Dear Carol: My mother, 93, is mentally sharp and lives in her own retirement apartment. As would be expected, she has some physical problems, including arthritis severe enough that she needed a hip replacement in her 80s. She uses a walker but her balance is iffy even with that. I’d like her to have physical therapy to help her improve her balance because of the risk of falling. I’ve communicated with a doctor and she said that we could have a therapist come to the apartment twice a week, but Mom refuses.

She takes little medication so there’s nothing detrimental that I can see that we can change except to improve her balance. It makes me angry that she won’t allow this therapist to come to help her. She’s always hated people fussing over her, so I get where she is coming from, but she still needs to have this therapy to stay on her feet. How can I convince her? — MJ.

Dear MJ: It’s hard to be in your shoes, wanting to do your best for your mom and then having her refuse what seems reasonable to you. Yet, your mom has lived a long life and may, at this time of life, just want to live each day as she has been doing. That’s also understandable.

Additionally, she probably doesn’t like the idea of having a stranger come into her home for any number of reasons, but most of all having in-home therapy probably signals to her the beginning of a loss of privacy that may be unavoidable as her health declines. Your mom’s balance is worrisome, though. At her age, she could easily break her remaining natural hip or damage the prosthesis in her other hip. This could, in turn, signal the end of her independence.

Have you approached her looking at her situation through this lens? If she can look at therapy as an extension of her independence rather than a step toward losing it, she may be more willing. If she’s in a lot of pain, this could also be a factor behind her refusal.

Doctors are, rightly, reluctant to prescribe many pain medications to older patients because the side effects can be detrimental and might contribute to falls. Still, older people deserve relief from pain due to any number of issues, including arthritis. If pain seems to lie behind your mom’s reluctance to start PT, you could point out that physical therapy can help with that as well.

If you have some gentle conversations with your mom and she still refuses to try PT, then your role will be to stand back for now and perhaps try again after some time has passed. She may need to feel that she’s made this decision herself.

If she continues to refuse over time, though, you might have to accept that this is her choice. If she’s reasonably content as she is, and is informed of the risks, then you have done what you can do.

Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at She can be reached at