My 96 year old mother in law broke her hip about 2 years ago. She made a pretty good recovery but has since been prone to falls. She has fortunately not suffered anymore fractures but the last time she fell she was using her cane. Since that time we have insisted that she use her walker. It seems like she is much less mobile and we’re wondering if using the walker is inhibiting her mobility. She is also showing signs of dementia and we are struggling with her nutrition since her appetite is very poor. Any advice would be greatly appreciated. We live in a rural area and many of the support systems aren’t available here.
If you can get MIL to use a walker be sure to get one that suits her. A rollator type may not work. Maybe just a simple lift n step type. My mom did well with the rolling type for awhile but as her dementia increased She couldn’t control it, set the brake and so on.
I think what happens is not using the walker properly and poor posture when using the walker is more detrimental and that is more of a problem that can cause a fall as well.
Adding to that the poor nutrition leads to more fragile bones poor muscle strength. This can cause the lack of mobility since there is less activity due to poor strength.
I would also eliminate any trip hazard in the house. Rugs, thresholds, throw rugs, electric cords that dangle, poor lighting, shoes, clothes and odds and ends left on the floor.
Went through with the surgery, and she rehabbed poorly and is now 100% dependent on the walker. It's sad, b/c the cane was not large or annoying. The walker does provide the kind of support she needs, but it was sad to see more deterioration after surgery.
Another thing about walkers--too many people don't use them properly--they are 'chasing' after them, rather than using them for proper support and posture.
She has both a rollator and a conventional walker. During her first stint in rehab, once her roommate got a rollator, well, she just wouldn't quit going on and on about getting one herself! She had never been a "keeping up with the Joneses" kind of person, but by golly, she went into full envy mode once she saw that fancy walker with the seat!! "Look, it has a seat, I can sit down whenever I need to, I will be much more willing to go out and walk with it because it has a SEAT!!" Yeah, no. Didn't motivate her at all to go out and walk. And now it's sort of moot, because among other issues, she has some serious balance problems, walker notwithstanding.
I agree with CWillie's assessment of a walker vs. a rollator. The rollator is really to big to get through regular sized doorways. And when she was on a steady IV solution, she got herself so tangled up in the rollator - there are waaaayyyyy more "pinch points" on a rollator than a regular walker - I had to unhook her from her pump to get her untangled. It is also quite a bit more heavy and takes up more room, even when folded up, that make it more trouble than it's worth to bring in the car. Also, as mom has become so much more frail, it's weight makes it very hard to get over the door saddles between rooms.
If your LO is someone who is inclined to be outside, however, the seat could come in handy if they need to rest frequently. Since the rollator has 4 wheels instead of 2, it does maneuver a little more easily over uneven ground.
( I already had an aluminum walker, and told my home health nurse, but she insisted she could get me one from Medicare, so she did...got me one identical to what I had. Sorry poor taxpayers, but she wouldn't return it. Go figure!) I used the aluminum walker as directed for a while as I recovered.
But then I then bought a rollator! It was clumsy at times but it got me moving again! I walk everywhere now, perfectly on my own, no walker needed. But love my rollator with its seat for moving boxes, laundry, groceries etc etc. I live alone and I think it now prevents falls by allowing me to do many chores safely.
My father fought off the need for a cane until my DH brought him to Walgreens and told him to pick one out, he'd wait. Then came the need for a walker, which he refused, of course, and wound up falling & breaking a hip which led to his death 10 months later. His mobility was compromised, as is my mother's, for a long time before he actually admitted it.
When I had a full hip replacement in 2017, I used a walker with no problem or resistance at all. I saw that it helped me, that I needed it, and it was there to assist me in getting back on my feet independently. Of course, I wasn't suffering dementia either, to the best of my knowledge, so my brain power wasn't compromised.
My mother's favorite saying is "It's a great life if you don't weaken." Your MIL probably hates admitting that she has a 'weakness' that requires her to use a walker. If so, she's sitting around more than usual as a result.
You might want to look into getting some Ensure or Boost shakes for her if she's suffering from a poor appetite. Or make her some smoothies yourself in the blender. Sometimes the elders prefer something they can drink rather than chew, especially if it tastes sweet (dementia gives them a HUGE sweet tooth). Keep in mind that a sedentary human being requires far fewer calories than we THINK they do to survive. So don't worry too much if she's not eating as much as you feel she should be eating. A few bites at each meal, supplemented with a snack here and there, should do the trick. Experiment to see which foods she seems to enjoy, and eliminate the ones she makes a face at and won't eat. No use in arguing such a thing at this stage of the game. In fact, I bring a couple of bags of junk food to my mother in the ALF every Sunday when we go for a window visit. She says she hates the food they serve her (she's gained 40 lbs, however) so she can supplement her diet with her favorites snacks. She'll be 94 in January; it's up to HER now what she eats or doesn't eat.
