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Hello all - so my FIL went into hospital yesterday with septic infection/we found him unconscious, but today he is alert & talking etc. He is being loaded up on IV. He is now refusing treatment for physical therapy & being mean to everyone in hospital. This man has never been mean or unkind 1 day of his life. He has to be moving or therapy says things will spiral quickly physically for him. Any suggestions? We just received his official diagnosis less than 1 week ago & we are grasping at this moment for help. We do live with him - thanks in advance

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Has he had a neuropsych evaluation? Something is off kilter, maybe there are meds that can help him. Also, perhaps he will improve as the sepsis is treated.

Good luck, This is a very difficult situation.
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Alisa, I wonder if the doctor did an Urinary Tract Infection test on father-in-law? An UTI is always worse on an elder and can make a person very mean. This can be cleared up with antibiotics.
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Could you or your husband be there when PT wants to do exercises? Maybe having a family member walk with him or do the movements with him would be more reassuring.
 
Also, give him the choice of times he'd rather do the therapy. Older folks feel like they no longer have control of their lives. "Dad, would you like to go for a walk at 10 or 11 am?" (Providing the PT can accommodate him.)

I'm sure they're doing blood cultures and will be doing IV antibiotic therapy soon, if not already. Infections speed up confusion, so the quicker his infection gets under control, the better he'll be.

The elderly also don't get thirsty so they are prone to dehydration. Remind him with sips frequently throughout the day. Maybe once his electrolytes are normal, he will be too. (Hopeful thinking).

Also, when demented elders are taken out of their environment and put into an unfamiliar one (like a hospital), it throws their confusion into hyperdrive. He can't relate to anything there and probably feels quite disconnected. Remember to approach him calmly and try not to seem to anxious (for refusal of therapy). 

Have you tried asking him why he doesn't want the therapy? Also, make sure they have reviewed all the x-rays before he starts movements and don't work beyond the point of pain. If it hurts to even start, that should be checked out.
Sometimes it can help if he sees you doing the therapy first (if the therapist will go along with the act).  It's kind of like how, at the pediatricians office, the nurse would do a fake injection on the mother to show that it isn't too painful before the child receives the real one.

Good luck. 
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For a UTI it is a culture of urine. Not all bacteria in urine will show up with the quick, standard test.
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I get your thought Mac, but hopefully the doctor ordered a urine 'culture' BEFORE any antibiotics were given. This will show if there IS a UTI and break down which antibiotics the bacteria is "sensitive" to. All abx don't kill all bacteria.
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If he does have a UTI unusual behaviour can last a while past the the antibiotics are given. My Mom was in the hospital for 4 days, rehab 18 for a UTI that made her combatant. After she got back to the AL one of the nurses told me (with a smile) that Mom hit her with her tooth brush. So the behavior doesn't go away overnight.
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We just had the full evaluation from Neurolgist #2 today & nothing is different from last week (Mri - CT scan EEG done yesterday) - Im praying its just a new enviornment & effects of the sepsis...Dr's havent determined where infection is as to date - he was just admitted yesterday
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I second the "look for the UTI". Make sure they get a culture.
Infections of any kind can cause this kind of behavior.

You found him unconscious? Had he fallen? How thoroughly did they check for breaks?

 I've had experience with both my mom and an elderly neighbor " refusing" PT. They each had an undected fracture. 

Dementia patients are not reliable reporters of pain.
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I agree with Mac, I thought sepsis was caused by a UTI. My opinion, if Dad doesn't want therapy than don't worry about it. Rehab is not a good place for the elderly. And they will milk Medicare as long as they can. If Dad has Parkinson's then he may have Dementia. Ask if therapy can be done at home.
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From website Healthline;
"Any infection can trigger sepsis, but the following types of infections are more likely to cause sepsis:
pneumonia
abdominal infection
kidney infection
bloodstream infection."

UTI's aren't the only cause.
There are also "antibiotic resistant bacteria" that aren't killed with certain abx. That's why you do a "Culture and Sensitivity" urine test first, so you don't waste the patients time with an abx. that won't work.
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