Can a 90-year-old expect to recover from a sedentary lifestyle over the past 2 years when they were active before? How can I help?
I have known my friend for about 7 years now…. From age 83 or so. In her early 80s she was cruising once a year and walking into town (15 mins) to visit her small business three times / week, in addition to another day out to do her own food shopping with a taxi home. Sunday evenings spent with us, no walking, but nevertheless another outing and lots of fun with a dog…So basically doing something or an agenda 5 days per week.
She had been slowing down a bit before Covid, only two days a week “working”, and getting a ride with her son or taking the bus instead of walking, still doing her own shopping and getting taxi home, but various lockdowns interrupted this routine and at first because we were so careful around her, for 6 weeks or so, we only brought her shopping and encouraged her to get out a bit. We were terrified of infecting her as all reports at the time said that Covid would be complicated or kill the elderly, so we kept our distance.
She understandably became bored & restless and so we broke lockdown “rules” and started having our Sunday dinners at her home instead of ours, because of our housemate working at the hospital and dealing with Covid patients daily. None of us were ever infected that we know of at this time. I even took her shopping once a week in addition to her own regular shopping trip…after the queuing and empty shelves episodes stopped. So many people gave me evil eyes for letting her push her own trolley in the supermarket, one time someone said why don’t you just do all her shopping for her? The fact is that we did…but when the only opportunity for her to get out and see people was in fact to go shopping…where was the harm in that?
Fast forward to present day… she can barely walk now.
I am not sure if her spirit has been broken, or if her body is just giving up? Her mind is still perfectly intact. She continually mentions that the constant “guidance” to stay home just made her feel old. And she is one of these people who constantly reflect on their age. Getting to 90 hit her hard and whilst it is understandable that she should feel old at 90, she refuses to call herself old and sometimes gets into a very critical mindset.
We have done some of the chores for her, (when she allowed us to do them or hire people to help), collected prescriptions and paid bills etc, but this is still a very independent young lady living in an old woman’s body. Very different from many of the stories I have read here and my heart goes out to all of you dealing with dementia! I have experience with that in my own family and I know it is so difficult x
This is difficult too though, because her legs just won’t work anymore and she systematically declined every single suggestion I had over the past two years to help, whilst also berating her son about this that or the other.
Are there any other carers out there dealing with able minds in a deteriorating body?
She has finally come around to the fact that she needs more help, has stopped insulting and degrading her son so much, and been very grateful for the help that we give her.
She has been doing some of the physio exercises prescribed after our last doctors visit, so she says, and finally consented to using a rollator - though she likes to call it a sholley.
The only thing I can think of to help with next is her diet. I know her diet should have been the starting point, but again, her consistently fierce independence has kind of got in the way of that. She has always eaten very regularly and pretty well. In the past she has hated any suggestions, but after a good heart to heart talk today I now know that she has not been eating as regularly as she should be or as much as she should and once again, finally!, she is open and receptive to receiving help or suggestions…Thank the Lord for that!
Can you suggest any nutrition shakes or smoothies?
Has anybody used jelly drops for people without dementia?
Any help is so very appreciated x
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Irene does in fact suffer from poor vision, she has done so her whole life. I knew she was lacking protein and has definitely included more over the last months, probably just not enough though…she has always been a good light eater, hence asking about a shake or something that she could just force herself to drink in order to get more nutrition or liquid.
She has dentures, some intolerances to onion, citrus, but she generally will try anything. She rarely drinks a single glass of water…I’m really curious about this group of people worldwide who drink no plain water at all, but that is for another time.
She completely lost her confidence over the past two years, but didn’t complain too much because of what other people were going through. I think that with the natural decline in her muscle mass, and being more sedentary, she has also had to mentally deal with too much - even though sound of mind to everyone around her, you are of course absolutely correct that she will have some cognitive decline too. A lot of regular people don’t understand this, so thanks for reminding me. So many relatives just believe that even though the body is deteriorating, the mind won’t, and it’s important to realise that because we can still have a great conversation…we don’t need to overload them either.
