So many of you know the saga of my FIL - just wanted to share - he mentioned to his VA primary that he has increased issues with his shoulders and knees (which could be due to the decreased usage but I digress) - which he is ALWAYS going to have because he has arthritis and refuses to move if he can help it. I think I've spoken before of the fact that he wants to feel zero pain. And he is NOT a proponent of the "no pain no gain" mentality whatsoever. More so the "no pain, no pain" motto.
By our estimation he thought that the doctor would throw some pain pills at him but he underestimated the situation he has himself in with all of his health issues and they can't really prescribe him too many pain pills anymore because it exacerbates his other health problems. What they can do, which is what they have been telling him to do all along, is get him moving. SHOCKER. That's what WE have been begging him to do as well. (over 300 pounds has been for YEARS, very limited mobility which continues to decrease of course, etc)
So now he has PT and OT coming to his home THREE times a week. Right in the middle of my SIL's surgery recovery and scheduling her own PT. So we have the home health caregivers there all day letting in PT, OT and bath aides....it's our own little skilled nursing facility in a jar! Honestly some days you just have to laugh or you'll cry. He has certainly gotten his way with staying home.
For those that aren't up to date...I'm having to take a not my monkeys, not my circus approach anymore...until BIL/SIL decide they are moving out...all my DH and I can do is sit back and watch all of this unfold and shake our heads anymore. We have agreed we will help with the occasional doctor's appointment if we need to but that's about it anymore. It's just getting ridiculous.
So, we'll see if he actually DOES the PT/OT this time. He hasn't the last three times he has had it - usually he just winds the clock down while they are there telling stories and complaining about how much it hurts. (don't misunderstand - I KNOW it hurts - I just know that he complains about a hangnail as if it was a broken arm - he's always 10/10)
I just wish he knew how incredibly lucky he is to get PT and OT to come to his HOME and do this for him. 8-16 weeks of PT and OT in his HOME. All he has to do is get out of bed and TRY! And it's like we are asking him to cut off his arm. It's just unreal to me. In his mind...when HE is ready he will just get his mobility back and they should just give him a pill for it (he actually said that.) He spends all of his time complaining about wanting to get out of the house and do things...ad nauseum...but he can't do those things if he can't physically get out of the house!! We can't safely take him out of the house if he can't safely transfer himself. The PT team lead that assessed him CRINGED at his transfers and literally said he needed to be in a skilled nursing facility TO HIM because even with all of the upgrades to make his home safe...it's still not safe for someone in his condition. It boggles the mind.
Anyway...thanks for listening to my saga. I don't know where we go from here. I have zero expectation that he will use this opportunity. I have 100% confidence that he will waste it. I would love for him to prove me wrong. Taking bets...
6 Answers
Helpful Newest
First Oldest
First
Your profile says Dad has Dementia. Does anyone have his POA? If so make it effective and get him placed. Its no longer what he wants, its what he needs. Even receiving Medicaid for his care, yiur in-laws can probably stay in the house claiming tgey have been his Caregivers. They may have to show, though, that they can keep tge house up, pay taxes and utilities.
You have a PT saying he needs LTC. Have her/him it put it in writing. Its an evaluation. He is never going to get better having Dementia. He can't be reasoned with.
Mother is super compliant when the 'hot' PT came to HER place and spent an hour with her. She'd be coy, 'darling' and COMPLIANT through how ever many weeks the PT was going on.
The last day, the PT was walked to the door, hugged and told how much he was loved and then she'd meander back to her apartment and the exercise bands and directions for 'alone PT' would disappear. She NEVER did an exercise on her own again.
Now, at 92, she moans and groans about how she WISHED she could just walk "100 feet, that's all I ask". I had HAD it one occasion and I called her out. I said "Mom, you QUIT trying the day Roger left. Your exercise bands are rotted through. IF you had cared so much to maintain your mobility, you would have worked at it". This was NOT taken well. Currently she is trying to get YB to let her use the wheelchair in her apartment, which is hoarded so badly she can barely get her walkers through the mess.
I actually asked the PT how many clients actually DO the FU stuff and he said "About 20% and that's a high estimate". How discouraging, for him, but he said he was used to it.
