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I have known my friend for about 7 years now…. From age 83 or so. In her early 80s she was cruising once a year and walking into town (15 mins) to visit her small business three times / week, in addition to another day out to do her own food shopping with a taxi home. Sunday evenings spent with us, no walking, but nevertheless another outing and lots of fun with a dog…So basically doing something or an agenda 5 days per week.



She had been slowing down a bit before Covid, only two days a week “working”, and getting a ride with her son or taking the bus instead of walking, still doing her own shopping and getting taxi home, but various lockdowns interrupted this routine and at first because we were so careful around her, for 6 weeks or so, we only brought her shopping and encouraged her to get out a bit. We were terrified of infecting her as all reports at the time said that Covid would be complicated or kill the elderly, so we kept our distance.



She understandably became bored & restless and so we broke lockdown “rules” and started having our Sunday dinners at her home instead of ours, because of our housemate working at the hospital and dealing with Covid patients daily. None of us were ever infected that we know of at this time. I even took her shopping once a week in addition to her own regular shopping trip…after the queuing and empty shelves episodes stopped. So many people gave me evil eyes for letting her push her own trolley in the supermarket, one time someone said why don’t you just do all her shopping for her? The fact is that we did…but when the only opportunity for her to get out and see people was in fact to go shopping…where was the harm in that?



Fast forward to present day… she can barely walk now.
I am not sure if her spirit has been broken, or if her body is just giving up? Her mind is still perfectly intact. She continually mentions that the constant “guidance” to stay home just made her feel old. And she is one of these people who constantly reflect on their age. Getting to 90 hit her hard and whilst it is understandable that she should feel old at 90, she refuses to call herself old and sometimes gets into a very critical mindset.



We have done some of the chores for her, (when she allowed us to do them or hire people to help), collected prescriptions and paid bills etc, but this is still a very independent young lady living in an old woman’s body. Very different from many of the stories I have read here and my heart goes out to all of you dealing with dementia! I have experience with that in my own family and I know it is so difficult x



This is difficult too though, because her legs just won’t work anymore and she systematically declined every single suggestion I had over the past two years to help, whilst also berating her son about this that or the other.



Are there any other carers out there dealing with able minds in a deteriorating body?



She has finally come around to the fact that she needs more help, has stopped insulting and degrading her son so much, and been very grateful for the help that we give her.



She has been doing some of the physio exercises prescribed after our last doctors visit, so she says, and finally consented to using a rollator - though she likes to call it a sholley.



The only thing I can think of to help with next is her diet. I know her diet should have been the starting point, but again, her consistently fierce independence has kind of got in the way of that. She has always eaten very regularly and pretty well. In the past she has hated any suggestions, but after a good heart to heart talk today I now know that she has not been eating as regularly as she should be or as much as she should and once again, finally!, she is open and receptive to receiving help or suggestions…Thank the Lord for that!



Can you suggest any nutrition shakes or smoothies?
Has anybody used jelly drops for people without dementia?



Any help is so very appreciated x

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Can you get her into physical therapy? My mom was isolated and sedentary the last 2 years too. I TRIED to get her out etc over the past 2 years to no avail. But she just had a lumbar fracture due to her osteoporosis too. But this past week she finally went to outpatient physical therapy and it was so helpful to her mental health as well!!!!! As much as I have been saying she can walk without a walker, she can do this etc, she didn’t believe me but she believed the PT guy. She’ll be going 3 days a week until she regains strength and gets more balance.
Good luck to you! I hope you can help her.
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MustHelp Apr 2022
Thank you soo much! I’m not sure if you saw my reply to you above…apologies as I am just working out the system here…my reply to you was:

“Yes! I can definitely suggest this and I know exactly what you mean… 
sometimes they just need to hear it from someone else!

Thank you so much and best wishes for you and your mother too xx”

I actually had to look up the difference between physical therapy and physiotherapy, because here in the UK physiotherapy kind of encompasses both. Many people just interchangeably use the words, but there is a slight difference in my opinion. I just wasn’t sure though…so thanks for helping me on this journey!

Many months ago I had suggested physiotherapy for her, she was finally able to see her doctor for a routine appointment and brought it up. At the time, she was in so much hip and leg pain that we did go for an X-ray, which ultimately just showed advanced osteoarthritis, I think, that’s what she told me anyway by saying… “all old people get it and I’m not going for an operation like my daughter does for every little thing she has a problem with”.

