My mom is 96, uses a walker, often needs assistance to stand, and is almost always in her armchair. Her activity is limited to walking the hall to the dining room and back in the morning and again at "supertime,"and for infrequent bathroom visits. She also walks a bit during sundowning, but that is less than it had been. I know she's getting weaker.
Should I be enforcing some level of physical activity beyond this? I feel guilty that I don't do exercises with her, but I just lack the motivation and confidence, somehow. I guess being the half-week caregiver saps my strength, mentally and physically. I don't think she qualifies yet for "PT" either. Ideas?
For both of my parents, they became more sedentary when they were feeling down. We wanted to prevent them from becoming dependent on a wheelchair.
Promote all non-sedentary behavior. If your mom spends her day dozing, try to find mentally stimulating activities to get her engaged, in better spirits and then more physical activity may follow. Instead of just watching television, fold laundry together and talk. Even a drive in the car can be rejuvenating and she may become interested in moving around more after she gets home. Play music that she is familiar with and encourage her to sing along.
How did your Mom like to get exercise when she was younger? Use that as a model.
When my dad could barely stand or walk, his occupational and physical therapists suggested he play video games (Wii) that allowed him to safely “play tennis” and golf - which he was longing for. He delighted in this activity and it made him stronger. (For safety, he had to be spotted/supervised). This was wonderful for him and improved his balance.
My mom didn’t like traditional exercise, so we tried our best to get her moving (for exercise) in ways she could also look forward to. We aimed to increase her balance and strength.
In order to get my mom more active, I would take her to the shopping mall as she had always enjoyed walking there. On one trip I realized she had grown so weak that she could only make it from one bench to the next. After that, we started going every day and working toward only sitting at every other bench, etc. She built up her strength. (I preferred the shopping mall because the floors were very even and smooth). She went from barely walking to walking 2 miles regularly. She stopped falling at home and this activity lightened her mood and motivated her.
Mom always loved plants and flowers. When Mom grew older, she couldn’t enjoy activities like going to a botanical center, however, because it became too overwhelming. She did, however, want to stand up and walk to get a closer look at the flowers planted in displays around town or even to browse flowers for sale at Home Depot.
Design an exercise plan for elders or fragile people, around what they like to do, maybe TRACK how far they walk. Only the most agile will generalize from specialized body strengthening alone. It doesn't matter if it's a small path that they walk, encourage and expand on THAT.
Younger people in medical or family roles get mixed up, too many think elders or disabled people want to return to activities they did in the past. Some delusion may encourage that idea. But reality differs: if an elder goes to a crowded restaurant to eat out with relatives - the elder is afraid to go, for those relatives are not used to her slower pace, she is not sure how to interrupt or find the bathroom. They think that just being there is the same for her as it was years ago, while she is fearful before going, cannot hear well, she was doing it for THEM, and she is exhausted. Instead, meet one on one, near her current arena.
You did what is so possible but underestimated and documented: you noticed your mom's CURRENT pace and preferences, so if she could not walk without tiring, you kept the activity, made sure she had enough places to sit, kept up frequency and gradually increased distance, till she had more stamina, and could learn ANYTHING better. Old dogs DO learn new tricks, but starting with where they ARE and can relate to, in their current world - and gradually increase it. It makes no sense to assess their ability levels when they have lost stamina, so they are more wobbly all the time.
My bro used to walk the length of the narrow nursing home building to get to the residential care end, where he met two other residents for games of Wii Bowling. He walked the building maybe 8 times a day. Until arguments arose after a couple of falls, and he was told not to walk anywhere, without calling for help, Months later he was seen as needing a wheelchair. Now that home shut down, he's in a new one, and they don't see him as able to walk. I'm trying to push for them to get him walking again, not to focus on "gross motor skills" and exercises or always have help beside him. First see what destinations he can have where he can safely walk on his own, even if it's just to walk to the bathroom, note his abilities to rise up and walk, and slowly increase the path, his confidence and stamina. The effort to "train him" the correct way to walk, just left him NOT walking for so long, he lost his whole ability to walk at all, and he's not getting any younger.
1, Can you put a scoop of collagen peptide powder in her tea or coffee once per day? Protein will help with her strength and also help on a cellular level. A one month supply is about 35 dollars.
Improving her nutrition a little could be helpful.
2. Your mom can get a great workout in with a recumbent exercise bike. All you would need to do is help her sit down on the bike, put her feet on/in the pedals and maybe have a TV she can watch while she pedals.
20-30 minutes per day on the bike will help her leg strength and cardio. Keep it at zero resistance and work her way up from 5-10 minutes to 30-45 minutes per day. Slowly increase the time she spends on it. If things go well, she could get addicted to riding that bike every day.
I hope she comes back strong!
