Making Grandma Get Up By Herself

[blu]

Every two hours, I tell Grandma it's time to go to the bathroom and then I leave the room. If I stay, she claims she can't get up by herself, gets grouchy/angry, and then I have to help her up. If I leave, she might call for me several times to which I do not respond, and then she usually gets up all by herself.

The more she can get up all on her own, the more she can maintain or gain strength. If I help her, she is not maintaining her strength and may become weak. If she becomes weak, I will not be able to handle her as I cannot lift that much weight without hurting myself or even her. If I cannot lift her, she will have to go to a nursing home and she does not want that.

Am I wrong in leaving the room when I tell her to get up? Is it wrong to leave her on her own to get up? To be clear, I do watch her from the other room. I can see her, but she can't see me. I can also hear her. So it's not like I abandoned her. If she truly needs me, I'll be there.

I suppose my concern is that some people might perceive my actions as cruel or uncaring. But helping her just makes things worse, believe me, I've tried it that way. She went from needing significant help to being able to get up all on her own solely because I started leaving the room every time. That to me speaks volumes about her capability.

 

[Bod]

You are right, for the right reasons.

Bod

 

[Bunpoots]

Your instincts are spot on @blu

 

[la lucia]

Every two hours, I tell Grandma it's time to go to the bathroom and then I leave the room. If I stay, she claims she can't get up by herself, gets grouchy/angry, and then I have to help her up. If I leave, she might call for me several times to which I do not respond, and then she usually gets up all by herself.

The more she can get up all on her own, the more she can maintain or gain strength. If I help her, she is not maintaining her strength and may become weak. If she becomes weak, I will not be able to handle her as I cannot lift that much weight without hurting myself or even her. If I cannot lift her, she will have to go to a nursing home and she does not want that.

Am I wrong in leaving the room when I tell her to get up? Is it wrong to leave her on her own to get up? To be clear, I do watch her from the other room. I can see her, but she can't see me. I can also hear her. So it's not like I abandoned her. If she truly needs me, I'll be there.

I suppose my concern is that some people might perceive my actions as cruel or uncaring. But helping her just makes things worse, believe me, I've tried it that way. She went from needing significant help to being able to get up all on her own solely because I started leaving the room every time. That to me speaks volumes about her capability.

This is definitely the right thing to do. Mobility, strength and balance mean better quality of life.

I applied this kind of logic to my mum. We had a no sitting to get dressed rule, we had specific words that everyone used for certain objects and actions, we showered mum standing up holding a grab bar and no matter how long it took she walked from the street up her garden path ( plus a couple of steps) to the front door.

My mum was 98 when she died earlier this year she'd had a stroke, a broken hip and very advanced mixed dementia. She was on pureed food and yet she was still walking (with a frame) 30 metres up until a couple of days before she died at home.

It took a lot of work, a super supportive GP, an encounter with an amazing occupational therapist and lots of arguing with certain other professionals and my mum's phenomenal will but we did it and she still got a degree of enjoyment out of life up to the very end.

 

[Jale]

I think you are right to do it - as long as you can see that your grandma is safe then keep her moving under her own steam for as long as possible

 

[Malalie]

I think you are very wise - obviously if the situation changes and incontinence, or not being able to get to the bathroom in time becomes a problem I'm sure that you will change your tactics.

MIL went into hospital with an infection and was put on a catheter - she desperately wanted to get up to go to the loo - I wish that there had been more nurses around to help her. She never walked again.

 

[Ohso]

Im reading this with interest.
Mum who has never been the most active is now so weakened she wouldnt be able to stand unaided for longer than a few seconds and furniture walks even a few steps.
She moved in with me yesterday and although using a commode in her room has opportunity to use a proper toilet about 25-30feet away, would doing this relatively short walk (shuffle/frame aided) actually do enough good to make an appreciable change?

 

[la lucia]

Im reading this with interest.
Mum who has never been the most active is now so weakened she wouldnt be able to stand unaided for longer than a few seconds and furniture walks even a few steps.
She moved in with me yesterday and although using a commode in her room has opportunity to use a proper toilet about 25-30feet away, would doing this relatively short walk (shuffle/frame aided) actually do enough good to make an appreciable change?

I used to take my mum's commode to the bathroom without the pot in it and put it over the toilet. There's a grab bar alongside the toilet.

My mum would walk to the toilet with her frame, take hold of the grab bar with both hands, and we would remove the frame and she would slowly turn to face the right way. She would hold grab bar with one hand and arm rest of commode with the other and slowly lower herself. All with supervision and repeated prompt words. She would pull herself up with one hand on the grab bar and push up with the other hand on the arm rest. Carer/or me would repeatedly remind her to stand up tall while cleaning her up. Then frame returned and off....

We found that by sticking rigorously to exactly the same words and routine she managed it to the very end. The repetition really helped her for those confusion days. It was as if her body could over ride her brain.

When she came out of hospital after pneumonia and total loss of mobility we got it back bit by bit by starting off only walking a tiny bit and increasing it gradually. I always made sure she got calories one way or another too for energy and strength.

