Motivating relative after surgery
August 22, 2023 6:32 PM Subscribe
A relative in her late 60s had a freak accident and fell. The fall required a major surgery that went well. Two months out she has not made much progress with physical therapy and recovery. I am looking for suggestions to help motivate her to do her rehab exercises, support her through anxiety about falling and encourage her to accept some sacrifices to make progress.
My relative is in her late 60s and has generally been in good health, independent and active. She had a freak accident and fell, which required a major surgery. The surgery went very well and she has not had any pain. Two months out she has not made the expected progress.
Her surgeon and physical therapists expect her to be graduated to a cane at this point but she is still clinging to the walker. She says she does not have any pain or discomfort but she is afraid of falling again. She lives alone. A relative stayed with her for a month after surgery and offered to stay longer but she declined.
She goes to a very good rehab three times a week but does not do her at home program each day as instructed. When asked about it, she gets defensive and she says she is busy but does "some" of it.
She has a lot of social support. For example, a friend who had the same surgery has offered several times to come over and practice walking with her with the cane but she declines, saying she is busy with paperwork. She is retired.
I have tried to be encouraging while affirming her fears about falling and commiserating that PT is no fun. We are close and she often listens to my advice but my gentle probing about PT and encouragement to take up offers to walk and other supports are met with "I''ll try." A few relatives have been less gentle, telling her that if she doesn't get better she'll be stuck on a walker and l lose her independence. That makes her defensive and upset. She often talks about wanting to get back to her usual activities that she can't do now.
I love her dearly and know this is an awful time for her. We all just want her to be able have her active, independent life. She is a sweet and smart person, but very rigid and has always had a hard time adapting to change/hardship. She often pretends bad things aren't happening and I think in some ways, that is what is happening here, combined with a true fear of falling again, rigidity about doing things differently, and a touch of laziness.
Please note, we have confirmed over and over she is not in pain. She is not taking any medication. I have validated her concerns about falling, as have her friends, such as the one who has offered to walk with her. Her home is safe. She is not open to therapy.
I live far away but will get to visit for a week soon. Any ideas on how I can support her from folks who have been in a similar boat are appreciated.
My relative is in her late 60s and has generally been in good health, independent and active. She had a freak accident and fell, which required a major surgery. The surgery went very well and she has not had any pain. Two months out she has not made the expected progress.
Her surgeon and physical therapists expect her to be graduated to a cane at this point but she is still clinging to the walker. She says she does not have any pain or discomfort but she is afraid of falling again. She lives alone. A relative stayed with her for a month after surgery and offered to stay longer but she declined.
She goes to a very good rehab three times a week but does not do her at home program each day as instructed. When asked about it, she gets defensive and she says she is busy but does "some" of it.
She has a lot of social support. For example, a friend who had the same surgery has offered several times to come over and practice walking with her with the cane but she declines, saying she is busy with paperwork. She is retired.
I have tried to be encouraging while affirming her fears about falling and commiserating that PT is no fun. We are close and she often listens to my advice but my gentle probing about PT and encouragement to take up offers to walk and other supports are met with "I''ll try." A few relatives have been less gentle, telling her that if she doesn't get better she'll be stuck on a walker and l lose her independence. That makes her defensive and upset. She often talks about wanting to get back to her usual activities that she can't do now.
I love her dearly and know this is an awful time for her. We all just want her to be able have her active, independent life. She is a sweet and smart person, but very rigid and has always had a hard time adapting to change/hardship. She often pretends bad things aren't happening and I think in some ways, that is what is happening here, combined with a true fear of falling again, rigidity about doing things differently, and a touch of laziness.
Please note, we have confirmed over and over she is not in pain. She is not taking any medication. I have validated her concerns about falling, as have her friends, such as the one who has offered to walk with her. Her home is safe. She is not open to therapy.
I live far away but will get to visit for a week soon. Any ideas on how I can support her from folks who have been in a similar boat are appreciated.
Falling to the point of needing major surgery is a huge trauma. Her body could simply be responding with very rational anxiety that falling is bad bad bad, and that's not necessarily something some simple reassurance is going to work her out of it. It's a physiological response, and working through it takes time.
