My Father (80) has decided he is quitting PT. Any advice?

hi dawners...please keep us updated on his results! thanks

Greetings! Update on my dad...
Today mom and dad had an appointment with the doctor who is the director of the PT program he was in at Ohio State University.
1. According to mom, he said (quietly) in the waiting room that he was only going to tell the doctor about how he didn't like the treadmill part of PT. Mom suspected he wasn't planning to tell the doctor that he doesn't intend to continue--and she was right.
2. So the appointment was mostly about him becoming able to cath himself (he still has urinary incontinence that gets worse and then better - urologist thinks it will get better as the cervical spine heals and recovers). Dad doesn't think he will ever be able to cath himself even though the OTs and doctor assure him he can and tell him that he will be more independent.
3. Because dad didn't cop to his decision to quit therapy and diverted her question about why he hasn't been in 2 weeks by saying they are in the middle of a bathroom remodel and it was too much for mom to drive him to PT 3x a week. THERE WAS NO DISCUSSION OF HIS DISCONTINUING PT! The doctor doesn't know he is quitting. Mom didn't say anything (she never does - this is her survival technique).
3. On the way home, dad said he was going to get PT at the VA. Along with that he wants to go to the VA to have someone look at his hip, get MRI's, x-rays, etc.
This is significant because when he fell apart last January, I spent a great deal of time, blood, sweat and tears untangling his health care (he was going to VA for some things and going to private doctors for others and not telling the doctors full information about what was going on. He literally had 2 doctors lists with 2 different med lists and instructions about what to tell which doctor and what not to tell another doctor. So, when he fell apart - of course, the health care team had to be narrowed and they had to know what was going on - and no one really knew! Anyhoo, long story short - I sidelined the VA in order to advocate and get care for him in the private hospital system he was in. There is no VA hospital in our area - only outpatient center.
CONCLUSIONS: Both of them are in denial. She is in denial because she has to be to live with what is going on everyday. I told her that he will spend the rest of his days seeking this doctor and that doctor and he is using VA because we (meaning me) won't really know what he doing and not doing. I told her that's fine and dandy until it all hits the fan again and we are left to figure out what he was doing.
Regarding the PT - It is like when I say "I will start my diet on Monday" and Monday never comes. I told her that he is probably just saying that to "benefit" her, me and my sister. As of now...he hasn't even called to get an appointment for a PCP or geriatric assessment (this assessment has a waiting list of up to 3 months) in order to get going.
BOTTOM LINE: I know and have known I can do nothing in this situation, except be there for mom when she melts down. I must work through my disappointment in my dad's behaviors and realize he is a "do as I say - not as I do" kinda guy. I promised my mom that I will be kind and loving the next time I see him and I will move heaven and earth to support her - but I will refuse to discuss anything medical or health related with him. Also, I told her that when he declines (because he will sit in a chair all winter), becomes ill or falls - I am not going to stand on my head to advocate for him. She is okay with this.
Sorry for the eternal post....I have no one else to talk to about this. Sister is an "ostrich" and rarely talks with me about dad, hubby is kind and listens the best he can.

Sorry Dawners, that's too bad. But, you really have done all that you can do. Your parents don't seem to be incompetent enough to force a guardianship so you could have say so over his medical care. But, even if you did...you can't force someone to do PT. It's his decision and he and your mom will have to live with it. I'd probably look around and see what is available, just so you'll be ready when the time comes, whether it's AL, rehab or NH.

Thanks Sunnygirl1 - you are right. Unfortunately, I already know all about the AL, rehabs, and NH's in their area since we spent a good deal of 2015 in hospital, NH, rehab. Although you are never ready - I guess you could say I am as ready as I can be. BTW...another "shake my head" moment was he told my mom that if he ever has to go into a nursing home again he will go to a VA facility. The nearest one is about an hour away from their home! Well that's considerate of his wife and daughters (sarcasm)! He doesn't get that the VA contracts with community providers and that the criteria for the VA to pay is strict and facilities use Medicare first (when the beneficiary is 65 +). He seems to think the VA is some magical, closed universe with unicorns and fairy dust that will make everything better. Yes, they can do good work, but my experience has been you never get the same doctor for any continuity of care and they just give him stuff (diabetic shoes, diabetic socks, adult diapers, compression socks, countless blood sugar meters, blood pressure cuffs, therapy bands - all of which he doesn't use). But, of course, that won't happen, according to him "he isn't going to get weak, he is not afraid of falling and he can make his own decisions." Alrighty then.....(sarcasm).

Dawners, you have a tough situation ahead of you. You know what will happen but your father's position prevents you from acting to provide protection.

I'm hoping that your father will recognize that his lack of cooperation isn't helping him, but that's probably not going to happen for some times, if it does happen at all.

You've done all you can; know that you've tried.

REF. to the VA. I'm not that familiar with their long term care services, but we have a family friend who stays at their long term facility. I think it's located in the VA hospital in Durham, NC. And it's free.

GardenArtist - THANK YOU!!!!

Sunnygirl1 - I know VA isn't on topic - but you are probably right, problem for us is that the nearest long term VA facility is over an hour away from their current home and my sister and 5 hours from me. It's not practical. There are guidelines and criteria for VA to pay...not an expert though. Thanks so much for being an open ear for me! I will follow you and GardenArtist so that maybe I can be of help to you sometime.

Dawners, I would certainly appreciate your keeping up on my father's progress; although he's insistent he won't leave his home, one never knows what may happen in the future, and the VA may be coming to his rescue.

hi Dawners thanks for the update...and please keep us informed! My thoughts...life is a process...there are sooooo many zigzags before we reach our end. The nice thing is that you are trying to adapt...and that is probably the most important thing I heard. Take care of yourself first...the rest will happen as it is going to happen...of course...that's up to your dad. take care!

Lots of great comments. Went thru this with my father- at home until he got a bad infection. Survived that but they had to rebuild his strength. After some therapy he said "I am 93, I don't have to do this"- never walked again or returned home. What are your father's mobility issues? My two main points are to supplement therapy with whatever assistive devices may be helpful to keep him independent. More importantly is to understand the risk of injury to your mother as she helps him. When a caregiver is injured it is often "game over" for both- don't sacrifice your mother's health. Let me know if I can offer suggestions to help- I see many innovative products at national tradeshows that most people know nothing about.

Friendlybedguy is right my mom was independent to and she got a bladder infection and the doctor gave her Cipro which blew her kidneys out and led to her death and she was in pretty good health.My Thanksgiving was the worst I ever had without her.Take care of your father and Mother you do only get 1.

ah...so sad. take care scottdenny!

Hi Dawners! Whew you have a lot there. Don't give up, because while Mom & Dad maybe in denial, it will catch up to them. 1st he needs to be sure to have ONE PCP, whether doc is a VA doc or a private doc doesn't matter. If he has dementia, it's really very very important that someone give the doctor ALL the facts. (I had to do this with mom, she kept forgetting to tell the doctor all her health issues). See if he will give you a Medical power of Attorney or Directive of Physicians. This will help you to discuss his health issues to the doctor. Or if not, most doctors have email, before his next visit send the doctor a note explaining that Dad refuses to do anymore PT. Then it's up to the doctor to explain to his patient (your dad) what could happen. Possible that he could do PT at home. Or find out if there is really something else going on that may be keeping him from the PT. Good luck.

As LME said a couple years ago, there are implications for Medicare. After 21 days, Medicare will pay a portion of nursing home room and board up to 100 days, so this has implications for anyone who is private pay. (My mother gave up after a short time, but I didn't have the heart to tell her she essentially threw $16K out the window!)