What to do when they refuse to use a walker? - AgingCare.com

What to do when they refuse to use a walker?

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Mom fell and broke her hip last Christmas 2014. She recovered in record time. Now, because she won't use a walker, she fell again in May 2015; this time resulting in a broken pelvis. She is currently in the last days of rehab and will return home to her 24/7 caregiver this coming week. But she refuses to participate in exercise and physical therapy to strengthen the weak leg, and she says the therapists just want to "fatten their pocketbooks".... ugh.
Mom has a walker coming when she gets home but she will refuse to use it. Hell she will barely accept the live-in aide. She has fired her many times. This "aide" is more like a gem from heaven. She goes above and beyond for my mom. She takes her out daily on little excursions, makes home cooked meals, and keeps the house spotless. Yet mom doesn't "need" anyone and often tells her she needs to find a new place to live. Mom is under the impression that she is doing the aide a favor by letting her live there and "eat her food"... :(
My mother is getting increasingly confused and agitated.
I know she is going to fall again. Physically she is in great shape for 92 years old, but mentally; well - she thinks the toothpaste is a skin cream and forgot dad (her husband of 68 years) died in 2009.
She is in the moderate/severe stages...guessing like a 5/6 at this point.
If she doesn't get her way (i.e. if you try to help her get to the bathroom, etc) she will hit you with the remote and say "leave me alone!"
Any suggestions?

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Nikki I seem to remember your posts some time ago ... mom living across the road? Sounds like she has deteriorated greatly since then. When I cared for my mother I bought her a walker but she refused to use it in the house, preferring to hang on to the walls and/or furniture and she was always falling. She wouldn't use it in the street or the supermarket either ... "whatever would people think!"

With physical issues of my own I couldn't pick her up without her co-operation and eventually at 2 a.m. I found her on the den floor, blood everywhere and out of it like a dead whale. She went to hospital by ambulance, stayed there a month and then went into a NH. She's been there 2.5 years now, broke a hip (her own fault), fell out of her wheelchair trying to pet her (phantom) cat and gashed her arm and has had more strokes. At this point her dementia is also at a later stage and she can barely speak. When I visited yesterday she told me I slept there overnight and I was dead. For a dead person I sure enjoyed that glass of wine last evening lol

I guess what I'm trying to say is that no matter what you do you can't save someone from themselves. All you can do is provide 24/7 assistance, such as the aide,and wait for the next disaster. You have gone above and beyond the call of duty for her always. {{{huggs}}}
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My mthr had great results from Seroquel. It is black box for elderly, but the choice was to leave her dangerous and unmedicated, so she might hurt someone else in her rage, or medicated and only in danger of hurting herself. She turned out to be much happier, and it was just for the duration of the stage. Once she was beyond the agitation, (6 mos) she was fine without it. Now that she is about 6.9-7.2, she only takes a Prevacid! She's calm, not depressed, but definitely not there. The agitation was something about the deteriorating brain chemistry just making her bonkers. Seroquel made it possible for the children to go see her.
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Hopsital social worker said that she needs to be walked by someone. Holding her arm and the hand on the other arm.. I learned to walk with mom and support her if she tripped or fell. It worked, she collapsed and i broke her fall. A bit of a twisted ankle but no broken bones....
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RichieZak, I wasn't there. When I told mom what she had done she looked at me in horror, exclaiming, "I never hit her! I might have pushed her...." and the aid just took it with a grain of salt. There are 60 ppl in the rehab which is also a long-term skilled nursing facility and apparently my mother is one of FOUR who acts like this on occasion... :(
The aid is a professional and a sweetheart and knew it wasn't my mom; but her d dementia which is worsening.
Mom has always been neurotic, Gardenartist... always. So now it's just escalating. I'm thinking Seroquel or Depakote. This is on the recommendation of the assistant to the psych doctor. Not sure what to do. She is already taking lexapro for depression and agitation but apparently she needs something else. She just wants to "go go go" and really refuses help. Her 24/7 caregiver is there like her shadow, which only irritates her more...
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How did the aid react to being hit by the remote?were you there at the time?
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Nikki, perhaps it's time to investigate some medication that might help her calm down. I'm not particularly fond of using meds except in emergencies and medical necessities, but it sounds as if she's not going to cooperate and could end up hurting herself. Even if you leave her alone, it could just be until and if another incident occurs.

I get the impression she'll object to anything and anyone at this stage. What would happen if you just left her alone? Do you think she'd get past the anger stage, or do you think she really needs something to settle her and control the anger?
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Thanks, Gardenartist - thing is I told mom daddy got her good insurance and this is all covered but she says "I don't want it!" and won't budge. Just the other night in rehab they were trying to help her put on her nightgown and she hit the aide with the remote for the TV!!! I couldn't believe it. Going there felt like going to school where your kid has disrupted the class. :( She says she will be fine and to LEAVE HER ALONE. Mom can't understand. She is in stage 5/6 of dementia (alzheimers, whatever) and is just not to be reasoned with. She thinks the toothpaste is a face cream.
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Correction, next to last paragraph: should read "producers", not "produces".

One woman I met online used to paint lovely flowers on walkers; she was hired by a local SNF to paint the walkers so the residents would find them more attractive and less "standard issue" to use. Apparently this was quite successful as her services were in demand.
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She could also be denying that she has a mobility problem, and be unwilling to face the fact that she needs assistance. Sounds like she's lashing out at those who try to help her.

Could you privately speak to the PCP at the rehab facility, or, better yet, both that doctor and the orthopedic doctor who performed the latest surgery? Sometimes doctors can tell it like it is and make it clear that the patient is not acting responsibly. If they're especially blunt and tell her that it's not likely she's live long if she doesn't do something to help herself, it might frighten her into being more open to help.

We've been told by doctors that the rate of survival after the second fall is quite dismal. Perhaps if your mother realizes that her stubbornness could contribute to a third fall, which might not be operable, she might be more realistic.

It could also be she's so angry, or confused, and lashing out at everyone who tries to help her that she just won't acknowledge the danger. Sometimes it's easier to remain in denial than to face the tough realities necessary to rehab successfully, especially from a fall.

Doctors have also told us, and I've seen this, that a femur or hip fracture can create different responses than something like an ankle or other bone fracture, because the femur and hip can so intensely compromise balance, stability and walking. It can affect someone's whole outlook.

If that's the situation, perhaps all you can do is try to make the home as safe as possible for her by adding grab bars, eliminating trip and fall hazards, etc.

If your mother is on Medicare, her premiums would be deducted in her monthly SS, so she really isn't paying that much, especially for rehab. You might also tell her that therapists aren't money grubbers, like some professionals. A therapist told us last year that to be a physical therapist now requires a doctorate! I was shocked.

So therapists put in a lot of time and money to do what they do. If they really were "money grubbers", they could just go on some silly reality show - I'm sure those people make a lot of money running around in jungles or doing stupid things that for reasons I don't understand seem to appeal to television produces and selective audiences.

Another option is to decorate the walker so that it's really pretty, if not just plain beautiful. Pretty ribbons can easily be added safely. Use it yourself when you take your mother places - see if you get any compliments and if it makes her jealous. Sometimes you have to be devious!
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