Please don't think that not doing excersizes for PT is lazy. PT is hard, repetitive work that's designed to push current ability. Lots of people don't do all the PT requested or even half of it and it's not because they are lazy, it's because PT is hard and frankly not a very enjoyiable activity.
Do talk to her about her goals and what she wants. Do be supportive and celebratory of effort and progress. Do discuss if there's ways that she wants you to help, or not help and respect that. Do ask if she wants an emergency response button. That service may provide her a little more confidence.
And most importantly it is absolutely okay if she uses a walker. She can still go out. She can still do many many many things. Encourage her to do activities with the walker, if she's not ready to use the cane. Please do not shame someone for using a device that helps keep them safe. If she uses it the rest of her life, it's just another way of getting around .
posted by AlexiaSky at 6:51 PM on August 22, 2023 [22 favorites]
Please don't think that not doing excersizes for PT is lazy. PT is hard, repetitive work that's designed to push current ability. Lots of people don't do all the PT requested or even half of it and it's not because they are lazy, it's because PT is hard and frankly not a very enjoyiable activity.
Do talk to her about her goals and what she wants. Do be supportive and celebratory of effort and progress. Do discuss if there's ways that she wants you to help, or not help and respect that. Do ask if she wants an emergency response button. That service may provide her a little more confidence.
And most importantly it is absolutely okay if she uses a walker. She can still go out. She can still do many many many things. Encourage her to do activities with the walker, if she's not ready to use the cane. Please do not shame someone for using a device that helps keep them safe. If she uses it the rest of her life, it's just another way of getting around .
posted by AlexiaSky at 6:51 PM on August 22, 2023 [22 favorites]
What are the things she could do with a cane but can't do with a walker? If she's anxious about walking without the walker, what about getting her a good rolling walker and encouraging her to becoming more active in that context? People who use walkers can do a lot of things! And can be very independent!
posted by macfly at 6:53 PM on August 22, 2023 [1 favorite]
posted by macfly at 6:53 PM on August 22, 2023 [1 favorite]
Response by poster: Just to clarify, she does not want to be on walker now or for the rest of her life. She says it every time we speak. She does go out (to PT, church, restaurants) with her walker. But it is time consuming and limiting and she despises it. She wants to walk free of any aides, as she did before. She wants to be able to do down to her basement, which she spent years remodeling. She wants to go back to water aerobics and her walking group etc.
posted by fies at 6:59 PM on August 22, 2023
posted by fies at 6:59 PM on August 22, 2023
It sounds like she really has a lot of anxiety about this and its turned into a genuine phobia. Maybe sitting down and asking her if she wants to brainstorm with you ideas for working through that anxiety. Recognizing that people with phobias often feel a lot of shame about them might help you (and her) understand what feels so irrational about all this, but could also help guide you towards some potential solutions.
For instance you could approach it with a kind of diy exposure therapy. There is a big task that currently feels very frightening: doing her PT exercises every day on her own. So break it down into smaller steps first. Perhaps the first step is doing one small exercise with you there, once, while you are having the conversation. Then leaving it alone and not talking about it for the rest of the day. Conversation over. But tomorrow you agree that at X time, you will do that small task again, and she will tell you how it went afterwards. After that, you'll agree what you're going to do the third day. And so on.
For the task, you could do something like these exercises, that seem a bit more fun, if she's into that kind of thing. Ok, they might not be the ones she is prescribed to do. But it could be an ice breaker. The first step to getting her moving at all.
But this all needs to be discussed with her first. She has to have input in the conversation and feel like her fears are taken seriously. Even though your own instinct to try and tell her to just do something already! also comes from a place of love and fear.
posted by EllaEm at 7:17 PM on August 22, 2023
For instance you could approach it with a kind of diy exposure therapy. There is a big task that currently feels very frightening: doing her PT exercises every day on her own. So break it down into smaller steps first. Perhaps the first step is doing one small exercise with you there, once, while you are having the conversation. Then leaving it alone and not talking about it for the rest of the day. Conversation over. But tomorrow you agree that at X time, you will do that small task again, and she will tell you how it went afterwards. After that, you'll agree what you're going to do the third day. And so on.
For the task, you could do something like these exercises, that seem a bit more fun, if she's into that kind of thing. Ok, they might not be the ones she is prescribed to do. But it could be an ice breaker. The first step to getting her moving at all.