Just as our terrible pandemic news was winding down, Irene also now has been affected by the war in Ukraine with it being on the news every day. It has almost invoked a kind of PTSD in her from world war 2, and having lost her parents as a child. Really. It has been another negative thing in addition to her ailments that has made her quite sad.
We have had a couple of extreme incidents with her and having to go visit in the night…only two…she bumped her head once on a cupboard, but was bleeding and shook up so we stayed for a long time with cups of tea and just making sure she was all right. It really was just a scratch, and of course we know how much the elderly can bleed at times. The other time, it was much later, during a lockdown, and she just started passing blood. She called her son and he started running over to her house, while I called an ambulance. Apparently, what happened was a common ailment of old age for females… She stayed overnight and has been physiologically fine since, just not physically fine so much and perhaps mentally with all of the stress…
And then her boiler (central heating tank) exploded on a dark evening at the end of January ten minutes after a qualified technician had been there! All electricity shut off and she had to navigate her way upstairs to grab her mobile phone listening to the tank flooding water all over the kitchen. Which is another story, or pretty much like a scene in Titanic, but with a 90 year old woman, in the dark.
It was very traumatic for her and we have really worked through all of it pretty well. I’m sure that these worldwide and home events have somewhat traumatised her and she really wants to get out of the funk.
We discussed at length having her move in, and then we heard that the house next door might be available… again, another story…
After these recent years of terrible news and then a couple of stress inducing incidents at home, perhaps we gave her too much to think about on top of it by talking about moving in or next door… she was totally enthusiastic at first, but it’s a complicated situation with the family next door and whether they will sell, rent or move in. We shall see. Irene doesn’t want to think about the possibility now, because it isn’t possible immediately, so it remains just an idea.
I know she is physically declining beyond the point of no return, but I also think that the Pandemic, the War, and some of her personal problems have exacerbated her physical exhaustion.
Would you recommend a heart rehab program for a 90 year old? I’ve not heard of this and am very interested…if not for her, for others.
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Supplements like boost, ensure etc are an easy way to boost calories, people like to diss them but it's way simpler to use these than to make dietary changes.
During the exam and the PT assessment she will be evaluated and PT can make a Care Plan that may help restore some of the strength. This is not the same as just giving her a walker to use. This would be a course of PT
There are many reasons that she may have had this decline.
If she is not steady and afraid that she may fall this could lead to inactivity and decreased muscle strength and balance making it m ore likely that she would fall. Sort of a "self fulfilling prophecy"
She may have had a series of mini strokes that have left her weakened.
Was she tested for cognitive decline?
One of the ways I knew something was "off/wrong? with my Husband is he stopped doing things that he had done previously. He stopped riding his bike to work, he stopped making repairs around the house. When I asked about it he said..."When I feel better". I think he was afraid that he would do something wrong, or forgot how to do some of these things.
She started walking, she started slowly and now walks over a mile daily. She walks in the grass so she doesn't get hurt if she falls.
If your friend is willing and able, she should get some sort of exercise daily to build her strength.
With my dad, I walked him up and down the aisles of big box stores 3x a week to build and retain his strength. It really helped him and he could use a cart for stability and they are climate controlled, which was important for his recovery.
It really boils down to her willingness and ability to get stronger. Best of luck!
My suggestion is that you have an HONEST discussion with your friend.
You cannot imagine the number of elders who told me honestly that they could not speak with family and friends about the truth of their lives because "they don't want to hear it" . Many expressed an exhaustion with life. NOT DEPRESSION. They had lived long and done what they wanted and they were TIRED. Ready for "the final exit" and ready for the long nap, ready for peace. However of the many ways they expressed it they were very tired of being pushed to do what they were now ready to STOP doing.
My own father felt this way and discussed it honestly with me. He said he just never really wanted to get out of bed but his own beloved wife couldn't hear that, wanted him up, eating, onto the scales. He did it "for her" and he was exhausted with it. Happily at 94 he died in his easy chair.
So discuss this honestly with your friend. She may be 90, but as a senior myself I can tell you there was a great change between 70 and my now 80. And my friend who is 90 says "ha, just WAIT". I hear the next decade isn't a whole lot of fun either, esp with deteriorating senses and bodily balance and function.
