My mom refuses to do physical therapy. What can I do?

Sparkling - I'd also look at posts regarding memory, like asking her what she remembers about home or what "home" means to her. In my family we talk about "remove the button". Mom asks a question or makes a statement you know is false at this moment, it seems to "push a button" in our subconscious and make us react a certain way. I take a deep breath and give the same answer I did the last time she asked. I'm starting to do that with my dad. He asked "do I have a $ left?" referring to the IRA I am draining right now. "Yep, you have a few $'s left" (He has enough to fund his 24/7 care in his home for about two more years without skimping and he'll turn 90. He is reaping the benefits of working hard, saving hard and investing well.)
I believe life is eternal and God guides us all the way to whatever is next in ways loving and helpful. It is difficult to watch the degradation of body and mind - watched my mom pass in January (I was in the room) after dementia set in. AND I simply loved and encouraged all caregivers to continuing loving, remove the buttons pushed, know my mom did not really mean what she said - no filter at all - and she was in God's hands, we simply had to do what God had in mind for us in that moment. We can encourage only so much, but we can love always.
You will be led to exactly what you need to do when you need to do it.
“I wish you enough sun to keep your attitude bright no matter how gray the day may appear. I wish you enough rain to appreciate the sun even more. I wish you enough happiness to keep your spirit alive and everlasting."
There are more verses from different authors, so "may you have enough"

sparkling: Prayers forthcoming.

I am so very sorry for you and your mom. Your mom may be dealing with post surgery cognitive disorder from anesthesia. My dad was never the same after hip replacement. Your mom should be placed in Memory Care facility. Please keep seeing your mom daily. Work with the doctors to control her pain. Your mom may not gain mobility, but keep trying.

Stop making her do painful physical therapy.
If she is refusing to cooperate with therapy, she can not stay in a Rehab facility. She will have to be moved to a long term care skilled nursing facility.

That much damage to an older body is hard to recover from. It is often the beginning of the end. She may not ever return home.

You can bring her home with hospice care, or find a very nice nursing home.

After a surgery sometimes elderly people react poorly to the meds they were given. My FIL and my dad both had bad reactions to the meds to the point they were violent, both very gentle old men otherwise. It took days to weeks to wear off. Get her checked for dementia as well. If you don't have POA, make sure someone does. If your mom was not easy to get along with before, it's only going to get worse. You might want to talk with some social workers that deal with the elderly on a regular basis and see what they recommend.

if I were you I would let her go home the woman sounds tired .

Your mom needs a psychiatrist ASAP for a Diagnosis and a Nuerologist for a brain scan. Could be Traumatic brain Injury or brain bleed .Poor woman should go home If Possible . She needs rest and sleep . A lot of sleep for her brain and body to heal. She can always do in Home Physical Therapy , Have a CNA and the VNA Nurse to come in. A High dose antidepressant is not going to help her.

I kind of skimmed over the replies. Are you from another country?

Why is Medicare not paying for her Rehab? And why are there so many people in one room? I live in a small populated area and our Rehabs have 2 people to a room. Even though Rehab and Longterm care are in the same building, Rehab is in a different wing. Even the LTC does not have more than 4 beds to a room.

If Mom were on Medicare and she was not doing the therapy, she would have been discharged. I don't understand why you are going thru Moms money when she won't comply.

Mom needs a good cognitive evaluation to see if she is capable of living on her own. An evaluation to see what her needs will be if she can be sent home. If her needs will be more than you can hanfpdle, then she may have to be placed in LTC. Really, if you have used up all her money on Rehab, where are you going to get it for Caregivers?

Oh my, what an incredibly distressing situation for you both! What devastating thing to happen at her age.

Good support and advice has been given to you by others.

Are you her PoA? If not, does she have one at all? If not, it will become increasingly more challenging to legally manage her affairs without it, including medical.

I'm an only child to a single Mom who is progressing in dementia. She created a PoA using an online service (Legalzoom.com but there are many others). You can download the forms, and then see if the facility has a notary (many do) to finalize the PoA (make it durable, and encourage her to give you all the authority). Then you can make decisions in her own best interests, whether she agrees with them or not, cooperates or not.