But this all needs to be discussed with her first. She has to have input in the conversation and feel like her fears are taken seriously. Even though your own instinct to try and tell her to just do something already! also comes from a place of love and fear.
posted by EllaEm at 7:17 PM on August 22, 2023
Something that helped me recover after a crisis - visualize doing the thing that scared me (in this case, going down some stairs). It was something I’d done a lot, but at the beginning of my recovery was terrifying.
I had a “hard” goal (I had to be able to go down the stairs to get to a Drs appointment), so that helped.
See if she can visualize walking with a cane, and then without an aid. Have her do these visualizations a few times a day (I did mine as I was falling asleep, and a couple other times), it doesn’t take long - 15-20 seconds. Then, after she’s done that for a few days, with you there, ask her if she can try walking a few steps with her cane.
If she can - great! If not, ask what she imagines might help her do that.
The point of the above is to get her to use her mind to overcome her mind (if that makes sense). We can get stuck in a loop of unhelpful thinking, and visualizations can really help us get unstuck. The very best wishes to her.
posted by dbmcd at 7:22 PM on August 22, 2023
I had a “hard” goal (I had to be able to go down the stairs to get to a Drs appointment), so that helped.
See if she can visualize walking with a cane, and then without an aid. Have her do these visualizations a few times a day (I did mine as I was falling asleep, and a couple other times), it doesn’t take long - 15-20 seconds. Then, after she’s done that for a few days, with you there, ask her if she can try walking a few steps with her cane.
If she can - great! If not, ask what she imagines might help her do that.
The point of the above is to get her to use her mind to overcome her mind (if that makes sense). We can get stuck in a loop of unhelpful thinking, and visualizations can really help us get unstuck. The very best wishes to her.
posted by dbmcd at 7:22 PM on August 22, 2023
So, there is a gap between what she wants and what she is doing. Can you gently talk to her with acceptance and curiosity about what is making it hard for her do the thing that would logically make sense. After all, there has to something causing the resistance, she's not refusing because she doesn't want to get better so trying to understand what is blocking her will help.
Just another thought, maybe a cane doesn't feel steady enough. You might to look at these smart crutch ergonomic crutches - they have a fat knob to hold onto and then an arm rest the runs from the wrist to the elbow to help with balance. (Most crutches are hard to balance on but these seem to actually make it easier.) Obviously check with her PT person but maybe looking for this kind of intermediate options that could ease her fear of falling while she gets stronger.
posted by metahawk at 7:28 PM on August 22, 2023 [2 favorites]
Just another thought, maybe a cane doesn't feel steady enough. You might to look at these smart crutch ergonomic crutches - they have a fat knob to hold onto and then an arm rest the runs from the wrist to the elbow to help with balance. (Most crutches are hard to balance on but these seem to actually make it easier.) Obviously check with her PT person but maybe looking for this kind of intermediate options that could ease her fear of falling while she gets stronger.
posted by metahawk at 7:28 PM on August 22, 2023 [2 favorites]
I think you should make sure the relative is assessed by a physiotherapist who specialises in balance to make sure that it is safe for her to walk without the walking frame.
The worst case scenario here is NOT that she uses a walking frame or a rollator for the next 2 years:
the worst case scenario is that she has another bad fall, and breaks a hip, or sustains a concussion/brain injury.
posted by chariot pulled by cassowaries at 8:02 PM on August 22, 2023 [9 favorites]
The worst case scenario here is NOT that she uses a walking frame or a rollator for the next 2 years:
the worst case scenario is that she has another bad fall, and breaks a hip, or sustains a concussion/brain injury.
posted by chariot pulled by cassowaries at 8:02 PM on August 22, 2023 [9 favorites]
Physical therapy isn't the only kind of therapy useful in these situations. Would she be open to seeing a mental health professional?
posted by Iris Gambol at 8:18 PM on August 22, 2023 [7 favorites]
posted by Iris Gambol at 8:18 PM on August 22, 2023 [7 favorites]
Seconding Iris Gambol - when I was a couple of decades younger than your relative I had a fall that damaged my face but not my mobility. I was nevertheless left with a phobia of walking on slippery or uneven surfaces that I still have trouble with, even though there's no physical reason I should have a problem with them. Since your relative does have mobility issues, she has an actual physical reason, but it might be the psychological reason that is the roadblock to her progress.
posted by LadyOscar at 8:45 PM on August 22, 2023 [3 favorites]
posted by LadyOscar at 8:45 PM on August 22, 2023 [3 favorites]
Could you install railings and handrails around her house to give her more confidence when walking around? Or correct flooring deficiencies that could be tripping hazards? I think trying to improve the environment would be easier than trying to change her mentality.
