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Bermuda Asked July 2013

Mother won't use walker! What on earth can I do?

My mother has been evaluated by a physical therapist and receives physical therapy at home and by a physical medicine doctor and she's been told she should be using her walker not just a cane. But she isn't using it whenever she goes to other doctor appointments, the grocery store, out to restaurants with her brother. She uses the cane (my uncle tells me) and lurches about leaning on things with her other hand. She simply will NOT listen and has fallen several times but has bones as stubborn as she is so no serious damage so far. I just simply don't know what to do. I am many states away so my involvement is by phone only though frequent. To make matters worse my mother has become angry at my uncle and is resisting accepting his help and not being honest with him about problems she's having where she needs his assistance. What on earth can I do? I am no position to move her to my location at this time, so whatever I do must be accomplished with her where she is at home. I have talked with her doctor but the doctor cannot force her to do anything and my mother lies straight to the doctor's face about what she's doing.

LadeeC Jul 2013
This may be simplistic, but .. take away the cane, keep a walker in both places where she might typically leave it behind (forgetting), and if she asks where the cane is, "Don't you remember, mom? We had to give it up. It's just the walker, now." (I'm willing to bet she was just as stubborn about using the cane, at first. Until she figured out it made it easier ... and less painful to walk?)

orangeblossom Jul 2013
Chicago, Yes sometimes due to a parent's "denial" attitude, and stubborness that they "can take care of themselves" and they "know what they are doing", that you end up just waiting it out. That's exactly what happened with my Mom. The last fall (without breaking anything) is what landed my Mom in the hospital, and once she was there, they recognized that due to her twisted back and legs, serious balance and instability, plus the progressive dementia, there was no way she could go back to her apt and live independently. I could not live with her, nor could either of us afford more in-home assistance than Medicaid was willing to provide (and I was seriously close to burn-out at that point). That's how she finally ended up in the NH.

Whirlpool, I though I had mentioned this, but it might have been in some other post. Since you cannot be "on the scene" with your Mom, have you considered finding a geriatric care manager? If you can afford it, it might be beneficial to your Mom and to your peace of mind to have someone coordinating on the home front and keeping in close communications with you. I saw some references to that option in the tabs at the top of this website (maybe under Elder Care). You can always use the search box to find the exact reference articles. I hope you find the assistance you need soon.

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Chicago1954 Jul 2013
We had to wait it out. A fall finally took her to the hospital and after that, the doctor no longer gave her the option of living at home.

CathyJ Jul 2013
Orangeblossom5: I like your suggestion of giving the nurse an envelope for the doctor to read before the appointment. I have information I need to communicate to the Dr. And that seems like a good way to do it without having to say things that would start an argument if I said them in front of Mom. Thanks!

Bermuda Jul 2013
My mother would win the Olympic gold in the show timing category! She's one crafty lady. Thank you so much Orangeblossom for sharing your experience and ideas. I will start on that journal today - it taxes my own memory to keep track of how many concerning events and outrageous lies occur. There's just too many. Being "firm" with my mother doesn't work too well, she's actually been in denial and refusing to listen to reason about things all of her life - this is a personality trait for her now made worse. I do think you are also right that there is the beginnings of dementia additionally. The neurologist has ordered more elaborate tests than the basic ones they do in the office, but they are scheduled many weeks away. My uncle is not interested in being in the caregiving role - he has certain things he's willing to do but draws a line. I do respect he has that right, but the problem is where he draws the line leaves my mother with needs that are unsafe not to be met, but she refuses to allow in home help so far. I definitely won't give up though and am much encouraged by the support here.

orangeblossom Jul 2013
One more suggestion: It might be a good idea for you as well as your Uncle to start keeping a journal of any and unusual or dangerous behaviours or serious lack of judgement with her physical safety. Dates, times, and brief descriptions - these will eventually be of help to the doctors to determine the level of progressive dementia or mental competency your Mom is displaying, and will be better able to diagnose and treat. This will also discount the "lies" your Mom is telling the doctor. As my Mom declined, when we went to the doctor, I would give the receptionist an envelope with my notes and on the outside I wrote "Doctor must read this before seeing Mom". That way, the doctor got a clearer picture of what we were dealing with, and understood that he could not rely on Mom's account of what her conditions were (according to her, she invariably was "perfectly fine" when she spoke to the doctor). This is called "show-timing" - like a display of false bravado, in an effort to preserve their pride.

orangeblossom Jul 2013
Dear Whirlpool, It is typical of an aging parent to be in denial about their diminshing capabilities. I believe it goes along witht he progression of dementia. My Mom's legs were in bad shape while she was still living independently, and the doctor had informed her that she must use the walker 24/7 instead of the cane. She insisted she did not need the walker at home and continued to use the cane, or just hobble around holding onto furniture and walls - so stubborn! Eventually she started falling also. I lived near her and started hiding the cane, and placing the walker near the chair she usually sat in. This helped somewhat, but eventually she also started forgetting the walker in one room and reverted to holding on to furniture again and could not remember where she left the walker. It is also typical to resist help from others and lie to doctors because it is so hard to accept that they are losing their independent abilities. My Mom has been in the NH over one year and still hates the walker. She now uses the wheel chair and paddles around with her feet and believes she is "walking" all day. BTW, there are times when your uncle will have to be firm with your Mom about using the walker, such as when going outside the home for errands and such. I told my mother she either uses the walker or just stays home. I explained to her that I have a bad back and could not support her leaning on me and if she lost her balance we could both fall down. She really didn't care about that, but I was firm anyway. A couple of times she literally threw the walker away from her like a petulant child. People were kind and helped me out to get her back into the walker so we could proceed with what we were doing. Eventually, you will have to get some additional help in the home for her besides the Phys Therapy. That is considered skilled care for "x" # of weeks (which can be extended), and during that time, your Mom is entitled to a home health (custodial) aide as well. Even if it just a couple of hours a day for 3 days a week, it is a help
(to her as well as your Uncle), and it will get your Mom used to having in-home assistance. She may likely object, but again, you have to be firm and just tell her it is "doctor's orders" (at least until her skilled care sessions are done). I'm sure it is difficult to manage her care from afar, but until you can make other living arrangements for her, thank goodness you have your uncle to rely on for accurate input on the dailiy situation with your Mom. I hope some of this info is helpful to you.

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