What should I be prepared for when my elderly goes from walking to being immobile?

I am not fifty yet and use a power wheelchair daily. almost 24/7. transitioned into it gradually, and have since lost the use of my hands and arms, concentration, and short term memory. Here are a few tips, from 20+ years of experience......

get a chair with the tightest turning radius you can find.....trust me on this...it will mean the difference in having to replace doors, and if needed, it is POSSIBLE to get a chair with a turning radius of 20" or less into a regular sized public bathroom stall.....(not closing the door, but that's what umbrella's and jackets are for.....). I can turn mine in a complete circle in a 20 x 20 inch square space.....this comes in handy at many many churches, btw.....most are exempt from complying with ADA regs, and while many are able to fit folks in, lots don't have room....

go ahead and cash pay the $66.00 (each) for the elevated leg rests if insurance denies (they will cover for edema, usually). They are outrageous, but so is that much spent on coffee at a coffee bar....and when having to sit all day, one really does need to be able to raise one's legs. Ditto with the head rest.

There is a WONDERFUL seat cushion called a roho, which is around 60.00....insurance pays if there is skin breakdown. Don't wait that long...it's MISERABLE. Amazon has a much much much cheaper.......under 20.00 knock off version called Cor-Flex medic-air seat cushion that does the same thing. It is possible to cut a hole in a tennis ball and put it on the joystick driver to make it easier to grab hold of. If you like to go outside, cover the heck out of it with reflective tape, and consider wearing a orange vest. Additionally, when it rains, it CAN be taken outside...as long as it's not storming, (although i have done that too...just cover everything, especially the controller, with lots of plastic.... Inside the house.....there are double hinged door hinges that can add two inches extra to door clearance. There are portable and adjustable ramps (amazon has some rubber ones) that can adjust to one, two, three, and four inch thresholds. There is a very helpful company spinlife and another, functional solutions, that have gadgets. I personally did not buy many of them other than ramps. There is one verzion of the jazzy chair that actually comes apart into eight pieces that fits into a trunk. loved that. The trick is to charge the batteries every night from a plug that belongs only to the WC. can be tricky if one also has oxygen.

In terms of what to expect every day, that changes over time. hard to say for each person. For me, it has meant more freedom in many ways....I live basically alone...my partner has dementia....in some ways, there is loss....folks in real life tend to expect less. Frustrating when one is barely 50. I keep a lot of my cooking things on the counter in my kitchen. Taking cabinet doors off means that i have more ability to get to stuff when i need to easier.

My bathroom is a regular apartment bathroom that I share with my partner who has a hip issue, so we have a raised toilet seat. prior to that, I put two grab bars on the wall behind the potty, parked in front of the potty, and sat facing the wall. easier for me. no room to pull in sideways and transfer. not a big deal. just make sure and power the chair off. LOL. transfer from the toilet to the tub. Get a shower chair that has a toilet in it. And I recommend a bariatric one, even though i weigh 120 pounds. They are just made better and last longer, imho.

There is a thing called a transfer board....google it, and if you are handy you can make your own....I did....that allows one to slide from a chair to a bed or a couch or a shower chair.....

There are clothes online (or if you like to sew you can modify existing clothes) that have snaps down the sides, so that dressing and undressing can be done from a seated position.

If you are helping someone in a seated position position put on a coat in a hurry.....like an evauation.....wrap a warm blanket around them in the back and put the coat on backwards.

a reacher is indispensible. Put a magnet on one end of it if you can only afford to buy one, and use metal silverware

I love to cook....I got myself a long rectangular card table and use that as a counter so i don't have to lower the counter in my apartment. works. So does a hot plate, a rice cooker, a crock pot, a combo toaster convection oven.

if you own your own house, the recomended adaptations suggest a side opening oven.....I know of a welder in someones house that did a switcheroo on some old stove and saved someone a lot of money. just sayin. it is safer.

one piece of technology that i love is the electronic thermostat, so i don't have to stand up to see the temperature in the house.

