102 yr old grandmother, almost fainted from walking...should we encourage walking?

[avocadofruit]

hello all...

this is my first post here...I've become sort of desperate to reach out to other caregivers, and feeling quite alone in trying to do this work by myself, with a very small family.

I'm caring for my grandmother, Sylvia, who is 102 years old...she does have 24/hour aides at her apt, through Medicaid (we are in the US).

She's become weaker, not wanting to drink as much (about 2.5 bottles of "ensure" a day, watered down for hydration), and has lost weight. I just took her to the ER last night for dehydration, and her walking has become very weak.

My question is...should we still be encouraging her to walk around, or just very slowly...or just use wheelchair in the house...?

I know being bed-bound is not the greatest thing...I don't have a medical background, so I'm not sure at what point people become bed-bound. Sylvia would like to sleep all the time, or just sit up in bed... but she's more reluctant to get out of bed and walk.

Should I accept this less-walking as part of her decreased abilities, or keep encouraging it? She almost fainted the other night, that is why this is on my mind....

Thank you for any thoughts...

 

[jenniferpa]

Hi and welcome to Talking Point.

Well at 102 my inclination would be to let her do what she wants (within reason). If she wants to walk then she needs someone with her at all times, but if she doesn't, you definitely shouldn't be pushing that. Bed-bound at 60 is not a good thing, bed bound at 102, well that's not unreasonable in my view.

There are obviously other health issues that impact on walking, and maybe impacted by a lack of same, but forgive me, realistically you are looking at a fairly short time frame in terms of life span and my feeling is that the way to go is whatever makes her happiest.

If you and her doctors really feel she should be up part of the time because it improves her overall health and well being, I do think a walker is an option between no walking and a wheelchair.

 

[Witzend]

At 102 I must say I think the poor lady should be allowed to stay in bed if she wants to.

 

[Amy in the US]

Hi avocadofruit, and welcome to TP. I am also in the States. I am sorry to hear about the difficulties you are having.

Disclaimer: not a doctor, and don't take my suggestions as medical advice. I think that first of all, I would get the GP/primary care doctor/geriatrics doc/family doctor/whoever your primary contact it, to check out her blood pressure for orthostatic hypotension. This is when you have a big change in blood pressure from lying down, to sitting up and/or sitting to standing. It can be part of dementia, happen as you age, be related to medications, or just happen. It can make you feel weak and that you only want to sit or lie down most of the time.

I'm not sure if your grandmother also has dementia, and what type and how advanced, and/or other health issues. Medications may also be playing a role here.

Obviously it's best to avoid becoming completely bed-bound but if she mostly wants to stay in bed or in a chair (and there are some special ones you can get to be comfortable and safe), and she will still get up occasionally, that's fine. I am not sure about encouraging walking. I think at 102 you have to manage your expectations and balance them with what the person wants to do. Becoming bedbound does bring on the problems of possible pressure sores, decreased circulation, et cetera, and it's something I would discuss with the doctor.

Dehydration will also make her feel lousy, of course, but again, I am not sure how much of an issue you want to make of this.

I'm sorry, I know it's hard, and it's really difficult to know what to do. I'd have a long conversation with the doctors and see what plan you can all come up with together.

Best wishes to you and your family.

 

[Mannie]

I would think twice about allowing her to become bed bound...there are a lot of negative affects, including boredom, for her and also for your family. Also in England the care costs more when pads need changing when the client is bed bound, one needs 2 Carers to mange the lifting.

Personally I agree with other comments, discuss with GP to try to figure what the cause is and (assuming GP thinks it is appropriate) ....how you can work to maintain her mobility gently step by step , because she will be able to enjoy life and feel more independant , mood will be better etc, with increased mobility.

 

[avocadofruit]

Hi avocadofruit, and welcome to TP. I am also in the States. I am sorry to hear about the difficulties you are having.