You mention she likes to do Water Aerobics. Could that be incorporated into her PT program? Sometimes training in water can be used to help recovery from injuries.
posted by DEiBnL13 at 9:19 PM on August 22, 2023 [3 favorites]
You mention she likes to do Water Aerobics. Could that be incorporated into her PT program? Sometimes training in water can be used to help recovery from injuries.
posted by DEiBnL13 at 9:19 PM on August 22, 2023 [3 favorites]
There are a lot of possibilities here. Trauma and stress can cause damage to executive functioning. I'd be curious if she is completely back to her old game in terms of things like planning and task initiation. Often troubles with task initiation look like anxiety to an outsider, and then can quickly turn into anxiety as the person struggling begins to be afraid to attempt activities in case they draw a distressing blank again.
I'd be surprised if talking to her about doing her PT would be the least little bit of use, no matter how your phrase it or who talks to her. If it were going to work to motivate her it already would have.
If she were someone I cared about and were close enough to her, I'd chat idly about all her general responsibilities and routines and ask questions so I could confirm if she what parts of her routines were still definitely working - Sometimes little things, like rearranging her space so that she doesn't have to put things away to set up her PT equipment can make a huge difference. For example, if she uses the dining room chairs to sort her tax paperwork and has to clear at least one of them off to use it for her PT exercises, it could be an insurmountable barrier - especially if she knows that moving those tax papers means she will have to start over on sorting the paperwork. Not only that, but she might be stuck on doing her paperwork because of executive functioning issues, or vision issues.
I'd also be concerned that the "freak accident" was not as freakish as you may have been led to believe. If she was getting a little wobbly before the accident, even if she doesn't acknowledge it, she will have to put in some extreme work before she can get back to being just a little wobbly. It may require more work than anyone wants to believe to get her to the stage where she is safe to give up the walker.
There is a good chance that she is not doing her PT because it has not been working. If it were working she'd find her success motivation to do it. But if it is difficult and it isn't working the PT can easily be something she avoids remembering. In fact if she is going to her very good PT sessions three times a week, that sounds like she IS committed to the PT program and the home sessions are not helping even when she does them.
When you visit her, it will be your chance to check out her home PT session routines and environment. Does she have enough space? Is she being distracted before completing the exercises? Is she literally too busy? Is she possibly running out of energy before doing a full routine? Do they involve balance exercises that make her afraid she will fall while doing them? Are her ordinary clothes not suitable for her PT routine? Is the August heat making exercise uncomfortably warm and tiring her more quickly? Your worst case scenario is that she is doing the exercises, whether or not perfectly, and they are just not giving her the strength and agility back that she needs.
It's really easy to hope for a simple solution. If she would just do her PT she'd be fine again. Merely find the right words and she will be inspired to push hard and enter the Senior Olympics. But sometimes it's not so simple and either a lot of problem solving will have to go into the solution, or far more effort than an outsider imagines it could need. The most likely reason why she is not doing as much PT as her therapist recommend is because it is really hard for her to do the exercises for some reason. Before you push or cajole, find out the reason.
posted by Jane the Brown at 9:27 PM on August 22, 2023 [6 favorites]
I'd be surprised if talking to her about doing her PT would be the least little bit of use, no matter how your phrase it or who talks to her. If it were going to work to motivate her it already would have.
If she were someone I cared about and were close enough to her, I'd chat idly about all her general responsibilities and routines and ask questions so I could confirm if she what parts of her routines were still definitely working - Sometimes little things, like rearranging her space so that she doesn't have to put things away to set up her PT equipment can make a huge difference. For example, if she uses the dining room chairs to sort her tax paperwork and has to clear at least one of them off to use it for her PT exercises, it could be an insurmountable barrier - especially if she knows that moving those tax papers means she will have to start over on sorting the paperwork. Not only that, but she might be stuck on doing her paperwork because of executive functioning issues, or vision issues.
