Honoring a parent’s wishes to live independently.

My mom lives independently and she is adamant that she intends to continue to do so until her dying day. I was recently visiting her and thought it would be a nice treat to take her out for lunch. On the way back, we decided to stop by the market to get her groceries. Normally, she prefers to do her grocery shopping on her own. 
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As she got her shopping cart, I noticed she automatically crossed her arms and leaned on the cart as she started into the store. I had noticed other elderly shoppers doing that in the past and hadn’t thought much about it. Now I saw it as a red flag.  

When I asked her why she was leaning on the cart vs. just pushing it along she responded: “Lot’s of people do it this way. I’m short so it’s easier.” With a little encouragement to push it so she could keep her muscles strong, I noticed her paced slowed considerably and she appeared less stable on the linoleum flooring. By the time we got to the end of the first aisle, she was back to leaning on it.  I was stunned to realize the cart was actually serving as a crutch to stabilize her.  

I started to wonder: Is she capable of continuing to live alone? What would happen if she fell, could she get up on her own? What was her core body strength and balance like if she was leaning on a cart? Is this something to worry about? Who could help me assess the situation? What could be done if we discover she’s on the slippery slope of decline? 

The Assessment--What can be done to regain strength and balance 

Thankfully, I was aware of a company that specialized in helping family members like me, and my mom, navigate the aging process while maintaining the elders’ quality of life: Eldercare Specialists. I knew they had a stellar reputation and a wide range of specialists from nurses and gerontologists to a physical therapist and life care specialist.
  
So I reached out. They were really responsive. Their physical therapist came to meet with mom and me and helped do an assessment, which included observing my mom getting in and out of a chair, moving across uneven surfaces, trying to get on her stationary bike and more. Her balance was less than ideal for someone living independently with no real plan to stay strong, which confirmed my initial fear. 

Mom was relying on using her arms not her glutes or legs to get up out of a chair.  She actually wasn’t riding her stationary bike anymore because she couldn’t swing her leg over the bar. We also discovered that when we had her sit on the floor she couldn’t get back up on her own. The physical therapist assured me that we could develop a plan to help her strengthen her core muscles, improve her balance and keep her independence in tact with some concerted effort. She also had some other recommendations to safe-guard my mom including two-sided tape for her large area carpets (she has stone paver flooring) and a fall alert.
 
The Plan—Make it enjoyable and attainable 

I have to say, the physical therapist was awesome. She came up with a strengthening program customized to my mom’s needs and capability. It started out really simple and could be added to over time as she built up her confidence and some tone and endurance.  The goal was to help mom strengthen her muscles, improve her balance, learn how to safely get up off the ground if she found herself there, and ultimately be able to ride her stationary bike again before winter came around.  

As you may know, having a plan is one thing. Implementing it is something else altogether. It’s a bit like starting a diet. It’s ok for the first week or two and slowly we don’t see it as a necessity to continue without some encouragement or oversight. 

My mom was no different. She’d rather sit in front of the TV, talk on the phone or read her email than exercise. I get it. If no one is holding me accountable or I don’t perceive it to be fun, I’m not likely to do something that requires extra energy. She needed a “buddy.” Someone to do her exercises with who would make sure she was doing them properly and cheer her on. Having a buddy (aka care manager), had the added benefit of someone having eyes on her and providing some socialization, which was equally important.  

Executing the Plan--A partner makes it so much easier to stay on track 

I set up with the physical therapist to come in a couple times a week to encourage and help her be accountable.

Initially, she started exercises in the kitchen with the support of the kitchen counter. Over time she was able to progress to doing most of them without relying on having the support, and the progress continued. We even added 1.5-pound ankle weights as her legs got stronger. To help with balance, we added in some supervised waltz moves for variety and to build up her confidence that she could safely step backwards too. It took about six weeks for her to be able to lift her leg over the bicycle bar and 12 weeks to do it without needing to be supervised.  She is continuing to progress and is thrilled to show me her new “moves” and how she’s doing on the bike. I couldn’t be happier. 
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Quality of Life--Honoring mom’s wishes while still living my own life 

Mom’s goal has always been to stay living independently. I had assumed that wouldn’t necessarily be a viable option and we’d need to look at assisted living. What I discovered is that there are wonderful options available to enable her wishes while also ensuring her health and safety much longer than I had envisioned.  

The best investment for us has been to engage a professional care manager to help her stay physically and mentally strong so she can live out her life the way she wishes too.  ​