My mother-in-law lives in Assisted Living. Circulation is about shot in her right leg and both feet are swollen to the point they popped. Any suggestions?

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My mother-in-law lives in Assisted Living. Circulation is about shot in her right leg and both feet are swollen to the point they popped. Any suggestions?

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some time ago. She can't get into any of her old shoes (size 8.5 wide). She is not walking well and is somewhat incontinent, so we are reluctant to try to take her to try on shoes (would have to travel at least 50 miles). We bought a pair of Deerfoams we hoped would work, size 11-12.5. She could get left one on, but not the right. I have ordered edema shoes in a men's size 12, but if that doesn't work, I'm out of ideas. Any suggestions?

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My relative gets gout attacks. Because of side effects for her, she can't take the normal medication or what will permanently treat her condition. So when she has an attack, I give her prednisone for a few days. She only needs two. But it's still in her system. but she's almost 97, and that's the worst she has.

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Keep in mind that though gout will contribute to swelling in the lower extremities, it is not the only causes.
There are a number of medications to treat gout. You can look at it two ways 1) Treat the 'effect'. 2) Treat the 'cause'. Generally, you treat the cause and be prepared to treat the effect. Most gout medications to treat the cause work by either preventing the body's creation of excessive uric acid or the improve the flushing of it. In my understanding, as the amount of uric acid is reduced in your system, the uric crystals that have formed in the tissues causing the pain, shrink in size with treatment, they move around again lodging elsewhere in the joint and you have another attack. Later the cycle repeats itself as the crystals become smaller until they are gone.
So management of pain with these attacks need to coincide with the reduction of the uric acid in the system. Generally Insaid or colchicine is used, but other pain medication is also used at times. Additionally, prednisone tablets may be used or a cortisone shot into the swollen joint if things get out of control. The problem with this treatment form, is people expect a "right now" fix. It doesn't work that way, it takes time to reduce the uric crystals and get them out of your system. The attacks can occur during this treatment phase for upwards and beyond a year in some people. Older people (and young also sometimes) don't understand this and are less inclined to cooperate for that long.
Edema has multiple causes which may be the primary or a contributing factor to her problems.
From what you said about this lady, she most likely is at a point that it is time to ask a/the physician to do another workup on her current status.

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Yeah, she's not connecting the dots between take her gout pills and her foot hurting like h-e double hockey sticks, which it probably does. That instinct to just rest and not use a painful or weak affected body part can become deadly if given it to for long enough. That's 70% of rehab - making people use it so they don't lose it.

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A doctor who cannot get gout and oedema under control, coupled with an overworked NP, in a setting that does not provide sufficient support with ADL, does not amount to "very good." Rather than expecting his mother to help herself, your husband should be seeking a more appropriate living environment for her and I agree that for the purpose of getting her back on her feet properly an NH or rehab sounds about right. I am not suggesting for one second that this is or should be your problem, let alone your fault, but your MIL needs more help than she is getting. QED.

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Like lou8 said, I think she should be in a hospital setting to get this under control. Never mind the shoes right now.

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Has she been seen by a geripsych? Ptsd?

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I know the doctor's care may seem unimpressive, but the NP is excellent, but overworked, and the Dr. is very good. My ML just seems bent on not helping herself. She has gout medication, but I am always finding pills hidden around her room. I report this to the nurse, but it is AL and not a babysitting service. We did visit on Sunday and "encouraged" her to walk down to the DL for Open House. Although she has been having someone push her in a wheelchair for weeks, she made it just fine on her own. She just does not want to help herself. She whines about wanting to be outside, but there is always an excuse why she can't do that (too hot, too cold, etc.). Sometimes, I think being caught in Katrina completed unglued her. She was in Picayune at the time and it was 5 days before we could get down to there to rescue her due to poor communication, road closures, etc.

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Alice, if your husband has ever had gout he will know how excruciatingly painful it is. I'm not surprised your MIL isn't keen on going for walks, and she probably found the pillow unbearable. Gout can also be a side effect of some medications, by the way, so it isn't just a matter of her passing on the port and over ripe cheese.

Clearly you and the family are doing all you can in terms of providing her with activities and comfort, but my question is: what in the blazes is her MD doing? The doctor's care you mention is… unimpressive, to judge by these results. Ask searching questions.

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We went up today to their open house. Although she has had someone push her to meals all week, we did have her try to go to the dining room on her walker and she made it just fine there and back. A lot of her problems seem to be self imposed. Her son will try explaining the situation to her to see if she can't be motivated to help herself.

I volunteer in a nursing home and would really hate to see her there.

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It sounds as though she is beyond AL care and needs a NH setting.

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It sounds like you've already done the caring, loving things to do. It is very painful to see someone we love being self-destructive. Is she still competent to make her own (wrong) decisios? If so, there is not much you can do.

That her shoes don't fit is no longer your problem. Sorry. :(

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I understand completely, Alice. We can provide all the opportunities, but can't make people do things. It is frustrating.

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Thanks for all the great answers and support. Yes she does have a lift chair and a special pillow to raise her feet above her heart at night. She sits in the lift chair, but will only raise her feet part way. She threw out the pillow the first night it arrived. She is on medication and is under a doctor's care, plus there is a nurse at her Assisted Living. In addition to the edema she has gout. They don't seem to do specialized diets there and she will not avoid things that inflame her gout. She seems to take pride in doing nothing to help herself. The facility has walking path, exercise programs, but she will not participate. I feel like I'm fighting a losing battle. My husgand is disgusted with her and the other son ignores her.

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What Pam & Jeanne said. I wouldn't worry about shoes as much as I would about getting the edema down. It sounds like she needs to be on Lasix, as well as doing other things to get the circulation to her limbs right.

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The source of this problem must be addressed! Get medical attention for her as soon as possible.

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Good grief, she should be on diuretics and have a hospital bed to elevate the legs, plus a recliner to do the same. Daily cleaning is needed to avoid sepsis. Without rapid intervention she will lose both feet. Call the MD and have orders written for the ALF to do this. Written orders are a must.

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Are her feet elevated at night? Is she taking medication to reduce the swelling? Does she have a lift chair to help her up that could also elevate her legs during the day? Enough about that.

Shoes. Try backless shoes.

These come in 12's. They're silly, fun and $20. The red strap you see goes UP so that it becomes nonfunction and out of the way.

Then this kind....?

Here's a men's slipper that comes in a 13:

This slipper comes in a 14-15:

Hope something helps. Surf around on the internet. There's lots out there.

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My mother-in-law lives in Assisted Living. Circulation is about shot in her right leg and both feet are swollen to the point they popped. Any suggestions?

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