I'd also be concerned that the "freak accident" was not as freakish as you may have been led to believe. If she was getting a little wobbly before the accident, even if she doesn't acknowledge it, she will have to put in some extreme work before she can get back to being just a little wobbly. It may require more work than anyone wants to believe to get her to the stage where she is safe to give up the walker.
There is a good chance that she is not doing her PT because it has not been working. If it were working she'd find her success motivation to do it. But if it is difficult and it isn't working the PT can easily be something she avoids remembering. In fact if she is going to her very good PT sessions three times a week, that sounds like she IS committed to the PT program and the home sessions are not helping even when she does them.
When you visit her, it will be your chance to check out her home PT session routines and environment. Does she have enough space? Is she being distracted before completing the exercises? Is she literally too busy? Is she possibly running out of energy before doing a full routine? Do they involve balance exercises that make her afraid she will fall while doing them? Are her ordinary clothes not suitable for her PT routine? Is the August heat making exercise uncomfortably warm and tiring her more quickly? Your worst case scenario is that she is doing the exercises, whether or not perfectly, and they are just not giving her the strength and agility back that she needs.
It's really easy to hope for a simple solution. If she would just do her PT she'd be fine again. Merely find the right words and she will be inspired to push hard and enter the Senior Olympics. But sometimes it's not so simple and either a lot of problem solving will have to go into the solution, or far more effort than an outsider imagines it could need. The most likely reason why she is not doing as much PT as her therapist recommend is because it is really hard for her to do the exercises for some reason. Before you push or cajole, find out the reason.
posted by Jane the Brown at 9:27 PM on August 22, 2023 [6 favorites]
She has got to do the PT. PT sucks, and hurts, and is a difficult slog, but it works.
But clearly there is trauma from the fall that is adding to her issues. She doesn't want to have to use a walker, but she isn't doing what she needs to do to get beyond that. And that seems to be the obvious red flag here.
But, I haven't flown in over a decade because of the DVT issue I had a decade ago. I would always rather drive for three days than spend three hours on a plane but I digress. Unless I'm going to Hawaii or Europe, I'm driving. So I get the trauma aspect. And just had another post surgical massive DVT with bonus pulmonary embolisms this year, so, probably won't be doing a lot of flying for another decade. Trauma is hard to overcome.
Three sessions a week? That is a lot. I had one session a week, and had to do all the home stuff on my own. Three a week with my PT would have been a lot, as she is a badass, and worked me hard. But I did my home stuff, and things got better. When you are visiting, try to watch her home sessions. Ask if she has done them yet. Without pushing her buttons. Ask if you can help her with them.
posted by Windopaene at 9:49 PM on August 22, 2023
But clearly there is trauma from the fall that is adding to her issues. She doesn't want to have to use a walker, but she isn't doing what she needs to do to get beyond that. And that seems to be the obvious red flag here.
But, I haven't flown in over a decade because of the DVT issue I had a decade ago. I would always rather drive for three days than spend three hours on a plane but I digress. Unless I'm going to Hawaii or Europe, I'm driving. So I get the trauma aspect. And just had another post surgical massive DVT with bonus pulmonary embolisms this year, so, probably won't be doing a lot of flying for another decade. Trauma is hard to overcome.
Three sessions a week? That is a lot. I had one session a week, and had to do all the home stuff on my own. Three a week with my PT would have been a lot, as she is a badass, and worked me hard. But I did my home stuff, and things got better. When you are visiting, try to watch her home sessions. Ask if she has done them yet. Without pushing her buttons. Ask if you can help her with them.
posted by Windopaene at 9:49 PM on August 22, 2023
Three times a week is a lot. Not saying its wrong but a lot. How does she get there? I observed both my mother and my aunt during courses of PT after falls and with both it was not the PT itself but getting there and back: washing, getting dressed, make sure have everything (eg incontinence pads, diabetes kit etc) , preparing a meal to be ready for the return, upon return rest, change, eat etc. Each PT Session was Just about the only thing they could manage.
