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Mom has Az but is still mobile. Some nights she refuses to lay down in bed and will sleep sitting up. Her ankles are quite swollen but she refuses to keep them elevated for any appreciable length of time. I have tried to convince her this is important but she becomes agitated refusing to lie down. Any advice would be appreciated.

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Have you tried getting her an adjustable bed? That way, she could just push the buttons on the remote and get the bed into a comfortable position and even elevate her ankles with your help. The last thing you would ever want to see happen is the skin actually splitting open from excessive swelling, which would spark another problem called infection. The skin can only stretch so much before it actually split wide open, this is a risk of her not keeping her swollen ankles elevated when really she should. Have you considered speaking to her doctor about possibly putting her on some kind of sedative that will allow you to lay her down and elevate her feet after she's asleep? Instead of laying her completely flat, you can play her elevated but still elevate her ankles. I'm sure if she was hospitalized they would find ways around the situation and still get the swelling down, which is what adjustable beds are for and the hospitals are full of them
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The memory foam mattress is a good idea. Also could try having her sleep on her side with a pillow between her knees and curled up a little bit...this is a classic back pain sleeping position, so if that's what is bothering her, she can sleep in that side position quite well. What about compression hosiery if the swelling really needs to get down? I believe lots of elders prefer to sleep in a recliner...in fact one of the end-stage dementia units I'm familiar with has almost all recliners in the seniors' room because that was their preference. My Mom currently has the kind of bed that lowers to the floor with a mat next to it. She was getting up repeatedly at night and wandering around her room and falling/breaking bones. She didn't like her recliner.
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My dad did the same thing. I think it is a subconscious thing about lying down means they can die. Sitting up they stay alive . Irrational thinking .
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You can actually have low back arthritis at any age, and low back arthritis will limit your ability to lay flat (on your back). Therefore, I strongly agree with needing to elevate your legs very least, because this actually takes the strain off of your lumbar section. When you have spinal arthritis, it's really not a good idea to lift anything heavy. I've actually had back trouble often on throughout my whole life since injuring my back at 14, after which I was in bed for four months straight. I've had trouble ever since, and a recent x-ray revealed lumbar arthritis. The sad part is I may have developed arthritis long ago, but I probably didn't know it until things got too bad at some point
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The Lasix will help with the edema.
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Most elderly have trouble lying flat due to several issues....back pain, breathing problems, gastric reflux. Your Mum may not be able to verbalize why she cannot do so. It is a catch 22 when legs need to be raised as well. Do what feels comfortable for her. as others have suggested, hospital bed, or any electric bed that moves up head and feet would work as well as recliner.
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Have her doctor try an RX "Lasix," e.g. Furosimide."
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EllerySir, another thing I forgot to mention is that infection is usually caused by fecal matter on hands which can get on your food. When you eat that food, you become infected. This is exactly why it's so important to scrub your hands with antibacterial soap and water. So many times people don't wash their hands after going to the bathroom or they'll run them under water thanking their hands are clean when really they're not. What they don't realize is that they still have that specific bacteria on their hands. This is why there's antibacterial soap on the market as well as moist wipes in some stores. You can wipe down shopping cart handles with those wipes, and this will help to reduce your chance of catching something. It's usually the hand to mouth that infects people if they don't really scrub their hands, and that's how many people get infected and they don't even know it sometimes until it's too late. My elderly friend died infected so it was never caught.
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EllerySir, I feel impelled to warn you about one of the problems you mentioned. I'm not trying to scare you, but I've been through acid reflux myself and I'm being treated right now for H pylori.

* I had acid reflux, as well as excess gas and heartburn. I must tell you that I tested positive for H pylori, the root cause of all that trouble. It usually starts with excess of gas that leads to acid reflux. H pylori burrows into your stomach lining and lives there causing much trouble for the host. H pylori can only be spread through body fluids. I'm currently under treatment, treatment usually runs around two weeks. H pylori thrives on sugar. Another thing to remember during treatment is to avoid stuff like pasta and potatoes. Pasta and potatoes both have starches, which converts to sugar that feeds H pylori and prolongs the problems it's causing. H pylori is hard to get rid of since it buries itself inside your stomach lining. This is why it's hard to get rid of and your system cannot seem to attack it very well. If not properly dressed and treated, H pylori will definitely spread. I know what I'm talking about because it happened to me until it was finally caught and treatment was started. It's very important to follow the instructions that come with your medicine and to keep up very strictly on each dose. Drinking lots of water is also key to getting rid of H pylori during treatment.

