When should I become concerned about my grandmothers discomfort/pain level?

Elders can break bones without a fall. This could be a broken hip or pelvis. If pain keeps one awake, it needs to be seen to by a doctor.

Call 911 and get her to the ER. She will refuse but if the pain is bad enough she may not argue. The EMTs will be able to assess her and give an opinion about a hip fracture which sounds most likely. Under no circumstances allow her to take more than the recomended dose of any medications including the over the counter ones like Advil. That can cause bleeding which can lead to a stroke or tylenol which can lead to kidney failure and death. Do not try and transport her to the Dr yourself you could cause further damage. Do not give her more than sips of water or other clear liquid in case she needs anesthesia. Have her taken to a hospital where orthopedic surgery is performed so she does not need to be transferred a second time. Stay with her in the ER and advocate for sufficient pain relief. Come back and let us know what happens.

She does need to see the doctor. Depending on the type of pain, ibuprofen may not be the best choice. Her doctor can order an MRI for her to see what may be causing the pain and how to ease it. There are many ways to help with pain now, so she may be suffering needlessly. Tell her it is better to see the doctor for some short trips than it is to spend weeks, months, or longer nested in heating pads and losing sleep to the pain. Good luck!

Does she have osteoporosis, do you know? This sounds alarmingly like a spine problem and she must see her doctor as soon as possible. Why is she reluctant to? Poor lady, I hope she'll agree to an appointment without further ado.

Sitting for too long will only exacerbate pain. Movement is what the body needs and taking too many Ibuprofen can have a "rebound" effect as well as the Xanax. Rather than "doubling" any medication, call her doctor and make an appointment to see what exactly is going on with her pain. She could be having a pulmonary emboli (blood clot) or a TIA. Pain is always the body's way of telling you something is wrong. Get to the dr. asap.

Agree with everyone here that her pain is very worrisome, and she does need to go get evaluated. A fracture in her spine or elsewhere is quite possible, and can happen without a fall.

To help her accept going, it might help to use "I" statements and also frame suggestions as ways to help her attain her goals, like "I'm very worried about you and we need to have you seen so we can understand what's going on and get you walking comfortably again." Also good to find out what her fears are "Tell me what's worrying you about going to the doctor, I'd really like to understand better because I'm worried about you and want you to feel better."

If she's in excruciating pain and can't walk, you can call 911 as people here have recommended. But it's also generally it's ok to try to move people as long as they haven't just had a fall.

FYI both ibuprofen and Xanax are on the list of medications to avoid or use with caution in older adults, so you may eventually want to ask the doctor to review benefits and risks. There are often safer alternatives for pain and anxiety.

Good luck!

Call the doctor and get her in the hospital to check if she has broken any bones. She may have a fracture and it will not get better without treatment. If everything checks out ok, the doctor should be able to figure out if this arthritis pain or a disc problem etc.

You mentioned she does not like to go to the doctor, so they may not have much on her overall health on file, so they will need to do a complete workup to know exactly what is going on. Your grandmother is not that old but after 80 and particularly after 85 an elder needs to keep regular doctor visits to keep things under control medically.
When they refuse to make time for these visits, readjustments in their meds etc they will not do well and will end up in the ER for one crisis after another. At this age it is the old "stitch in time saves nine".

Good luck --I fear she may have a fracture or a disc problem. It can happen so easily at this stage of life. Your note seems to indicate she is living alone. This may not be an option much longer either. I would have a medical alert button on her and perhaps a part time home health aide to assist her and keep her safe.

As Dr. K says above, Xanax is in a class of drugs that are known to be harmful to elders longterm in some circumstances. An antidepressant that has anti anxiety properties is probably a better choice. When the pain has been figured out, especially if she's in the hospital, ask for a geriatric psychiatrist to see her and evaluate her for meds. Post back and let us know how she and you are doing.

I hope you can get her to a hospital. With that kind of pain, it's likely they will order x-rays and maybe an MRI. There are some open IRI's but if they don't have one, they can go with gentle sedation for the MRI. I would encourage her to allow the tests. Explain there are things they can do they will help her pain.

The other posts here are very true. With brittle bones, you can fracture a bone without even falling down. It sounds like she's afraid and that's why she doesn't want to see a doctor. It's just too risky to wait this out.

Sending positive thoughts & sincere prayers to you for strength and to grandma for relief and healing. She does need medical attention. The xanax can be addictive, however they usually only prescribe 0.25 mg of it which is very small dose, but even then it is a Controlled Substance so not to be two at a time.