Anyone have suggestions on how to deal with my husband not doing his PT exercises?

Did you get help? I am seeing this 8/1/22. When insurance declines, doctors can recode and submit a new request based on "medical necessity." Reconsideration or Appeals take too long - up to six months. Writing a new request with better coding and explanation usually this is approved.

Once you leave hospital in US, the hospital can't arrange out patient therapy. Call family doctor for medically necessary referral.

Meanwhile, vent your frustrations to a friend or psychologist, not at your husband. It can take MONTHS for anesthesia to work itself out of the body. You could both get support from counseling covered by insurance on how best work together. He probably has a mix of emotions: fear, anxiety, embarrassment he can't fix this faster/ better, feels like he is emasculated and letting you down, angry, frustrated, and flat out needing rest to recover.

Knee replacement recovery bounceback varies depending on person. Everyone is different.

Be his cheerleader, not his disciplinarian. Being the "bad guy" will negatively impact your marriage and sex life.

Let his doctor and PT be the one to challenge him. He needs a soft trusted supportive person.

I hope he is doing better now. I don't know your husband's personality. If he isn't great at sharing feelings, does he have a guy buddy who can get him out for coffee or a beer? If he is depressed, it might give him a place to talk and to cheer up.

Riding his bum will probably get you nowhere - except more frustrated.

Those suggesting to hire assorted caregivers keep in mind those of us that simply cannot afford it. Financial limitations are a reality for many struggling in the caregiving role. We know it's hard and kind words (as opposed to letures) can salvage a difficult day.

Omg! This is exactly what I’m going thru with my father who refuses to do his exercises with his PT and OT.
The exercise are so SIMPLE, but he acts like they’re making him run a marathon 🤦🏽‍♀️ He’s sleeping like a baby with NO PAIN, but when he sees either the PT or OT, OMG! he says his pain activates. They tell him he needs to move to reduce the pressure on his back because all he does most of the day is sleep. His exercise are like 20 minutes each session, once or twice a week. My dad has stage 4 lung cancer and I think by him laying down the whole day is making his dizziness worse day after day. Good luck to both of us. We only want what’s best for our loved ones.

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.

KarenHelp: I did see your post wherein you stated that your husband began outpatient therapy on Monday, which was June 27. I agree that he needs that to attempt to recover. My brother, who is due to turn 72 in one month had knee replacement surgery in December, 2021. However, even though he followed his physician's instructions, he did NOT recover fully. As a result, he is due for a 'manipulation' procedure very soon. If that fails, he will have to have revision surgery.

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.

oh boy! i don't envy you - my brother was supposed to go to PT that didn't work our - then he had the P.T. come to home - my brother sent the guy home.

it's a battle hate to say it - how do you make a person do something they refuse to do. you talk to the dr and try to scare them that doesn't work, you say you won't listen when they complain, that doesn't work. so short of leaving him, forget it - he is on his own if he is a stubborn man, maybe start goin out see what he says

Call the doctor and ask him to arrange outpatient therapy. Tell dr he has no real instruction on what he should be doing and just complains about the pain. It is very important that he start moving that joint or he's going to be in worse shape that prior to surgery. No, it does not magically heal on its' own without the exercising and it will hurt.

This happened to my dad. He wanted to stay in bed, and have meals delivered to him, and coddled. He had no interest in moving his knee. I think he wanted the pain med too. My mom said she's not catering.
She put him in a nursing home. Not sure how long. A week or 2? My dad liked it there. He told me, he had a cna give him a shower/shave. I said your arms didn't get operated on. I put a stop to that, and everyone worked on getting him moving again. Took away his wheel chair. Made him get up. He didn't like the pain, but he elected to get the surg. It's surg, it's gonna hurt rehabbing.

My dad started looking in to sev surgies as well. We think he enjoyed the pain meds a little to much. He never drank/smoke. So my mom put a stop to that. Said they couldn't afford it. Luckily he didn't try to seek it out elsewhere. You also have to stop with the urinal and food. Otherwise, he's king on the couch. He's got no reason to move. You can take the remote away, turn off tv. He's got to get up to get it lol. Good luck.

This happened to my dad. He wanted to stay in bed, and have meals delivered to him, and coddled. He had no interest in moving his knee. I think he wanted the pain med too. My mom said she's not catering.
She put him in a nursing home. Not sure how long. A week or 2? My dad liked it there. He told me, he had a cna give him a shower/shave. I said your arms didn't get operated on. I put a stop to that, and everyone worked on getting him moving again. Took away his wheel chair. Made him get up. He didn't like the pain, but he elected to get the surg. It's surg, it's gonna hurt rehabbing.

