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My 96 year old mother in law broke her hip about 2 years ago. She made a pretty good recovery but has since been prone to falls. She has fortunately not suffered anymore fractures but the last time she fell she was using her cane. Since that time we have insisted that she use her walker. It seems like she is much less mobile and we’re wondering if using the walker is inhibiting her mobility. She is also showing signs of dementia and we are struggling with her nutrition since her appetite is very poor. Any advice would be greatly appreciated. We live in a rural area and many of the support systems aren’t available here.

I feel some sort of evaluation of your Mothers mobility by a physical therapist would be beneficial. That would determine which type of mobility aide would be most appropriate for her. I dont know what type of walker you are currently using with her, but perhaps it is the specific type of walker that is limiting her not the walker itself. Standard walkers can be painful to use for someone with bad shoulders, for example. 4 wheeled walkers with seats can move too fast for some and scare the person. The 3 components to balance, which are vision, sensation and inner ear balance may be declining and need to be addressed. I feel it's much better to stay mobile with the appropriate device than to limit walking and lose function and strength. I'm a therapist, by the way.
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Reply to Poppy11
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A physical therapist told me a cane is dangerous, because people put too much weight on it, lose their balance, then pivot and fall sideways. A cane is only safe(ish) if you use it with one hand and have the other hand on the wall. In other words, using it outside the home is not a good idea.

A walker is a pain in the neck because they're always banging it into the doorways and furniture, but by design it requires them to use both hands to use it, and they have to be facing it to walk anywhere. The ones with wheels aren't good for anyone of your MIL's age -- they really should be for much younger folks. (My mother never could figure out the hand brakes, so we gave up on it, thank goodness.)

She's 96 and sounds like she's slowing down and heading for her eventual end. Let her eat what she wants, when she wants. Offer her a small breakfast, then a snack every couple of hours and see if you have better luck that way, but honestly, if she's not hungry, she's not hungry. I have a relative who lived to be 102 eating little more than fried chicken and Oreos the last 15 years of her life. If she hadn't, maybe she might have made it to 105, but why? She died with a smile on her face.
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Reply to MJ1929
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By virtue of the fact that your MIL needs a walker her mobility is compromised. My own mother fought off using hers for ages, insisting she didn't need one and was doing fine without one. She's fallen over 48x that I'm aware of to date, even when she finally DID start using the walker.

My father fought off the need for a cane until my DH brought him to Walgreens and told him to pick one out, he'd wait. Then came the need for a walker, which he refused, of course, and wound up falling & breaking a hip which led to his death 10 months later. His mobility was compromised, as is my mother's, for a long time before he actually admitted it.

When I had a full hip replacement in 2017, I used a walker with no problem or resistance at all. I saw that it helped me, that I needed it, and it was there to assist me in getting back on my feet independently. Of course, I wasn't suffering dementia either, to the best of my knowledge, so my brain power wasn't compromised.

My mother's favorite saying is "It's a great life if you don't weaken." Your MIL probably hates admitting that she has a 'weakness' that requires her to use a walker. If so, she's sitting around more than usual as a result.

You might want to look into getting some Ensure or Boost shakes for her if she's suffering from a poor appetite. Or make her some smoothies yourself in the blender. Sometimes the elders prefer something they can drink rather than chew, especially if it tastes sweet (dementia gives them a HUGE sweet tooth). Keep in mind that a sedentary human being requires far fewer calories than we THINK they do to survive. So don't worry too much if she's not eating as much as you feel she should be eating. A few bites at each meal, supplemented with a snack here and there, should do the trick. Experiment to see which foods she seems to enjoy, and eliminate the ones she makes a face at and won't eat. No use in arguing such a thing at this stage of the game. In fact, I bring a couple of bags of junk food to my mother in the ALF every Sunday when we go for a window visit. She says she hates the food they serve her (she's gained 40 lbs, however) so she can supplement her diet with her favorites snacks. She'll be 94 in January; it's up to HER now what she eats or doesn't eat.

I think you should allow your MIL, at 96, to be less mobile if that's what she seems to want. Don't push for her to be active; it makes no sense, really. She's earned the right to do as she pleases and besides, with dementia, you can't really argue with them....it's impossible! It only gives YOU heartburn and becomes a losing battle.

