So Grandma is 93 and taking blood thinners (Xarelto). Every so often she complains about pain. Today she's been moaning and groaning because of back pain, yesterday it was leg pain. I make her get up every two hours to go to the bathroom, but she needs to move around more according to her physical therapist. The problem is that she turns into a nasty, hateful witch whenever I make her get up every two hours, I can't imagine making her get up every hour.

So... I guess all the sitting leads to pain which leads to moaning/groaning which leads to her literally driving me crazy. I can't give her NSAIDs (Advil, Aleve) and Tylenol is useless. Is there anything the doctor can prescribe to help with pain? I've considered switching her back to Coumadin/Warfarin since I consider it a safer blood thinner and just giving her the occasional Advil (with the doctor's approval).

I'm just not sure what to do because I'm not sure why she's in pain. I'm just looking for advice and maybe a different view on the matter. I don't know why no one can develop a blood thinner that can safely be used with NSAIDs.

Warfarin requires frequent blood tests for clotting time (INR level); this is an inconvenience for many as they need to have bloodwork drawn frequently. I would rethink changing her to Warfarin. Xarelto may be a better fit for her circumstances & to avoid needle sticks for lab draws.
I too suggest asking her PCP for a narcotic pain medication or even a low dose fentanyl patch. As CM stated, you have to “stay ahead” of the pain and routinely administer the pain med to maintain a level.
Often Tylenol is just not effective.
You already know not to give NSAIDS or aspirin due to additional blood thinning side effects.
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Reply to Shane1124

You might find Tylenol a bit less useless if you give it preventively, following a strict schedule according to the directions on the packet.

Can the PT perhaps suggest stretching and moving exercises that your grandmother can do that are more comfortable for her? If you can get her to move a little bit in a way that is enjoyable, or at least not unpleasant, perhaps it will boost her morale and spur her on.

You can also ask about warming pads and gels to relieve her back pain, but don't do this without medical approval and watch out for skin issues.

How would your grandmother feel about massage? You might find an aromatherapist with a special interest in older clients.

NSAIDs are blood-thinners, is the trouble there. I suppose in a way we're victims of the sophistication of our pharmaceutical arsenal nowadays. They've cleverly developed improved anticoagulants without the drawbacks of NSAIDs; the difficulty is that they don't either have all the same therapeutic effects. I think it was Walt Whitman who said: "what we call progress is merely the exchange of one nuisance for another nuisance."
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Reply to Countrymouse

This is something you need to discuss with the doctor. I know my exes father was on Xarelto and was prescribed narcotics for pain. So there is something the doctor can do.
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Reply to tacy022

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