Patient not responding well to rehab

My mum is week 3 into her stay at the rehabilitation hospital and a nurse took me to one side today and told me that the rehab is not going very well. My mum is not sleeping at night and just wants to stay in bed, instead of staying in a chair for longer periods of time. The nurse says that if this continues the rehab will stop and my mum will be put in a nursing home. The nurse says that sometimes family talking to the patient can help. However, we are only allowed a 1 hour visit per day, so don’t think this can help. Has anyone got any suggestions of how to increase her motivation to get better? Thank you

Hi @A.Hakes welcome, though so sorry to hear about your mum.

This must be so frustrating for you to hear from the nursing staff and from the SS position, 3 weeks post stroke is very early stages, fatigue can be overwhelming and all they may want to do is sleep.

Encourage your mum as much as you can during your visit, tell her she’s doing great and that she needs to remain positive and try the best she can with her rehab.

Ultimately it’s up to your mum, she has to want to participate. Talk to her about things that she is passionate about to motivate her.

Sending you both hugs and best wishes.

Maybe try getting a little notebook to keep track of her progress. I used to count the steps I took each day. Then I could look back in it and realize I really was making progress. You might try putting down a star for each 10 minutes spent in a chair rather than bed. Have her increase her time every few days if she can. You can bring her something she really likes for reaching certain milestones. When she can visually see in her notebook that things are changing and she really is improving she may be more motivated to do things. Rehab is exhausting. It takes a lot of faith and motivation to persist. My best to you both. :slightly_smiling_face: :heart:Jeanne

This is very sad but not unusual. When I was in rehab the ward sister said that whilst there were those determined to improve, there were others, for whatever reason, refused to exercise and just stayed in bed. I have known cases of this myself. Part of it may be to do with mum’s age, part might be due to her feeling her life is over as she knew it.

All you can do is try to encourage her. Perhaps she could be persuaded to stay in her chair a little longer each day? From my own experience, you have to draw on the grit and determination that saw you through other crisis points in life. That said, stroke is a devastating experience, so I also understand her sense of hopelessness.

@A.Hakes welcome But sorry to hear about your mums stroke. I echo what @Mahoney said about fatigue. I know in the very early stages post stroke I was so fatigued that I could do very little. I did try & do some regab each day though even if a tiny amount.
Some of the suggestions above are good ones. It is about seeing progress however small. There may also need to be some tough love. Not sure how old your mum is but does she need to be told that if she doesn’t participate she will be the way she is now for a long time. You need to gauge how she’d react to tough love though.
Is there any way you can increase your time with her & then maybe you could do some stuff with her?
Give her lots of praise & encouragement for everything she manages however small. Resist the temptation to get frustrated with her.
Wishing you the best of luck xx

Shwmae @A.Hakes, sorry to read that your mum is stuck in this predicament. There are many post-stroke exercises that can be done in bed, from working extremities to visual retraining. I don’t really see the difference between being in a bed or chair at her stage of stroke recovery and rehabilitation options. I spent six months, essentially, bed bound after the stroke but I exercised on the side of the bed. It might just be that they have a program they follow at the rehabilitation centre, and are not willing to be flexible enough to adapt to a patient’s needs. Or it could be, as @John_Jeff_Maynard suggested, connected to her disposition. After stroke, it can sometimes be exhausting just thinking about needing to think.

Just to add, it might be beneficial as a family member to concentrate on her mood and motivational needs. Perhaps, bringing in pleasurable distractions for her. Distracting the brain gives it some relief from the quandary it is in, and let’s it get on with self-repair without draining it with external activity.

Hi, I was 45 when I had my stroke. Rehab was very tiring at the start but I had my young family and life to get back to and that drove me on. Saying all that I understand the issue with the chair. I hated moving to my chair as I felt stranded once moved and was more at ease in my bed. I felt safe in my bed. I remember being desperate for my husband to visit and take me for a “walk” in my wheelchair but once out I was tetchy and overwhelmed and wanted to go back. It was hard to understand what I wanted. I do remember an early physio when it was all I could do to stay awake so we checked my meds and I was still on anti nausea pills and that contributed to my fatigue. I no longer needed them and felt much more awake when I stopped taking. Perhaps get the nurses to check what she is taking. Finally I would try to get her talk about what she wants to do most when back at home and how the rehab could help her. Rehab is tough but about where what you to get to . Hope that helps. All my best to your family