So I don't vote for diets and exams for depression (unless there are real symptoms of it). I would decrease my expectations and honestly discuss things with your friend...............follow her lead. She may be OLD but she may also have still some ideas about how she wants to live her life ongoing.
Best out to you and thanks for your caring heart and your will to help.
The thing is, she speaks to me, and has said so many times that she does not want to get out of bed some mornings. Yet..she also says that she will “buck up” and get going again. How can I ignore that?
Irene barely went to the doctor once a year for her whole 90 year life before Covid.
After our first lockdown, and the subsequent one in November, instead of her children taking her for her first vaccine, she asked me to go with her…
I bought her a rollator before asking her if she would use it…her son said good luck… I mentioned to her that it was a possibility to use one on her walks and definitely for her walk into the big public space where she had to “get jabbed” which she totally wanted to do, and she said absolutely no way with a rollator, I will lean on you. And she did, twice…Third time, the vaccine stewards saw that she couldn’t walk very well by herself, offered a wheelchair.
Thankfully Irene and I had already had a good conversation about it…. I had told her that the walk was longer and that if there were wheelchairs available she should not argue with me. I said it was our little secret, I wouldn’t be telling anyone that she needed the extra help.
She gave me a good hard long look before accepting the wheelchair option…. And then thanked me after. Days later, in front of her son, she mentioned that she was grateful for the extra help.
Now she is using the rollator as well…saying things like, oh I should have listened to you sooner… maybe I should get one with a motor?
She is clearly upset about her family situation, but also her own physical health… Her phone froze the other day, and she finally consented to me buying her another phone as backup. ( I suggested this more than 6 months ago and she shot me down telling me it was not necessary, and today she is really happy that she has a new phone as an option in case one fails).
I am so happy for you and your father that he passed so peacefully.
The honest discussions I have had with her have led to her telling me about certain female problems that she is probably too old to have corrected. My own grandmother went in for a sort of routine surgery over 25 years ago, with the same sort tuck in procedure that many older women have to deal with … we’ve had only two discussions about it… and both times were when she had experienced another trauma about the heating going off, or during a lockdown situation.
Maybe I need to bring it up with her again… but the surgery is too difficult for women of that age. Maybe she doesn’t want to live with it anymore, but how can I ignore her and not try to help?
On the positive side of things, we have set up a tea station upstairs. A small kettle and tiny fridge upstairs for her to have her tea and breakfast upstairs, rather than having to run up and downstairs all the time.
She has refused to move in with us, or move next door…she generally does not want to move at all….so we will keep her comfortable in her own home for as long as we can.
Thank you so much for your insight.
Once a nurse, always a good caregiver x
Good luck to you! I hope you can help her.
“Yes! I can definitely suggest this and I know exactly what you mean…
sometimes they just need to hear it from someone else!
Thank you so much and best wishes for you and your mother too xx”
I actually had to look up the difference between physical therapy and physiotherapy, because here in the UK physiotherapy kind of encompasses both. Many people just interchangeably use the words, but there is a slight difference in my opinion. I just wasn’t sure though…so thanks for helping me on this journey!
Many months ago I had suggested physiotherapy for her, she was finally able to see her doctor for a routine appointment and brought it up. At the time, she was in so much hip and leg pain that we did go for an X-ray, which ultimately just showed advanced osteoarthritis, I think, that’s what she told me anyway by saying… “all old people get it and I’m not going for an operation like my daughter does for every little thing she has a problem with”.
Shortly after this she confided a vaginal problem to me, that my own grandmother had….and at almost 93…she did go in for a “simple” correctional procedure that seemed to have been successful, until she died 10 days later. I haven’t told Irene about this and don’t intend to, yet.
After the X-ray, they then scheduled a phone call with a therapist, went well, then a brief appointment where she was given a print out of some exercises she should do at home. She was told to await a phone call the following week and had waited around all morning / early afternoon for it and finally decided to go shopping as usual. There was great comfort for her in being able to get out and lean on the shopping basket….She came home to a message that the therapist had finally called later that afternoon… she then went for another follow up visit, but it was a different therapist who met her and basically he told her there was not much to do. So she says… I know she would have just preferred the demeanour of the nice lady before and not the stern man she met with.