Shortly after this she confided a vaginal problem to me, that my own grandmother had….and at almost 93…she did go in for a “simple” correctional procedure that seemed to have been successful, until she died 10 days later. I haven’t told Irene about this and don’t intend to, yet.

After the X-ray, they then scheduled a phone call with a therapist, went well, then a brief appointment where she was given a print out of some exercises she should do at home. She was told to await a phone call the following week and had waited around all morning / early afternoon for it and finally decided to go shopping as usual. There was great comfort for her in being able to get out and lean on the shopping basket….She came home to a message that the therapist had finally called later that afternoon… she then went for another follow up visit, but it was a different therapist who met her and basically he told her there was not much to do. So she says… I know she would have just preferred the demeanour of the nice lady before and not the stern man she met with.

We have small obstacles we are tackling each week and she actually is in a much better mindset than she was a month ago. That was my stumbling block…I reached out for help here because I was about to say “enough”…enough moaning around me without accepting any help! Fortunately, thanks to you and many of the other thoughtful replies here I have been able to encourage her even more…and even over the past few days it has really really helped!

I’m very grateful and thanks for taking the time to even write that first suggestion!

I can tell you are excited by your mother’s progress and that is so heart warming! Well done xx

My golden girl will talk my head off complaining and then mention one or two things I suggested to her kind of estranged daughter - who has an even bigger moan about all her problems - and as soon as her daughter says it’s a good idea she’ll do it! It was frustrating at first, but I am now thinking of calling her daughter to suggest certain things, so that if they came from her…Irene might just listen and do more…every time we have gone to various appointments together, she shoots me a look as if to say…you were right…but she just needed that second opinion from someone else. Shame she can’t get it from her own daughter…and her sons are of a generation where they just don’t want to hear about mum’s health…

We’ll go back to the doctor and ask for more physio help, if not maybe pay privately… but just knowing that she ‘can’ recover a bit thanks to you and many others here, things are looking so much more positive.

Thank you again and best wishes!
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Yes! I can definitely suggest this and I know exactly what you mean…
sometimes they just need to hear it from someone else!

Thank you so much and best wishes for you and your mother too xx
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Normally the body slows down as we age. The reason is obvious, it's wear and tear. Old people suffer a decline in all the vital organs, including muscle volume, strength and brain functions. There is loss of muscle mass, loss of muscle strength and poor balance, that gets worse if accompanied by poor vision. Then, there are problems with arthritis or osteoporosis affecting the bones and joints. To keep physically active in old age is difficult, but lack of regular physical activity invites death. Becoming sedentary is very easy for old people. It takes a lot of effort to keep moving our bodies, but we have to push ourselves if necessary. Joining the YMCA or other exercise programs may provide motivation. Physical therapy is for treating specific muscle groups, but it does not provide general cardiovascular fitness. Heart rehab programs do. Remember, it's not enough to be active. Cardiovascular exercise requires to be continued without interruptions for at least 30 minutes per day, minimum. A 30 minute daily walk is considered adequate for an old person. Of course, we can't keep exercising for eternity, and have to accept that there is a limit. In regard to nutrition, protein intake is vey important to replace muscle loss. Remember that 90 years old is an age well above the average life expectancy. May be there nothing wrong with that lady.
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MustHelp Apr 2022
Thank you so much for your thoughtful reply.
Irene does in fact suffer from poor vision, she has done so her whole life. I knew she was lacking protein and has definitely included more over the last months, probably just not enough though…she has always been a good light eater, hence asking about a shake or something that she could just force herself to drink in order to get more nutrition or liquid.

She has dentures, some intolerances to onion, citrus, but she generally will try anything. She rarely drinks a single glass of water…I’m really curious about this group of people worldwide who drink no plain water at all, but that is for another time.

She completely lost her confidence over the past two years, but didn’t complain too much because of what other people were going through. I think that with the natural decline in her muscle mass, and being more sedentary, she has also had to mentally deal with too much - even though sound of mind to everyone around her, you are of course absolutely correct that she will have some cognitive decline too. A lot of regular people don’t understand this, so thanks for reminding me. So many relatives just believe that even though the body is deteriorating, the mind won’t, and it’s important to realise that because we can still have a great conversation…we don’t need to overload them either.