My dad started looking in to sev surgies as well. We think he enjoyed the pain meds a little to much. He never drank/smoke. So my mom put a stop to that. Said they couldn't afford it. Luckily he didn't try to seek it out elsewhere. Call the soc worker at the hospital. Maybe they can help set it up. Good luck.

Make sure he takes his pain medication as prescribed for at least a week. Get a walker and make him use it to go to the bathroom - every time. Call doctor's office about a referral for outpatient physical therapy or if he can be placed into rehab for physical therapy.

I learned the hard way, it has to come from within the person, you'll never force recovery onto someone.
My wife after her stroke 3 yrs ago wont lift a finger to accomplish prescribed home therapy , unless I'm dragging ber by the hand the whole way. I've concluded she likes it on the couch all day watching me cook, clean, manage the house and acreage.
Our insurance approved another round of outpatient PT and that helped until I finally started planning her day for her full of manageable tasks and refuse to do it for her. This is where it seems you'll need help getting started. Any kids, neighbors or friends that can stop by a couple times a week and get him up and started? Or look at home assistance products such as pull bars, ropes or even a lift chair? Let him know the consequences of letting the procedure heal in one place, meaning another surgery.
Have you explained your situation to a outpaitent thearpy center to see if they had a service to come pick him up?

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.

Difference
with PT - I did my PT before surgery and after surgery knowing that PT is the key to no pain after about 2 weeks I had no pain and my PT was done regularly. I was released from the doctor and back to work in 6 weeks. I used a cane for the next two weeks and BAM! Walkin' great since. I have no pain and I have done a 5K since.
without PT - My two friends had same surgery as me. One has pain not a lot but enough that she walks for a bit and the needs to sit. My other friend says her knees burn. Both did the least amount of PT they were asked to do. None before barely any after.
Also - if the knee is not moved scar tissue WILL build up where the scar is and another surgery will needed. I took a massage tool I purchased at the dollar store and rubbed it along the scar and I could bend my knee more than 90 degrees within 6 weeks!
PT is the key yes pain now no pain later!
Prayers for you and yours

Yeah, that’s a bad deal. Moving is the bestbt(ing for him. Yes, painful at first, but will only get worse if he doesn’t try.

Would he consider doing the exercises with you…if you did them too? Could it be a challenge or a game to pass the time? That’s a stretch, but I thought I’d throw it out there.

If not, you must contact the Dr regarding the outpatient therapy. There are PT places all over most cities (not sure where you live).

Sorry to be so harsh, but the way you phrased it ‘the hospital never got back to us on outpatient therapy’. Is sooo passive. They probably should have, but this is on you guys…contact the Dr who did the surgery and explain your husband flat refuses to to home exercises and tell him you want him to sched PT for your husband. Please do this ASAP. Be sure to tell the Dr all your husband is doing is laying on the couch complaining about the pain.

Sounds like this will be one of those situations where your husband will bellyache to people….”oh I had surgery and I’m worse then ever…” He will leave out the part he refused to follow Drs orders for post surgery PT.

Oh I am so sorry you're dealing with this frustration.( same with my husband) Wish I had magic words to get through to him, I'm sure you've tried all the obvious. We did have a minor breakthrough with a different ortho that REALLY read my husband the riot act. It's still a struggle, sadly. Hope he comes around for both of you. Hugs

Get a Playboy magazine. Separate each page. Show him the stack of pages from across the room and tell him for 30 minutes of exercise he gets first the cover then additional pages after each day he exercises. Remember to hide the stack.

Or, of equal value, go to a great bakery, buy two eclairs, flash 'em from 5 feet away from the sofa and while you take a bite out of one tell him the other one will be waiting for him in a cooler on the other side of the yard.

Karen,
Any update on how the Outpatient PT went?
Hopefully he is feeling better and is doing some of the PT that he needs to do.

He probably feels terrible physically and emotionally.

Give him rewards for completing his therapy. Try different things to see what works for him. Watching a movie together on Netflix? Serving his favorite food for dinner? Give better or more rewards for more reps/greater participation/more attempts. These rewards don’t have to be expensive or difficult. Positivity is encouraging.

Be creative and use what works for him. Don’t scold or hold anything over his head. You don’t even have to let him know this plan.

