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My mother has mixed dementia (vascular & Alzheimers), mobility issues (awaiting a hip op'), osteoarthritis, plus an answer for everything!
She says she's comfortable there & can't see the point of moving. The longest my mother has sat there for is 2 hours before myself and a carer managed to move her to the bed. She will sometimes say she wants to sit back on the bed, and thinks she can do it by herself, but doesn't want to stand to do so.
I know fear is behind the decision (she sees the comode as a 'safe' place), but I'm concerned that she will start to lose the use of her legs. Because of her cognitive problems, my mother cannot see how not moving is causing her more pain in her joints. Any advice is most welcome.

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Sounds like pain, fear or both. Also try to rule out constipation.
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First I would have to say that I certainly wouldn't put her through a hip surgery if she isn't interested in being mobile. And I'm sure that you're aware that the anesthesia often makes peoples dementia worse, so those 2 things themselves would make me put the breaks on any more surgeries at this point in her life.
When my late husband was having mobility issues I put his bedside commode over the toilet in our master bath which number 1 allowed for him to be up much higher on the toilet and it also gave him handles to hold onto when he tried to get up and he wasn't having to get up from such a low position which was really helpful for him.
Your mom may just be afraid that she's going to fall if she tries to get up, so just reassure her that you and the aide are right there to help her.
Hopefully this is just a phase she's going through and it too shall pass.
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You mention moving her back to bed, and also her desire to sit on the edge of the bed, does she not have a safe, comfortable chair she can sit in rather than the commode?
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How is she standing up from the commode? Does she have anything to hold on to to pull herself up, or is she pushing up on the arms of the frame, or what?
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You and or the caregiver are or should be the ones in control of the situation not your mother.
If you need to set a timer for her and when the timer goes off she moves from the commode.
Give her cues and explain what is going to happen. For example..
Momma, in 10 minutes we have to help you up. Caregiver Susie and I will help you so you will not fall, you are safe.
You and Caregiver Susie can be on each side of her and tell her that on the count of 3 you are going to help her up...then count slowly but firmly 1..2..3.. and then you say "UP" and help her up. She will get used to the routine and the count and will begin to anticipate the help up. It might take a bit but it will help. If this really does not work then the use of a Sit To Stand might have to come into play. Easy to use and safer than trying to help someone up or down.
2 Hours is the maximum length of time that she should be in 1 position in any case but 2 hours on the commode is far longer than necessary or safe. Not only can her legs become less steady due to the position cutting off circulation as well as compressing nerves but the seat of a commode or toilet are pretty hard and that kind of pressure on thin skin is a problem.
2 Hours in a chair, couch, in bed is fine but she needs to be repositioned or some how move so that she does not run the risk of pressure sores.
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Countrymouse Jan 2023
Help her up, how?
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