to ask for help with what to do for DM

[beclev24]

We live abroad, DM lives in the UK. She is early 70s. We visited recently and it is pretty clear that she won't be able to carry on as she is for much longer.

She is very very overweight ( probably by about 10stone) and has bad arthritis in her knees. She is on very strong painkillers, and is now unable to walk more than half a block or so without very significant pain and becoming very out of breath. She can just about climb the stairs in her house but it is very very hard for her. She ddrives everywhere or gets uber but can only really go to places where she can be dropped off right outside the front door. I can only see things going downill from here.

I don't think there is any hope now that she will lose the weight- she seems totally unmotivated to do so. I need to have a serious conversation with her about the next stage of her life but need help in thinking what the options might be, especially as this is quite an emotional subject for me and for her. Fortunately she should be able to afford help. Can anyone advise on some possible options? What about an electric wheelchair? How would that work with driving/ getting in and out of the car etc? Would she need a live in carer if she used a wheelchair? What about a mobility scooter? How do those normally work? Do they go in cars? What adaptations do people need to have at home or in their cars etc etc (she can still walk a bit so can get in and out of cars etc.) What about a disabled badge for her car? Is that a possibility? Where would I go for this information? It's hard being abroad and not knowing the options.

Please be gentle with me here- . Thanks so much for any advice

I'm so sorry you have to deal with this. My first thought is that your mother should not be living in a home with stairs. That's just a recipe for disaster, and chances are the upstairs will become useless anyway as she won't be able to get up there. Would she be open to moving to a more suitable home?

aqua thanks for your kind message. I don't know. She is very very attached to her home as it where she's been for 45 years/ knows her neighbours etc. I guess moving is an option though- I just wonder if she moves now, then would have to move again in a year or two when she can no longer live alone. But maybe that's ok. It's weird because physically she now seems very very old but mentally she is all there and is in total denial about her physical state

anyone else?

In her current home, is her bedroom upstairs? Would it be possible to move in to a room downstairs? I would think that would help out with her mobility for the immediate future.

If she is in denial its tricky - I would focus on getting a power of attorney sorted out now while shes still got capacity
www.gov.uk/power-of-attorney

this helps in making decisions if she gets ill/incapacited..

can the downstairs of the house being adapted at all?
the other first port of call is the adult social services department of her local council...
they may help specifying any adaptations- look at the council website
and search on adaptations....

However they will do all contact /communication with her and she will have to be up for it! hopefully otehrs will be able to help you with how to have those conversations as we have failed miserably with our elderly parents

First I’d get a stairlift installed , my mum refused to have one for ages but we got it put in a couple of years ago and it’s been fantastic for her . We went through Dolphin as they do several different makes , are good prices and did a bariatric one . We also have a rise / recliner chair ( better life / Parker knoll / Hsl ) and a bath cushion thing that deflates and inflates so she can get in and out . As regards mobility scooters we don’t have one as my mum doesn’t leave the house alone and no longer drives but you can get ramps and adaptations so they can be got in and out of the car easily . With regards to a blue badge it’s just a case of filling in the form and seeing what happens , if you do it online you can see if she pre qualifies fairly easily or whether she will need an assessment .

thank you for these helpful suggestions. Yes the denial part isn't easy at all. I will start researching stairlifts and wheelchairs etc. want to have some idea of the options/ costs/ what is possible etc before having hte conversation wtih her. I"m really dreading it all

I would leave her with the stairs and doing what little walking she does do as that is probably the only exercise she gets. Is she sociable? Maybe encourage her to join a local Age UK where she can go a few times a week, or if she is too young for that, suggest she volunteers for them to sit and chat to the more elderly and make cups of tea etc.
If she is quite overweight she would need a large wheelchair/scooter and they are not easy to get in out car unless you adapt the car. There are some big towns that have Shopmobility schemes where you can drive and park and borrow a scooter. Most councils have a scheme called Wellbeing and they run exercise groups and weight loss schemes etc and you could see if she would agree to a wellbeing assessment. IIf she decides to stay in the house she could eventually get a stairlift. If the stairs are straight up it is not as expensive as most people think. This will depend on her weight and shape but she would have to be very large for it to not be possible.

Can I say with hindsight that for my elderly parents having a stairlift fitted was the worst thing they did. It enabled them to delude themselves that they could carry on living in their unsuitable house in a very rural location instead of moving somewhere easier. We failed miserably too in trying to persuade them and sadly it didn't end well.

I think you could try for a disabled badge. My mother has one, and she can sometimes walk some distances. But sometimes she can’t, and if there is any sort of slope she’s shafted. It was her doctor who pointed out that she might qualify.

If she’s that overweight she may need bariatric items- extra strong chair/mobility scooter/stairlift. These items are usually large and more expensive than standard items. Unless she has unusually wide doorways she would most likely not be able to use an electric wheelchair indoors.

Does she use any walking aids eg a walking frame/rollator? Does she have one of those wheeled trollies to use in the house?

She might benefit from seeing a physio about her mobility needs, and maybe an occupational therapist for items that might help around the house. Mobility scooters/electric wheelchairs are often very heavy- even folding ones, and can be difficult to get in a car unless it is adapted.

thanks v much- this is all very helpful. Ithink she can manage without a wheelchair/ scooter for a while, but looking at the future, I don't see how much longer it can go on. I wish she would lose the weight, but I don't think that will ever happen now. I like the idea of the wheeled trolley for the house even for now as it will help her carry stuff from room to room.

You can get social services or someone to assess her needs. They could get her wheeled tray, handles for the bath etc.

She might prefer a house lift to moving house. If she needs a wheelchair a two-person lift would most likely be needed. I've taken advice on this from lift suppliers and an occupational therapist. This would give her more flexibility than a stair lift in that it would let her move stuff upstairs when needed, as well as herself in a wheelchair. As a ballpark figure, think around £15-17,000 installed.

She really should have a full medical checkup to help identify any as-yet unknown medical problems that could affect her future decision making. There are still benefits available for people over pension age who have disabilities; even if you think she's not going to be eligible for any benefits, it's worthwhile checking. This government page is a good place to start.

Oh bless her, it must be tough. She’ll be in a vicious cycle with the pain limiting her activity and the weight exacerbating her pain. Some strong painkillers can cause weight gain too.

I second contacting her local social services for an assessment - she could have an OT assessment to see what equipment would help with activties of daily living. Stuff like a perching stool for cooking, frame for over the toilet can be sorted by an OT. They could also look at what support she’d be entitled to for personal care.

Would she need a mobility scooter? As it stands she is managing if she gets dropped off at the door. If she’s within walking distance of shops, a scooter might help. She may well be entitled to a disabled badge which could help. Has she been assessed for any kind of disability benefits yet?

Can she cook? It might be worth looking at a food delivery service. My Grandma had Wiltshire farm foods which she said were pretty nice meals - my uncle ordered a few and tried them himself (he’s that kind of chap!) before he got them for her and he said most of them were nice.

for you, it’s hard to see a loved one in such a difficult position. I hope you’re able to get the help she needs.

YY to phoning social services. Also, some disabled living/independent living centres have occupational therapists/equipment and advice and could bypass having to wait months for an occupational therapy appt through social services if your mum can wash herself just now. If you phone social services helpdesk the staff there should be able to advise if there is something like that in your area.

this is all really helpful. thanks so much for taking teh time to answer