 

[la lucia]

Im reading this with interest.
Mum who has never been the most active is now so weakened she wouldnt be able to stand unaided for longer than a few seconds and furniture walks even a few steps.
She moved in with me yesterday and although using a commode in her room has opportunity to use a proper toilet about 25-30feet away, would doing this relatively short walk (shuffle/frame aided) actually do enough good to make an appreciable change?

I was motivated by an amazing occupational therapist who taught me to see everything as an opportunity for building/maintaining strength and mobility. Literally everything.

 

[rhubarbtree]

I am sure you are correct Blu. I take my OH to the day centre and expect him to get out of the car and walk across the car park unaided. When we first went there I noticed he copied some of the other PWDs and held out his hand for aid. I think the staff have got the measure of him now and chivvy him along. It is like having children it is so much easier to do things for them but it will not help in the long run.

 

[blu]

So can someone tell me what the following means:

Last night I was really sleepy and told Grandma it was time for bed. So she tries twice to stand up then starts crying that she needs someone to help her get up. Now I know this routine too well. She didn't put any real effort into getting up and she always asks for help when she doesn't need it. I immediately got mad (I try not to) and yelled at her to get up, then took her blanket and threw it on the floor, then left the room. I watched her from the other doorway (she couldn't see me) and she immediately got up all by herself with no problems. Everytime someone gets mad at her and yells at her, she suddenly has enough strength to get up all by herself with no problems.

What does that mean exactly? It means something. Is this part of dementia? Whatever it is makes me even madder. Things would be so much simpler if she just did what she's supposed to do. She's worse than a child and I know things will only get worse. I usually try not to get mad and I've gotten better about that as times go by, but every now and then I just get so angry that I find myself yelling at her.

 

[Bunpoots]

I'm afraid this is part of dementia. My dad used to drive me bonkers at times not doing things and I'd have to go into an other room, scream silently and do an angry dance ( anyone who saw me would've thought I was mad! ) then put my game face back on and try again.

I didn't live with dad though. You sound exhausted and frustrated and it's no wonder.

Do you have any help with your grandma?

 

[canary]

I remember my MIL was not able to stand even with help and was having to be hoisted and pushed around in a wheelchair. The physio assessed her when she was in hospital and got her standing unaided and I was astounded! She never stood again and passed away 3 months later. I was told later that physios can often make people with dementia perform much better than usual because the physios are perceived as an authority figure and the PWD makes a supreme effort to do what they want. It seems to me to be very akin to the phenomenon of "host mode" that we all see.

I am wondering whether it is a similar thing in your case.

 

[Ohso]

I agree with Canary, mum was recently in hospital and was accessed by the OT and told mum was perfectly fit to be discharged and could manage stairs (unaided) this from a woman who could barely manage to get herself out of bed at home before the fall and had been virtually bed-bound in hospital too.
Anyway, she has moved in with me and since then has been walking ( with some help/walking frame) to the toilet several times a day and lately has been taking herself in the middle of the night.
Earlier this week we had an OT visit her and told us to stop helping her,(unless she really needs it) but to let her get herself in and out of bed/to the toilet and more importantly to assume she can do something till she shows otherwise.

I can understand your frustration and its hard not to project assumptions about the whys, I tend to think that its like mental arithmetic, we can all probably do it, but given the chance, if we can get the answer in a less taxing way then we will as the older we get the less we are able to follow through that thought process and walking is just another thought process

Imagine you were having to describe the steps to get out of bed to someone it becomes a mission rather than the automatic thing most of us do every single morning without even thinking..

1. Push covers back
2. Now further because our legs are weak so we cant kick them off
3. Sit up in the bed
4. Move legs to edge of bed
5. Remember not to fall backwards towards pillow
6. Try to remember why we are sitting up
7. Stretch one foot to floor
8. Remember not to fall backwards towards wall
9. Try to remember if we are getting up or getting into bed......and we still haven't even got two feet on the floor yet.

And so it goes on, now if I just had someone else making decisions and helping me move how simple life would be...

 

[rhubarbtree]

Hello again Blu,

You say you were extremely sleepy but PWD does not care about that or if you have to get up early in the morning or if you are ill or in pain. Afraid carer's needs go by the wayside. I always stay up too late because I cannot face the getting into bed stuff so am often in the same place as you.

I know shouting is not good for the carer or the PWD but I do resort to it sometimes from sheer frustration. It might be that your grandma does not hear or register instructions given in softer, sing song voice. On a good day I am able to give instructions in a firm, clear way. Repeating a basic instruction without any frills or room for argument. (This was called the broken record method when I was teaching). It works most of the time. Another trick I use from my teaching days is praise. My OH responds to a "Well done" even though it seems strange to be saying it to someone who perhaps has just managed to swing their legs off the bed. OH obviously thinks "Well done" is good because he says it to me when he has watched me clearing the kitchen after cooking the dinner!

I refuse to beat myself up for any bad caring that occurs but do praise myself when getting dressed/undressed is accomplished in a reasonable manner.

My latest triumph is stopping my OH from sleeping in his socks. (I told him it was making his feet swell). No socks in the morning means I can get him in the shower much easier as he was using having socks on as an excuse not to get in the shower. Crafty 1 - Obsinate 0.