Good luck!!!
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Reply to lealonnie1
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Dear Tommyann,
I am writing from the patients perspective. I was diagnosed with a form of Muscular Dystrophy at the age of 40 where in between age circa 8-40 I was told there was nothing the matter with me. Finally on my 40th birthday, I was told I had M.D. My Ortho doctor recommended I get a walker to use on days when walking was difficult, inclement weather, or very long distance. He told me not to be using it everyday, but if I needed it use it. That was 21 years ago and rarely have I used the walker, but I've not been shy about using it especially when traveling and walking in unfamiliar locations.
Four years ago I was diagnosed with early onset ALZ and I use the walker more often. I have suffered a handful of falls in the last year, no major injuries, but I am now less stable. I'd think a very senior citizen, should use the walker for their own safety. I hope if I begin to rebel against using it as I further decline, that my family will insist upon me using it for my own safety. I hope this is helpful.
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Reply to jfbctc
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I believe both my parents walked longer b/c of the walkers. Getting the proper one does make a difference though. Posture is important and there are plenty of brands. My dad used one that only rolled when you squeezed the bars b/c his neuropathy left him with terrible balance. He eventually fell, but not b/c of the walker; his Alzheimer’s led him to believe he didn’t use or need one. He broke his hip and has been wheelchair bound since, but he walked a lot longer using a walker. You can gussy one up if a percent wants a sportier looking one! Good luck!
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Reply to DadsGurl
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I will be 87 and can't walk due to severe spinal issues. I force myself to do the impossible so as not to be so frustrated and ashamed to be a misfit but the pain is overwhelming. One thing I must do if using a walker is use one suitable for a child because to keep my balance and mobility and ease the pain in my back, my arms must be poker straight from my shoulders and as close to the floor as I can stretch them. If I am able to keep my arms poker straight down, I can walk safely but if, like 99% of walkers and people with disabilities, if I have to bend my arms at the elbows because the handle is too far up, I am in agony and don't have good control over walking. Each case is different - try handle bars very low for stability and then experiment with them up a bit.
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Reply to Riley2166
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NeedHelpWithMom Sep 13, 2020
I admire your courage and determination. A lot of people would have a pity party and resign to a wheelchair. I am certainly not putting down people who use wheelchairs as a last resort because they simply aren’t able to be mobile any longer.

Take care.
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My mom started with a cane. She then moved to a walker. She fell many times. There is no way she could walk without a walker. With Parkinson’s she has numerous mobility issues.

It’s tricky to know what is the best thing. My mom would like nothing more than to sit in a wheelchair because it is absolutely exhausting for her to walk just a short distance.

When I spoke to her doctor about her wanting to be in a wheelchair he was adamant that she should continue to walk.

She’s well into her 90’s and still going but every step is painful. So who knows how long a person can push themselves? It’s so hard to know.

My mom continually said that the doctor did not know the pain and fatigue that she felt. She had a point. It made me feel awful for her every time I would hear her say it.

Parkinson’s is a dreadful progressive disease. There isn’t a cure. Those who suffer with it will never improve. Many eventually end up in wheelchairs. I think that has to be an extremely difficult challenge to care to a person in a wheelchair.
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PAH321 Sep 13, 2020
NeedHelpWithMom - My 92 year old Mom who used a walker fell multiple times this year resulting in fracturing a hip and then later a leg. She ended up having to use a wheelchair. She is unable to propel the wheelchair on her own and an electric wheelchair is not an option due to issues with eyesight. Using a wheelchair has not protected her from falls as she has slipped out of the wheelchair twice onto the floor and also fallen once when the aid was trying to transfer her to the wheelchair. She now has a broken foot from one of those falls. She is also now completely dependent upon others for absolutely everything. Sitting in the wheelchair for hours is making her weaker every day and she is at risk for pressure sores and a host of other problems. She has very little quality of life. I know there are lots of people who use a wheelchair and for them it has been beneficial. Unfortunately, for my Mom it has not. From this experience, I agree with your Mom’s doctor — continue to walk as long as possible as the ramifications from going into a wheelchair could ultimately be much worse.
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My MIL uses a walker with wheels. This is what she is used to. She also has a wheelchair for longer distances or she is confused about where she is going. She is 80 and has Parkinson's. She just was diagnosed with dementia. Her neurologist said that she should always use a walker. For the dining room/kitchen, which is 2 steps up, another walker should be available to use. She tends to ignore her walkers because she said she doesn't feel unsteady. She will argue with me. I tell her the doctor said she has to use one. She shuffles and her legs wobble when she walks. Her walkers help her.
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Reply to Mammajae
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anrean Sep 13, 2020
We have more than one walker for my mother, too. The small steps are too much to navigate, so we got a 2nd walker and she transfers to that when on the higher level
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About the walker, in our case the neurologist told Mom to use the walker all the time, in house and out, rather than the cane to prevent falls. The last thing you want is a fall. She had multiple falls and months later we found out she had broken a vertebrae in her back causing excruciating pain.

If she can still learn new things a walker with wheels should be fine. Once she learns the brakes and internalizes that it should be automatic.

I am not an expert!
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Reply to Weeroo
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Ask your noms doctor for a video doctors visit. She can order home physical Therapy after that. My Mother in law broke her hip at 95. The inpatient rehab said she had to use a walker. The home physical therapist asked if mom had used a walker before before we said no. He said with her dementia she would not probably remember to use the walker. He worked with my mother in law on balance when walking and using walls if needed. My mother in law lived to 97 and never used a walker and never fell again. She stoped doing stairs after the hip. If you decide to go the route of a home physical therapist. See if your community has a rolator and walker with front wheels only you could borrow for your mom’s first few sessions. Let the physical therapist help you come up with the solution. As far as eating less that comes with aging and your moms end of life journey. Keep mom hydrated. My moms taste buds and likes and dislikes changed monthly towards the end. Loved cheerios, tomato soup, ice cream, slowly she pushed them aside. She did well with vegetable soup, boost, I found a good shake mix with fiber and protein. There are some clear protein drinks like protein 20. All you can do is try your best and down the road never question the could of, would of, should of. That will drive you crazy if you do. Wishing you the best.
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Reply to KaleyBug
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NeedHelpWithMom Sep 13, 2020
This is true. My mom had several rounds of home health with physical and occupational therapy. It helps a lot.

They do have to continue the exercises after the sessions end. Unfortunately, my mom wouldn’t do as much on her own and would regress.
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