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My Mom is 86 and has severe osteoarthritis in her knees (as well as osteoperosis) She is also very unsteady & not a candidate for knee replacement. Mom uses a walker and is in assisted living (thank god). Here is the issue: Mom can barely get out of a chair, off a toilet and so forth. This becomes a major issue when I take her out. I'm a petite gal (with pre-osteopena) and while I manage to help her up, I'm becoming increasingly concerned and stressed that one day I won't be able to, or even if I'm holding her she is going to lose her balance (or her legs will collapse) taking us both down. (Mom weighs about 140) Mom also gets extremely panicky~ she's starts flipping out, screaming that I'm not holding her etc. This obviously adds stress to the whole situation. It's getting to the point where I dread taking her out cause I'm afraid. I feel bad, but I really fear something is going to happen (she's fallen in her room several times, and it always takes two people to help her) I should also mention that Mom is incontinent so going to the bathroom is a given while we are out. She uses the bathroom's handicap stall if available but sometimes the seat is too low for her to get up from. Also, once she's up she'll also start crying cause she is in so much pain (initially anyway) I just don't want to take her out anymore~ I feel horrible for feeling this way. Her assisted living facility is very nice and she does have opportunities to get out~ so it's not like she'd be a prisoner....thoughts/suggestions???

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this won't solve your entire problem but check into getting her a gait belt. This thing is a godsend. My father was a big man even with weight loss. the gait belt allows the caregiver/aide to easily bring the patient from a sitting to a standing position.
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Depends or pull up adult garments allow one freedom to go out without embarrassing accidents. There is an item on the market that is portable and works like a chair lift much like a lift chair. The device sits on a chair and 'lifts' the person to a more standing position-this helps with the pain one feels when standing. Always look for a handicap commode as it is taller that a regular one. Go with her to the doctor, ask about pain control, make sure the doc understands the pain is decreasing her quality of life. There are pain patches and prescription gels that can be rubbed on the affected area which can decrease the pain. Ask if physical therapy could help, it's worth a try. It is scary to think of falling because you always know you can get hurt and getting up is also painful. Until her pain is under control, going out is difficult for her. I feel for her because I have arthritis too and know how I feel so I can only imagine how she feels I'm sorry she has declined. Good luck.
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Thanks everyone. I appreciate the feedback.

I will definitely look into having someone from the ALF accompany us- that's the ideal as she really likes the help there and is very amenable to their assistance.

Re: PT - we've gone down that path several times. Part of the issue is her knee is literally bone on bone. She gets cortisone shots- helps a little bit. She had kidney issues so can't take. NSAIDs. Hydrotherapy would be perfect for strengthening - I'll have to look into that.