I tie a long rope on my front door and i can close it behind me just fine when i leave down the ramp....I have to go back up to lock it, but it's an older apartment....no worries, right. it's a classy neighborhood.

Get rid of the rugs. just do it.

tile is actually better.

wipe down the chair after every trip outside and at least once a week.

if you like to go shopping, get the stupid looking wire basket for the back. it cuts down the turning radius, but it comes off in the house, and it's easier to get to stuff from that than it is from the back pack

if you are dealing with hover round.....do not fall for the 349.00 upgrade of a reclining seatback ......get the doctor to order it, and decline on delivery.....then go to your tool box, get a pair of pliers and remove the COTTER PIN....and thank me....I paid for THAT education.....ping me if you have any more questions.......

Please don't assume that because your dad can't walk, he's immobile. He can and should use a wheelchair to get around. My mom went through this transition in the past year due to bad knees. At 89 her doc won't even consider knee replacement; surgery and recovery are too difficult.

If your parent still has some leg strength and arm strength, a wheel chair is a good option. your dad should be able to get physical or occupational therapy-paid by medicare - to help him learn to "pull" with his feet, roll and turn with his hands. My mom goes slow but she still gets around under her own power. It's a small bit of independence but it helps keep her as active as possible and she feels good that she can get around to the table, toilet, etc. There is some added difficulty getting TO the toilet, sometimes she needs help but an aide and grab bars are always close by.

If your dad will be bedridden in your home, ask his doctor to prescribe a home health nurse for a week or two to help train YOU. you need to understand how & when to turn him, how to move him without hurting yourself, how to use a bedpan, how to bathe him. You should also be very aware of pressure (or bed) sores whether he's in a wheelchair or bedridden these can be quite painful and become septic and fetid.

It's very wise of you to seek advice from others. Doing something like this is hard work -physically and emotionally. Best of luck to you and your father.

I agree with everything Lynn wrote. Especially the part about not being immobile.

One question: Is the inability to walk due to strength, muscle issues or something else? Is a walker a possible option. My mother used a walker for several years before needing a full time wheel chair. Also, a combination of a wheel chair and walker are possible.

If you father does move to a wheel chair, it is important he get out of it as much as possible. A "lift chair" can help with the transitions. A visiting nurse and/or PT is an excellent idea.

One thing I recommend if your father does require a wheel chair is to invest some time rearranging his closets, cabinets, etc., especially in the kitchen. Just moving staples, glasses and dishes to waste height can make all the difference in the world.

wf

My grandmother is 98 years old, just in the last few weeks unable to use her legs; my mom who is 67 and in decent physical health is her sole caregiver. I go to assist daily, mostly at night to help with getting her ready for bed as I work full time; I have been online doing a lot of searches looking for equipment or tools that can help my mom transition without hurting herself. There are nurses that comes out weekly to keep check on basic things like blood pressure and circulation and bathe her twice a week but it is the regular things like to the toilet and from bed to chair movments that I feel over time will wear my mom out.
Any suggestions?

Just because someone can no longer stand does not mean that it has to be difficult to transfer them. Balance Pivot transfer techniques reduce the transfer weight by 90% allowing a smaller caregiver to transfer a larger person without stress or strain. There are several excellent tools about the size of a laptop that can make this possible called a mrswivel.

SARCOPENIA - He's okay getting up from bed, going to his desk, going to the restroom, going to the living room recliner and back. It takes all manner of chicanery and trickery to get him to go outside for a "walk." It used to be easy just two months ago.

I've done some research, and it seems to be sarcopenia, the fancy term for losing muscle with age. It seems to accelerate rapidly above 80, which my dad is. The only counteracting forces is some resistance training, even just once a week, so we will try that.

Otherwise it seems that with age, the cells in the body don't process protein-to-muscle well, and there's not much to counteract that via diet, meds. Since he likes nuts anyway, we'll pretty much give him carde-blanch on peanuts to snack on to increase his protein intake.

