Dr. Jacqueline Gerhart: What should I do to help my aging grandmother?
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
My grandmother is in good health, but she is getting weaker. She takes awhile to get out of her chair and makes me nervous when she walks, but she insists on staying at home without any "in-home" aid. I want to help but she says, "no". What should I do?
One way to assess your grandmother's ability to live without help, is to watch her do her activities of daily living. These activities (called ADLs for short) include ambulating (walking), bathing, cooking/eating, communicating, money management, toileting. Your grandmother who has difficulty walking, may also have difficulty standing to make food on the stove, maneuvering the pedals in her car, or getting onto and off of the toilet.
These changes can be safety hazards, leading to falls, burns, and accidents. Unfortunately, even when people have the insight to realize they are unsafe or need help, they often do not tell their family members. They may not want their family to see that their health is changing, or they may be reluctant to ask for help.
With each thing that is taken away — walking, driving, balancing the checkbook – an increasing amount of independence is lost. Loving children or grandchildren who point out these changes, or who offer solutions, may be met with a stern or resistant response from their elder. Keeping the peace while keeping her safe can be tough. You have the right idea in mind: making her environment as safe as possible, and helping her sustain her independence as long as she can.
To prevent falls, remove any slippery rugs, and minimize the number of stairs or precarious surfaces that she uses. You may want your grandmother to have a "mobility examination" done at her primary care office or in her home.
Part of this visit may include a "get up and go" test, which measures the time it takes for a person to get out of a chair, walk across the room, turn around, and sit back in the chair. Additionally, your provider may recommend physical therapy or occupational therapy to work on stability and strengthening, and to assist with modifications to help with activities of daily living.
Her medications should also be reviewed by her physician to make sure none of them interact in unhealthy ways, and that they do not cause confusion, sedation, or movement side effects.
Wisconsin has many great resources for assisting families with aging. The Wisconsin Institute for Healthy Aging, the Coalition of Wisconsin Aging Groups, and your community's senior center are all great resources.
We also have many local experts in elderly care. To name a few: Dr. Melissa Stiles, one of my former teachers, is a local expert on geriatrics and practices in Belleville. Dr. Irene Hamrick, is a new geriatrician in the greater-Madison area, and Dr. Bill Rock is a long-time local expert in medical ethics and hospice.
Thanks for the question, and for being so proactive in the care of your grandmother!
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 11/01/2011