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My parents recently were discharged from home health PT/OT. Since then they have done very little to do any follow up exercise as instructed


My mother continues to blame multiple reasons for not following through. She continues to point out that my father is weak and not doing his exercise. My father does use his walker to go to breakfast at their ALF, but again she has multiple excuses that she can't go?

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As an elderly person (83) I will try to tell you why I don't do the PT exercises other than when the therapist is here. I HATE to exercise and always have, and I have a daughter who taught exercise, She gave me all the CD's for low impact workouts and encouraged me a lot. Did NO good. Being alone does not help. Yes, I have mild pain constantly from my various medical conditions and use that as an excuse along with being on the computer so much. I am now looking to transfer from my home to a Senior Independent/Assisted Living facility. I am hoping that being able to do PT of some type with a group will provide the motivation to keep me on my feet. I will have to walk to the main dining room and other common areas for clubs, music events, etc. I also liked the idea of the PT playing music while exercising. Wish me luck, Friends.
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waytomisery Mar 2024
Good luck !! Good for you for looking for ways to possibly be motivated.
Totally understand the difficulty to be motivated on your own to exercise .
A group with music and an instructor sounds great! I’m glad you are willing to go to clubs , events etc . You’ll socialize and meet friends .
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The reasons I’ve been told ….
1) PT doesn’t work
2) I don’t believe in PT
3) OT is stupid , she makes me hang up clothes hangers in the closet, which I don’t need because the laundry staff does that for me here ( in ALF).
4) I’m fine , I don’t need that cr4p
5) Leave me alone , I need to rest ( after a stroke ).
6) They are just wasting Medicare money.
7) I don’t want to
8) I’m tired .
9) They come too early .
10) I’m not old like the rest of these people .

It boils down to they either don’t understand , have no energy , or don’t care ( depressed) or all of the above .
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Sounds like my mother! Mine does horrible with PT and tries to move as little as humanly possible. And makes lame excuses for not going down to meals at her ALF. Why do they do it?? Good question!
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If she wasn't allowed meals in her room she would need to get to the dining room, where is the AL staff in all of this and why isn't she being firmly encouraged to do so?
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She just doesn't want to. Period. Her mental status may not allow her to understand the consequences. She might say she does, but she can't if her brain is broken.
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Pain. Fear of falling. Lacking motivation. Depression.

Way, I'll add one more your list.
11) No-one ever told me I need to walk.
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”I don’t want to and you can’t make me.”

After 2 years of refusing to stand or walk (she was an avid walker until the day she stopped) my mother (99) is still certain that, if she wants to, she can hop right out of bed, walk down the stairs and drive away in her car (which is long gone). She yelled at the physiotherapists to leave her alone. I think she truly believes that, when she feels like it, she’ll just pick up where she left off 2 years ago. Another dementia delusion.

Beatty, you made me snort. ‘11) No-one ever told me I need to walk.’

I asked my mother why she was being spoon fed instead of feeding herself. She informed me that nobody told her to feed herself. So I told her to pick up the cutlery and feed herself. She did. That was 2 years ago. She still feeds herself some days. Depends on her mood.
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djenning6msncom Mar 2024
I agree - my husband still thinks he can walk, so why do these weird exercises? The brain protects him from his grim reality. Not much that reasoning can do.
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Your mother does not wish to partake in PT/OT, that's why. So she'll likely wind up in a wheelchair like my mother did, losing core strength and needing help in and out of bed, the toilet, and the chair. No use telling her that either, because dementia prevents the message from getting through.

It is what it is. Accept it and don't ruin your relationship with mom by constantly nagging her. That's my suggestion.
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Accept that she doesn't want to do the exercises. Maybe she felt sore or tired afterwards. Maybe she didn't enjoy the exercise or the therapist. See if she wants to regain mobility and strength. Remind her that not exercising, leads to permanent physical problems. I would recommend doing her exercises with her or see if there is group activities that mimic the exercises she was doing. Sometimes doing things as a group works better.
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As many of us (not old/er, we have excuses). It takes effort and recovery exercises can feel like they 'hurt,' even if they are doing us good, and are needed for recovery.

Aspects of resistance could include:

* Dementia
* Depression
* Feeling overwhelm
* Lack of will
* Anxiety

Best to talk with her about how she feels instead / not 'push' her.
She won't respond well to any pushing or most likely telling her the why she needs to do xxx for recovery and if she doesn't xxx will happen (i.e., go back to the way it was, worse, lose muscle mass). "This 'logic talk' doesn't help in my experience (although not a parent; it was a client).

I'd bet that this was your mom's MO for some or most of her life 'blaming others.' People do that when they aren't (able) / ready to take responsibility for their feelings and/or behavior. Ultimately, she will do what she wants and suffer the consequences of her actions or inactions.

I wonder if she'd benefit form someone doing them with her?
Not that that is easy to do / accomplish.

If there is a 'carrot on the stick' that will get her going, use it.
Along with this, I would try to relax / express calmness towards her.
She'll pick up on your stress and frustration which won't help either of you.

Take her hand, smile, look in her eyes. Just be with her.
Perhaps with this quality connection with you, she'll be more motivated to do what is in her best interest. She is likely suffering (tired, depressed, etc) If you can focus on this - a bit - perhaps she will respond. Although be careful to not over-do it... she may 'just' want the attention and be baiting you for that. I don't know. It is often a fine dance and we just have to try different approaches until something might click / work ... and then know when to rest / stop / accept what is. It isn't easy. We do what we can and then step back.

Gena / Touch Matters
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