@tazcat Welcome to Mayo Clinic Connect. It must be heartbreaking for you that your husband had a stroke which is life threatening and now appears to not want to do the therapy to gain back some function. Are you caring for your husband at home on your own? That's a huge task as you wrote that your husband is in a hospital bed and a tilt wheelchair. Do you have any help?

Has your husband already had an evaluation with the speech-language pathologist? I ask this because the evaluation will tell the speech-language pathologist and you about his capabilities in understanding speech and expressing himself. If your husband's speech understanding (comprehension) is good then here is my suggestion.

Please try to let your husband know how much you love and care about him. You almost lost him to a stroke and you were very frightened by that prospect. You'd like him to participate in therapy (physical therapy? speech therapy? home exercises?) so he can regain as much as is possible. You want him "around" longer and you aren't ready to lose him. Four months is a short period of time since his stroke and there is still a lot of possibility to regain physical and speech function.

In a previous career I worked in speech rehab (as a speech-language pathologist) with patients with strokes. Many of my patients were not motivated to participate because they were very depressed. I would then ask for a psychiatry consult in the hope that a medication trial would be helpful for the patient. I'm wondering if your husband's refusal to do therapy is related to depression. Research and patient experiences tell us that depression is treatable so this is why I bring this up.

You have probably figured out that you cannot "make" your husband participate in therapy. It has to come from him. So, the above are a few ideas of ways you can encourage him.