The problem is he has told PT and OT that he does not need it because he is going to die. He looks better and his brain function has come back to a point. The NH has called me and told me that if he does not help with PT they are going to stop it totally. My husband wants to come home but I have told him he has to work to gain back his strength or he will not come home. How do I make him realize he needs the PT and eventually we all die at some point.
I pretty much do variations of this on a daily basis with my mom and because of her dementia she doesn't remember I say these things so she continues to do her best and we are able to eke out another day of living life to the fullest we can muster...
If he is normally healthy, active no dementia and no reason that he can not participate in his therapy this could be a sign of depression and he should be evaluated for that.
If he has other health problems and is not a candidate for Hospice is there a way he can continue rehab at home? Most of the in home PT can be just as effective as in patient rehab.
If he has other health concerns and has been diagnosed with a "life limiting" disease then this could very well be his wishes that he does not want to go on. Have him evaluated for Hospice and go from there.
Now if he is anything like my Husband was if you explain to him that if he does not participate in rehab then Medicare will no continue to pay for extended care and he will be stuck with the bills. The thought that something would cost more to to my Husband was usually enough to get him to do what I needed him to do. (this was early on before his dementia diagnosis)
As he progressed though in the later stages there is no way he would have been able to participate, it was hard enough in the middle stages to get him to cooperate with the therapists after he broke his hip.
"This is what the doctor ordered, and I will not hear anymore about dying".
"Now, what do you want me to bring you for lunch, after you have done your exercises?"
This works for some personalities, I am told.
For the NH, the PT and OT to make you feel responsible for your husband's co-operation is not fine. Naturally, you will support and encourage him as much as you can: you love him, and you want him to recover as well as possible. But when it comes down to the hows and whats to do; well, those are part of the various professionals' remits. Therapists are trained to motivate and assist their patients.
So you'll do what you can, of course; but "making" your husband do anything is more up to them than to you. Don't assume more responsibility than you reasonably can.
I've read this so often here - UTI - have him checked for a UTI. Urinary Tract Infections can make some of this happen. They "know" they're dying and they don't think clearly. My DH had a UTI and he acted in a similar fashion to your DH.