How do I convince my mother that it is time to use a walker?
I'm noticing that my mother is getting more and more unsteady. I always have to hold her hand whenever we walk anywhere. Yesterday as we were coming out of the elevator, she just stood against the back railing and was waiting for me to grab her hand. She usually starts to move towards me since I go out first then reach for her hand. Well, as a result, the elevator door started to close and hit her on the arm. She looked at me like it was my fault. Same thing when I'm in her apartment, she acts like she can't walk alone from the living room to the kitchen, which is about 8 feet, yet she must do it on her own when I'm not there. I feel she acts more like a child when I'm around, but at the same time, I try to explain to her that if she fell, she might not be able to live alone anymore. She has a few issues going on; pain in her knee, mild Parkinson's Disease, and swollen ankles. We are gong to the cardiologist tomorrow, so maybe that can be remedied, but I had to fight her tooth and nail to get her to go. Ugh!
I don't think our parents EVERY start to think of us as "real" adults who might know what's best for them. Whenever there has been something that my mom has needed to be told, we've always been more successful if one of her healthcare providers tells her or if we can arrange for her to think it was her idea.
ability was only temporary. And that (as she tells everyone) it's "all in my head!" She prefers to walk hanging onto someone's arm when she's out. Didn't want to listen that it was unsafe. No good deed goes unpunished, of course. She says that she can't possibly "impose upon" other people to put her walker in their car, so I'm the one who has to drive her to church most weeks.
The PT was the one who told her she must always have the walker when she leaves her condo. My mother never would have listened to me.
(Oh, and the elevator...does anyone else have the ridiculous scenario I have when my mother encounters an elevator? I must leap into the elevator ahead of her to keep pushing the Door Open button. She panics that the door will shut on her. I also have to hear her admonition to not look down the shaft at the crack (there is nothing to see; it's dark!). Yep...just another of many anxieties and "rules" I must obey...yet her doctor "doesn't like to put older patients on anti-anxiety meds." All she needs is "social support.")
In her condo, she likes to stagger down her hallway with no cane or walker. "See! I'm just fine and don't need anything!"
Someday she will fall, and that will the end of her "independent" life.
We got mom into Independent Living, where she saw a geriatric psychiatrist on a regular basis to manage her anxiety. Psychiatrist insisted that mom have neurocognitive testing (mom was "sharp as a tack" as far as family could see).
Mom was diagnosed with Mild Cognitive Impairment. The MCI (and the attendant anxiety) was the result of a stroke, seen on brain imaging, but never diagnosed in the past. Big wake up call for all of us.
Ask him to order PT so she can be evaluated. PT can strengthen her muscles, address her knee and recommend a walker or cane if needed. The therapy might help the ankles as well. My aunt uses a cane very effectively. My mother used a walker. Therapy helped them be more aware of the proper usage and how the aid of a walker or cane could help. She can get the therapy in her home or at a therapy location. Either will improve her balance and walking.
My aunts daughter takes her for boxing therapy to help her Parkinson's.
Parkinson's can definitely cause problems with walking. It can also involve dementia. Not everyone with PD has dementia, but a large percentage do, so a medical evaluation of that might be in order. One manifestation of that kind of dementia is a problem with depth perception. A doorway threshold can look like a huge step to get over. The difference between the floor in the hallway and the floor in the elevator can be frightening. Sometimes a shiny floor looks like it has water on it. All these perceptions can cause issues with walking. And these issues don't go away with a walker or cane.
Using a walker or cane is not a guarantee to prevent falls. The National Center for Injury Prevention states that up to 47,300 people each year over 65 go to the ER due to a fall with a walking aid. In addition to convincing your mom to use a walker you'll have to remind her about using it correctly. (Or, better yet, a medical person should do the reminding, which you can just repeat.)
In the house, many elderly do "furniture walking" -- placing their hand on the back of this chair, leaning a little against the wall, touching the dresser, etc. They get used to certain pathways they feel safe with. Using a walker means giving up this safe path and the transition may be difficult.
The resistance to using a walker may involve a lot more than stubbornness or the wish not to appear "old."
But regardless, it would make no difference. She would refuse to have neurocognitive testing done, and will refuse to take any kind of anti-anxiety meds. And her PCP doesn't like to prescribe them to older patients.
