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If she is keen to move then IMHO any movement is beneficial, even if it never leads to any improvement. Anybody who has had PT in the home knows that the therapist comes in for one session every week or two and you are left to do your "homework" in between, so it seems to me that you don't necessarily need a licensed physical therapist to continue to work with your mother. Think outside the box, a student with an interest in nursing, personal training or kinesiology who has half a brain should be able to follow guidelines and simple exercises.
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I’ve worked with PT’s before and never knew any of them to work for essentially cash. They bill insurance, be it private or Medicare, and patient is billed for what portion isn’t covered through whatever billing service is used. PT’s all want to be able to document progress, and aren’t likely to work long on what can’t be changed or helped. I’d hope you can end this discussion with your mom, blame the medical profession, and move on
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There could well be ethical concerns here; you might ask them about that. If they truly assess that PT would be of no help, and could possibly harm a patient there are certain places they "cannot go". That is my only thought, because as is a more "norm" in all things USA, you can follow the money, and once people are willing to PAY a lot of ethics go out the window. I would ask them to discuss honestly with you, and tell them all you told us.
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There is a certain law of diminishing returns, it's true. More is not necessarily better. Are the PTs working with your mother at all at this point?

If she were on our books, and she wanted to work at mobility, we certainly wouldn't tell her no however unrealistic it might be that she'll be leaping about like a young gazelle ever again. There are so many things she *might* be able to improve on, such as standing with a stand-aid, with or without a sling - that's certainly what springs to mind.

There could be a dozen reasons the PTs aren't getting back to you, not limited to their (slightly snotty, I have to say) attitude that they won't waste their time/you shouldn't waste your money; don't forget the Covid Chaos going on out there, for a start.
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So, I know that you would like to help your mom. I understand this. You say that you want to give her hope. Does she want hope or has she given up? Do you think that you want hope more for yourself than your mom?

What has the doctor told you about PT? Some people are helped by it and others aren’t a candidate for it.

I have always been told that physical therapy works best when combined with occupational therapy. What therapy has she had in the past?
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Riverdale Jun 2021
She asks me to pursue this. I have accepted the reality. A director at the facility told me there would be cost to have them work with her that I would be responsible for. They did try PT and billed Medicare and determined she was not likely to physically support herself so of course it could not continue.She feels she has become somewhat stronger but I doubt she is strong enough. While I would love to have her be able to walk I accept the reality.
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I think I would tell mom "I'm talking to the doctor about that" and " the doctor is talking to thectherapists, mom".
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If the therapists believe she has peaked in her ability to improve, they won't keep going no matter what amount of money you offer them (in the U.S.) because of how they get paid (through insurance billing codes) and they probably don't have any way to bill for it privately, don't have the facility and don't have liability insurance. We tried this with my own MIL and once she stopped improving (or refused to cooperate) they were done. Period. If they refuse your mom, I think she is done with rehab as well because it would be unethical to continue, and you are not the one who decides her medical prognosis. Should she have an appendectomy just because you think it will "help" her? Of course not. The same is true in physical therapy. Healthcare differs by state so maybe you will find a loophole and if you do please share it with the rest of us. Thanks!
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Did the therapist tell Mom directly that more PT will not help her walk?

What you may need to do is take her to her doctor. Hopefully PT sent him their report. When u make the appointment, ask if they have the PT report if not ask if they can request it. Make sure they know why ur making the appointment. Then her doctor can review the report. He can then tell your Mom how he feels. No matter if Medicare pays or u private pay, they need a doctor's order to take Mom on as a Client.

If the doctor feels further PT will not help Mom, HE needs to tell her. Sit right down in front of her, look her in the eye and tell her that further PT will not help her walk. Then when she starts again you can say, "Mom the doctor sat there and said PT will not help. And without an order from him, PT cannot be ordered." There is nothing YOU personally can do.
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