Anyway, another thing to avoid is all kinds of bread and crackers, which all have carbs that also convert to sugar, and sugar again feeds H pylori, and H pylori is the root cause of acid reflux, heartburn excess gas, Specifically belching if the problem is in your upper G.I., specifically in your stomach lining. For a while I had a problem with a specific spot inside my stomach expelling air bubbles. After a while, H pylori moved much deeper down into my intestines. Another danger to watch out for is that H pylori will also attack your esophagus as well as eventually get to your heart. If it attacks your esophagus, what will you do without an esophagus? Most importantly, what will you do when H pylori finally attacks your heart? You can't live without either one of them, which is why it's important to get a breath test done, which is how I tested positive because so many times doctors miss or dismiss H pylori, and many people have actually died with it. One good example is an elderly friend of mine who turned out to have infected me but I didn't know it for quite a while until things started pointing toward H pylori. My elderly friend actually died with H pylori. You really don't want to let this problem go on, and I hate to have to tell you that anti-acids only mask the problem and they never address the real issue of H pylori. If you get rid of H pylori you get rid of the other problems. I took those products on the market for a while until I could no longer take them or even the other stomach medicine I was on from my doctor. If you don't watch what you put in your mouth after getting rid of H pylori, it will come back, and most likely with a vengeance.
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What I immediately thought is maybe some people are describing here, perhaps your mom might have difficulty breathing laying down. Another thing I was thinking is the possibility she may have back or other joint issues depending on the mattress she's sleeping on. With all of the mattresses on the market, not all of them are high-quality or arthritis friendly. Having arthritis myself, I found that sleeping on Tempur-pedic is my best bet.

Have you considered an adjustable bed for her? This will be far more comfortable than a recliner, because a bed can support you in ways that a recliner cannot.
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Have you taken her to the doctor? Sleeping in a chair combined with swollen legs are a sign of congestive heart failure. Deceased functioning of the heart causes fluid back up to the lower extremities and to the lungs. Makes the legs swell and makes if difficult to fully expand the lungs. If you can't breath, you can't sleep either. Sitting up makes expanding the lungs fully much easier...See what the doc says. And simple change of medications might help (not cure) a bit.
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Can't breathe laying down - awaken in the night. Sleep Apnea.
Even my wife who has no cognition and is resistive to any foreign object, welcomes the Cpap machine.
Acid reflux. Stop all packaged foods with msg and watch processed tomato sauces.
Of all name brands, we have found that great value brand does not cause reflux.
Crystallized Ginger from nutsdotcom, the only place we found it. Like gummy bear. Or do a search for crystallized ginger. A little spicy if chewed. Great if dissolved. Pieces are a little large so tear off a piece postage stamp size for immediate relief lasting all night and cures whatever caused the bout.
Healthy for you anyway.
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That was my mom when she was still at home, spent all her time in the recliner, sat up all night watching tv, dozing off now and then. She was like that all her life, watching tv late into the night. So it was nothing new!.... She had swollen ankles, though the doctor just said it was from eating too many salty snacks, microwave frozen meals, everything high in salt and sodium. (that's what happens when they get older, don't cook any more, they buy prepared foods, boxes of hamburger helper, frozen tv dinners, and eat potato chips and pretzels.)
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My father couldn't lay flat, He felt like he couldn't breathe. Try the recliner? Thats where he would sleep. My Dad had Copd & CHF
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Try allowing her to do what she wants to do. If she wants to sleep sitting up, just make sure she is safe and won't fall, but let her do what she wants. Save your breath trying to convince her to put her feet up to reduce the ankle swelling. She has a terminal illness and there is not much you can do to stop that. Just love her for the time she has remaining. Best wishes!
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This happened with my mom. Suddenly she refused to get into bed. I argued, pleaded, tried to reason--same issues, swollen ankles, etc. Finally realized no sense fighting it. Bought a recliner. She was OK with that. Wasn't as good as a bed but it allowed me to raise her feet.
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If your mom is eligible for a hospital bed thru medicare, that may work. We took the side rails off and put a regular memory foam mattress on it and mom loved it. She could fall asleep sitting up and then I would lower the head some and raise her feet.
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I should have added the Geni can inflate to any level. I don't always put mine all the way but just a little at times as it has a remote. Better than pillows and more like a hospital bed.
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My mom does the same thing! I tried a wedge but she told me to remove it. I now give her melatonin at night per doctor's suggestion. It calms her so she falls asleep in bed but only till about 3am but still some relief. Then she sits up about 30 mins, does her potty break and back to bed. I think for my mother it's an acid reflux issue. She likes to snack at night so trying to keep it under control is challenging. She also takes Lasix for swelling in her legs(she has heart issues).elevating helps but she won't do it for very long in her recliner. She's 86 years old so not as mobile as before. Compression stockings help. Finally found ones she'll leave on! They're tube socks on a roll and easier to pull on too. I hope you find something here to help you.
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Your mother isn't going to be able to understand the need to keep her ankles elevated or even the reason she should lie down. I agree that she may not be lying flat may be pain so a wedge may help, but I'd discuss both of these issues with the doctor. There's a reason for the edema (often heart related) so this needs checking anyway. It's possible that pain medications and/or a relaxant at night may help her recline. Check with the doctor on both of these issues. They are important for comfort if nothing else.
Take care,
Carol
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I personally can't lie flat to sleep due to spine issues.
About what 6 years ago I purchased a Matteres Geni from tv. It's a wedge operated by remote to raise the head of bed. They still show on tv sometimes, but may be your answer. I paid $99. And now they are $129. but well worth it.
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I wonder about the reason for the edema, does she have heart issues? I remember my mom used to have trouble breathing when she was lying flat in bed. If so then elevating the head of the bed might help, you can put wedges of some kind (books, pillows whatever) under the mattress to raise it several inches.
Or do you have a recliner, would she be more comfortable in that??
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Is she on any meds at this point? Will your physician prescribe anything to calm her before bed? Have you researched anyway to elevate her head/ waist area in bed so she can still lie flat? Are you able to determine why she does not feel comfortable lying flat? Does she have low blood pressure ?
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