Just as our terrible pandemic news was winding down, Irene also now has been affected by the war in Ukraine with it being on the news every day. It has almost invoked a kind of PTSD in her from world war 2, and having lost her parents as a child. Really. It has been another negative thing in addition to her ailments that has made her quite sad.

We have had a couple of extreme incidents with her and having to go visit in the night…only two…she bumped her head once on a cupboard, but was bleeding and shook up so we stayed for a long time with cups of tea and just making sure she was all right. It really was just a scratch, and of course we know how much the elderly can bleed at times. The other time, it was much later, during a lockdown, and she just started passing blood. She called her son and he started running over to her house, while I called an ambulance. Apparently, what happened was a common ailment of old age for females… She stayed overnight and has been physiologically fine since, just not physically fine so much and perhaps mentally with all of the stress…

And then her boiler (central heating tank) exploded on a dark evening at the end of January ten minutes after a qualified technician had been there! All electricity shut off and she had to navigate her way upstairs to grab her mobile phone listening to the tank flooding water all over the kitchen. Which is another story, or pretty much like a scene in Titanic, but with a 90 year old woman, in the dark.

It was very traumatic for her and we have really worked through all of it pretty well. I’m sure that these worldwide and home events have somewhat traumatised her and she really wants to get out of the funk.

We discussed at length having her move in, and then we heard that the house next door might be available… again, another story…

After these recent years of terrible news and then a couple of stress inducing incidents at home, perhaps we gave her too much to think about on top of it by talking about moving in or next door… she was totally enthusiastic at first, but it’s a complicated situation with the family next door and whether they will sell, rent or move in. We shall see. Irene doesn’t want to think about the possibility now, because it isn’t possible immediately, so it remains just an idea.

I know she is physically declining beyond the point of no return, but I also think that the Pandemic, the War, and some of her personal problems have exacerbated her physical exhaustion.

Would you recommend a heart rehab program for a 90 year old? I’ve not heard of this and am very interested…if not for her, for others.



I
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My mom lived on her own into her 90's and was fine... until she wasn't. When I looked back critically I realized that a gradual loss of appetite coupled with a mostly sedentary life had lead to frailty, and that lead to her first falls and things just spiralled down from that point. The best advice I can give is to encourage her to walk (yes, using the rollator!).
Supplements like boost, ensure etc are an easy way to boost calories, people like to diss them but it's way simpler to use these than to make dietary changes.
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Her doctor can order PT
During the exam and the PT assessment she will be evaluated and PT can make a Care Plan that may help restore some of the strength. This is not the same as just giving her a walker to use. This would be a course of PT
There are many reasons that she may have had this decline.
If she is not steady and afraid that she may fall this could lead to inactivity and decreased muscle strength and balance making it m ore likely that she would fall. Sort of a "self fulfilling prophecy"
She may have had a series of mini strokes that have left her weakened.
Was she tested for cognitive decline?
One of the ways I knew something was "off/wrong? with my Husband is he stopped doing things that he had done previously. He stopped riding his bike to work, he stopped making repairs around the house. When I asked about it he said..."When I feel better". I think he was afraid that he would do something wrong, or forgot how to do some of these things.
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TChamp Apr 2022
A decline in physical activities after 90 is considered normal. What's the point for checking for mini strokes and cognitive decline? That could be normal for age 90. PT does not provide aerobic exercise. Leave that lady alone. You can't fool mother nature.
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Daily exercise can delay natural death only to a point. If a person is old enough to die, nothing will prevent it. That's nature's law.
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cwillie Apr 2022
Yes death will surely come, but debility can be delayed and remaining active has many quality of life benefits.
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My father (and my mother) had been avid walkers for years, and Dad continued to walk as much as he could as he aged.   He was still walking with the aid of a rollator when he was 99; it was only during the last few months that walking ability declined drastically.

We worked together on this; going for walks in the area, especially at the local park and down to the lack in his own home area.   He either walked  independently or gradually with a walker, then took a rollator for support, then used an Amigo riding machine (like those in grocery stores).  With the latter, even though he wasn't walking, he was getting fresh air and interacting with neighbors, both very helpful.

I would definitely, most definitely look to PT; ask her doctors to script for it.   The interaction with physical therapists is extraordinarily helpful, as is the confidence coming from being able to restore some level of physical activity.

You can supplement that with a reasonably priced hand/foot exerciser.   Dad had one, pedaled with it while sitting in his favorite chair listening to music.   He bought his through one of the catalogues (Miles Kimball type), which you could do, or could buy a more expensive one at one of the DME stores.

