He's had a few falls outdoors and in their apartment, and he already has a broken rib from a recent fall. In order to get him to keep up with her when they go out, she takes his hand and pulls him along behind her. Watching the two of them like that is frightening enough, but it's even scarier now that he's gotten more frail over the last two months. At a recent dr's visit the dr witnessed how shaky on his feet he was, and told us it was way past time we got in-home care & the use of a wheelchair for my dad, and that we should especially use the wheelchair whenever my dad's outside. My stepmother bought the wheelchair the next day, but immediately began to refuse to let him use it--or to allow the aides to transport him outside the house with the chair. She says to me/to him that she thinks I'm trying to turn him into an invalid, and tells all of us--including the aides--that the dr doesn't know what he's talking about, and he can't dictate to her that my dad has to use a wheelchair. The last thing I want is for my dad to be an invalid or have his mobility limited. But I feel just as strongly about not wanting him to be at heightened risk for another fall. I know my stepmother doesn't want him to be hurt or to suffer from a fall either, but this has now become an extremely charged issue between my stepmother and I, which isn't good for my father's quality of life. Or for hers...or mine, either. But I'm frantic with worry that he's going to fall and hurt himself, break a hip, etc. I live out of state but visit at least once a month, and I try to plan my trips to go with them to as many dr visits as I can. I also pay for half of the in-home care, which I'd been offering and trying, in vain, to put in place for over a year. Finally having aides, who help BOTH of them, is providing needed respite and relief for her, and trained support for my dad as his dementia symptoms escalate. My stepmother now says she wishes she'd agreed to accept in-home aides a long time ago. But I need help in getting her to accept using the wheelchair for him. I'm failing miserably in gaining her cooperation in following the dr's instructions/recommendations, especially when it relates to my dad's safety. Any suggestions that can help us to communicate better and work more as a team to support my dad's care would be greatly appreciated.
My husband fell and fell and fell again when he developed dementia. He faithfully used a walker, but it did not prevent falls. His doctor suggested a wheelchair. She advised us to make sure he still did some walking so he wouldn't lose the strength to do transfers.
He loved the wheelchair! Suddenly he could scoot himself around the house (using his feet) without fear of falling. It made a huge difference in his outlook. It was one of the best things that happened in the first year of his dementia.
I think both your Dad and Stepmom may wish they'd done this sooner, once they accept it. I hope you can help facilitate that.
Please let us know how this works out.
I digress. What I would heartily recommend is that you book a training session for your stepmother with a physical therapist specialising in elder care, so that the PT can demonstrate techniques and your stepmother can practice under expert supervision. I would also recommend that you look online at the vast range of walking frames and rollators available, and see if you can't see one that might be suitable for your father - indoors, outdoors or both. The thing is, your stepmother is absolutely right in that you don't give up on mobility without a fight - so she does have your Dad's best interests at heart, as you recognise.
But I also sympathise with that permanent sick, heart-in-the-mouth feeling you must have, fearing a serious fall. Hugs to you, hope you find a happy solution.
I would brief the therapists privately (that's what I've done several times) and ask them to tactfully demonstrate the proper techniques, every time they come, if necessary. They can also ask your stepmother to perform the moves, etc. just to "ensure that they've communicated adequately the steps she needs to take."
You might also ask them privately to document if they see stepmom isn't cooperating. They might already do that w/o prompting.
I saw this same attitude in a mentally unstable cousin who managed to push family away and isolate her mother, sometimes overmedicating her with drugs (NSAIDS) to the point that eventually surgery was necessary.
I'm not saying that the same symptoms are present in your stepmother. But there is that kind of "I know better" approach.
I think there's a variation of Munchhausen's by proxy that sometimes afflicts caregivers. Instead of making their charges ill so they can effect cures or recovery, they feel that they know more than the medical professionals and are qualified to evaluate and initiate corrective measures on their own. I know at least 2 caregivers with this approach. It's impossible to make any suggestions to them because only they know what's best for their relative.
I think your plan to involve a geriatrician is a wise one. I would at least for the time being though back off entirely on having your stepmother evaluated. If the aide is right, she's responding to her own anxieties and seeing a doctor on that level would probably only exacerbate the tension between the two of you.
She needs to find a way to address her own fears, with support but not oversight. Maybe you can take her out to dinner, bring her flowers, make her more amenable to your involvement.
And if you can persuade her that you're concerned for her health as a caregiver, and want to ensure that she's still in good health, that's a different story. But, honestly, I'd be really cautious about trying to determine any kind of dementia status because I think she'd recoil like a rattle snake and you'd be the victim if she lashes out.
I'd think very carefully about how to encourage her and turn the situation around so that she does rely on you rather than perhaps seeing your efforts as threats to her own actions.
And as to replacing the one doctor, well, there are often long waits to see another doctor, you have your own life and can't call dozens of doctors, and of course you never really know what a doctor's like until you meet him or her.
A few years ago an internist was highly recommended by a surgeon, nurse and a woman with whom I shared a hospital room. I was disappointed when I met the doctor; she wasn't at all cognizant of older people's issues other than to be sure to ask certain questions segregated by Medicare for special payment.
She ignored 1 critical issue (anaphylaxis) and pooh poohed another (anemia). Obviously I never went back; the first visit was a waste of time.
it really is hard to find good doctors.
I've noticed on all sorts of occasions that when an older person is struggling, the instinctive reaction is to try to get them where they're going as fast as possible so that they can sit down. It's natural, but it's the opposite of helpful, because what then happens is the person gets bustled and hurried which is the last thing they need. Pausing and letting them catch their breath or steady themselves is trying on the nerves - not to mention the patience - but it is what you need to do to support independent mobility.
Combining extra time with a sturdy, seated rollator, or a lightweight wheelchair that your SM can keep to hand or in the car, or both; that should keep your father beetling about safely for as long as possible.
Thanks for sharing an observation which I'm sure could apply to a lot of us, especially me.
I'm in a similar situation with stubborn elderly parents. Dad has dementia, Mom does not officially have dementia but with all her meds and at age 85 her executive reasoning is just not good anymore. Your step mom sounds similar.
I've expressed this before on this forum but again I think it fits this discussion.
There comes a point where we have done all we can do. We have done all our elders will allow us to do. We are dealing with legal competence but a reality of bad decisions and judgement. It does me no good anymore to keep badgering my mom about her diet or using her walker. It just upsets us both and changes nothing.
No matter how much we do, make the house safe, get the meds, the right docs, stuff is still going to happen. Illness, falls etc. We can't control everything.
I'm not suggesting total surrender, but pick your battles. Eventually a crisis will force things to change. Like many caregivers, I'm in the waiting game for the issue that will force my folks to accept the help they need.