Relative refusing to get out of bed

[BB49]

Just wondering how to encourage father in law, who is 88, has a managed heart condition and slight breathlessness with arthritis, to move around a little more? He’s had no recent major medical events, but 6 months ago was walking to the shops to do his shopping and now can barely walk around his house. Nothing major has happened to cause that change that we know of.

He has recently been given a walker to use in the house and has carers coming in daily to help him wash and dress but often refuses to get out of bed otherwise.

I have tried to tell him that he is going to lose all his mobility if he doesn’t walk around. He tells me I am bullying him saying this and he just doesn’t want to move and he’s most comfortable in bed. He’s not in any severe pain, but just recently seems to have lost all his core strength which makes standing unpleasant for him I suppose.

As he is refusing to generally walk around the house he isn’t doing any of his meals and making himself tea. Which is a problem as he’s calling us to come and make him a cup of tea in the morning - which is impossible!

It may be that the problem is mental rather than physical but we’re not sure where to go next, given all his conditions are managed and no serious problems. Any advice very welcome. He more or less has capacity mentally but short term memory seems to be going and he is stubborn as a mule.

Time to consider a care home, if he can afford it?

@Ellmau is a care home really the next step? I would have thought it would be a bit premature at this stage, as it seems that he is not ready for it yet?

I think that's a good call. He's not looking after himself and would probably benefit from increased levels of care, not just daily visits.

Have you asked the GP to call?
He may have mild dementia.

Kindly, if he is 88 and declining rapidly, and needs wants/more care then his current set up provides, and his mobility is reducing, then a residential home is a very logical step.

Also, moving earlier may mean he adapts better, will be in a better shape to take advantage of the facilities, trips etc.

He might be able to get carers in more often to assist with meals though. Contacting the GP would be a good first step.

Yes my Aunt refused to get out of bed when she was in hospital after a fall. Physios came. She would still not get up. The hospital would only discharge her to a care home and she spent the next 3 years in bed in the care home before she died. Luckily she was self funding so she could go to a decent home.

If he can be managed at home then he can stay at home. Is he wearing pads? I'm assuming that relatively soon he'll be bed bound and will have to wear pads. But still, if he can be managed at home, that's nicer for him

He's 88 and he can't manage at home, he won't even make himself a cup of tea.

You mention cognitive issues and I suspect that he can't make himself a cup of tea or a prepare a meal. People with dementia develop sequencing problems, where they cannot remember how to do simple every day tasks (like make a cup of tea). My mother lost the ability to even deal with ready meals. She also lost her mobility.

Carers popping in can do the basics like dressing and washing, but if he has dementia he may be reaching the stage where he should not be left on his own for a large portion of the day. If the person lives alone it means a move to residential care.

Is it that he physically can’t move around or mentally has lost the motivation to?
Either way, a GP appointment would be a good idea.
He may be depressed and just not want to move. Or he may have an infection or new pain and that’s causing problems.
Moving to a care home isn’t necessarily the answer. He could have carers come in the morning to get him up and/or people pop in through the day to check on him, keep him company.
I have an elderly relative who goes to a care home but only during the day. She gets dropped off in the morning, joins in the activities (they do bingo etc), has lunch there, and gets taken home late afternoon. Eventually she will move in there but for now this gives her the company she’s craving but still the security of being in her own home.

Hi OP, I’m a social worker for adults. Does your FIW self fund his present support, or is it provided through the local authority?

If he hasn’t had a social care assessment then I’d suggest that’s the first port of call.

The worker will assess his current level of need and his capacity regarding care and support.

If he has capacity and his wish is to stay at home, additional support can be considered as well as practical input such as some rehab workers visiting to assess his abilities and build his confidence. Rehab workers work to a different plan than home care workers, as the focus is on achieving whatever level of independence is possible.

Given his age his presentation may be due to age related deterioration.

How is his mood? Do you think there may be an element of depression? To go from being fairly active to staying in bed could indicate this but obviously I don’t know him to know how accurate this is.

And yes, gain his consent to speak to his GP regarding his short term memory, he may need a referral to the memory clinic service.

lying in bed he may get bed sores and not being mobile wont do any good. he may be depressed? i assume that he has been checked out by his GP or Specialist? Definitely you may have to be tough and consider a nursing home

If he is becoming more frail then the GP can do a holistic review of your dad including reviewing his medications, any new weight loss, mood etc to look for any reasons for his recent decline

My mother took to her bed because she couldn’t be bothered being downstairs any more and she was more comfortable watching telly in bed. In hindsight it coincided with the decline in cognitive powers. She was getting carer visits four times a day for medication, food and drink and assistance with personal hygiene.

Mum lasted about 2 years at home in bed being waited on hand and foot by the carers and me Predictably, she lost her strength due to lying in bed 23.5 hours a day and is now in a (very good) care home being wheeled about in a chair because she wasn’t able to get from her bed to the loo without falling over.

She was similarly very resistant to any suggestions “for her own good” and until her last fall was deemed competent to be able to make her own decision on where to live.

i used to say she was like the bed bound elderly mother in ‘Allo ‘Allo, bashing the floor with her walking stick. Only semi-joking, as I think mums generation remembers their very elderly relatives being in bed while family looked after them, so now it’s their turn.

Sorry that’s probably not much help @BB49 . I wish I’d persuaded mum into her care home a year before she went as she’d have really enjoyed the activities and days out, rather than mouldering away in her bed. But it was her decision in the end.