They look like this:

https://www.mykneedoc.co.uk/6-tips-to-get-the-most-out-of-your-virtual-consultation-copy/

Photo 1:  basic model:

Photo 2:  a bit of data enhancement:

Photo 3:  more expensive, comparable to those in rehab facilities.  More sturdy, especially for hand use, but also much more expensive and not easily moved by an elder person who doesn't work our for arm muscle strength.

Diet:     Dad ordered Meals on Wheels, which had another benefit besides food:  interaction with very friendly, supportive volunteers who delivered the meals.

If she's willing to go out, a good senior center might have special activities, such as holiday meals.   Interaction with others would be a secondary benefit.

Sometimes Dad got milkshakes when we stopped for a quick meal, but they weren't regularly in his diet.   Ensure and other similar products could provide some nutrients, and they did during the dysphagia stage.    You might be able to buy some nutrition shakes at health food places, or even gyms which have a little health food bar for the work-out folks.

I can't speak to "jelly drops"; I have no experience with them.  My father drank a lot of water, and some orange juice, so hydration wasn't an issue until he became dysphagic.  Then he had to add Thik-It to liquid products.

Final thought as to losing weight and straying from good diets during Covid.  I can certainly attest to that.    W/o even trying, I lost a lot of weight, and still can't eat anywhere near what I consumed before Covid changed my lifestyle.   And even though I walk in the house, I've noticed a drastic decline in arm strength.  

Covid changes us in more ways than we may have imagined.
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It's hard to say if your friend will or won't recover in this situation. Physical therapy may prove to be most beneficial for her, I would think. The moronic lockdowns have affected more people negatively than anything else, especially elders such as your friend who have been forced to isolate 'for their own good'. They'd have likely been better off catching the stupid virus and taking their chances than to be locked away as they were. Humans are herd animals and not intended to live in isolation for long periods of time.

I hope PT proves to be helpful for your friend and that the walker is a useful tool for her to get moving once again. I have no idea what 'jelly drops' are but I wouldn't force too rigid a diet on the poor soul at this juncture either. 6 small meals a day should do her lots more good than harm as frequent small meals keep the blood sugar regulated which is most important for all of us.

Good luck!
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Feelingguilty22 Apr 2022
I agree 100%. The lockdowns and fear has caused more harm than anything. I know this firsthand from how my Mom was before and after the lockdowns. I encouraged her to get out but she was too scared. Wouldn’t even let me or my brother in her house during that time.
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Does your friend have a weight problem?

I would ask her doctor to give her an order for OT/PT in her home. The therapist cam evaluate her and see if its something physical causing the problem. Your friend may more likely do her exercises if a therapist is there. If she hasn't had a good physical maybe time for some labs to see what her numbers are.
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I would suggest adding the high calorie boost or ensure to her diet. Upright exercises can be tricky at that age. You don’t want them to fall. There are some really good seated exercise DVD’s for seniors and people in wheelchairs. They give you a nice work out. Swimming or water aerobics would be good as well if she enjoys it. It’s easy on the joints. They make special bottoms for the pool if she is incontinent. Most importantly, keep her spirits up. Loneliness seems to be such a big problem for the elderly. She needs to have conversation to keep her stimulated. Maybe she could join a seniors group once a week or find a hobby. Audio books might be enjoyable for her. It’s no fun getting older and not being able to do what you once could. You have to be fearless, find purpose, have interests, have friends, push yourself every day, and accept the idea of eternal life with God one day.
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I would recommend swimming and if you have a YMCA around . My Dad was Bicycling everywhere before Quarantine . He was alone during that time . I got home and he had declined . I took him to Maine and got him walking for 5 weeks but Once we got home he didn't want to go out . He got the vaccine last march and took a trip to California to visit My sister . He had a small fall when we went to visit Florida . We went to Maine and when we returned he had another small fall in the Bath tub. Then I think a stroke going downtown on the Bus in the high heat to the Apple store and was in the Hospital for 4 days . We got PT and OT and Nurses and a CNA for bathing . he ddi quite well but another big fall after Labor Day and a small fall raking leaves in October . the last time I got him to go out was for Thanksgiving Dinner . Since then he refuses to go out . There is a fear of falling and the weather has been very cold . Now that the weather is better I will ask him to go out But if he refuses that is his choice .
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babziellia May 2022
Once someone starts falling, that fear is REAL and hard to overcome. With each fall, the fear worsens.
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I have a friend that is 91 and she "lost her legs" during quarantine.

