Are these changes common after a hospital stay or is something wrong?

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My mom has Alz/dementia, went to the ER because of choking and subsequent aspiration pneumonia. Stayed 4 nights, did not come home confused about the house, but now sleeping through the night (prior she woke various times/night) and is having more and more trouble walking, on stairs, and getting up from chair. She also needs supplemental oxygen since the hospital visit, which we hope is not long term. Does this rapid change in physical level seem par for the course, and is it possible that she can re-coup any abiliities? Before this she was slow on stairs, but ok, and walking without assistance. Sometimes she couldn't get up from a chair, but it's much worse now. Thoughts appreciated.

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My 96-year-old father has had 6 surgeries this summer, and is finally on the mend. The physical therapist told us that we should count on a week of recovery for each day of hospitalization. We were also told that it is important to get him on his feet every hour, even if just for a minute or two. With those 2 pieces of advice, we are starting to see REAL recovery starting about 2.5 weeks after discharge. Keep her moving. So important.
Jamie
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Beet, it might be time to consider sponge bathing or using no rinse shampoo and soap for her instead of taking her upstairs for a shower. That sounds like a real challenge until she recovers more.
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thanks - hadn't considered that being tethered to a tube might be slowing her down mentally. We have a follow up with her primary tomorrow, and I'll ask about weaning. Am looking into stair lifts, so that she can still use both floors, as the only shower is on the second floor. The puree diet doesn't seem to bother her - she wasn't really chewing her food before, hence the choking. I'll know to keep a good eye on her and luckily we have an aide that is experienced to help.
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Another advantage of therapy is that usually (but not always), home care therapists are used to working with the elderly, are compassionate, sympathetic and engage easily. Not only does that help draw out the elder to be more friendly, it offers emotional support outside of the family.
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For now she is still recovering, but don't let it go on too long. The website eldergym has some very good exercises, many of them are the same as those my mom's PT had her do. The ability to rise from a chair is too important to lose, is she won't try them with you see if you can get an order for some PT.
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As to the oxygen, sometimes just the concept of now needing oxygen, literally being linked by a tube to a machine pumping oxygen, can be enough to cause mental fatigue, which leads to physical fatigue and sleeping more. Being on oxygen is a real adjustment. And it's a limiting one, similar to being in a hospital and having to drag an IV pole around.

As to needing oxygen being short or long term, you'll probably have to raise the issue of oxygen weaning with her pulmonary doctor. Do you know if any oxygen weaning took place in the hospital? If not, it'll be up to you to address the issue.

Is she going to be getting home therapy? If so, ask the nurse about the weaning. In the meantime, get a good pulse ox to measure her SAT rate and start keeping track of it, when she's resting, walking around, and especially when she's more active. That kind of log can help her pulmonary doctor determine her short and perhaps long term need for it.

That doctor can also perform tests during an office visit to gauge her pulmonary capacity.

It wouldn't surprise me if this hospitalization was overwhelming for her, and she needs the rest to give her body time to acclimate. I think she should have PT, but perhaps she's not ready for it, and having a PT as well as nurse, occupational therapist, possibly an aide, might be just too much right now.

One thing she can do is strengthen her arms by using a little device similar to bicycle wheels. It's essentially the pedal function and can be used not only for arm strengthening but for leg strengthening. If she is getting home care, ask about her being able to use that until she gets PT.

Building her arm strength will help her get out of a chair more safely. And if no one's raised the issue, she should scoot to the edge of her chair and push up with her arms to get out of the chair. Sometimes seniors try to get up while sitting with their back to the chair, and hurling themselves up. That's a bad move.

Is there any way you can move her bed or create a semi-bedroom on the first floor so she doesn't have to climb stairs? That's a real challenge if not danger to someone unsteady on her feet. If you have a bathroom on the first floor, create an area for her to sleep on that floor w/o having the extra challenge of climbing stairs, apparently attached to a long tube connected to an oxygen concentrator.

If you need input on a dysphagia diet requiring puree foods, just let us know. Some of us have (and I currently am) going through that now. There are a few tricks that can be used, such as using gravy and juice to make foods easier to puree.

And tackling that can also be depressing to someone, because it takes away much of the pleasure of chewing while eating. So she's dealing with pneumonia recovery, limited mobility, oxygen use and some level of dysphagia, apparently none of which she had before she was hospitalized.

That's enough to slow anyone down and impede a recovery. She'll need a lot of support during this period.
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Bee
My 94 year old mom was hospitalized briefly 6 weeks ago with a UTI and has not made any improvement - she is in bed some 15+ hours a day now and needs a lift to be transferred

Medicare covered minimal physical therapy and she didnt really make any progress - it's as if she had a stroke and she too is now on purée for choking

So hard to go from being able to stand and walk a bit to being bedridden almost overnight

Hope your mom regains her strength
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cwillie - it's been a couple of weeks. There is no sign of the pneumonia, but yes, I think with even one day of inactivity she had lost mobility. Today was a little better in terms of walking, the hardest is getting up from a chair. In terms of swallowing, yes, they did an xray and functionally she is fine, but she doesn't chew food thoroughly - we are now on a puree diet.

Eyerishlass - thanks for telling me not to force the exercises. I am also of the mind to let her rest as needed, but she is now really having trouble on the stairs, and it makes everything so much harder so fast. "If you take your mom through the exercises" - ha! will try, but she is stubborn and won't do exercise for exercise's sake. Will try, though. thank you.
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I agree with cwillie in that your mom may still be recovering from the pneumonia. Infections hit the elderly a lot harder than they do in someone younger.

When your mom was in the hospital did the nurses get her up to walk regularly? They may not have and I'm thinking that could account for your mom's decline in mobility.

When we get sick we feel awful for a few days but we bounce back. When an elderly person gets sick it can have a cumulative effect on them. Your mom may not bounce back to where she was before she got sick but there are things you can do to help her such as light PT on her legs and standing exercises at the sink. If you're unfamiliar with these exercises talk to her Dr.'s office but make sure your mom is feeling up to it first. Get her cleared through her Dr.

Don't force the exercises. There are passive exercises she can do from a sitting position if she's still weak from the pneumonia. If you take your mom through them on a regular basis her strength and mobility may improve a little bit. It definitely won't hurt.
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I'm not sure how much time has passed since the hospitalization, is she still being treated for the pneumonia? Any king of infection in the elderly will be much more debilitating and take a much longer to recovery from than in someone younger. Her body need the extra rest, but do your best to keep her physically active because once abilities are lost it is hard to regain them. Some simple PT exercises a few minutes a day can be surprisingly helpful.
Have you met with a speech - language pathologist to address the cause of her choking? Are you following up with her respirologist?
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