What can you do when they refuse to get out of bed and mobilise?

[BB49]

FIL is currently in a rehab hospital after a fall a few weeks ago when he fractured a few ribs. He is in no pain from that now and the hospital is trying to encourage him to do physiotherapy and move around using a walker and support, as well as sit in a chair for short periods, but he is pretty much refusing to do anything. He is meant to be discharged soon to go back home with carer support, but as he is barely walking and cannot get out of bed or a chair unaided I am not sure how this is going to go? He is more than likely going to fall again when back home.

He keeps saying he is most comfortable in bed. He sleeps a huge amount and we can't really reason with him very well to try and move around to strengthen his body as there is some short term memory loss.

Yes you are all right. It is difficult to watch and I accept it is not the fault of the hospital really. We need to check about the TEP form.

Incontinence doesn't require nursing care. My mother's care home dealt with all her mobility and continence needs and it was not a nursing home.

However, you said he has short term memory problems. So you may need to look at a dementia care home, or at least a home which has both dementia and residential wings, so that he can be transferred if necessary.

(It's possible that he is not engaging with the physios/OT because of his cognition problems - he isn't able to engage, rather than refusing. It can difficult to spot the extent of cognition issues unless you are actually living with the person, they mask them.)

When you have a care home in mind, call and ask if the manager will come to the hospital to assess him. S/he will then do an assessment and decide if they can meet his needs.

It’s tough, because geberally we see people get ill and want to get better and get back to their life how it was pre illness.

When people get to later in life, their wishes and priorities change. It’s a big adjustment to get head around if not come across it before.

Sounds like you’re doing all the right things on listening to what he’s wanting, rather than just what others think he should be doing. The ward staff and discharge planning will be familiar with this, do use their expertise to help build your understanding on next steps. Can also use them to make sure hes aware of consequences, it’s a try now or try never type situation with mobility and continence. Not a skive off for a month or two and then decide you want to improve things.

DH works in a hospital and the stats for elderly people who fall and then stay in hospital are frightening. I think you lose 10% of muscle mass per week (and they are unlikely to have much of it to lose). When his mum (90) has had issues he’s pushed to get her out of hospital asap. She’s not one to do her exercises.

I am really sorry for the situation you find yourself in, OP. It is so hard for you because you want to do everything you can to get your FIL back on his feet.

I have looked through the posts and I haven’t seen, or I have missed, how old he is. I’m guessing late 70s/s? I’m not quite that old but I do have chronic illnesses and I would like to say that being ill is really hard work and so is recovery from being ill. If you add advanced ange into that, it really can get to a point where it’s all just too much. You don’t have any more the resources in you to make the effort for exercise and for getting up and doing things. Or just for getting up. What you just want to do is rest. It’s not so much that you want to give up; you just want a rest. And however much rest you have, it’s never enough. As PP have said, this may be the beginning of the end.

It’s a delicate balance, but what he needs is care. Pushing him, however gently, to do things he doesn’t feel strong enough to do will be stressful for you and for him. I really want to emphasise that age, tiredness after illness and general frailty are exhausting in themselves. The inner resources that there were just a few years or even months ago are no longer there and one simply isn’t the same person.

He is 88.

As a pp said, there is a very steep decline in muscle mass once someone has been bed bound for a while. He’s 88 and deserves to live the rest of his life how he’d like to. He’ll be well looked after in a residential home. The home will assess and see if they can meet his needs.

Theyre not cheap so be prepared for that.