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Monday, July 29, 2013

The PT War Zone

The Battle: Part 1

So it starts with the therapist, who calls me on Wednesday to set up a time for Bob's first physical therapy session. She tells me she can come tomorrow (Thursday) but her schedule is full that day and she wouldn't be able to spend "much time" with him, or she could come on Friday when she'd have "more time" to dedicate to him, so I tell her to come on Friday. She says that she'll be here between 1-2 p.m.

Friday rolls around and I get Bob ready and pumped for his first PT session and at 1:30 the therapist calls and tells me that she can't remember what time she's supposed to here.... grrr... So I tell her that she's supposed to be here, um, right about now, between 1-2. And she says that she'll have to make it between 2-3, but "closer to 2" and I say, OK and hang up the phone.

Three o'clock rolls around and still no therapist. I have to take Boomer out to take a leak, and I'm thinking, if she doesn't show up by the time we get back into the house, I'm going to call her and cancel this appointment because, truth be told, Bob and I are both tired of waiting. I open the front door, with the dog on a leash, and there's the therapist walking up to the house...

She comes in and takes Bob's blood pressure, then makes some notes in her file and asks a couple of questions, all of which takes about 10 minutes. Then she helps Bob do some leg lifts and a couple of neck stretching exercises and I leave the room. Next thing I know, she's holding out a form for me to sign and then off she goes. And I'm thinking, huh? That was fast. And I look at my watch and I swear, she had only been there about 30 minutes....

The more I think about this, the more steamed I am getting, because truthfully, what good is about 20 minutes worth of therapy? Not to mention waiting for two hours for twenty minutes of therapy.... Not to mention that she was going to spend "more time" with him on Friday.... And how much time would she have spent with him when her schedule was "full"?

On Saturday, I get the insurance "approval notice" for physical therapy which tells me that Bob is approved for "20 visits" but it doesn't tell me how long a visit should last. So I call the insurance company and ask them, just out of curiosity, how long is a visit for at-home PT? I mean, they're paying for it and they must be paying it based on hourly wage, right? But unfortunately the benefits representative has no clue how long a visit should last, though she does agree that 20 minutes of therapy doesn't seem near long enough. She advises me to call the agency on Monday and ask them.

The more I'm thinking of all of this, the more I think that I will call the agency on Monday and ask them how long a visit is supposed to last and also request a different therapist. Because I'm not so sure about this new PT...

At 8:00 p.m. on Saturday night, the phone rings. And it's the PT. She leaves a message stating that she wants to schedule an appointment for Sunday. And I'm thinking, what? You call at 8:00 p.m. and want to schedule something for tomorrow? As if I don't have life! Well, truth be told, I don't have a life, but that's not the point, as I would sort of like some advance notice so I can prepare. Besides, I'm still ticked that we waited for her for two hours and then she only spent 20 minutes working with Bob...

And I almost do not call her back. I think, forget it. I'll just call the agency on Monday. But then, I think, well, that would be kind of mean... and I should probably give her a chance to explain herself. But, by the same token, I do not want to be taken advantage of and I don't want to be kept waiting and I certainly want her to spend some time with him when she comes. So, I call her back. And I say, something to the effect of, "gee, you know, you really seem very busy and perhaps you just have more clients than you can handle at this time, so I'm thinking about requesting another therapist, one who can spend more time with my husband..." and she, of course, freaks out.

And she apologizes. And she asks for a "second chance". So we make an appointment for Sunday, between 1-2 p.m.

On Sunday, she arrives right on time and stays an entire hour. And looks like I won this particular battle. Until:


The Battle: Part 2

Which is Bob. Yes, Bob. Who flat out refuses to cooperate with the therapist. And I mean, flat out. She tells him to lift his leg, he says, "No!"

She lifts his leg, he screams, "Hurts!"

She wants him to get into the wheelchair, he refuses to budge.