My mom “hated” exercise. But she loved going shopping at the mall and her favorite thing was jewelry. When she was recovering from spinal surgery I thought she might never get better. Although she could still walk, her doctors said she might never transition out of a wheelchair. We took her to the shopping mall. One of my children was on one side and I was on the other, holding her hands snd walking, kind of like a human rollator. Mom could only make it from one bench to the next. (In those days there were lots of benches, positioned less than a block apart.) We would go to one bench and sit. Go to another and sit. And then to the next. At every bench we would take a short break. She wanted to go into the jewelry store and look. “Great idea! We will go after 10 benches.” The next day it was a different store after more benches. Within a relatively short time she was asking us to walk two benches without a rest, and then to just walk with no benches. (We made it to two miles, with no breaks after two weeks of this). If we would have said “let’s go exercise” (or even “let’s go to PT”) we would have never made it out the door. The idea of shopping is what made her happy, and we never even needed to even buy anything.

Make sure he doesn’t spend too much time on the couch or sleeping, or taking more painkillers than he needs.

He could be feeling depressed snd defeated. Take this positive approach to help him lift himself back up.

I can understand your frustration. My mom had a hip replacement three years ago. She did great with PT while inpatient and did have home PT. After that she refused to do the exercises on her own. I had a hip replacement years before her and told her I'd do the exercises with her. She still refuses and is still using a walker. Now the only time she leaves home is to go to her medical doctor. She refuses to go back to the orthopedic.

Check out https://foxtherapyservices.com/ They provide therapy services in the home but it is billed differently than Home Health services. It won't hurt to ask them for information because they will not take you if they can't expect payment from the Insurance company. This has been an answer for us because my husband responds much more to a therapist rather than me trying to coach him. With COVID numbers rising in our area, I feel it is much safer at home too.

I am surprised you did not come home with home health, I thought it was standard for at least a couple of weeks after major surgery. It is scary how tight insurance companies are getting... the money they save on this puts them at risk of higher claims if he falls. You may want to contact your provider to be sure the proper code was used when the order was made because something as simple as that can get care rejected.

If he is a veteran, there may be options there. Contact me privately if you are not sure where to start.

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.

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)

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.

I would contact the doctors office ASAP about the outpatient therapy.
On the off chance that there is a problem If he can not get up and you can not help him this is a potential problem for blood clots.
I might be inclined to call 911 for a "Lift Assist" the paramedics will come and lift him off the sofa. If you do not want him back in the hospital they can place him where you want him, in bed, on a chair...but if he will not move I would be inclined to send him back to the hospital.
When is his follow up appointment with his doctor?

*I can tell you from experience (at least my sisters experience) her husband also did not do the PT that he was supposed to do and his knees are no where near what they should be range of motion wise. The adage Use it or Lose it is true!

My son is just as stubborn; he refuses to see any doctors for any reason (oh, and no dentists either)...........I just suggested he get his will written and prepare for whatever disease or Disability visits his life: even gum infections can end lives.

You can call Adult Protective Services who can send professionals to help him envision the future of being totally disabled. As Dr. Phil says, "Every choice has a consequence."

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.

Lost my post, starting over.

1. Appeal the insurance denial. Send it by certified or registered mail, return receipt requested, and document everything, including any phone calls although I would try to avoid phone calls though and stick to contact that can be documented (i.e., via mail).

2. Ask his treating physician to prescribe home PT.

3. Ask also if he can script for a home hand/foot "bicycler." Your husband can use it sitting down, and "biking", or weight it down on a table and use it for his arms. It's a comfortable and easy way to work out arms and legs.

Nova Medical Portable Hand and Foot Pedal Exerciser - 6002-R (senior.com)

4. He may be depressed or just overwhelmed. Try to cheer him up by playing his favorite CDs, listening to music channels on tv, going through old photo albums, discussions of his interests, etc. If you can get him to exercise, provide a reward, something special to eat, or something that makes him feel good about himself.

Perhaps you can rent a continuous passive motion (CPM) machine. It is a motorized device that passively moves a joint through a pre-set range of motion. These devices are used after surgery to reduce joint stiffness and improve range of motion. A Visiting nurse could help set it up and encourage him to exercise. The real danger which my sister-in- law had is scar tissue build up. She had to return for surgery to break up the scar tissue because of lack of exercise.

I would appeal the no PT decision. Did doc prescribe in home?