Convincing a parent to use a walker when you can't reason with them

Mike in NC · June 12

How can I convince my 89-year-old mother to use a walker in the house if I can't be expected to reason with a dementia patient? She has repeatedly rejected the idea over the phone and says she doesn't need one but my daughter who lives with her is insisting she use one after a fall at home that was scary for both of them. Mom insists she's fine and rejects any help that suggests otherwise, viewing walkers as the ultimate sign of age and frailty.

I have been a remote carer but am planning a trip to see her next week so that I can see for myself where she is now mentally and physically. I'm also planning to attend her next physical while I'm there so I'll let the doctor know and enlist her help and opinion. Sometimes "The doctor said…" helps. Any other suggestions?

H1235 · June 13

I’ll be watching for suggestions myself. Mom shoots daggers at me when I remind her she needs her cane. The other day she was half way into the dentist office when I realized she left her cane in the car. She lost her balance and almost fell. A doctor suggestion helps, but is quickly forgotten. My mom won’t refuse to use it, but will get mad at the suggestion.

ARIL · June 13

If “the doctor said…” helps, lean into that in a big way! Of course, you know that.

I think this is a very common issue. In the MCF where my LO lives, I see staff dealing with this all the time with residents who need walkers or sometimes even wheelchairs. The staff will say, “Sue, let’s get your walker” and then set it in front of Sue, walking beside her so she can really only move forward if she pushes it. Or they say, “Ed, where’s your walker? In your room? Sit down right here and I’ll go get it for you.” That is, it takes a lot of direct, hands-on work. They tend to keep their voices very level and calm, and they don’t offer reasons or explanations. (Well, once I heard a caregiver say to a late-stage resident, “Jim, let’s use the wheelchair this time. Your wife wants you to.”)

I have seen walkers decorated with artificial flowers or feather boas or racing stripes or sports team stickers. Apparently families were trying to make the object itself more attractive/interesting.

When my LO was still living at home, I bought a cane to help on trips outside the house. I think it was used once. There was no active rejection; it was just forgotten.

My LO forgets to drink water but will drink if I hold a small, brightly colored cup in my hand, say, “Have a drink,” and hand it over. This works maybe 75% of the time, and much better if we are taking a walk in the hall: we get to the end of a hallway, and I say, “How about a drink after all that?” I hand it over. So, no discussion, no rationalizing, just prompting a physical response that feels natural. Something similar might help with the walker. Possibly?

It’s a tough nut to crack.

SDianeL · June 13

welcome. To answer your question. You can’t. Her reasoner is broken. Her memory is gone. She also has agonosia(sp?) (which means she is incapable of understanding she has an illness). If she’s living alone it may be time to move her to a safe place where she can get 24/7 assistance every time she gets up to walk. You can ask for an home evaluation to make the home safer for her but even with 24/7 care and assistance she will more than likely fall again. One thing you might try that I did for my step Dad that had a stroke is buy her a Hurrycane cane. You can buy them at Walmart or online. Get her a bright color one. He would use that but refused to use a walker. Someone will still have to remind her to use the cane though.

lisn2cats · June 13

When my mom needed a cane and refused to use one despite repeated falls, my dad found one that was both practical and stylish. She saw it more like an accessory that also kept her from falling. When she needed something sturdier, we found one that came in different colors so she can match her outfits. We aren't quite at the walker stage yet but at 90, it's inevitable). Since I don't think I'll find a Medicare (?) approved one, I'm working with my artist friend to come with ideas to visually enhance it when the time comes.

Mike in NC · June 16

Thanks for your replies. I purchased both a hybrid walker and quad cane (like a hurrycane), both in pink, so that I'll have options in case she'll adopt the cane if not the walker. We'll see how it goes.

harshedbuzz · June 17

@Mike in NC

One of the sad realities of this situation is that you are not going to "beat" dementia or gravity. That goes double for any attempt made over the phone.

There are three aspects of dementia that will thwart your efforts.

The first is anosognosia; she is unable to appreciate that she is impaired in any way and the need to use a mobility device for safety. In her mind she is just fine without it.

The second is the loss of executive function that prevent her from following a logical argument or problem solving around fall prevention on her own.

And the third is that even if an authority figure whom she would have believed in the past made a case for using a walker, her short-term memory is such that she would recall it.

We weren't able to get consistent compliance with a walker with dad who had dementia. At best, we or his aides would wordlessly place it in front of him to encourage use. Discussing or verbally coaching had the opposite effect. Mom (no dementia) wasn't great about walker compliance needed after sepsis and pneumonia. I found she accepted a rollator grudgingly and only to haul her POC.

HB

Convincing a parent to use a walker when you can't reason with them

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