Also, I'm not sure about your mom, but, when my cousin starting having strokes, she refused to use her walker or cane. I thought that she was being stubborn, but, as it turns out, she had cognitive impairment, that caused her to lose her better judgment AND she forgot to use it too. So, the only way to get her to use it, was to be with her constantly and to constantly remind her to use it.
I wish I had better news.
I wonder if inventing a rule might help in this case. "The insurance company will increase your premium if you are seen not using your walker outside your home."
I bought her a quad cane and a walker but she won't follow instructions about how to use them properly. She wants to lay on the cane so hard she throws her balance off and hurts her shoulders. And she makes a point of crashing the walker into the walls and furniture to demonstrate her impatience with it. No good answer really, it's going to have to be her idea.
I hope you will find the right strategy, brdlvr! Maybe she will accept a cane more readily, first?
But I think the answers are that you don't have to convince an elder, words don't work. You do have to say you are worried, and to make you feel better, you can then leave a walker in her house, near ONE open spot that she crosses.
You can say that you've heard stories of falls, and it worries you, and that you know, maybe she'll never use it, but you'll feel better if you know she has it available, so you want to leave it here, "just for this one spot", if you ever feel you want to use it, that generally she seems to do well, but one time she may feel tired, and she may be glad to use it.
I did that with an elder client, who refused to have a walker in the house.
Generally, by the way, it is great if they want to keep trying on their own, it keeps up muscles and alertness. But has risks, yes. And you can tell her, she doesn't want to take risks she can't manage, but don't expect her to agree, just from a talk - or to remember the agreement, even if she did.
I got a free walker at the Council on Aging (where they offer used equipment that is in good shape), put the tennis balls on the bottom so it could slide on her carpet, and brought it over one day, and said I think it could be useful. When she didn't agree, I agreed with her, that she might never need it, for she does so well on her own. But I also noted that maybe sometimes she will feel tired, and having a little help will be a good thing. When I left, I left the walker there.
The one I brought was for the main floor (and to note, I would not expect her to carry it upstairs, where she also "wall-walked" - up there I organized her clothes so the current ones were on the same side of the closet as the dresser which was half way down the wall, so she could have a solid grab spot along the way.
Details can change, but the idea is to let her experience - in non disruptive ways - be her way of getting used to a new idea. Be helpful in key ways, and not oppose, just see how you can help in ways that she finds useful and enjoy her and her efforts, even if you talk about it briefly, each time you worry. Get on the same side. After 2-3 weeks, you will find that the odd time, she does use the walker. Let life do the teaching then, notice and encourage.
I just don't think that talk is the way to help many seniors try new things, they are proud of the skills they retain and of using their own judgment, and those are good qualities to hold onto, as long as one can.
It can take juggling and some talk - but the talk needs to always celebrate the way she is already doing it, and just suggesting and setting a small change for her to "try". Keep it light, and be patient, set up equipment that's simple but works in the space, then the trial itself can help shift the behavior.
Mother had both knees replaced last decade....then she was leaning so heavily on a cane, she began falling a lot. Turns out she just wasn't coordinated enough to use the cane. She'd lean very heavily on it and they are just for gentle support, not made to hold a person upright.
After mother's hip replacement, she really went downhill. She has to have the walker (either the folding one or the "rolling" one when she takes a step. Sadly, she has hunched herself over the walker to the point her spine is now permanently curved into a C shape, which then brought on neck and back issues--b/c she refuses to do exercises. She will occasionally try to walk w/o the walker a few steps, to the bathroom, or down the hall, clinging for dear life to anything--and we all know she's one fall away from breaking that second hip.
ALL of us kids told her she needed the walker, it took her dr to tell her she had to use it and his word is like scripture.
One funny thing: If you are the person taking her to the dr, even though his office is definitely within her ability to walk to, she insists on the wheelchair. Now she's talking about getting a "power chair" but it won't fit through her doors. She would ride if from her bedroom to the kitchen (20 feet) and the transfer to the walker.
Also--if your mother is hanging on to you and starts to fall--you're both going down. My mother would hang onto me so hard, I'd ache for days. She never fell with me, thank goodness, but it certainly could have happened.