I think you should allow your MIL, at 96, to be less mobile if that's what she seems to want. Don't push for her to be active; it makes no sense, really. She's earned the right to do as she pleases and besides, with dementia, you can't really argue with them....it's impossible! It only gives YOU heartburn and becomes a losing battle.
Good luck!!!
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If going over hardwood then put tennis balls on the back legs. You cut an X on them then slide them over the end of the leg.
You may want to see if you can get a therapist in to show her how to use a walker safely. Get an order from her Dr. Medicare should pay for it. The therapist will adjust it for her comfort and show her how to correctly use it. Rollators are not for everyone. They can get away from some people.
Here is what I found posted on line about all this - and I agree totally with this. I am a retired nurse and do have a bit of experience with aging and the problems it can bring - so I do know how frustrating it can be for any caretaker to deal with the elderly that have such severe problems that they are unable to understand the simple things of the brakes on the walker - but they are much like the brakes on a wheelchair - I am actually more afraid of the motorized versions of mobility devices than I am of the wheels on my walker - I am 80 and now very limited with my moving and walking. Here is what I copied:
Elders are often reluctant to get (and consistently use) a mobility aid, even though these devices can play a key role in helping them continue to lead safe and active lives. It is important to ensure they are using the proper mobility aid and using it correctly. A physical therapist or occupational therapist should conduct an assessment, prescribe a device, and educate the patient on how to use it.
Maybe some of us are living too long these days??? lol - hmm
A walker is a pain in the neck because they're always banging it into the doorways and furniture, but by design it requires them to use both hands to use it, and they have to be facing it to walk anywhere. The ones with wheels aren't good for anyone of your MIL's age -- they really should be for much younger folks. (My mother never could figure out the hand brakes, so we gave up on it, thank goodness.)
She's 96 and sounds like she's slowing down and heading for her eventual end. Let her eat what she wants, when she wants. Offer her a small breakfast, then a snack every couple of hours and see if you have better luck that way, but honestly, if she's not hungry, she's not hungry. I have a relative who lived to be 102 eating little more than fried chicken and Oreos the last 15 years of her life. If she hadn't, maybe she might have made it to 105, but why? She died with a smile on her face.
It’s tricky to know what is the best thing. My mom would like nothing more than to sit in a wheelchair because it is absolutely exhausting for her to walk just a short distance.
When I spoke to her doctor about her wanting to be in a wheelchair he was adamant that she should continue to walk.
She’s well into her 90’s and still going but every step is painful. So who knows how long a person can push themselves? It’s so hard to know.
My mom continually said that the doctor did not know the pain and fatigue that she felt. She had a point. It made me feel awful for her every time I would hear her say it.
Parkinson’s is a dreadful progressive disease. There isn’t a cure. Those who suffer with it will never improve. Many eventually end up in wheelchairs. I think that has to be an extremely difficult challenge to care to a person in a wheelchair.
7 Things That Cause the Elderly to Fall- AgingCare.com
https://www.agingcare.com/articles/falls-in-elderly-people-133953.htm
If she can still learn new things a walker with wheels should be fine. Once she learns the brakes and internalizes that it should be automatic.
I am not an expert!
They do have to continue the exercises after the sessions end. Unfortunately, my mom wouldn’t do as much on her own and would regress.
A combination of sitting too much and yummy ice cream bars, she gained 20# her first year there! I do believe the lack of moving (she was self mobile for about 2 years too!) contributed to weakness and now she refuses to stand or walk, so she's in a wheelchair. Combined weight gain, high BP (on meds for YEARS), lack of movement, etc has led to a recent mini-stroke, so she'll not be walking any time soon.
If mom seems comfortable and steady, use it on short outings, but always with supervision.
When mom is alone, she should rely on the walker.
Make certain it is set at the proper height.
My 96 yr old Dad went from a cane to a walker a couple years ago.
As for the meals, why not give her appetite increasing teas like dill, fennel, and ginger. Try mixing them up like giving her fennel tea one day and ginger the next and so on. It works on my mom.