How likely is it that an elderly person can recover the ability to walk after a period of not doing so?

She can't "exercise" safely now without the guidance of a physical therapist, which will require a doctor's order. She needs to go to an orthopedist and get it, regardless as to why she's lost strength (maybe a TIA?).

If she doesn't regain her ability then help her apply for TLC, which can be covered by Medicaid. You must make a clear boundary that you cannot transport someone who needs a wheelchair, due to back problems (getting her in and out of your vehicle and lifting a wheelchair into your trunk). And if you don't have back problems now, you will after trying to get her places.

It's very much your business, given that this relative expects you to take her places. You can't fix her, especially if there's a physical problem that is causing the weakness. You can let her know your boundaries: If you're not willing to take her places if you have to help her with "transfers," push a wheelchair, or accompany her every time she goes to the bathroom, tell her this.

It’s true that if too much time passes and she loses too much muscle mass she’ll have to work very hard to get back to baseline. My experience is that many elders don’t want to do the hard work of PT or exercise. It’s not fun and it’s uncomfortable and it is easier to not do it.

It's not likely without physical therapy that the elder is willing to do. But I have seen it work in my own mom. She was able to regain the strength to walk with a cane, and each time she went into the hospital she would go to rehab and then she could walk again, but she was still getting older. Eventually she was using a walker all the time, which was ok, and she still was getting around the house as best she could. She did the therapy, which surprised me, but I was also taking her to the appointments and staying with her during it. It really did help but she wanted to do it. In her case she was always hoping she could start driving again, so that made her motivated.

It can also be motivating for you to say directly that you are afraid you won't be able to safely escort her places if she can't move well enough to help you with getting her in and out of the car etc. Transferring can be dangerous for the carer and the patient. I wouldn't be afraid to bring it up directly, and let her know that you want to make sure the two of you are safe.

Recent personal experience with losing leg muscle tone and exercising to get it back again! We did a 2 day 1500km road trip to Adelaide over Christmas, me with very limited movement as passenger. Then 4 days in Adelaide, including a 4 hour car trip back and forth to the old farm, then the 2 day 1500km road trip back up to Alice Springs. I was surprised by how much weaker my legs were when we got home, very obvious when climbing the 20 steps to our bedroom floor. It’s taken nearly 2 weeks to come right, and I’m a reasonably muscled 78 year old.

Experience suggests to me that the easiest ‘therapy’ for walking would be sitting down to use a push-push or rotary leg exerciser (of the sort quite common in gyms). That is not going to risk falls, or require any supervision or assistance in walking. Buying, borrowing or hiring one would help provide much more leg exercise, without one-on-one therapist assistance.

The facility Nurse could have the doctor order in home therapy. Medicare will pay for it. This way a physical therapist can evaluate your relative and determine if exercise will help or this is part of the aging process. My husbands Aunt lost the ability to walk in her mid 90s.

I second getting her signed up for physical therapy and occupational therapy. If she's in assisted living, there are PTs and OTs who visit there to see patients on Medicare whose doctors have prescribed the therapy. They need to certify for Medicare that the patient is benefiting from this, so if you relative continues refusing to try, they will stop. But the OT in particular may be able to help her develop some alternate skills such as how to transfer.

Let her know that if she does not regain her mobility, you will not be able to take her out. It's possible that she won't try. It's possible that she'll try and succeed. It's possible that she'll try and not succeed, because it's not possible anymore at her stage. In any case, tell her that she needs to prepare to use the transport services provided by the Assisted Living facility. That, after all, is one of the reasons for moving to AL.

The AL transportation services (in-house, or contracted) will take her to medical appointments. Check into whether there are doctors and nurse practitioners who visit the facility, that she can switch to. She may be able to do some of her appointments by zoom. The facility probably has someone who will take blood and send it out to a lab.

