Matt:
One thing that was a little hard for me to accept with my partner was that my biggest resource was me. I won't try to duck it - I really wanted some things to happen magically, which they don't.
When he had his first fall, he went into hospital for two days, was ill (tempered) as a hornet, discharged himself against medical advice, and came home and changed none of his ways, except he became more demanding.
The second fall was the real turning point. That time, he was in for two weeks, and came home weighing about 108 pounds, his chart marked "failure to thrive," and with the hospice people telling me, "This man has about two weeks. Sorry, but that's the truth."
Well, that really, really angered me, because he'd been in hospital for half a month, and was coming home in far worse shape than when he'd gone in. The hospice people were trying to be helpful, but they were calling it as they saw it. As Delta Burke used to say, Oh. Kay.
That meant I had to ask myself what my partner would want (he was very out of it much of the time at this point), and what I wanted. Well, I didn't want anyone dying if it could be avoided, that was for damn sure. And I'd seen part of the problem at the hospital (Veteran's Administration); the food was awful, no choices on anything, everything sealed up in dreadful wrappers that debilitated patients couldn't open. And I couldn't help him there, because he was an MICU patient, with very restricted visiting hours.
So, I began feeding him. Not just feeding him - I fed him like it was his birthday at breakfast, Christmas at lunch, and like he'd made it to Heaven for dinner. He got all his favourites, he was asked what he'd like, and no damn wrappers on anything.
He began responding within a week, getting some colour back and complaining about being in bed so much. I brought him the walker and told him that he needed to do something about that. It was like two steps that day. Three a day or two later. Same thing the day after that. After about two weeks of exercise, he was able to manage trips to the bathroom - about twelve steps - again by himself. The hospice people were amazed.
For all their training, no one had thought to give him what he liked, nor had they thought to insist that he do what little he could. I had to spend a lot of time with him while he exercised, for fear of falls, but he got stronger and walked better every week. The professionals didn't do this for him - they have a different mindset. Plus, they didn't have the latitude to talk back to him that I did - which I did, trust me. I was as kind as I knew how to be, but sometimes my partner was his own worst enemy, and at those times, I did say what I thought needed to be said. We used to joke that my frankness gave his circulation something to fight against.
So, it might be helpful if you just tell the old gentleman that it's time to get his arse out of that bed and walk until he can't any more, at which point you will help him back to it. However many steps he takes that day, count 'em, and insist on at least one more step the next day. And one more than that the day after, and so on.
That's what P.T. is anyway - getting the patient to strengthen himself one exercise period at a time - and you can do a lot of that just being there with him. If you do this, be sure to praise when praise is due, and not in a condescending way - celebrate with ice cream, or whatever. Tell him you're proud of him if you are, or just that you appreciate his efforts, because they're helping you - which they will, because anything he can do for himself is one less "M-a-a-a-a-a-a-t!" you have to run answer.
My partner eventually got so much better that the hospice company had to discharge him under Medicare rules - he was not showing the decline needed to maintain eligibility. Sadly, when he returned to V.A. care, he was given sleeping meds again unsupervised, and started abusing them. I hauled fourteen partially used containers of Temazepam out of his room at one point not too long before he died; the stuff affected his health so much he ended up with more heart damage and back in hospice care, this time for good. That's another story, though.
