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Mom is definitely winding down. Most days when I am helping her with meals she will keep rocking forward in her wheelchair, I believe she is trying to relieve pain in her back. I can't really give her a back rub because she can't lean forward more than an inch or two. I can't use voltaren for the same reason. She is on tylenol with the option of ibuprofen if needed (only when I ask, of course). When she was still at home we avoided opioids because of her slow transit bowel problems, I honestly don't know how well they are managing that in the NH. I just don't want her uncomfortable.... what kind of pain medication should I ask for?

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Does your Mom have a gel cushion on the back of her wheel chair as well as on the seat of her wheel chair? Ask if the physical therapist can look at your Mom's wheelchair and see if it needs to readjusted so that she is sitting more comfortably in it. If your Mom is quite frail, she may need even more padding like a "Wheelchair pillow" that folds so there is padding on both sides and on the back of the wheelchair. Talk to the physical therapist about getting one of those.

Has your Mom's doctor tried Lidocaine patches applied to your Mom's spine where the pain is the worse? They are applied daily. My Mom wore the Lidocaine patch and that seemed to help relieve some of her back pain.
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She might actually talk if I try shoving ice on her back, and the words would probably not be nice!
Unfortunately anything I suggest is going to have to be done by the staff at the NH, and they tend to do a p*$$ poor job when they have to deviate outside their normal routines.
I think I'm really looking for drugs, because I assume we are approaching EOL and are past the point of trying alternative therapies.
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The cushions made a big diff in my mom’s life. The ice alternated with heat also gave comfort and the lidocaine patches really helped. The problem with pills is they come with side effects. Constipation etc.
ask for the therapists help if that’s possible.
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Slip an ice pack down between the wheelchair and her if she can tolerate ice. Wrapping the ice pack makes the cold sink in slower.
Also, ice pack on bed, again covered with a thin t-shirt like cloth.
Recommended by my chiropractor for back pain.

Others use heat. An elderly cannot be left alone with a heating pad.

Back pain may get worse when constipation is a problem. Imo.

Does she have an orthopedic pad on the wheelchair?
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Zims Max Freeze muscle and joint SPRAY, greaseless, vanishing scent, contains organic ilex and aloe, Arnica, vitamin E, and tea tree oil. Leaning forward just 2 inches will work.

Do not spray in a manner that causes her to have to breathe it in or smell it for the first 10 seconds. It dissipates fast.

It is my favorite 1st choice for easing the pain, next to icing. Try it yourself first.

Wal-Mart carries this product, or it is online.

Under ten dollars. Or, $7.99 in U.S.
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Sorry that your Mom is declining so. I am for the comfort pads on the wheelchair.
Are you sure she is not slipping out of the chair?
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Talk to the physical therapist about treatments for your Mom's back pain as that is another part of their job.
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I don't think it is the chair, the back is a moulded cushion that is supposed to prevent her from tilting to the side, but she *is* in it all day except for an afternoon nap so that has to contribute to the discomfort. She can't really move much at all on her own, I'm amazed she can still rock forward when the chair is tilted upright.

Back when she had her MRI I remember the doctor going over all the problem vertebrae (it was all greek to me at the time), I know it seemed a very long list.
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"the (wheelchair) back is a moulded cushion that is supposed to prevent her from tilting to the side"--But is the molded cushion ALSO made for COMFORT or only for support?
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Sigh. One would assume the backs are built with comfort in mind but who knows? The danged wheelchair cost as much as a used car, it's less than 2 yrs old and I've already had to upgrade the seat with an expensive ROHO cushion.
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