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My husband had knee replacement surgery on 6/21. He came home yesterday (even though I felt he should have stayed another night). He’s been on the sofa since. He has no upper body strength and cannot stand. He’s too big for me to lift. Our insurance declined in-home therapy and the hospital never got back to us on outpatient therapy. I’m so frustrated that he won’t try. I know it hurts. He was so much in agreement and willing with the PT at the hospital but since he got home he thinks laying around will eventually help him get up and walk. Help!

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"He’s been on the sofa since. He has no upper body strength and cannot stand. He’s too big for me to lift. "

Please don't injure yourself attempting to help him stand!
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His knee will be sore, stiff & swollen. He may not have slept well for days. Yet.. move he must.

Bloodflow promotes healing. Blood clots are a real threat.

What reasons does he give to not move?

My ideas start with;
* Pain? Take the meds prescribed (many don't).
* Stiffness? Gentle bending.
* Swollen? Ice.
* Tired? Take a nap.

It's awful to be 'The Nag' 😣
What solutions can HE come up with to overcome HIS obstacles HIMSELF? (It is HIS new knee afterall)

I don't know your Husband's age, other medical issues or pain tolerance of course. But my next ideas would be;
Today - Him: Walk to & sit at the table for all meals. Physio exercises as prescribed then ice & rest. On repeat.

Today - yourself: Call the hospital. Explain. He will not be the 1st patient to only have motivation for a 'professional'. If instay rehab is not an option, ask to get home visits PT set up. (See if your health insurance covers this or pay if possible). Then he can move to outpatient rehab sessions when he is a little more recovered.

Good luck!
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I would appeal the no PT decision. Did doc prescribe in home?
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KarenHelp Jun 2022
Yes but there are no staff available in any of the nearby facilities. Any facility over 20 miles away they say it’s too far. Very frustrating.
the hospital lied to us. My insurance does cover inhome PT. They recommended not to take hospital staff at their word. It’s been a whirlwind of a day.
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As one who preaches to everyone that you cannot change others I literally BEGGED my sweet bro to do his balance exercises as they helped him enormously the month he was in rehab. He had Lewy's and it affected his balance a lot.
He wouldn't. He would say he would and then wouldn't. I had to relearn that lesson I tried always to reinforce for others. We just are powerless to make people do anything. I agree with appealing the decision on home PT.
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Beethoven13 Jun 2022
Thanks, I needed to hear this today. My 92 yo father had a stroke in April. He did 3 weeks in acute rehab and now home with home PT. He is walking around the house with his walker. Some days he works with PT pretty well. Some days he complains constantly and is very negative "there's nothing they can do." "It won't get better. That's it". He refused the balance work on the blue cushion yesterday. He has R hand weakness but can use the hand, its just weak and has fine motor problems, and he has speech problems - about half of what he says is intelligible and other half, word substitutions and gibberish. Cajoling only helps so much. Thanks for the reminder, you can not make another adult do something they don't want to do.
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So sorry that your hubby is being a bad patient. My mom is just like that! I swear I have PTSD type of memories from trying to help her with PT after her knee surgery. She was IMPOSSIBLE. She did go to rehab after the hospital, thankfully.

Glad to see he's getting into outpatient PT. I agree with other poster about hiring someone to do his exercises with him at home on the non-PT days. That is the ONLY way my mom will do her exercises. She does not listen to me but makes excuses and whines. Too difficult and annoying for me to handle. They ALWAYS behave better for someone else. He may not like it but too bad. Tell him when he's better and consistently doing exercise on his own without you begging him, etc. then maybe the extra aids can be dismissed.

It is crucial that he get his range of motion back or he will have ongoing issues.

If you are waiting on him and catering to him, allowing him to sit, you are going to have to take a deep breath and set some boundaries and stick to them. Like meals are served at the kitchen table. He needs to get himself there to eat them.

As long as he is cognitively capable, ask him to take responsibility for his own recovery. He's an adult and should care about getting better. Tell him YOU need him to be independent and do what he should be doing to get the most out of his operation. That you are not going to do more for him because he is choosing to do less than he should be. Time for some tough love. It may not be easy but it's necessary at this point.
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My father was in out-patient PT and really liked it but wasn't interested in doing the follow up exercises at home by himself. So I posted a job on Care.com for someone to come to the house every day to do the PT exercises with him and go for a walk; it works great and he has greatly improved.
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There is another Youtube video that may motivate him,(or other members and their loved ones :} it's called:

This Aerobic Video Wins Everything (480p Extended)
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Take it from someone who's had 6 knee surgeries including bilateral total knee replacements that you want to follow your PT instructions to a tee if you want full motion of that knee! It really hurts postop (take your pain med 30 minutes prior to therapy & ice it afterwards) but knowing that if you do your exercises as instructed that you'll be walking without any difficulty or pain afterwards. I know that may sound insensitive, but the advice is from the heart & experience.
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I have been in a similar situation. Perhaps the most frustrating problem is getting someone to do something they do not want to do. My wife has declined since a broken hip 1.5 years ago and recent a hand fracture. The docs say nothing wrong but now she is bed ridden. It is a mental battle. In most cases you can build off something that is successful that they like to do. But now with dementia setting in it is hard to even find those things. Not many people like to exercise but find something that is mobile that they like to do and do it.
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AliBoBali Jun 2022
My grandmother loved music from her youth and surprised me by dancing with me and showing me the cha cha. I'm not suggesting that your wife will get up and dance, but I think fun music from your youth could help raise spirits. I hope you can find something to motivate her. I agree it's a mental battle and it's understandable that someone would be depressed after a painful injury.

"Build off something they like to do." In clinical terms, this is called high-p or behavioral momentum. You nailed it, and it works.
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When a relative was in rehab after a stroke, there were various patients who wouldn’t do the work. One day when I was there the head doctor of the facility, a normal nice soft-spoken man, visited the patient in the room across the hall. I was startled that the doctor laid into that goy so forcefully. He raised his voice and emphatically stated exactly what would happen if the patient didn’t do the work. “Your muscles will waste away and you won’t be able to walk again,” on and on etc. Then doctor states that they were giving him a chance to get back to normal and he damn sure better take it, etc etc. it was one fantastic motivational speech, loud and emphatic. I don’t know what happened to that guy, but if it had been me, I would have been too scared about the consequences not to comply.
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Cover999 Jul 2022
He is right though maybe he could have used a better way to convey that.
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