They needed the days inbetween to recuperate and do normal life.
Neither one had the spoons for home PT.
I think when you visit don't push. Listen to what is difficult. It sounds like you truly care and she will notice and while PT is important emotional comfort is more important.
posted by 15L06 at 2:28 AM on August 23, 2023 [5 favorites]
They needed the days inbetween to recuperate and do normal life.
Neither one had the spoons for home PT.
I think when you visit don't push. Listen to what is difficult. It sounds like you truly care and she will notice and while PT is important emotional comfort is more important.
posted by 15L06 at 2:28 AM on August 23, 2023 [5 favorites]
What about seeing if one of those three sessions could be with an occupational therapist? OTs are more trained in working through all the complexities of task-based needs. So for example, the physio can help her manage stairs, but the OT can work on all the barriers between her and the pool or the basement, use of equipment, etc.
Your role might be in encouraging her to take a few steps with you here and there. Take her to a quiet cafe and encourage her to come the few steps to the pastry case on your arm, etc. it sounds like everyone is offering advice but really I think we take these leaps task by task. And if she doesn’t want to - she is an adult. It’s okay to cheer her on and let her find her solutions.
Also, 2 months isn’t that long. My surgeon, completely confident in his plates, was very optimistic about my progress after I broke my leg, and so was my PT. I had a hard time with canes (it was winter.) I was hesitant a lot longer about certain things…but I got there. I’m fairly resilient and younger. It just may take her more time.
posted by warriorqueen at 3:58 AM on August 23, 2023
Your role might be in encouraging her to take a few steps with you here and there. Take her to a quiet cafe and encourage her to come the few steps to the pastry case on your arm, etc. it sounds like everyone is offering advice but really I think we take these leaps task by task. And if she doesn’t want to - she is an adult. It’s okay to cheer her on and let her find her solutions.
Also, 2 months isn’t that long. My surgeon, completely confident in his plates, was very optimistic about my progress after I broke my leg, and so was my PT. I had a hard time with canes (it was winter.) I was hesitant a lot longer about certain things…but I got there. I’m fairly resilient and younger. It just may take her more time.
posted by warriorqueen at 3:58 AM on August 23, 2023
I would look into hiring an in-home personal trainer who will come on the not-PT days, do her PT exercises with her, and add some strength exercises to the mix. Insurance might even cover some in- home work.
PT can sometimes seem like pointless little motions that won't do much, and it can take months or years to appreciate what is being done. So it might help to add explicit "we're going to get you strong so you won't be at risk of falling" training.
Really what helped me in a very similar time was wanting to, and getting back to, the things I wanted to do. They helped me get stronger, and then I wanted to be stronger to do them more.
I totally get the fear of falling. But you can still fall with a walker - I did, on my last day in the hospital (an amazing PT jumped over a bed and caught me).
posted by Dashy at 3:59 AM on August 23, 2023 [2 favorites]
PT can sometimes seem like pointless little motions that won't do much, and it can take months or years to appreciate what is being done. So it might help to add explicit "we're going to get you strong so you won't be at risk of falling" training.
Really what helped me in a very similar time was wanting to, and getting back to, the things I wanted to do. They helped me get stronger, and then I wanted to be stronger to do them more.
I totally get the fear of falling. But you can still fall with a walker - I did, on my last day in the hospital (an amazing PT jumped over a bed and caught me).
posted by Dashy at 3:59 AM on August 23, 2023 [2 favorites]
"Water aerobics" really stood out to me. The pool could be a great way to get her strength and mobility back. Is there any way the PT could create a water-based routine, and then you help to find a way (some sort of service/health aide) to help get her to/from and in/out of the pool? I would imagine the fear of falling wouldn't be an issue once she's in the pool.
Eventually she will need to work on things out of the pool but maybe getting some more strength back will help her confidence. I merely tore my ACL in my late 30s and there was a lot of trepidation and fear for a long time. I just didn't trust my knee wouldn't give out, and that took a couple years to fully get over. But you also lose sooo much strength after a surgery; you really have to re-train your muscles to fire and build them back up and it feels strange and weak and is just awful.
I don't think 3x a week is unusual after surgery; both I and my partner were going that frequently immediately after our respective knee surgeries. The more progress she can make at home the more likely that frequency will be dialed down (or when her insurance starts to complain about paying for it).