She started walking, she started slowly and now walks over a mile daily. She walks in the grass so she doesn't get hurt if she falls.

If your friend is willing and able, she should get some sort of exercise daily to build her strength.

With my dad, I walked him up and down the aisles of big box stores 3x a week to build and retain his strength. It really helped him and he could use a cart for stability and they are climate controlled, which was important for his recovery.

It really boils down to her willingness and ability to get stronger. Best of luck!
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with respect to your diet and more protein in the diet questions, here is my experience: Mother drinks Ensure almost daily. A carton or two daily of the high protein is loaded with nutrients and calories. My dad doesn't really like it. Takes a sip now and then. He eats a small serving of Ice cream daily. They eat a lot of peanut butter on toast or wheat crackers. Aide makes simple, ham sandwiches and keeps a supply in the fridge so they can help themselves during the day. basic oat Cereal with milk daily. Hard boiled egg with toast. I make nutritious soups and proteins and salads with whatever is fresh and in season when I am visiting every month or so, but I don't live there. My mother is not a cook. They get a hot meal delivered daily (M-F) from Meals on Wheels and they eat most of that. Their weights have been stable for the last few years. Their activity and energy levels are declining some but still active enough to do daily tasks and walk in and around the house, go to bank and grocery store. Both have had various physical therapies both inpatient and outpatient and home health care over the last 8 years. The acute rehab physical therapies certainly made the biggest impact by getting them back up and walking and doing their activities immediately after acute illnesses and injuries. And, my parent's own desire to want to remain independent. They were not always the easiest patients, often a lot of drama, catastrophizing thinking (dad), but they did the work to get better and do the therapy, no one could do that for them. Home health eased the transition from inpatient to back at home and gave them some visiting company for a few weeks after coming home. My mother enjoyed outpatient physical therapy in the pool for a few weeks on a few occasions, ordered by her physician.
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My mother is also 90 and has declined with lack of activity during covid. I suspected and the doctor verified that she was in a depression and she is now on anti depressants. That has helped. My mother is overweight and always has been but she had also been very active. Her doctor recommended PT and my mother likes it but she keeps missing appointments since the time of her appointment varies too much. She is looking into having a more regular schedule. I recently got her a recumbent bike since she liked the ones at the PT center. Having that at home has really helped so far. I sometimes have to remind her to use it during our nightly calls but she has now been using it more regularly without the prodding. The first time I stayed on the phone with her for the time she was on it which made it easier to start. It has only been a couple of weeks since she got it but I am seeing a difference. Getting her circulation going has helped her cognitive ability and mood as well. I live a couple of hours away and I do go to take her to appointments and other things but visiting on a daily basis would be too much. I did find people to help around the house a few times a week so she does have human interactions other than me. Her diet is an issue since she “lives to eat” right now but I’m trying to encourage better habits there.
I have had to gently push and prod her to start new things and sometimes it works, sometimes she’s too stubborn and I don’t get anywhere. Each positive change is a victory and well worth it. I’m lucky to have a good relationship with her doctors and going with her allows me to take notes so I can remind her of what the doctor has said. That can also help because it is a different person making recommendations, not just me! I can also bring up issues she forget to mention or is too embarrassed by to talk about. She complains about my sharing her secrets but also knows that her doctor needs to hear about all of it.
Anyway, I found that having a form of exercise she likes and can do at home has made a difference since she can do it when she wants and doesn’t have to go through worrying about getting there in time or at all. I hope to gradually build on that start.
Good luck with your friend! I’m sure that your encouragement does help a lot, even though they can be stubborn at times and won’t admit it!
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I read all the answers here and am so glad Irene is doing better.
I'm 82 and feel in many ways very similar to Irene.
Yes, the pandemic and the Ukraine are tough to take- especially with WW2
flashbacks and other ageing changes......
One thing I'd like to say is- can Irene visit your house and have fun with the dog again? -at a time when your tenant isn't there (for Covid proximity
reasons)- not necessarily even for dinner- just to talk with you, have a cup of tea, and play with the dog once a week or so. You are a good friend and
if it was me I would love to do just that.
Sending you both much love!
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MustHelp May 2022
Hi Tashi!
I have been meaning to reply to you for so long now, I’m sorry for the delay. I wish we could have a cup of tea together with Irene and the big dog! Sadly, for her, he still has way too much energy at 7 years old for her to walk him herself.