We have small obstacles we are tackling each week and she actually is in a much better mindset than she was a month ago. That was my stumbling block…I reached out for help here because I was about to say “enough”…enough moaning around me without accepting any help! Fortunately, thanks to you and many of the other thoughtful replies here I have been able to encourage her even more…and even over the past few days it has really really helped!
I’m very grateful and thanks for taking the time to even write that first suggestion!
I can tell you are excited by your mother’s progress and that is so heart warming! Well done xx
My golden girl will talk my head off complaining and then mention one or two things I suggested to her kind of estranged daughter - who has an even bigger moan about all her problems - and as soon as her daughter says it’s a good idea she’ll do it! It was frustrating at first, but I am now thinking of calling her daughter to suggest certain things, so that if they came from her…Irene might just listen and do more…every time we have gone to various appointments together, she shoots me a look as if to say…you were right…but she just needed that second opinion from someone else. Shame she can’t get it from her own daughter…and her sons are of a generation where they just don’t want to hear about mum’s health…
We’ll go back to the doctor and ask for more physio help, if not maybe pay privately… but just knowing that she ‘can’ recover a bit thanks to you and many others here, things are looking so much more positive.
Thank you again and best wishes!
We worked together on this; going for walks in the area, especially at the local park and down to the lack in his own home area. He either walked independently or gradually with a walker, then took a rollator for support, then used an Amigo riding machine (like those in grocery stores). With the latter, even though he wasn't walking, he was getting fresh air and interacting with neighbors, both very helpful.
I would definitely, most definitely look to PT; ask her doctors to script for it. The interaction with physical therapists is extraordinarily helpful, as is the confidence coming from being able to restore some level of physical activity.
You can supplement that with a reasonably priced hand/foot exerciser. Dad had one, pedaled with it while sitting in his favorite chair listening to music. He bought his through one of the catalogues (Miles Kimball type), which you could do, or could buy a more expensive one at one of the DME stores.
They look like this:
https://www.mykneedoc.co.uk/6-tips-to-get-the-most-out-of-your-virtual-consultation-copy/
Photo 1: basic model:
Photo 2: a bit of data enhancement:
Photo 3: more expensive, comparable to those in rehab facilities. More sturdy, especially for hand use, but also much more expensive and not easily moved by an elder person who doesn't work our for arm muscle strength.
Diet: Dad ordered Meals on Wheels, which had another benefit besides food: interaction with very friendly, supportive volunteers who delivered the meals.
If she's willing to go out, a good senior center might have special activities, such as holiday meals. Interaction with others would be a secondary benefit.
Sometimes Dad got milkshakes when we stopped for a quick meal, but they weren't regularly in his diet. Ensure and other similar products could provide some nutrients, and they did during the dysphagia stage. You might be able to buy some nutrition shakes at health food places, or even gyms which have a little health food bar for the work-out folks.
I can't speak to "jelly drops"; I have no experience with them. My father drank a lot of water, and some orange juice, so hydration wasn't an issue until he became dysphagic. Then he had to add Thik-It to liquid products.
Final thought as to losing weight and straying from good diets during Covid. I can certainly attest to that. W/o even trying, I lost a lot of weight, and still can't eat anywhere near what I consumed before Covid changed my lifestyle. And even though I walk in the house, I've noticed a drastic decline in arm strength.
Covid changes us in more ways than we may have imagined.
I hope PT proves to be helpful for your friend and that the walker is a useful tool for her to get moving once again. I have no idea what 'jelly drops' are but I wouldn't force too rigid a diet on the poor soul at this juncture either. 6 small meals a day should do her lots more good than harm as frequent small meals keep the blood sugar regulated which is most important for all of us.
Good luck!
I would ask her doctor to give her an order for OT/PT in her home. The therapist cam evaluate her and see if its something physical causing the problem. Your friend may more likely do her exercises if a therapist is there. If she hasn't had a good physical maybe time for some labs to see what her numbers are.
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