How do you deal with a spouse who refuses to do therapy?

Posted by tazcat @tazcat, Aug 26 2:57pm

How do you deal with a spouse who refuses to do therapy? My husband had a stroke 4 months ago , wouldn’t do therapy in rehab and does very little therapy with in home therapists. He is in a hospital bed and needs a tilt wheelchair. He can move his arms and legs , but refuses to exercise and get stronger.

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Profile picture for strokesurvivordynamo @strokesurvivordynamo

@tazcat it sounds like you’re doing all the right things! Your husband is very fortunate to have you on his team. I felt like a burden for a long time when I couldn’t drive. Hearing positive feedback from my family and getting encouragement every day was really helpful.

My OT had me use an app called ConstantTherapy for the cognitive stuff. You can get a free 30-day trial to try it. It was helpful for cognitive exercises and it measures improvement which I liked. I was discouraged from doing puzzles or games because there is no evidence they help with anything except getting good at the puzzle or games - I was surprised to hear that.

This is a good OT account to follow on Instagram, possibly things you can learn from and adapt.
https://www.instagram.com/poststrokeorg?igsh=bWhrMnhqcWptMTZk

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I try to not ever use those “ I told you so “ words. I also always try to explain why I am trying to get him to do something, I can’t say I am 100 percent at it but I do try. I also alway try to make him feel useful. He use to be the main cook in our home because he was very good at it and I hate it. I have to do the cooking now , but I try to include him by asking his simple things about the recipe I am using. He seems to remember quite a bit about cooking. I do know the recipe but it includes him if I ask for his “ advice “ on the recipe, cook times, temp , spices etc.
He is not walking for now , so I use an electric peddle exerciser to keep the circulation in his legs and feet.
I will definitely go to the 2 sites you posted. I can always use suggestions to try and help him . Thank you so much

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You are extraordinary, would that all who suffer have such support. Therapy with a capital P or O can be a pain, a burden, or even experienced as a forced obligation. On the other hand, anything done IS therapy. Talking, reading, turning pages, drinking through a straw and on and on. I hated my Bozo the clown suportive velcro fastened shoes. I don't remember how many tries it took before I tied a bow in my old running shoes, but I did. Bozo begone! I wanted to cut my own pancake, scissors worked, and then followed in due time butter with a knife (dull) and syrup. Little steps, but they add up. Sure, I walk like a drunk, but I walk. Help when neccessary(I hate to ask, but I do). Memory, speech, do it the best you can, but do it I would not be here except for the help and encouragement of my bride for 63 years .

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Profile picture for tazcat @tazcat

I try to not ever use those “ I told you so “ words. I also always try to explain why I am trying to get him to do something, I can’t say I am 100 percent at it but I do try. I also alway try to make him feel useful. He use to be the main cook in our home because he was very good at it and I hate it. I have to do the cooking now , but I try to include him by asking his simple things about the recipe I am using. He seems to remember quite a bit about cooking. I do know the recipe but it includes him if I ask for his “ advice “ on the recipe, cook times, temp , spices etc.
He is not walking for now , so I use an electric peddle exerciser to keep the circulation in his legs and feet.
I will definitely go to the 2 sites you posted. I can always use suggestions to try and help him . Thank you so much

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@tazcat - how are things going lately with your husband and his therapy?

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Profile picture for Lisa Lucier, Moderator @lisalucier

@tazcat - how are things going lately with your husband and his therapy?

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Not bad. I am trying to work on his cognitive abilities by asking him to spell random words or ask questions about cooking. He is differentiating words that sound alike but are spelled different pretty well….such as hair and hare….piece and peace. He still doesn’t like exercise , so I have to make it “ fun” and not look like exercise. His attitude is getting perkier. So I would say all that is a plus. Thanks for asking .

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My sister at 80 has been a caretaker for our two parents now passed and her 92 year old husband who needs 24 hour care. Her years married has been challenging as a pleaser and caretaker. She wont go to a group. And dipped her foot into therapy, which helped for the modt part. She has such anxiety worried each day he will not wake up. They have the money but he doesn't want it and she doesn't see the need. But her stress level is not healthy. I know there is nothing I can do...is there? Ps, her husband and I dont get along, from the first day I met him. Over 60 years he has been miserable, as a dry alcoholic, tho generous with money. I feel so sorry for her and she lives far away. But now we are unable to connect. She has had much trauma but she thinks it not worth learning about it. I feel I have to pull back to take care of my own challenges. I have a great therapist.

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Edit above. My sister's husband WILL NOT ALLOW SOMEONE TO HELP OUT and she thinks she can do it herself.

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Profile picture for Helen, Volunteer Mentor @naturegirl5

@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.

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I would add that you may need a support group. Perhaps you local medical facility has a social worker who can give you resources. Senior centers often have caregiver support groups

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Profile picture for strokesurvivordynamo @strokesurvivordynamo

Hi @tazcat - it’s really difficult when we forget and it’s hard when we hear “I told you that” or “you did it yesterday, remember.”

I can’t relate to aphasia but the Aphasia Institute (link below) may be a helpful resource for him and any caregivers.

Patience is important, approach each day as a fresh start…explain that today’s exercises are XYZ - and they will help you with this-that-and the other thing. Understanding why I was doing something was very helpful.

Also there is strong research and evidence that cardiovascular exercise (even just walking) is helpful in stroke recovery. It’s helps to pump oxygenated blood to the brain. I’m sure I can find you more info if you need it.

Final note, it took me 5-years to realize that recovery is a journey and not a destination. It took a lot of the pressure off me on where I was right now.
https://www.aphasia.ca/

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Hi @strokesurvivordynamo - I really like your concept of recovery being a journey and not a destination. I'm currently seeing the "destination" mindset being harmful to a family member who recently had orthopedic surgery.

Wondering how you are doing lately?

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Profile picture for Lisa Lucier, Moderator @lisalucier

Hi @strokesurvivordynamo - I really like your concept of recovery being a journey and not a destination. I'm currently seeing the "destination" mindset being harmful to a family member who recently had orthopedic surgery.

Wondering how you are doing lately?

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@lisalucier I'm almost 10-years into this brain injury journey and 80% recovered. I feel fortunate for every day I'm here. Failing to hit that "recovered" goal post is tough. It took me 5-years to realize that recovery after a brain injury is a journey and NOT a destination. My deficits are invisible and mostly cognitive - executive function, brain processing speed, central auditory processing difficulties, and when I'm tired my balance takes a hit and my post trauma vision syndrome symptoms flare.

Now, from an ortho surgery perspective, because I'm about to embark on one - I'm expecting a recovery goal post. So I do think it's different. Most ortho surgeries do have expected dates and milestones to hit. Brain injuries don't fall in that category because every stroke is like a snowflake and no two are the same.

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