This sounds really difficult, thank you for trying to help. It sounds like you are being kind and respectful.
posted by misskaz at 4:52 AM on August 23, 2023 [1 favorite]
Eventually she will need to work on things out of the pool but maybe getting some more strength back will help her confidence. I merely tore my ACL in my late 30s and there was a lot of trepidation and fear for a long time. I just didn't trust my knee wouldn't give out, and that took a couple years to fully get over. But you also lose sooo much strength after a surgery; you really have to re-train your muscles to fire and build them back up and it feels strange and weak and is just awful.
I don't think 3x a week is unusual after surgery; both I and my partner were going that frequently immediately after our respective knee surgeries. The more progress she can make at home the more likely that frequency will be dialed down (or when her insurance starts to complain about paying for it).
This sounds really difficult, thank you for trying to help. It sounds like you are being kind and respectful.
posted by misskaz at 4:52 AM on August 23, 2023 [1 favorite]
I know it's obvious, but we need to overtly name the elephant in the room and go from there: This is not physical, it's psychological.
When she can admit her fears and trauma to herself and to others, she can start to address it. Have you asked her if she's open to talking with a therapist? It could be quite short-term, depending on her general psychological health.
Ask her directly what she thinks it will take to transition away from using the walker. If she says something "big" and/or vague, ask her to break it down into the first step. Ask her how she would like you to support her in taking that first step.
posted by interbeing at 6:15 AM on August 23, 2023
When she can admit her fears and trauma to herself and to others, she can start to address it. Have you asked her if she's open to talking with a therapist? It could be quite short-term, depending on her general psychological health.
Ask her directly what she thinks it will take to transition away from using the walker. If she says something "big" and/or vague, ask her to break it down into the first step. Ask her how she would like you to support her in taking that first step.
posted by interbeing at 6:15 AM on August 23, 2023
If she's at all open to it, short term SSRIs might help a lot. That "pretends bad things aren't happening" sounds like she had anxiety to start with. A primary care doctor can prescribe them in a pinch here, I'm not sure about overseas. I'd prime her to complain about motivation for PT, low mood or poor sleep. (Do keep an eye on what she actually gets - a relative in her 80s in similar circumstances got Xanax and kicking that addiction was a hell of a thing.)
posted by I claim sanctuary at 6:54 AM on August 23, 2023
posted by I claim sanctuary at 6:54 AM on August 23, 2023
Response by poster: Thank you for the comments. The suggestions about getting some in-home and occupational therapy are very helpful. Also, looking into a cane that feels more sturdy. I think she might be open to doing some visualizations with me as well. As I mentioned, she will not do mental health therapy. While she would love to be in the pool, she can not yet get into it and is very fearful of slippery surfaces, so a PT program there is not yet possible. She has asked me to come to PT with her so I will have a better sense of what exactly she is working on, which will be helpful.
She told me she is excited for my visit and we plan to have some fun, so it won't be all about this. I know she has been through something traumatic and needs a lot of emotional support and some normalcy. Thanks.
posted by fies at 8:20 AM on August 23, 2023 [6 favorites]
She told me she is excited for my visit and we plan to have some fun, so it won't be all about this. I know she has been through something traumatic and needs a lot of emotional support and some normalcy. Thanks.
posted by fies at 8:20 AM on August 23, 2023 [6 favorites]
I apologize for missing the 'not open to therapy' in your question. When an older relative had the same bias, having their usual doctor prescribe sessions ("we've seen people get back on their feet faster adding talk therapy, it complements p/t") helped.
posted by Iris Gambol at 1:19 PM on August 23, 2023
posted by Iris Gambol at 1:19 PM on August 23, 2023
I wonder if two canes instead of one might feel more sturdy? Of course, check this idea with the PT before doing it.
posted by metahawk at 6:17 PM on August 23, 2023
posted by metahawk at 6:17 PM on August 23, 2023
« Older Does my dream iphone keyboard exist? | Better premium economy experience: Lufthansa vs.... Newer »
You are not logged in, either login or create an account to post comments
posted by shock muppet at 6:47 PM on August 22, 2023 [5 favorites]