I have a cousin with ALZ who started to keep her eyes shut all the time, even when having conversations with people she knew. I agree with others that your Mom either was having the beginning of dementia before the accident or she now has a TBI, or was impacted my the anesthesia from her treatment, or all of the above. The Dad of a good friend of mine went in to surgery for a shoulder repair and came out permanently impacted cognitively by the anesthesia. Even so, there is nothing to be done about it other than to make sure she doesn't have a UTI or some other infection, which can alter a person's behavior.

I also agree with others who point out that PT will be resisted if her pain isn't under control. We learned this from my MIL when she broke her back and also refused PT -- and had the beginnings of memory loss, which we didn't realize.

Maybe what your Mom now needs is LTC in a good facility. LTC can be covered by the combination of Medicaid and her SS income. She has to qualify both medically and financially. You should talk to either a certified elder law attorney who is experienced with Medicaid, or a Medicaid Planner for your Mom's home state. They will help you figure out if she will qualify financially (because I don't think medically will be a problem for her) and when to apply. Please please do not for 1 minute think about paying for her care: it is unsustainable and will rob you of your own care options in your future.

Insisting on going home, especially if it is in the afternoon, is a dementia behavior called Sundowning. The home they are referring to is not their current home but one in their childhood, or an imaged place where they'd feel safe. It's possible if your Mom has dementia that this is what is going on, but hard to know. This is part of the reason why a PoA would need to be overseeing her care decisions.

My MIL was in LTC in a great facility for 7 years (and passed at 89). This may be the best and only option for her going forward. I don't have experience with TBI, but sounds very like she should at least get some sort of diagnosis regarding her cognitive condition.

Kudos to you for being there for her. Your relatives realize that helping your Mom will be a strenuous, ongoing committment that is beyond what they are willing and able to do. You need to realize this yourself. May you receive wisdom and peace in your heart as you work out the most appropriate care for your Mom.

From what you said, M is choosing to have the ‘screaming ladies around’ because she likes the view. Why??? If you give in and let her move home, make it for a fixed time (eg a month) and on fixed terms (eg you go in every two days, she organises her food and other care). Sometimes things have to ‘fall over’ before they can change. Make her, not you, organise so that things don’t ‘fall over’. You have a big mental shift to appreciate that if she is refusing, she is staying in control, and you are not responsible. She needs to understand what she can control, and that it isn’t you!

Sparkling, I had the same thought as waytomisery, that there is a traumatic brain injury. Also possibly PTSD from the accident, and some degree of oppositional defiance disorder as part of her original personality, now increasing from the ongoing difficulties. Has your mother been seen by a neurologist and a geriatric neuropsychiatrist? The facility should have them available to come in. Push for it, if you have to. Also, her claim of pain needs to taken seriously, with an evaluation by a chronic pain specialist.

I feel terrible for her, that this happened, and for you, dealing with the fallout! What a nightmare all around. Thanks for taking the time to reply. Keep us posted on how things are going. There is always a lot of wisdom here,

Sparkling, many many posters have had relatives who ‘just wanted to go home’ and refused to co-operate in every way they could. No the relative didn’t “finally decide to move”. Usually they fought all the way. They moved when they were given no choice. At only age 71, it’s possible that M could go “back to normal”, but probably unlikely.

‘When the money runs out, she would be sent home’ – but it must be a safe discharge. That means ‘home’ includes adequate care and support. Even if you find a suitable caregiver, full time one-on-one care is considerably more expensive than a facility where staff time is shared, so you are stuck with ‘the money running out’ anyway. The alternative is to take on slavery yourselves – which many many posters have done and regretted.

That is the harsh reality. Waiting for M to become more reasonable all by herself is unlikely to help. As long as she is getting her own way, she is unlikely to change.

My main reason for starting this thread was to hopefully hear from others whose moms were in the same boat and what happened to them after that, did they finally decide to move? Were they back to normal.

Is this facility known for rehab for people with TBI ( traumatic brain injury) ?
It is very important for your Mom to be in a facility with staff who have proper training working with patients with TBI.
Some of her behaviors could be TBI related .
I also agree about pain management needing to be addressed .

