Tom is trying to control some of the few things he still has control over.
I can't imagine how frustrating it must be for him to be almost totally helpless.

I wonder - is he able to pay his concertina? It might help him feel a bit more himself. Just leave it by his chair, let him know it's there IF he wants it. No discussion or argument, just there for him.

Hang in there, Tom. And break whatever you please - that would be how I would handle it. In fact, it's what I do now when I get too frustrated. Nothing eases the tension like shattering pottery.

Love,
SINS