Transportation and resisting help

Kaustin1741

I already limit how much I take MIL out of the house. She uses a walker to get around and is incontinent so she is already stressed she is going to have an accident in public. But, sometimes there are doctors appointments. So getting her from the house to the car is a struggle of her telling me she can’t do it because her legs hurt or she’s tired and why am I doing this to her and treating her so badly. Most recently once we get to the car she resists my instructions on how to get into the car and physically pushes against help I am trying to provide. The last appointment we made it to the doctor but getting into the car after the appointment was a nightmare. She doesn’t have the strength to lift her legs into the car but pushes against me lifting her leg into the car. I try to guide her hand above her head to grab the handle but she’s crying “I can’t, I can’t “ and using all her strength not to reach above her head. She’s crying “help me, please help me “ but then doesn’t let me help. After 45 minutes of trying to get her in the car and almost dropping her because of all the resistance, I had to call my husband to come and get her. Luckily his workday was over and wasn’t that far away. He had to physically lift and force her into the car while she resisted him the whole time and holding onto the frame of the door for dear life like she was being harmed. I never want to take her out of the house again! Then the next day she finds out I’m going to the grocery store and says she will go with me. Completely forgetting what happened and the fact that she can’t walk very far and once we get to  the grocery store she won’t even want to go in or will ask to be taken home. I end up being the bad guy telling her what she can and can’t do. 

I don’t know how to handle this......

star26

My Dad also used a walker and had A LOT of difficulty getting into vehicles, including some drama and yelling as I tried to help. His body was very stiff and he could feel pain easily so I think that was part of his resistance, along with the anxiety of being stuck in a bad position. We had a physical therapist teach us how to get in and out. If you're not already doing this, here is the system that worked really well for us: 

We had 2 cars, regular & SUV, and we tried it with both to find out which was better for him (regular car) and then we never used any other car. 

Move the passenger seat as far back as possible. You can move it forward later if you see she doesn't need all that room to get her legs in and out.  

1. Have her stand with her back facing the open door and her front facing you. She should back up to get as close to the car as possible and be lined up with rear part of the seat. She should feel the car on the back of her legs. She may start to sit too soon. She's got to stay standing and move back up against the car first. She can keep the walker with her as she does this. 

2. Tell her to stick her butt way back and sit down. She should sit as far back as possible (towards the center console). That might be the most important step. If she doesn't sit back far enough it is worth it to tell her to stand up and do it again. After sitting, she is still facing you with her feet on the ground outside. The actual seatback should be up against her right side. Now, you can move away the walker. 

3. Next she'll start to turn towards the front of the car. She will lift one leg in at a time. She may need to life them with her hands. As she is doing this you'll also watch her head as it comes into the car. Getting his legs in the car was the hardest for my Dad. Sometimes I would try to help lift them but I learned it was much better for him to work on it because when I did it I risked hurting him.  

4. Gently guiding her hand to the ceiling grab bar as soon as she starts turning can help her with the turning process and help her scoot back in the seat if needed once facing forward. 

Don't park at a curb because this won't work. 

Take your time. We needed to be methodical and slow with this process. Don't rush her. If you don't start it with the correct alignment, it won't work. Sometimes I would need to demonstrate the first steps. Getting out is the reversal, with her sitting in the seat facing out to the side and both feet on the ground outside the car. Then she can lean forward and use her hands to push on the seat on either side of her body to stand up and her walker should be right there. I had to tell my Dad to wait for me to come to his side of the car otherwise he'd start getting out in a way that wouldn't work. Expect to guide her through the process each time and be standing right there with her when she's getting both in and out.   

I hope the situation improves for you. 

M1

Two thoughts: would purchasing an inexpensive wheelchair help? And check around for a palliative care medical practice that makes home visits. Lots of places do that now.

harshedbuzz

You've already gotten some great advice.

I would look at whether all of the appointments make sense at this point in time. Perhaps you could move to a gerontologist who could oversee all her care with a mix of office and telemed visits. You could also hire medical transport for her appointments; we did this with dad as he was unsteady on his feet and sometimes struggled with coordinating purposeful body movement even with prompts. 

As for her desire to tag along at the grocery store? That's easy. Don't tell her. Either slip out while she's engaged in something else or tell her you are headed to an appointment of your own. If she gets in a snit when you return with groceries, just explain that you picked up a few things on the way home.

Marta

Telehealth.

Telehealth.

Telehealth.

Ask her providers if they would do Telehealth.

dayn2nite2

Your LO isn't "resisting help."  They don't understand.  Big difference.  Do telehealth or tell these doctors all that goes with getting her to their office and tell them to give you an alternative.

Rhonda59

First off, I would like to say thank you to Star 26 for the step by step tutorial.  My mom has not left her house in almost 2 years.  She very much needs to see a doctor as she suffers from hypertension, kidney disease, and dementia.  She now has a tumor on her arm and I got a nurse from hospice to come do an evaluation and she believes it's cancer as do I.  Hospice cannot admit her because she needs to see a doctor to get a more current definitive diagnosis.  We have a telehealth appointment tomorrow but I don't have much hope that anything will come of it.  My point here is, telehealth is only helpful to a point.  I think that with my, large, brother's help and the instructions from Star 26, we could get her into his car and to an appointment.  We have a wheelchair and I am well versed in dealing with people with dementia as I just lost my husband to Alz last Dec.  Kaustin 1741,  I agree that taking your MIL to the grocery store is above and beyond the call of duty.  Good luck to you.

Marta

I do telehealth visits with my dementia patients on a regular basis.  At a certain point in the disease, there is no value in seeing the patient in person - we are relying on input from the family, and the visit is more to support the family in taking care of the patient.  During a telehealth visit we can observe the patient's behavior, and family can show us video of any meltdowns or other problematic behaviors.  They can show us skin issues remarkably well.  Many skin tumors can be identified by sight only - and specifically evaluated as to  whether a biopsy is indicated.  Family can check home vital signs and blood sugars.  Even A1Cs can be checked at home, if needed.  Certainly during a pandemic and in a polar vortex as much of the country is experiencing;  and given the capabilities of telehealth, there is little justification for asking to see a patient in person.

ladyzetta

The next time you need to take her to the doctor just ask for help getting her in the car. When I took my DH to the doctor he was a big man and it was hard getting him in and out of the car I was so thankful all I had to do was ask for help. I was able to pull right up to the door.

I agree just don't tell her when you are going to the store, you don't need that added stress and you need get away time.