Disclaimer: not a doctor, and don't take my suggestions as medical advice. I think that first of all, I would get the GP/primary care doctor/geriatrics doc/family doctor/whoever your primary contact it, to check out her blood pressure for orthostatic hypotension. This is when you have a big change in blood pressure from lying down, to sitting up and/or sitting to standing. It can be part of dementia, happen as you age, be related to medications, or just happen. It can make you feel weak and that you only want to sit or lie down most of the time.

I'm not sure if your grandmother also has dementia, and what type and how advanced, and/or other health issues. Medications may also be playing a role here.

Obviously it's best to avoid becoming completely bed-bound but if she mostly wants to stay in bed or in a chair (and there are some special ones you can get to be comfortable and safe), and she will still get up occasionally, that's fine. I am not sure about encouraging walking. I think at 102 you have to manage your expectations and balance them with what the person wants to do. Becoming bedbound does bring on the problems of possible pressure sores, decreased circulation, et cetera, and it's something I would discuss with the doctor.

Dehydration will also make her feel lousy, of course, but again, I am not sure how much of an issue you want to make of this.

I'm sorry, I know it's hard, and it's really difficult to know what to do. I'd have a long conversation with the doctors and see what plan you can all come up with together.

Best wishes to you and your family.

Thank you all for your thoughts, and thank you for these thoughts in particular...

Yes, we don't have a great setup with doctors right now. They are house call docs, so they see her every few months for like 15 minutes...and that would be a long visit.
There are 3 on the team, so it's hard to balance what they each say, or who ever saw her on the last occasion.

It's just weird because her health has changed so dramatically in the past 4 months... by "walking" I just mean walking to get up from the bed, to the commode, and to the couch or chair in other room. 4 months ago, even 3 months ago, she was able to get up from couch by herself and walk to the chair, multiple times a day.

Now, she's... in a very strange state, very weak. Honestly I fundamentally can't tell whether this is something she will emerge from with more care, although I am trying everything I know. It's a strange time.

 

[avocadofruit]

I would think twice about allowing her to become bed bound...there are a lot of negative affects, including boredom, for her and also for your family. Also in England the care costs more when pads need changing when the client is bed bound, one needs 2 Carers to mange the lifting.

Personally I agree with other comments, discuss with GP to try to figure what the cause is and (assuming GP thinks it is appropriate) ....how you can work to maintain her mobility gently step by step , because she will be able to enjoy life and feel more independant , mood will be better etc, with increased mobility.

And yes...this is what I am worried about. We are running into these issues right now; they don't magically send 2 aides through the agencies, I have just been going to the house twice a day to help the aide get Sylvia out of bed.

 

[its a struggle]

hello all...

this is my first post here...I've become sort of desperate to reach out to other caregivers, and feeling quite alone in trying to do this work by myself, with a very small family.

I'm caring for my grandmother, Sylvia, who is 102 years old...she does have 24/hour aides at her apt, through Medicaid (we are in the US).

She's become weaker, not wanting to drink as much (about 2.5 bottles of "ensure" a day, watered down for hydration), and has lost weight. I just took her to the ER last night for dehydration, and her walking has become very weak.

My question is...should we still be encouraging her to walk around, or just very slowly...or just use wheelchair in the house...?

I know being bed-bound is not the greatest thing...I don't have a medical background, so I'm not sure at what point people become bed-bound. Sylvia would like to sleep all the time, or just sit up in bed... but she's more reluctant to get out of bed and walk.

Should I accept this less-walking as part of her decreased abilities, or keep encouraging it? She almost fainted the other night, that is why this is on my mind....

Thank you for any thoughts...

Hello A,

My mother in law (mil) had a similar problem with walking. MIL is 86 and kept falling on standing, and very unsteady when walking around her flat, having been pretty steady & able to walk some distance.
She was found to have postural hypotension, - blood pressure dropping dramatically on standing. Ask her doctor to check her blood pressure both seated & standing. This very simple test will show if this is the problem.

MIL is now on a low dose of steroids to raise her low blood pressure.

Hope you get to the bottom of the problem soon.