My 99 year old mother fell about a month ago and fractured her hip. She was living in Assisted Living. She has had multiple falls and injuries in the past. She had always participated willingly and fully in physical therapy she even seemed to enjoy the attention at times. With this new injury everthing has changed. She does not want to do the therapy, she does not want to get out of bed. She seems to have given up and feels there is no reason to make any effort. The therapists force her to try and stand, the goal is to allow her to at least stand and transfer so the hoyer lift (which frightens her) will no longer be necessary.
The last month since the fall has been one of non-stop physical, mental and emotional torture. All for her own good.
Her Dr. put her on anti depressants but so far they have made no difference.
So my question, is there a time we respect the wishes of the person, even if dementia and depression affect her thinking? Should we continue forcing her to do therapy in the hope that she will be more mobile eventually? There has been some improvement as she can now stand for a minute or so with support from the therapist.
Is there anything she WILL leave her room for?
Are there any aspects of her therapy that she’ll express interest in?
Has she had any past friendships in her residence that she still maintain?
Does her therapist encourage you to think that she can improve enough to reach any reasonable goal?
Does her MD attempt to find some medication that may elevate her spirits?
A very tough call. In a somewhat similar situation with my mother, she usually participated reasonably in physical therapy until she was required to try a full flight of stairs. She started to cry and shut down. The therapist agreed that the demands of her therapy schedule were in excess of potential gain.
She was 90 at the time, and shortly after began using a wheelchair full time.
Is your mother staying in bed to avoid attempts to engage her in therapy?
Positive reactions, not really.
The staff, (she is at a nursing home, re-hab facility) gets her up, she has breakfast, goes to re-hab, has lunch and goes back to bed. She is not positive about any of it. They have to use a lift to get her out of bed which frightens her.
She is in a different facility from her previous AL. But she had no friendships there. Some relatives, friends from her hometown keep in touch or visit.
The therapists say she has improved and they are right. She can stand for a minute or so but she protests the entire time and asks to sit back down. She says it hurts her to stand and I don't doubt that it does. How much should she be expected to tolerate or understand? How much is pain and how much is fear and trauma I do not know. No one can say at this time how much she is capable of improving. Will she be able to use a walker again? Just stand and transfer to a chair? Unknown.
There is no way to do less therapy. This is the first step, stretching, strengthening, getting her to stand. It is do this or she is bedridden or into a chair using that dreaded lift.
She wants to go back to bed because she says she is tired and in pain. She has therapy in the morning soon after getting up.
The Dr. put her on an anti-depressant to try and help her mood and outlook. It's been about two weeks and I don't see much change except she is less sleepy and groggy. I don't know if that's from the meds or she has just gotten stronger and she is in less pain.
Such a hard decision. I really don't think a 99 yr old should be forced to do anything and especially if she is anxious and scared. She will just be in a wheelchair for the rest of her life which with numerous falls, she should have been in anyway. Why a hoyer? Is Mom a big lady?
You realize, at this point, she will not be able to go back to an AL. Her care will be too much.