You all are awesome, God knows how happy and thankful I am to receive all your nice messages. I will to answer all the questions here. Prior to this accident, she was living independently at her own home, browsing the web or watching TV all day, taking a shower a couple of times a week, not really an outgoing person, even a simple shopping would have been an extraordinary thing for her. No dementia then or now, she has always been stubborn. Never wanted anyone to tell her what to do, single mom. Healthy and no issues. As for the physical therapy, she would feel pain when they try to move her leg, when we told her let's have the doctor check, she said nope, I don't want to go get checked. The loose stool issue went away after her colonoscopy. She is in diaper now, the only time she even attempts to sit, is when they sit her on a wheelchair to take her to be cleaned up. Her doctor says she closes her eyes every time he tries to talk to her or check on her pretending she is asleep. I have access to her back account so all this time, the money would be sent to the rehab center directly and she didn't even care how much it was. Her money is running out and when I told her the money is running out this month and she said she doesn't give a ***. I told her she will not be able to stay there anymore and she says that's exactly what she wants and that she wants to go home and I have to find her a nurse. All the relatives tell me they will pray for me and that's it, no help whatsoever. What the colonoscopy showed was yet another polyp, she had three before. She was so stubborn even when the surgeon did her surgery and told her that she has to leave the hospital due to infection and she would just not leave. If you were in the same boat, what happened to that person ultimately? Did they feel happier at home and eventually decide to move? I know she hates that facility and also hated the one prior to that. When the money runs out, she would be sent home, we probably should hire a caregiver who most likely will not have any medical experience which she would not get a long with either (so expensive, too) and we will end up finding a new caregiver for her every couple of weeks (if mot days), I just don't see a light at the end of this tunnel. Please share your experience so I know what will happen, I hope my mom doesn't die.

Has mom been tested for dementia? Since her head was involved in the car accident, it's a good idea.

Also, if her pain is not being properly controlled, how can she be expected to do physical therapy exercises, I don't understand?

How is it there are 90+ women in a room at this rehab SNF?? This makes no sense to me?

If mom cannot make progress to where she can function, then she'll have to stay permanently in Skilled Nursing care because she'll be too much to handle at home.

What are you being told about her progress? What is the case manager's plans for her care moving forward? What does her doctor say?

There are many questions with no answers here. Not everyone can successfully be rehabilitated after such serious injuries, unfortunately.

Wishing you the best of luck with a difficult situation.

Non stop loose stool can be Microscopic Colitis which is pretty common in women over 50. Sometimes meds cause it (as a side effect.)

The only way to get a diagnosis is through a colonoscopy WITH MULTIPLE BIOPSIES. MAKE SURE IF SHE DOES GET A COLONOSCOPY THAT SHE GETS MULTIPLE BIOPSIES TO TEST FOR Microscopic Colitis.

I just reread your post. Did they test for Microscopic Colitis with multiple biopsies when they did the colonoscopy?

Your mom is awful young to have given up on life already.
Hopefully the anti-depressant will help along with the pain medication they have her on. And if her pain medication isn't helping, make sure that you talk to her doctor about trying something else.
Perhaps it best that her doctor share with her what will happen if she doesn't do what needs to be done to get her moving again. And tell them not to mince words but to speak the cold hard truth.

Perhaps start with the money. M’s own money should be paying for the ‘so expensive facility’. When will her money run out? What will her options be then? If they are a lot worse, she may realise that her current choices will make things worse for HER.

Second, check again on her reasons for her current choices. Is she really in a lot of pain? If so, does the doctor need to prescribe more pain medication, not just anti-depressants?

Third, I’m even wondering whether a therapist might help HER – perhaps pretending to be a helpful friend of yours because you have to go away for a week or two. If M is blaming the doctors, the accident driver, ‘the system’ and the family for her problems, talking to a new person might just help.

Very difficult, sympathy to everyone involved!

Prior to the accident what was your mom like in terms of daily activities and health? Is this a complete shift in personality and level of interest in life?

My mom has begun refusing to go to physical therapy or do walks with her aid. My position is you can encourage it but you can't force it.