But stamina can be built in any circumstances, if someone notices what activity you CAN do, and encourages it along with small increments, so you do it more. Getting up from a chair to stand - that's an exercise - that may seem pointless without a destination, so creating a repetitive destination is hugely helpful - like this woman's realization that mom liked walking through the supermarket. I noticed that my brother liked walking outdoors, so I found him a nursing home, when he needed one eventually, on flat streets in a quiet neighborhood. Letting him walk for half an hour outdoors regularly, added all kinds of exercise, getting up, dressed, use bathroom, outdoor clothes and walk outdoors with walker, then in and repeat in reverse order, but know that life was more exciting with the outside excursion. Set it up so two patients can walk together - not for miles, but a defined distance..
She did have a lift chair and found it very helpful.
Perhaps she enjoys a game of cards or a board game? Playing WWII music could probably bring some smiles. Just Google WWII MUSIC. You can enjoy your time with her if you just focus on her happiness.
Check out chair exercises:
Sit and Be Fit Osteoporosis Workout
Award-Winning Chair Exercise for Seniors
by Mary Ann Wilson
DVD
https://www.amazon.com/Osteoporosis-Workout-Award-Winning-Exercise-Seniors/dp/B013RC1W8G/ref=asc_df_B013RC1W8G/?tag=hyprod-20&linkCode=df0&hvadid=312170781249&hvpos=&hvnetw=g&hvrand=4636662039013241712&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9033430&hvtargid=pla-568716668624&psc=1&tag=&ref=&adgrpid=58898437101&hvpone=&hvptwo=&hvadid=312170781249&hvpos=&hvnetw=g&hvrand=4636662039013241712&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9033430&hvtargid=pla-568716668624
Check out Sit and Be Fit on YouTube. She can do that at home with you.
Yesterday evening I followed a client back from her bedroom to her living room laughing internally: all the way to her armchair she recited "push forward, step in, push forward, step in, push forward, step in..." using her frame, then she turned through ninety degrees, step by step like a musical box doll, shuffled back, looked down to see her legs were touching her chair, placed right hand left hand onto the arms of the chair, and seated herself under control.
Yup. You can always tell when there's been a therapy visit that afternoon :)
We're supporting this lady because falls led her to lose confidence in mobility. I don't think she'll need us much longer!
PTs can teach your mother safe standing, walking and sitting techniques, they can help her improve her balance, they can encourage her to engage in seated exercise to improve her respiration and circulation, they can help her protect her own skin integrity by good positioning habits. And sessions make a little ritual of self-care, too, which will encourage your mother to feel she's an active contributor to her own wellbeing and health.
Do not feel guilty for not being a cheerleader and therapist combined. What's wrong with asking the professionals?
Gentle Tai Chi and Qi Gong - 25 minutes
I use it as well and it is fantastic. We both use it every day and her mobility and mine has increased greatly and it helps us mentally as well.
I think it would be a great exercise for both of you.
A physical therapist evaluation to teach you how to safely assist her in mobility would be a good idea. there are tips and tricks to make the job easier on your back, and safer for both of you.
Think about increasing reasons/opportunities to walk around inside the house....
sit out on a porch or deck if you have one, or by a window. A bird feeder can make looking out a window interesting.
Also start planning for how to manage her care when she is no longer able to move around much - do you have room for a wheelchair in the house? An electric lifting recliner might be helpful now - reduces the physical labor of standing up so that she has a bit more energy for actually walking around can help.
My 99-yr old aunt with mod/adv dementia needs to be helped up out of the chair and held by a belt to move with a walker from place to place. She is taken out to the mailbox every day, and also uses an arm/foot pedal machine 2x a day for 15-ish minutes.
I do agree with Cwillie that once your LO is no longer able to move with a walk, caregiving will become far more challenging. A secondary benefit to exercising is that she will sleep better. We have my aunt fold a large pile of kitchen towels several times a day, sort colored poker chips, fold napkins for dinner, etc. This also burns mental energy and she requires no sleep aids now where she prior was being given Tylenol PM (and causing her great constipation).
My MIL is now in LTC because she just refused to get out of bed even though there was technically nothing preventing her, but she couldn't be forced. We tried all sorts of PT and incentives, to no avail. Just be tempered in how much your push exercise to your LO and have reasonable expectations.
My mom is 85 & aunt is 93. They have the same level of activity, watch TV in between naps and thats about it.
Mom had several cycles of PT and she makes a feeble attempt to do some arm stretches with the large rubber band. She is wheelchair bound and walks very little. She can transfer herself but that is it.
Aunt shuffles to bathroom with her walker and to eat but thats all. She is getting slower & weaker.
I would not insist on anymore activity.
https://eldergym.com/leg-exercises/
are exactly what my mom's PT had her doing, I was surprised how beneficial just 10 to 15 minutes several times a week were.
She's also not going to get PT nor would she benefit from it. If you want to try to get her to swing her arms around a bit while sitting in a chair, OK, but it really won't do anything. She's moving about as much as I'd expect from someone in her condition.