.

Also, an evaluation for depression.

It’s a very sad situation.

I’ve visited my LOs in rehab, and in one there was a very fine doctor who was head of the place. I learned how forceful he could be in advising patients in similar circumstances as your mom. He raised his voice and told them in no uncertain terms where they’d end up if they didn’t follow the program. He made it sound like a circle of hell. It was his way of motivating, giving them a last chance to respond to treatment.

I don’t think it ever worked because those patients disappeared to long-term nursing across the street.

Sometimes all you can do is give up. Your mom will do what she wants to do, and maybe she knows best. Keeping her alive to experience full-blown dementia may not be such a great idea. I’m very sorry you’re going through this.

My mother was fully mobile - an avid walker - when she was hospitalized. In fact she kept trying to escape. Illness, not injury. A few weeks in she got angry and refused to ever move again. Wouldn’t even feed herself or roll over. (lots of tests) Raged at the PTs. Did stage a few escape attempts when nobody was looking. She was late mid-stage at the time.

While it is likely that your mother has untreated pain or a fear of any movement as her mind may tell her she’s falling, I am sharing my story because my mother suddenly stopped moving, without any injury. Incredibly frustrating - her own worst enemy. And that was one year ago.

Thanks everyone for your ideas and concern. She is on something for sleep/depression - trazodone- that she takes at night. That may need to be reevaluated. I will have to ask about the fentanyl patch too.

PT and OT in rehab with a dementia patient is an exercise in futility, as are pep talks for someone with a brain disease . They have neither the ability or the desire to exercise, nor should they be forced into it ( especially with pain being a factor) or convinced to comprehend something they simply cannot.

Hospice is also a good idea if there is no chance of improving. And with just dementia at play, there is no chance for improvement, unfortunately. Also, if there are drugs to "slow the progression" of Alzheimer's, I'm unaware of them. Besides, why would anyone want to prolong an elders battle with such a dreadful disease?

Anti depression meds may help, but mom may be approaching the end of her life now which hospice can assist with. After a certain point, it's impossible for an elder to recover from so many health blows, and so begins the final leg of their earthly journey. Once my father gave up, he passed away 19 days later from an inoperable brain tumor. Hospice kept him comfy in his AL apartment who agreed to keep him until death. Dad made no progress either in rehab, so he was released in pretty short order.

My condolences on the loss of your dad, and watching the wretched progression of AD which I went thru w my own mother.

Is Hospice possible ? I would ask for a hospice evaluation and see if she qualifies… had my MIL in the ER and the care representative said she wouldn’t qualify. A couple days later, The memory care called a hospice for an evaluation, yes she did qualify.

with hospice comes the added care. A wheelchair , hospital bed , hoyer lift, care supplies. RN weekly who will manage meds with physician. CNA twice a week

hospice doesn’t mean imminently dying. She would be reevaluated periodically. I read here where their loved one was on hospice for long periods of time…

If she doesnt want therapy that is her choice & her life. Be with her & support her she will come around when ready...remind her how much you love her.