Whether it's the person with the acute health situation or the immediately surrounding people who can provide support, somehow, people can recover within imperfect family dynamics.
Ideally, if he needs intense, inpatient rehab he'll get back to it after the holiday. While not ideal, in some ways, the haranguing Thanksgiving trip might have been good for him - stimulating, and a push to increase stamina for activity while giving a sense of regular living could be a set of underlying benefits. How any of that compares to his stress, risk of the ride, and pain levels creates the level of net positive aspects.
My overall recommendation from having a family elder a year ago with fractured vertebrae and him trying really hard to get pneumonia while bed ridden with a terrible bout of hay fever (sounds like your friend is in better shape than this, which is good!) is to get as much home health support as possible coming to the house for ongoing PT, OT, and health aides. (Btw, at 90 years old, he did recover and got back on his feet with the help of a walker after a successful procedure and intensive PT/ home healthcare).
I've found that home health isn't emphasized or always directly offered at hospitals. Have had to ask, and insist at times. It’s been the family practioner for my family members on Medicare who can prescribe home health service. The service in their area will come out and do an evaluation for how many visits/type of care. Professionals coming to the home can help bring attention to the person’s needs that untrained or aloof family members cannot recognize on their own. They’re also trained to keep an eye out for neglect and abuse, which can take some pressure off of you watching your friend’s situation from the outside.
I have given the same advice to acquaintances going through similar situations and have gotten reports back that home health PT, etc. really helped them. I think just conveying how this process works with the general practioner needing to be in the mix is helpful. Retired nurses (who certainly have their own healthcare blind spots and peculiarities, but with good skills and extra vocabulary, may listen closer to the authority of healthcare professionals in the home) may not be aware of this, as these services have become more common in recent years.
Otherwise, imo, your friend, the patient at the center of this needs to take ownership of his recovery. Asking him about it and nudging him with positive support to keep up his motivation to stay on his recovery regimen is important. I could be wrong, but I suspect he’s leaned on his wife for health matters over the years, so having a friend give him positive feedback about the results of his PT efforts is super helpful for reiterating that it’s his efforts, his work that gets results.
Hope you find this helpful, but I must emphasize that I’m not a health professional, and I’ll go ahead and beg your pardon if I’m telling you stuff you already know. I’m fortunate to have had good, meaningful relationships/friendships with seniors and elders all my life. Having had my own health problems starting as a young adult has helped me key into health needs of the people around me, and have found I’m compelled to speak up when folks are struggling with health situations.
And props to you, for being a good friend by watching out for your friend’s well-being!
(And because this post is already long, I'd like to add the importance of getting enough vitamin D this time of year. Having levels checked/asking one's doctor if adding some vitamin D is okay during these fall/winter months can be helpful for someone spending more time indoors while recovering. Low iron levels can also be a drag on energy and healing. Have run into this for myself and others over the years.)
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