If he were to be in a wheelchair, he wouldn't have the arm strength to move it around. We'd really have to have someone with him 24-7 then it seems. Right now, he "hugs" the walls as he walks around now, so we've arranged furniture as needed to clear his paths. Unfortunately I rent my place, otherwise I'd put up arm rails all around.

We've made a "snack" station that is a little above waist level for him to pour himself something to drink and to place snacks. It's right near his room..a bit of encouragement to get "up and out" and moving at least a little.

You know, babies at least get to transition smoothly from crawling to toddling, but at least in this respect, growing old -- doesn't seem to have as nice a transition.

I once saw on a TV special about taking care of elders in Japan, a community center had a walking-lap pool that was heated and with water at chest height and hand rails inside the pool with railed-stairs down from ground level. Has anyone ever seen such a great accommodation in the U.S? Or are we just so far behind?

Due to strokes, Alzheimers and a fractured spine and hand, my cousin went from a cane to a walker then wheelchair in a few months.. She is still able to walk a few steps though. If your dad's doctor sees fit, I would try to get some therapy ordered to keep his legs as strong as possible, even if it's just enough for him to stand in order to get in and out of bed and on the toilet with assistance. That makes a big difference.

I realize that keeping your dad walking is a great goal, but I would be careful that he is able to do it safely. My loved had too many balance problems on top of weak bones and muslces and kept falling and breaking bones. Walking was just not safe for her anymore.

I actually think my loved one felt relief when going to the wheelchair, because she was so afraid of falling again.

Windyridge- good post- assistive products can be a huge help. Many caregivers put the person (and themselves) at risk of injury by just trying to do things manually. Or if that can't work just let the person stay in bed and decline further. Had a woman call us and say her husband spent 90% of his day in bed while she worked. He had mobility problems (and strength) but without help/hope it sounded like he was also depressed. With proper products he could have safely/independently got himself in/out of bed. Nothing happened- last I heard he was in hospital with severe weakness and other health issues. The old saying is true- "use it or lose it". As people age problems will occur- either something is done to address the problems (therapy, products, outside help) or do nothing as the person fades away.

As a primary caregiver, it is important that you prepare and plan for caring for a loved one who may eventually become immobile. No matter how light or heavy, caring for a person who is immobile can be very difficult and add to the daily stress. I was able to care for my mom who was 2 1/2 times my weight. The following is an outline of a few of the tools (hardware) I used to move my mom from place to place with dignity and mutual comfort. Wheelchairs can often be found at Goodwill for about $45.00. Check to make sure that the leg rests fit. The larger heavier wheelchairs are easier to navigate. The lighter models are easier to Iift but often harder to navigate. In terms of stair lifts, if you can follow a You Tube video and are willing to install a stair lift, Ameriglide provides self install stair lifts for less than $2,500 with used models as low as $1,800. The YouTube videos show a two hour instal. It took me 8 hours and found it challenging but do-able. A Hoyer style lift is important to be able to lift the person from the floor to the bed or from a bed to a chair. I found Hoyer Lifts on eBay ranging from $400+. Often slings have to be purchased separately. Moving a person from a bed to a chair, to Wheelchair to a car I found the Take Along Lift very helpful. This lift provides great back support, folds up, is very durable and has wheels. It easily fits in a car trunk. (There are illustrations on the website). These lifts run about $2,500. They sell an additional sling to lift a person from the floor to the bed/chair but I never used the sling as I had a Hoyer lift prior to getting the Take Along Lift. A bubble mattress that alternately inflates and deflates bubbles on the surface to alternate pressure is helpful to prevent bed sores. Bed mats are essential to change bed linens and should be layered under the patient. They are also helpful in turning the patient and keeping the bedding clean. Last but not least be careful of urinary track infections that can confuse matters and make a difficult situation harder to deal with. I hope this helps.

carolbb technically, yes, an OT can help, but you need to find one who is certified to fit people for Wheelchairs and DME. check and see if your area has a Disability resource center. They can refer you to a person with the appropriate certification.