Every Sunday without fail she comes over for about 4 hours and gets to spend all that time with the dog. Once in a while she gets to see him during the week too… my housemates (her son and our nurse friend) are going to get another dog in the next 6 months, a puppy of the same breed…and we have suggested that she come over like she did 6-7 years ago to “dog sit” during the day. Just a couple of hours… she is really looking forward to that!

I hope to reply to all of the amazing answers here soon, but I am going on my first two night break in about 3 years and must look after myself for two nights now.

The rollator is working! She is still complaining about it, but she is using it two days a week when she comes to work and still doing her own shopping (a third day out) by hanging on the shopping trolley around the supermarket. She refuses the help to have it done for her and she is still coming into “work” (sit at a desk and talk to people with all of her knowledge and expertise) two days a week. She has finally consented to a regular cleaner a day a week as well.

She had a cold last week… lots of people saying Covid is around us again, but she has pulled through that and it only lasted three days. Oddly, she has not been invited for a fourth jab yet…or she might be not telling me :-) That’s fine.

She is doing well and much better thanks to all of the advice here. I have only told her that there are many others going through similar circumstances…

I have thought about showing her all the responses here, but she is not ready nor may never be ready for some of them. So I will show her some responses in time, but never the ones that tell “me” to just give in to her physical decline.

I’ve felt more confident in advising her that it’s not over yet and there are so many things we can try! What an amazing group of people here! Thank you all x. I don’t push her beyond anything reasonable, be assured, but sometimes just a small push in the right direction, or even backing off for a bit to let her gain her own ground again has really helped.

So many good people and responses I need to reply to here, but my heart really goes out to you…do you get to spend time with any pets? Are you getting the support you need?

Thank you so much for your wise and encouraging advise, more people need to hear it and I hope you have a way of doing that. How amazing that we can reach out on the internet across oceans now and get different opinions and perspectives.

All the best to you and I don’t know how this site works yet, but if I can upload a picture of the dog…let me know how!

Much love from across the pond xxoo
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A very good question. In the case of my wife I think it really has a lot to do with mental state. The problem I find is people want the result but do not want to do the work. The worse they get the farther away the goal line is. So if anyone has suggestions to keep motivations high I want to know. How do you make exercise a priority when it is something you do not like to do. Me included
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MustHelp: Perhaps your friend requires a medical examination, although dealing with the Novel Coronavirus, even if you're fortunate enough to not contract the virus, can be depressing.
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I think she sounds depressed. The shutdowns brought depression and anxiety to all ages.
Not all depressed people wallow, but some, especially active and engaging personalities, hide it very well.

Depression, IMO, is a silent killer in the elderly. If you don't mentally operate well, you'll stop taking care of yourself, i.e., not eating right, regular or at all, and you'll curtail your daily activities.

I strongly suggest seeing a psychiatrist for evaluation and monthly therapy.

PT is great. She needs to maintain her socializing, so out-patient therapy is better.

The other thing I suggest for her, with her hips, arthritis and muscle weakness is regulat CLINICAL massage therapy. Hopefully, your friend can stand the pressure. A good clinical masseuse will start gently and progress over time as the patient tolerates it.

I changed my and hubby's life by introducing regular clinical message and dietary changes (check out AIP diet and Forks Over Knives). My insurance doesn't cover my massage therapy (medical field is slowly coming around to realizing clinical massage is beneficial), but some will work with you on cost and offer great discounts if you buy a package. Do yall have Groupon or such in UK where you can buy really cheap intro session? That way you can try out a therapist to find one she likes.

I manage my wellbeing and long time physical problems (F57) with 2-hr sessions at least once a month or every 2 weeks if I'm lucky. Hubby is on a strict 1-hour session every two weeks; he only needed to regain and his muscle strength after losing 30 lbs in a month due to a very rare autoimmune disease that was diagnosed. He was extremely fit prior to that.

