My mother (87) refuses to use her rollator walker. Any input?
Noncompliance with mobility assistance. Her balance is terrible, she's riddled worth osteoarthritis, has a hip and knee replacement and her non replaced knee is buckling very badly and she says it often feels like it won't hold her. She also suffers from afib, heart failure, pulmonary hypertension and vascular dementia. She's had a number of falls. In fact 2 in the last month. When reminded she used to say I forgot or it's too cumbersome. Now when she leaves it behind and when I say I wish you would use your walker I get answers like "there are lots of things I wish". Did I mention she is very depressed and hallucinations? She's in her own apartment but she is rarely alone as I or be of my sisters are here. Afraid she'll seal her fate and wind up in a nursing home if she continues to teeter around like Frankenstein. Any input is most appreciated.
At her stage of dementia plus her other medical issues she is not safe to live alone. But even having someone with her 100% of the time is not a guarantee against falling. At 87 with all those impairments your mother is probably going to die of something sooner rather than later. That something may be triggered by a fall. Of course you will do everything you can to prevent that, but it may happen anyway. Try not to blame your mother and certainly don't take guilt on yourself.
WearyinPit, my Mom refused to use a walker and half the time didn't use her cane.... my Mom would do what is referred to as "furniture walking", thus using the furniture and the walls to balance her.
Well, not using a walker was my Mom's downfall, literally. She fell in the kitchen, hitting her head on the counter top which caused a brain bleed. She went into rehab/long-term-care and never came home.
Too bad on my Mom's death certificate the doctor couldn't write "died due to sheer stubbornness". So sad :(
There are several factors at play.
1. Your mother's vascular dementia may at this point prevent her from comprehending and/or applying the normal thought sequence we instinctively go through when there is a risk we need to assess. You and I, no doubt your mother previously, do it unconsciously: e.g. the pavement is icy - the ice will make it slippery - I will use additional measures so as not to fall. The only visible difference is that we adjust our gait, go back indoors for grippier footwear or whatever - we do the risk assessment and adjust our behaviour without noticing.
In your mother's case, she claims that the rollator is too cumbersome, or makes whatever excuse, only when you remind her of its very existence. The thought of using it at the appropriate moment probably never crossed her mind, in actual fact. So, in a way, yes she forgot; but forgot is too big a term. She can't form the thought well enough in the first place to forget it.
2. The vascular dementia may also have - excuse me, this is the technical term - b*ggered your mother's balance, on top of her physical disabilities.
3. With the heart failure, she may be experiencing postural hypOtension. Ironically enough. So that when she gets up, the blood supply to her brain will falter, she may feel dizzy, and falls become almost a racing certainty.
4. You're getting a smart alec answer to your heartfelt wish because she's cross (and who can blame her) and it saves her the effort of arguing.
Solutions (I'm afraid these are of very limited value, but a) they're better than nothing and b) they can salve the feeling of "I must DO something.")
Chair alarm. This is a pad that goes under the cushion of her main easy chair and triggers an alarm when she gets out of it. You, or the person supervising her, carry a monitor which goes off and you can then hurtle to the room and hope to catch her in time. You can verbally remind her about her rollator, but if she's anything like my mother you'll just get the brush-off. Instead, smile encouragingly, place the frame in front of her and help her get her grip comfortably adjusted. You should, with any luck, find that she then beetles along with it quite happily. You may even observe some pretty impressive manoeuvres.
Bed alarm. Similar idea. If you get the right box of electronic tricks, you can get chair alarms, bed alarms, pendant or wrist watch call buttons (if your mother ever presses it intentionally let me know so that I can eat my hat) that all link in to the same monitor. The only thing they haven't come up with is an alarm that will tell you *before* the person gets up. Tunstall CareAssist is the make we had; I don't if this brand is available in the US, but I'm sure there'll be something similar.
Commode. If your mother crashes around the place at night, it may be that she needs the bathroom and loses her way. Placing a commode by her bedside saves her having to leave her room.
Do you know what's causing her hallucinations? Anecdote: certain forms of codeine can have this side-effect. If she is taking codeine for pain relief, it might be worth asking about.
From the tone of your description, you clearly know better than to argue with or scold your mother. Quite right, and not only because that would be unkind and unpleasant - it would also be a complete waste of breath. Your mother is not being 'stubborn' or 'forgetful'. The bit of her brain that would know that using the rollator is a helpful, sensible precaution no longer works. She *can't* think of it.
It might, if you haven't already done it, be a good idea to get an occupational therapist in to see if there are any home adaptations or bits of equipment that could help make your mother's environment safer. Anything your mother has to engage with actively is probably not going to work, but there are plenty of other things - grab rails, brightly coloured duct tape marking out safe routes - that might help her.
It does sound as if your mother shouldn't, really, be left on her own now for any significant length of time. It becomes less about total falls prevention - 100% success is the impossible dream, I'm afraid, even if you're on hand 24/7 - and more about how quickly she'll get help when she does fall.
I've certainly depressed myself, I'm sorry to sound so downbeat. I hope some of this is of practical use.
Plus, you say she is depressed and having hallucinations. I'd have her checked for other causes, such as UTI, medications, infections, etc., but if its the dementia causing it, ask for advice from her doctor for medications to help her. Mental anguish is just as painful as physical pain. She may be more compliant and cooperative if she were comfortable mentally.
Based on what you have described with her condition, I would be scared to leave her alone in her home. Except for the early stages of dementia. it's just very risky. I would explore getting someone to be with her at all times to ensure she uses care with her walking and other activities. A fracture at that age is very serious. If she fell who would be there to assist her?