Why is MIL bending double?

[StrawberryPot]

90 year old MIL lives with us. She has mobility issues and clear cognitive impairment- both understandable at her age.

She was in hospital for a week recently following a fall. She needs a walker but was happy to demonstrate to the nurses that she could get to the bathroom under her own steam. She actually seemed to really enjoy being in hospital and made friends with the 94 year old in the next bed. When I visited she was always sitting upright in her chair by the bed.

However she was very keen to get home and relished being back - sitting in the sun, enjoying nice food and seeing our old dog. That lasted about a week.

A couple of weeks ago she suddenly started bending forward in her chair - pretty much all the time. Not just leaning forward - she practically bends herself double. This is not something she's done before and is gradually doing more often. She suddenly started doing it all the time a couple of weeks ago. If we ask her why - she'll make some nonsensical excuse like she's looking at the tv (she's not - she's so bent forward she's looking at the floor) or she's exercising (when I haven't seen her move for an hour). I ask if she's in pain - she says not. I ask if we could get her a more comfortable seat. She says no. Dr has been out to check on her and of course she sits up fine then. She also sits up fine to eat.

It's so sad to see her bent double like this. My mum had dementia and after a while seemed oblivious to the arthritic aches and pains she was previously plagued by. I always worried that she was still aware of them but couldn't articulate. I worry that MIL is now in pain/discomfort but is no longer able to articulate this to us.

Does anyone have experience of this?

I assumed you meant she was bent over when walking. That sounds very unusual. Have you tried sitting in her chair yourself to make sure there is nothing structural/sharp that she can’t vocalise that is causing her to sit like that?

other than that I can’t think but just wanted to bump in case anyone else had any idea.

Maybe try some painkillers and see if that helps or at least rules out pain.

I'm wondering about putting a mirror in the vicinity and see if she responds to that, sounds cruel but I'd worry about her digestion if this becomes a habit among other things.

Maybe try some basic neurological tests on reflexes etc.

I think stooped posture and mobility issues affect quite a lot of people OP. There are so many different dementias out there. Mil at 89 is very stooped all of a sudden but she has been very immobile this past year.

Have you tried sitting in her chair yourself to make sure there is nothing structural/sharp that she can’t vocalise that is causing her to sit like that?

It's not the most comfortable seat (end of a sofa) imo but she chose it and it would kill her to admit there's anything wrong with it! She's been sitting on it for 3 years and it doesn't seem to have changed. I have floated the idea of getting a reclining armchair and have left that to percolate for a bit! She does the same when she's sitting on the garden bench.

Maybe try some basic neurological tests on reflexes etc

What sort of thing do you mean? She's not terribly cooperative and if she thought I was suggesting any sort of failing she would be cross with me!

Mil at 89 is very stooped all of a sudden but she has been very immobile this past year.

MIL also has limited mobility. She broke her hip 2.5 years ago and refused to do any physio afterwards. 🤷‍♀️

My dad did this for a while because his ears felt blocked, he would bend forward and keep swallowing hard until they cleared. He went and had it checked out and they put it down to anxiety. Once he knew there was nothing wrong he stopped doing it.

Don't get a reclining chair if she has cognitive impairment as she may tip herself out or end up climbing out of the recline position instead of using the controls.

On the bending forward is it a gradual process?

Like imagine two triangles and a cylinder. First triangle her hips on the seat with her spine going up to her rib cage which is the cylinder.
On top of that is a triangular shape formed by her sholder blades with her head on top sitting of her neck as the point.
First she is sitting with her arms propped on each thigh or a cushion.
These act as independant pillars.
Her shoulder blades make a nice long base sitting at the back of the ribcage.
Her spine/neck supports the middle of the base

Then her neck muscles stops fully supporting the weight of her head.
If you can imagine the weight slumps her neck to form a C shape and the C continues the down her spine.
Her arms keep her shoulder blades level but the middle support has sagged down into her ribcage.
At that stage the point of the triangle is falling over
She is a little like a baby learning sit up who can't control its neck and ends up faceplanting but in slow motion.
(Hope that makes sense)

If she can self correct immediately, it's possible that it is like her brain just decided that if she is not "actively" engaged in sitting up that her muscles can stop working so hard.
But run through the stroke FACE test if you can get her to participate.

If you can get a OT in they may be able to recomend a good chair to help support her.
A chair with arms is probably safer than the sofa as it allows her to use both arms to support her position when seated.

A lot of elderly people do this. There isn't a reason for it, it's just a bad habit they get into.

Test it - next time she does it ask her to straighten her back.

I was thinking a recliner because she has poor circulation, a tendency towards swollen ankles and knees so is meant to elevate her legs.

Good point about her getting stuck or tipping herself out though. We actually have a fairly upright but comfortable chair with firm arms which I think would work well for her. I'd just need to persuade her to use it ....

She isn't hunched at other times? MIL developed quite bad osteoporosis which lead to her doubling over whenever seated. She could straighten up on demand but soon bent over again. X-rays showed she had cracked a couple of vertebrae in her upper back and could no longer support the weight of her head.