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My mom is 87, very active for her age, and occasionally overdoes it and has to use her lifeline. There's been 4 episodes in the last two years and we're worried. It seems like she's careful after each episode, but then after a few months she wakes up and gets busy around her house, doesn't eat breakfast, gets short of breath and hits the alarm. She'd like to stay at home and does well except for these incidents. She's agreed to meals on wheels now, so there'll be someone there three days a week. Is there other resources available for low maintenance situations like this?

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Should have read proceed on 3 fronts....
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My father gets MOW each weekday. In our area, they can also provide 2 meals on Friday to take care of Saturday as well. Over the months, the folks who generously offer their time to deliver the meals become acquainted with the homebound folks and provide nice little breaks in the day for some human interaction.

You might want to see if you can get MOW for her every weekday.

I'm wondering as well why she doesn't eat breakfast. Does she become excited about doing things around the house and anxious to get started?

We generally contact each other every day, morning, periodically through the afternoon if there are special issues, and before night. So I generally have an idea what Dad's going to do after MOW comes in late morning and ask him to call me before and after he's undertaken any project.

I would try to find out why she isn't eating, and also explore the issue of shortness of breath by seeing a pulmonary doctor who can test her for oxygenation on exertion. It could be that she moves too quickly, might need oxygen for activity, dusts too much and coughs from the dust and becomes short of breath if there are nasal complications....could be a lot of things.

But if she does needs supplemental oxygen, it might show up after exertion before any other activity. You could ask if it's appropriate to use an incentive spirometer, which can increase lung capacity. It's easy to use - kind of like those circus or fair activities when someone hits a hammer to see how high the indicator can go. Same principle except the individual sucks into a tube.

Deep breathing exercises can help as well, if done properly. A pulmonary doctor can demonstrate how to do these, as can nurses.

Perhaps you could also get her to agree not to work more than, say, 1/2 hour without sitting down to rest. Maybe you could get her a timer and try to get her to use it as a reminder when it's time to take a break.

Occupational therapists have given us very good and helpful literature on energy conservation for someone recovering from illness or injury, as well as older folks. It's basically about time and energy management - work a while, rest a while, work some more, rest some more. It's common sense but it really does help if adapted and implemented properly.

So I'd proceed on at least 2 fronts: (1) more contact in the morning so you know what she'll be doing, and (2) medical checkup for pulmonary issues, and (3) planned rests periodically throughout the day.
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4 instances in 2 years is pretty good for someone who is 87!

I'm curious why she skips breakfast. Is the shortness of breath because of COPD or some other diagnosed illness? Has she had a cognitive workup?

The more you know about her condition, the better handle you'll have on what steps to take. If she's simply forgetting breakfast, how about one of you calling to check in each am, just for a brief chat to see if she's eaten?
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She drives during the day. What the meals on wheels people do is all I think she needs. Just a quick check...
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There are professional agencies that offer home helper/companionship that you can hire. These agencies are licensed, bonded, insured, do the payroll, and have workman's comp in case one of their employees gets hurt on the job. Check around for prices.

As for Meals on Wheels, they usually just come in drop off the meal and chat for a few moments because they have other lunch deliveries to make.

Is there a senior center nearby that your Mom might like going to? Usually such centers offer transportation to and from.
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