How Can I Get My Mother-in-law to Do Her PT Exercises in Between Therapists Visits?
My mother-in-law is still recuperating from a broken hip she got when she fell in October 2011. Sjhe has mild to moderate dementia. Her Ortho-doctor prescribed P.T. which is now on an out-patient status. She will not cooperate with her live-in care-giver to do her exercises in between visits. She tells the p.t. she will do them, but she doesn't & her therapy will no longer be covered by medicare if she does not show progress.
The disappointing but realistic answer is that you cannot MAKE her do her exercises. I know this is hard to hear. You want more than anything for her to do everything possible to keep her pain free and mobile. Here are a couple suggestions that may help. Look into exercise classes through your local senior center. these would probably be appropriate and the guidance and social aspect may be encouraging. Water classes are especially good if they are available in your area. The other thing is that you can ask your caregiver to do more exercise based activity with your MIL without telling her they are "PT exercises." No one really likes to do exercise for the sake of exercise. So ....things like...take more walks. Have a destination. Have her walk out to get the mail with her caregiver. Have her walk to the neighbors house or park the car further away from the store so she has to walk further in the parking lot. Make sure your caregiver is trained to help to keep her safe but not to over help her by doing too many things for her. .I am not sure of your MIL's functional level--but the more she can get up and down from a chair by herself etc--the stronger she will stay. I hope this helps.
We hired a student to help my husband do his exercises. He likes having someone to talk to. Even though you already have a live in caregiver, would someone different who was associated with time to exercise help?
I think Pamsc may be right. My mom had her hip replaced and it was amazing the difference in her attitude based on which PT was working with her whether it was inpatient at the rehab facility or if the therapist came to her home. (she never did do her exercises at home by herself, and one PT told me they never expected older women to REALLY do their assigned exercises.) Actually the only time I saw her do an exercise at home without a therapist there was to demonstrate to one of her grandkids the "silly" things they were asking her to do.
This is not an answer to your question, but how much progress does a person with moderate dementia really want? I have long believed that if my mind or body were failing badly, I would not want to suffer longer than naturally the severely inevitable decline in the quality of my life - and that of the people caring for and about me. But then I have no children.
I agree; you can't "make" them do their PT exercises at home. My husband would make remarkable progress every time he was in PT but then they'd cut it back to 2x/week and give him homework and he wouldn't do it. So he wouldn't improve, and they'd let him go. I even hired a non-Medicare provider at $125/hour who came to our home three times a week for a while, but he only did that for a while and then didn't want to do it anymore. But they hired a recreation therapist at the stroke recovery center (where he won't exercise in the gym) who gets the clients throwing different kinds of balls to each other, tossing beanbags, shooting rubber darts at a target and similar activities--after several weeks of saying he never wanted to do it again and losing his temper a couple of times because he perceived that he was being "told what to do", he started to enjoy it! Now he looks forward to doing this twice a week, and lately he's been getting to his feet part of the time instead of sitting through the whole activity. One day we bumbled into "dance therapy" by accident, and it was country music and all kinds of stroke-survivor-accessible movement and whooping it up and he was really having fun, so we've added this to our routine too. I think the hardest thing is the TIMELINE--it takes him SO long to not be afraid, to not feel threatened by other people getting too close to him--I'm learning patience and having more faith in repetition. Plus, it's PLAY, not work! That could be the key.
Response to person who said "how much progress does a person with moderate dementia really want?" Hip problems can cause pain and put a person, who could get themselves around, in a wheel chair. Since this woman has mild to moderate dementia and the average course of Alzheimer's from diagnosis is 4-8 years, she probably has several years of life left. For her sake and for the caretakers, being ambulatory as long as possible is important.
Careful thought does has to be given as to what care is useful as we age. A lot of individual factors go into personal decisions. There are no one all size solutions and plans made years ahead may need to be reassessed as important details change.
I "forget" things when I take Mom to the grocery store so we have to back track and walk the aisles a couple of times. I used to have her get the newspaper in the morning, but had to stop that once she had problems bending over. She would be content if I brought her meals to her, but I try to make her get up to come eat or she will just sit there, wanting to be waited on hand and foot! She refuses to go to ANY physical therapy. She quit after 3 visits. It is so hard sometimes to get them to realize that if they decide to quit moving around, they will loose the ability to. I try to incorperate as much physical activity into Mom's day as safely as possible. It's nothing big, but I believe every movement she makes, from getting up out of her chair to walking to the kitchen to get her food is better than not expending any energy at all. I've tried everything to get Mom to go back to PT, but as we all agree, it is basically up to them. I know it is frustrating, but we need to keep them moving! Good luck!
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