FYI, I started having muscular issues after a strange stroke-like attach in 2010. I went to all kinds of drs and thru all kinds of testing, sometimes painful testing - e.g. EMG - but none of the drs could figure out what it is. A neuro put me on a neuro pain inhibitor that made me feel better. but then also worse. My PCP took me off. :)
I started clinical massage, and now I function really well. (we changed our diet in 2016, and that hybrid of the two mentioned above really got rid of my fatigue and helped my mental state too. )

I truly believe an psychiatrist therapy, better living thru better eating, and clinical massage to get stronger, oh, and daily active life.
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Old retired RN here.
My suggestion is that you have an HONEST discussion with your friend.
You cannot imagine the number of elders who told me honestly that they could not speak with family and friends about the truth of their lives because "they don't want to hear it" . Many expressed an exhaustion with life. NOT DEPRESSION. They had lived long and done what they wanted and they were TIRED. Ready for "the final exit" and ready for the long nap, ready for peace. However of the many ways they expressed it they were very tired of being pushed to do what they were now ready to STOP doing.
My own father felt this way and discussed it honestly with me. He said he just never really wanted to get out of bed but his own beloved wife couldn't hear that, wanted him up, eating, onto the scales. He did it "for her" and he was exhausted with it. Happily at 94 he died in his easy chair.
So discuss this honestly with your friend. She may be 90, but as a senior myself I can tell you there was a great change between 70 and my now 80. And my friend who is 90 says "ha, just WAIT". I hear the next decade isn't a whole lot of fun either, esp with deteriorating senses and bodily balance and function.
So I don't vote for diets and exams for depression (unless there are real symptoms of it). I would decrease my expectations and honestly discuss things with your friend...............follow her lead. She may be OLD but she may also have still some ideas about how she wants to live her life ongoing.
Best out to you and thanks for your caring heart and your will to help.
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MustHelp May 2022
Ya, I’m not even going to go there with any extra exams…for depression or otherwise. It is very interesting to read other thoughts on the matter, but I’m not really the person to suggest or force her into taking any tests and I don’t believe any of her family will look into anything because they just put it down to old age.

The thing is, she speaks to me, and has said so many times that she does not want to get out of bed some mornings. Yet..she also says that she will “buck up” and get going again. How can I ignore that?

Irene barely went to the doctor once a year for her whole 90 year life before Covid.

After our first lockdown, and the subsequent one in November, instead of her children taking her for her first vaccine, she asked me to go with her…

I bought her a rollator before asking her if she would use it…her son said good luck… I mentioned to her that it was a possibility to use one on her walks and definitely for her walk into the big public space where she had to “get jabbed” which she totally wanted to do, and she said absolutely no way with a rollator, I will lean on you. And she did, twice…Third time, the vaccine stewards saw that she couldn’t walk very well by herself, offered a wheelchair.

Thankfully Irene and I had already had a good conversation about it…. I had told her that the walk was longer and that if there were wheelchairs available she should not argue with me. I said it was our little secret, I wouldn’t be telling anyone that she needed the extra help.

She gave me a good hard long look before accepting the wheelchair option…. And then thanked me after. Days later, in front of her son, she mentioned that she was grateful for the extra help.

Now she is using the rollator as well…saying things like, oh I should have listened to you sooner… maybe I should get one with a motor?

She is clearly upset about her family situation, but also her own physical health… Her phone froze the other day, and she finally consented to me buying her another phone as backup. ( I suggested this more than 6 months ago and she shot me down telling me it was not necessary, and today she is really happy that she has a new phone as an option in case one fails).

I am so happy for you and your father that he passed so peacefully.

The honest discussions I have had with her have led to her telling me about certain female problems that she is probably too old to have corrected. My own grandmother went in for a sort of routine surgery over 25 years ago, with the same sort tuck in procedure that many older women have to deal with … we’ve had only two discussions about it… and both times were when she had experienced another trauma about the heating going off, or during a lockdown situation.

Maybe I need to bring it up with her again… but the surgery is too difficult for women of that age. Maybe she doesn’t want to live with it anymore, but how can I ignore her and not try to help?

On the positive side of things, we have set up a tea station upstairs. A small kettle and tiny fridge upstairs for her to have her tea and breakfast upstairs, rather than having to run up and downstairs all the time.

She has refused to move in with us, or move next door…she generally does not want to move at all….so we will keep her comfortable in her own home for as long as we can.

Thank you so much for your insight.
Once a nurse, always a good caregiver x
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A heart rehabilitation program for a 90 year old? How about a weight lifting program too? and a marathon running training, as well? Lets be realistic, people do not live forever. There is point when all athletic trainings become useless because there are no muscles left to train.
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Musthelp, the only way to post a picture of your dog is as your avatar.
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Musthelp, what a cutie.
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