I coax, beg, plead with him to cooperate and he glares at me. And I mean really glares. One of those if looks could kill glares. Though I do manage to get him into the wheelchair and I do manage to get him to cooperate with the bed exercises, but it's not without constant grumbling, complaining and giving me the evil eye....

Then the PT leaves and I shut the door only to hear Bob yell at me, "YOU F**KER!"

I tell you, I can't believe it. I really can't believe it. So I walk out of the room, because I can't believe it. I mean, what's gotten into him? And how am I supposed to respond to that? And this, after first having to fight with the therapist to get her here and on time and cooperating, and now I have to fight with Bob? And am I the only one who wants this darn therapy, anway???

Then I realize it's time to drop the bomb on this particular war zone. I'm talking about the dreaded N-Word. At The Pink House on the Corner, the dreaded N-Word is: Nursing Home.

So I go back into Bob's room and tell him, in so many words, that I am not going to continue to keep working my buns off taking care of him if he is not going to cooperate with the only thing I expect from him which is for him to do his therapy because I'm not going to sit around watching him get worse and worse, etc. etc. And I end this diatribe with DO YOU WANT TO END UP IN THE FREAKING NURSING HOME??!!!! BECAUSE, HONEY,  THAT IS WHERE YOU ARE HEADED IF YOU DON'T DO YOUR THERAPY!!!! AND I CAN START LOOKING AROUND FOR A NICE NURSING HOME THIS WEEK, IF THAT IS WHAT YOU WANT ME TO DO!!!

So bomb dropped.

Smoke clears.

Soldiers retreat.

And treaty signed. He promises to cooperate next time.

She's coming here tomorrow, between 2-3, and we'll see what happens....

Stay tuned.


Barb Polan said...

I am distressed that you ended up having this happen - both Bob and the PT behaved very badly. Using the N-word does not mean that you behaved badly. Tough Love was the perfect technique.

Anonymous said...

I have had to use the N word on more than one occasion. I prayed very, very hard after I had the melt down, but I had to tell my husband I was not going to continue to kill myself and he do nothing. He will surely end up in a nursing home then, as there is no one else to take care of him. I then asked him if he understood what I was saying. He said absolutely. I felt terrible to have to say those things, but at the time it was necessary.

Anonymous said...

Way to go, Diane. I give you credit for all you do for him. I wish your life was easier sweetie. If anyone has shown love for their mate, it's you. Some day you may not be able to physically take care of him alone. When that day comes, I hope this is all settled and you get the help that you deserve. financially and in all other ways. Love you, Aunt Rose

J.L. Murphey said...

Sometimes tough love is all you got. You did everything perfectly. BTW look at the time on the sheet before you sign it. First visits are usually a meet and greet and testing resistance and ROM as a base line. 20 visits usually means twenty hours but check with your insurance provider.

Bob behaved badly and just like the adult in the fight you played the Ace card. You did what you had to do to bring him out of his tantrum.

In our house it's not the N word but the H word (hospice).

Jenn said...

Well then. Decompression... Check. Q - Since Bob is in more pain, has he reached a tolerance level in his pain meds making them less effective?

Diane said...

Jenn, he certainly could use some different or stronger pain meds, but the doctors won't prescribe anything stronger because of all these silly prescription narcotics laws... I am hoping he will be on a more even keel once his foot problems are solved... fingers crossed!

Rebecca Dutton said...

The N word is not a threat it's a fact. If Bob can't or won't help you will say the N word from a hospital bed after you collapse. I hope things go better soon.

Anonymous said...

As I read your blog today, it brought back memories of a near repeat of that situation with my wife a couple of years ago. The therapists attitude was the same, and Karen's refusal to participate in the PT process, along with that "if looks could kill" stare was all there. I too had to use the dreaded NH threat to get her to do the required exercises, and over the following two years , used that threat many times.

Keep doing what you're doing Diane. You are an inspiration to all caregivers.

Hugs and prayers, Dan