Family caregivers have to deal with so many little things that come up in their day. Sometimes the issues are small and require little effort, like doing laundry or loading a dishwasher. Even handyman chores can be accomplished with relative ease.
Other issues require a significant amount of intervention. Loss of mobility can impact a broad spectrum of abilities that allow us to be relatively independent on many levels. Walking, rising from a chair, bed, or toilet seat, feeding oneself, personal hygiene, and the like all involve the ability to move our arms and legs and maintain our balance. All of these skills require a certain amount of strength and agility.
A catastrophic event like an automobile accident, a bad fall, a stroke, or a heart attack can cause a sudden loss of mobility that mandates immediate intervention with significant levels of hands-on care. Still, sometimes the loss occurs gradually over weeks or months. This loss might not even be noticeable to the untrained eye of a casual observer.
When Betsy was traveling to be with her mother monthly during the last two years of Sarah’s life, she began to see her mother’s declining mobility in ways that her brother had not noticed. While he checked in on their mom almost daily, she was usually seated in her recliner and didn’t get up during his visit, so he didn’t see how she struggled to rise or how unsteady she was when she walked down the hallway to the bathroom. When Betsy visited, she was with her mom in the house all day. She realized her mother was rapidly losing her ability to rise and walk unassisted, and she had to act quickly. The house was old; the doorways were too narrow to accommodate a wheelchair comfortably, and the bathroom would have become entirely inaccessible if Sarah could no longer walk. She would have been forced to move into facility-based care if she could not regain her mobility.
As we age and become more sedentary, either because of career changes or personal choices, our “move” muscles begin to lose their vitality. Muscles not used regularly start to lose flexibility and capacity. We simply aren’t as strong as we used to be when we were younger and more active. Some of this happens with age, regardless of our routines. We have the power to make decisions that slow our muscular degeneration and rebuild our strength and mobility when the loss comes from lack of use.
Betsy first reached out to her mother’s doctor to request a referral for a local home health company and had her mother evaluated for services. That referral paid off, and Medicare paid for the services provided. The home health coordinator created a comprehensive plan of care that built a partnership between their team and Sarah’s care family. Sarah’s Home Instead caregiver reinforced weekly visits by Physical and Occupational therapists (PT and OT). She encouraged daily PT/OT exercises along with regular walks to the mailbox and frequent “chair breaks” (where Sarah would have to get up out of her chair and walk around in the house for a few minutes).
This path was not easy for Sarah or those who cared for her. She would argue with her caregiver that she didn’t want to walk to the mailbox, or claim that she had already done her leg exercises for the day. There were days when the chair breaks simply didn’t happen. Nobody’s perfect, and we all have good days and bad. But she did enough, incentivized by some straightforward reminders of what could happen if she didn’t build up her leg strength, and the plan paid off. Through teamwork and consistent messaging from those who loved her, Betsy’s mother regained enough mobility so that she was able to remain at home until her death several years later.
When mobility has been lost and cannot be regained, the picture is very different from what Sarah experienced. When the ability to move is significantly compromised or eliminated entirely because of an accident or a stroke, a new care plan is needed that can identify and address the skills required to meet emerging needs. Recovery usually begins in a rehabilitative facility setting that follows hospitalization for the primary event. A home health agency that provides rehabilitative therapies like PT and OT can be instrumental in helping your loved one continue their rehab once they return home. Prescribed exercises similar to what was used in the facility may be modified for home usage to continue progress toward regaining additional range of motion and ability to control movement. Home health can also be of assistance by suggesting adaptive equipment and showing you how to modify your approach to providing care. Alternatively, if the new care needs exceed your abilities, information can be provided to help identify other community resources and services that might be of benefit to you in the coming weeks and months.
Betsy and I hope you’ll join us this week here at Heart of the Caregiver and share your heart about managing mobility challenges.