We have NO illusions that mother will ever be more mobile. Interestingly enough, HER mother walked 5 miles a day, 5 days a week. Was completely independent until just a few weeks before her death at age 96. Mom has been immobile for the last 8 years, since she was 84. Gma used to say "If I feel stiff, I walk 3 miles, if I feel LOUSY I walk 5". She was amazing.
ADVERTISEMENT
He has got to be compliant for care and making progress within both. Progress can be teeeeny tiiiny, but the therapist will have reports done that indicate just where he is or isn’t in his therapy plan.
If he gets all “maybe manana” so makes no effort on doing therapy or is all “it hurts, I’m stopping”. That will be written up. If he reaches a plateau in therapy, that too gets written up. Once it goes 2-3 sessions, that’s it as the insurer will stop coverage. It’ll be beyond hard to get it continued as it’s all there documented in his therapist notes as to what’s what. Insurance is NOT going to pay for 4 mos / 16 weeks for PT or OT to go to his home and chat. He’s got to work his therapy or it’s 86’d
fwiw2, if therapist(s) use a program that has sensors and tied into an app, what he does or doesn’t is all recorded to the second for every visit they make. It’s centrally monitored so therapists don’t have to take time to do quite so many notes or measurements. Downside is PT / OT cannot fudge on what he is or is NOT doing & if not compliant or hit a plateau insurance will stop. If the inhome therapist sets him up on a monitoring via a tablet & sensors tied into an App therapy program (like Hinge Health) for days therapist not there, he’ll be fully expected to do exercises on his own; if he doesn’t, it will be known & insurance stops.
I mention all this as it sounds like he’s the type to push boundaries; that he’s going to be “I have weeks & weeks to do therapy so I have no need to bother today….” nonsense. He’s got to, GOT 2, understand “8-16 weeks” is not at all guaranteed. It could be 5 visits and if he doesn’t actually work with the therapist, he’s toast and it will stop.
The last time they actually EXTENDED him I think largely due to the fact that COVID was still a big thing and a lot of people weren't comfortable with having anyone in their homes and they could afford to dawdle with him and entertain the shenanigans he partakes in on a regular basis because they didn't have as many clients at the time.
Quite frankly I hope they are very direct with him and set him straight that they DON'T have time for his tomfoolery and he either needs to buckle down and do the work and they a have to move on this time. He got way too much attention the last time for someone that should have been doing way more than he did and as a narcissist he ate that up with the proverbial spoon!
As far as the app and sensors - none of that occurred at all. He did absolutely NOTHING when they weren't there. He barely did a thing when they were.
It is not safe for FIL nor is it safe for you or your husband to care for him.
The fact that PT and OT said he should be in a Skilled Nursing facility might be what would be needed to get that done.
PT and OT will not continue if he is not compliant and does not make progress.
Is he qualified for one of the VA homes? Or VA inpatient rehab?
If you do not get a response from the doctors I would suggest talking with a Patient Advocate or even a Social Worker.
If more adaptations are needed see if a Hoyer lift or a lift system can be installed that would be safer than trying to transfer him.
For some reason - even though he has not been compliant in a number of years - the VA continues to send PT and OT every year or so to see if they can achieve something new. They can't give him too much in the way of pain medication due to other medication interactions and his other comorbidities so I guess this is the only option? They just keep trying it every 12-15 months or so to see if they get a different outcome.
(please send any money i get, to: bundle of joy, who-lives-somewhere-over-there).
dear OP,
it's hard. i'm sending empathy your way.
hard to help our elderly LOs...especially when they don't want to follow wise advice.
actually, i better follow wise advice, too. i'm terrible at following good advice.
hugs from me!
try to have an AWESOME monday.
bundle of joy
when her pain dr prescribed PT I didn’t follow up because I knew it was a waste. Complained how she fell because someone stole her knee brace… (didn’t happen, found it in her closet when I moved her ) brace appears, she wouldn’t wear it.
Just have to accept what they won’t do….
I know I need to just get over it because he's going to do what he is going to do. But it just infuriates me that he wastes so many opportunities that others would be so grateful for.
As far as following up - they basically schedule it and send them out - and they do it all through him - and he is NEVER going to turn down services because they don't cost him a thing - even if he won't do them. He feels he is owed anything he can get from anyone (that alone is a book in itself).