The facility may have occasional shopping trips that residents can sign up for, to go to certain stores. She can order, or you can order for her, groceries for delivery and everything else online. Instead of going to restaurants you can order a meal for pickup or use delivery by Doordash or UberEats.

Don't commit yourself to risking your own physical health by doing her transportation.

Once mobility is lost in an elder it is VERY difficult to build the body muscle, bone, tendon strength back up. As an RN I would over and over again see a doctor come in and order "bedrest" and have the patients reply that was "out of the question" and go on to explain that once off their feet they wouldn't be getting back up on them and they were well aware of that.

This is for discussion--your own unique case here--with the MD, but what is REALLY required here is a PT consult and a medical POA at the side of this person to listen in and to help with "sticking to the plan". The assessment will begin with the question of whether or not this is doable in the "best circumstances".

It is not at all likely that she will re-gain the ability to walk, if she is already weak and not doing anything to strengthen her legs or body.
You are right to be worried about how much more hands-on assistance will be required to take her out in public. It takes a lot of strength to safely help someone in and out of a car. It takes a lot of strength to fold up the wheelchair or walker and put it in the car, then take out at every stop. If in a wheelchair, you will probably be pushing her, and you will find how many places in public are inaccessible by wheelchair. You never notice until you're in that position!

Believe me, I did it for years with my husband. It has caused my own hips and legs to break down and I can no longer do it.

If she accepts her lack of mobility, it will affect her ability to go shopping, to restaurants, and everywhere else she wants to go. You will not be able to take her everywhere that she wants to go. And, she has no right to "expect" you to take her everywhere if she is unable to stand and support herself.

One thing you can do that I forgot and didn't see anyone else mention is that you can ask for PT/OT specifically to teach YOU how to safely move your loved one. You would go with a list of your own physical limitations (back problems, carpal tunnel, heart conditions) and give PT/OT info about places you take the patient, particularly what kind of stairs and entrances are involved, how to get them in and out of their chair and toilet if necessary. Bring the vehicle you normally use. They will practice with you and your loved one.

As a far more general statement, I was a personal trainer with a certification specializing in elderly and disabled clients. You'd see me when you'd come to at the gym after you were released from PT/OT. There are studies published in reputable journals where people in their 70s, 80s and 90s began lifting weights under trained supervision after clearance from a doctor. They were able to build muscle and strength. It helped with movement, balance and in many cases had cognitive benefits as well. It makes bones stronger which is especially important for women of all ages.

The only reason I mention that is to let you know it is *possible* for someone to build muscle in very old age even if they never worked out before, but there are caveats. First of all they have to be willing and able to exercise consistently. That's the biggest hurdle. Professional supervision is key. Another caveat is diet, and making sure there is enough protein. Cognitive factors will come into play but dementia doesn't automatically exclude someone from training w a professional.

Now, the practical aspect. Is your loved one willing to consistently exercise? It sounds like the answer is no. If there is PT/OT involved you can ask them sit in on a session with your LO. In my experience, telling a LO to exercise gets resistance. You might start by saying "I won't be able to take you anywhere if we don't do our exercises regularly because I can't get you in and out of the car."

There are a lot of variables here and none of what I am saying is or should be considered professional advice. It's what you (and the LO) are comfortable with and willing to do. It will include a mix of professional and personal efforts from several people. I don't know what your level of commitment is with time and effort. You can't make someone do something, but you can make it safer to do what you're willing to do for them.

For the rest of us on the forum, women in particular often avoid using weights but they do strengthen bones. If you are taking care of someone else, the stronger you are, the easier it will be for a longer time. You won't be as tired either after you get going on a program, even though it sounds like it would be the opposite. Did I work out while taking care of my mom at home? Not enough, that's for sure, and I felt and saw the results. When I go back to the gym next month I'll be thinking about my own future as an elderly woman and how what I do today will help me in the future.

And don't think I can't hear the laughter from all you caregivers about having to do one more freaking thing in your day or expend one more ounce of energy to do it. I hear it, and I am laughing too.