Occupational therapy for MIL?

[BogstandardBelle]

Hello

I've just spent a few days days with my PIL. My MIL has been diagnosed with osteoporosis, and it's pretty bad - she's doubled right over, unable to straighten, lost a lot of upper body strength and while staying with them I've noticed that there is a whole range of things she can no longer do, including...

Lift the kettle to the sink, fill it, carry it back to the stand
Make a cup of tea
Carry more than one thing at a time
Carry anything likely to spill - drinks etc
Carry anything remotely heavy - like a dinner plate of food
Lift milk out of the fridge door
Reach to any cupboards / surfaces above shoulder height
Get dressed / put her coat on
Get in and out of a car unaided
Push a hoover around
I've not seen how she's coping with bathing or toileting, but I have noticed that she doesn't smell as fresh as she could, and she's told me that she doesn't bathe any more (has never showered), just washes as best she can with a jug and a sponge.

She's relying on FIL to do all these things / help her with them, except the bathing and toileting. My SIL lives nearby and sees them often, but because she either sees them at her house or just drops in, I don't think she's aware of how restricted her mum is or how much her dad is taking on a carer role (and he has said that he's finding it very hard doing all these things).

I'm not sure what we should be aiming for here... obviously we all want her to be as independent as possible, but no one seems to be talking about how to make this happen. Is her GP likely to refer her to an OT (I think that's who she should see?) or would she have to request this? We're in Scotland BTW. She will be attending physio soon, and they've all pinned their hopes on her making big improvements and 'getting back to normal' - but I just can't see that happening, and I really think they need to start looking at how they can adapt their house / furnishings / lifestyle to accommodate her changed needs.

Thanks for any advice, it's new territory for us all!

I live in England and I think things are a bit different in Scotland, especially the financial side. I found a website for you Care Information Scotland which may help.

Is she on any treatment yet?

In England this would warrant an assessment by social care and gp could refer to community services, so you’ll need to check what happens in Scotland.

Until mum gets assessed at home it might be worth buying a walker trolley with a shelf on it so she can put her food, drinks and personal items on. It would be better to have a ot or physiotherapist assess her walking and balance first though to see if it's right for her. You can buy non spill plates, cutlery and mugs from any disability shop or online. With clothing it might be easier for her to have blouses and cardigans rather than jumpers, elasticated waist skirts and trousers, Velcro slippers. The ot can do a home assessment to get equipment in but there is a lot you can buy anyway. Does she really need to Hoover, that must be very difficult for her and if she isn't able to straighten up then everything she needs should be moved to waist levels, would he be able to fill the kettle for her and put,it on the stand. Would they be happy to have carers coming in each day to help. You could also ask for a bathing service if there is one.

She is on medication for the osteo, but it can only halt the decline not repair crumbled bones.Maybe we have to go through the motions of going to physio etc though, and after that doesn't put things back to 'normal' they'll accept that things need to change.

They are seriously in denial at the moment: even my suggestion of a swivel seat for the car was dismissed as being 'for disabled people'. I don't know how to get them to make the mental shift to accepting that these aids are exactly for people in MILs situation. There is no way she'd accept that she needs a walking trolley / frame - but she'll expect my FIL to keep doing everything for her instead.

Thanks for the links, and the support, I'll follow them up.

I had PT for Oestoarthritis and it really has helped enormously. I was nowhere near as bad as your MiL sounds though.

The problem I see is, because your MiL is denial, she is unlikely to do the excersises, from the Physical Therapist or the Occupational Therapist. I have found that to make any improvement you have to rigoursly follow the exercises. They do hurt at first and take a little while to improve things.

There is a lot of obstinacy when people say, they want onto be independent. They don’t want to be dependent on outside Agencies, but don’t seem to mind how much family members suffer trying to help them. I think convincing her to get help is a huge obstacle.

This is meat and drink to an Occupational Therapist. Ask the gp for a referral to community therapy. An assessment, appropriate aids and simple adjustments and adaptations could make life a whole lot safer and easier. ( OT here).

In that case I'd request a referral to older adult psychology if you have a service. Or the community teams will likely be used to this kind of presentation. Are arthritis UK any use?

Most therapists are well used to fiercely independent elderly people who are just beginning to struggle a bit. A sensitive therapist should take the time and trouble to get to know your PIL and plan intervention accordingly. Many are frightened that they will have to pay for items supplied, which is not the case in most instances.

Re the car, a simple device like the Car Handle fits easily on to the door to help someone to get in and out. A plastic bag on the seat can help with the swivel, but don’t leave it under anyone when moving. Raise the seat as high as it will go.
As pps have said, a trolley for transporting items, some reorganisation in the kitchen, a kettle tipper or a kettle which dispenses a cup of boiling water e.g Breville One Cup, filled from a jug, new techniques for dressing. There are a lot of options. Most of these do not really count as disability equipment.

Doctordonowt you are spot on: she's already been to a physio, was given exercises to do - and didn't. She seemed to feel she'd been palmed off and sent home. The exercises were very simple, but would probably have been effective - if she had done them. Both she and PIL seem to think that physio should just 'fix' her.

Another problem is that DH and I live overseas and his DSis, who is a lovely kind person is also very un-assertive. MIL won't let her come to any medical appointments, and SIL finds it very hard to persuade / nag / tell her mum what to do. That's why I wondered if the GP or the Physio would be likely to refer her to an OT without either her or DSis pushing for it?