Also takes Lasix that doesn't help,obviously, with the peeing issue. She does wear diapers; and of course that helps however, it's not the answer in that I certainly do not want her in a soiled diaper when we are out. That just seems dehumanizing.
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If she has any type of dementia they should still work with her w/ PT, OT if they are a good facility they undertand the dementia/Alzheimers issues a patient may not feel like it or even remember they do therapy daily...the point is to keep her healthy as possibe and as strong as possible for as long as possible..if she just plan refuses and is totally clear-which it doesn't sound like-once she can no longer fit their qualifications for admissions they will refuse to care for her and send her home with you or to a SNF if there is an open bed if they even try to find one. You may now appeal if they say they can't work with her......some therapist she may like others not but they can't just write her off......the laws have changed and Medicare must pay to keep them in the best possible condition even if that means ongoing Therapy....no longer 10 visits and you're done.But many still like to do it... if she is too much "trouble" for them incontience, lack of transferring etc...they can say she is beyond their scope of care and then you will really be in a pickle. Try to make it fun for her, out for an ice cream or a game she likes etc...after she completes her therapy. Don't let her just rot in bed or a chair there will be all kinds of vascular,skin break down, infection and other issues then. Talk to the director of her ALF and explain the situation!Maybe she should see a geriatric counselor it may help with the fear/anger and motivation. Please don't let her not do nothing....she will never come back from it and if you think it is hard now just wait until she needs a Hoyer lift to move her around. Unfortunately we become the parents and they may be mad at us(like a child) for trying to keep them healthy and happy but that is the cards we have been dealt.Just do your best for her and beher advocate :)
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The transfer wheelchair is very helpful and light weight (less than 25lbs). i got one when mom was still very able to get around with her walker. Perhaps you could go out on one of the scheduled trips with the ALF? Then there would be someone else to help. You might want to make sure she has pain meds before you leave and something for anxiety. And if you are unsure of her safety with you DO NO TAKE HER out. For your safety and hers!
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Does she have a bedside commode? When my Dad was still with us and had limited mobility we were shown how to use a transfer bench from car to wheelchair. She might not panic so much? We got an inexpensive transfer wheelchair for my mom as she just can't walk any distance now and also for you they are light weight. My mom is on a pain management now also as suggested and it has helped. Best wishes.
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Don't take her out. You say she has opportunities to go out at the ALF. That apparently means they have staff to help her. Go with her on some of these outings. You aren't capable enough to take her out on your own. Can't be fun for either of you.
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Even if she has had therapy before Medicare will allow it again within a certain time frame. Yes, if she refuses therapy 3x they can't continue.
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Loved one has to co-operate with PT to get stronger. Many have forgotten how or simply don't want to.
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Grandma Lynn is righ she should be getting PT and OT at her ALF to get her stronger.....if not look into a Rehab Hospital usually a 2 week stay for intensive therapy they can do wonders. Sounds as if she is ready for a wheelchair not a walker and they can teach her to transfer from that maybe just with the assistance of the walker for transfers. Don't take her out unless in a transport wheelchair until she is better if she gets better.Don't get yourself hurt in the process!
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I don't even take my Mom up and down stairs. TG I have my husband. If I didn't, I wouldn't be able to care for her since I live in a split level with 4 floors. I'm 65, 5ft tall and have no upper body strength so taking my Mom out by myself wouldn't happen. With my husband I get her out to eat and out of the house. I have her use the bathroom before we leave. I don't want to use a stall. Too confining. She does useca pullup and that started at rehab. So, if I were you, without help, I would not take my Mom out. See if you can bring lunch in and sit at a table alone or eat dinner there. You just pay for ur meal. You don't want her to fall and u harm yourself in the process.
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I just want to say - don't feel bad about not wanting to take her out! My mom is confined to a wheelchair due to mobility issues. We tried taking her to see my grandma last year, who was dying. My mom is heavy--230 pounds. She is able to transfer to the toiled with a walker and two people. Of course she had to use the bathroom since we were 45 minutes away from her nursing home. However, when we attempted to get her into our vehicle, she started falling. My fiance could not hold her, so I ran back into grandma's nursing home and got a couple people to come out and help. It took us 30 minutes to get her into the vehicle. I will not ever take her out again. Our only alternative is to get a taxi that has a wheelchair lift so she can stay in her wheelchair the entire time...and yes, she was to wear a diaper. You cannot feel bad about this. You can only do so much, and you don't want to hurt yourself--or both of you. Always check for options with her assisted living facility--they are aware of what is available to help YOU help her!
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All good suggestions. Definitely do not take her out alone anymore. Only go to places where you know there are good handicap facilities. There is much more awareness these days about the needs of the handicapped. In NYS all businesses must be handicap acessible or there must be someone availsble to help that person. I have noticed that many fast food places have converted their 2 stall bathrooms into a much larger 1 stall to accomodate the needs of the handicapped. if you can not take her out safely alone given her disability and pain it is prudent not to do it. can you just take her for car rides where the facility will help her in and out of the car. If you need food just do a drive thro or maybe only stop for ice cream. There are also specialist pain clinics that can do much to help these days. pain like dementia is a much underserved condition but equally devastating
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A couple thoughts come to mind from my experiences with my mother (96 with osteoarthritis). The first one is how to help her up and down safely. I had an occupational therapist work with me and my mother so I could learn how to manage her and for her to feel sate. It was a one-time visit to her facility, and it helped us both a lot. Has she been seen by her doctor to help deal with the issues you describe? Perhaps there is something that can be done for the pain. My mother is on a very low dose time release morphine script. That keeps her pain under control overnight, and she functions better the next day because she's had a good night's sleep. I also recently took her to see a musculoskeletal doctor to evaluate her wrist in her case because she could no longer cut her food or hold things because of loss of feeling in her hands. He was able to give her an injection in her wrist that has helped her quite a bit. Perhaps there is something short of surgery that could give her relief. The referral to this doctor was done by her primary care physician. Hope this helps.
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At my dad's assisted living facility we are able to hire personal assistants on an hourly basis that are allowed to come out into the community with us. I am no longer able to take my dad out without the help of one of these assistants who are better trained in patient care and much younger than I am.
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Would she be willing to wear a diaper when she goes out? This would solve the bathroom problem.
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