How do I get my mum moving?

I finally figured out with my mom (she has moderate to advanced dementia) that "ow!" didn't mean she was in pain, but feared falling. I would get her to participate in getting up and changing her by telling her we were going out for ice cream, or getting ready to fly to Florida to see her parents. Anything to motivate her to allow us to clean her, bathe her, change her clothes. Also we now have a Barton Chair, which makes a transfer from her hospital bed to a "chair" much easier. It is like a folding wheelchair, and lays flat and can be raised and lowered easily. Medicare pays for the monthly rental, which is about $400-600 per month. If she sits in a wet or poopy diaper for more than a little while, it can cause break down of the skin, leading to bedsores, and a systemic infection which could kill her. Her diaper should be checked every hour, or every 2 hours at the most. After you take off the dirty diaper, clean her thoroughly, and dry her thoroughly. Then apply a barrier cream all over her butt and lower back and upper inside thighs. This protects the skin better if she does have a dirty diaper on for a while. If she is immobile, you may qualify for home visits by a doctor, like my mom gets. Also, your mom may need a mood enhancer to take the edge off of her stress or fears or anxiety, and that might make her more agreeable to be taken care of, and to getting up and walking a bit. I bought a great rolling walker with a seat off of amazon about a year ago, and it was less than $60. The bottom line is this: You must keep her clean and healthy, and thus happy, to avoid having to place her in a nursing home. Let her live out her last years in the comfort of home. Nursing homes can't provide as constant attention to each resident as you would expect.

I finally figured out with my mom (she has moderate to advanced dementia) that "ow!" didn't mean she was in pain, but feared falling. I would get her to participate in getting up and changing her by telling her we were going out for ice cream, or getting ready to fly to Florida to see her parents. Anything to motivate her to allow us to clean her, bathe her, change her clothes. Also we now have a Barton Chair, which makes a transfer from her hospital bed to a "chair" much easier. It is like a folding wheelchair, and lays flat and can be raised and lowered easily. Medicare pays for the monthly rental, which is about $400-600 per month. If she sits in a wet or poopy diaper for more than a little while, it can cause break down of the skin, leading to bedsores, and a systemic infection which could kill her. Her diaper should be checked every hour, or every 2 hours at the most. After you take off the dirty diaper, clean her thoroughly, and dry her thoroughly. Then apply a barrier cream all over her butt and lower back and upper inside thighs. This protects the skin better if she does have a dirty diaper on for a while. If she is immobile, you may qualify for home visits by a doctor, like my mom gets. Also, your mom may need a mood enhancer to take the edge off of her stress or fears or anxiety, and that might make her more agreeable to be taken care of, and to getting up and walking a bit. I bought a great rolling walker with a seat off of amazon about a year ago, and it was less than $60. The bottom line is this: You must keep her clean and healthy, and thus happy, to avoid having to place her in a nursing home. Let her live out her last years in the comfort of home. Nursing homes can't provide as constant attention to each resident as you would expect.

I do not suggest pulling her up by yourself. Elderly skin and bones are fragile and you risk harming her even with your best intentions.
A recliner that helps someone stand from a sitting position is great, then you can pivot her to a wheelchair and clean her up while she is standing, if she can indeed stand up. Those recliners, I believe, are self pay. A hoyer lift is another great suggestion.

I am wondering where the people live that suggest you need to put your loved one in a facility. We had put our mom in a nursing home for $7200 and then got a bill for $265 for a case of latex gloves. You would think for $7200 they could provide gloves. We have now changed her to another home where she seems a little more content (also $7200) and are praying we don't run out of money. So unless you have an abundance of cash, a facility is not always an option.

Leaving someone sitting in it when they won't cooperate requires physical efforts to get them out of wherever they are sitting. If the caregiver doesn't do it, someone else will, trust me on this one! 

* I'm serious, if you don't take whatever measures are absolutely necessary to get her out of that chair and she ends up with more serious problems, you'll be the one who gets in trouble since you assumed full responsibility for her care. 

If verbal prompts don't work then the next thing left would be physical removal from the chair. The patient sounds like she's going to have to be physically removed from the chair because you can't just leave her sitting in it if she's soiled. If you must call medical professionals in such as EMTs, they themselves may very well be faced with the same dilemma of physically removing her from the chair, loading her onto a stretcher and taking her to the hospital. At some point even the hospital staff will discover the patient as being noncompliant and they will be able to hook her up with proper resources. If she needs placed in a proper facility that specializes in these types of issues, they will get a hold of an appropriate home to admit her. If she won't cooperate at the nursing home, same thing, the workers will physically move her to where she must go. In fact, I saw this happen with my foster dad when he was noncompliant, there were two workers physically handling him and he was fighting but the workers one this one actually won physically handling him and he was fighting but the workers won this one. I have no reason to lie, I saw it myself with my own two eyes. Workers will use the physical route if verbal prompting doesn't work, it's no different than being cared for at home. If the patient won't move when necessary, then physical measures are absolutely necessary, like it or not, plain and simple, hook line and sinker, it's reality.
What you can try doing is warning her that this is so important and such a dire need that if she doesn't comply then she'll absolutely need to be physically removed from the chair. If she still doesn't comply, that's when physical action will be needed. Others hair may not see this as a necessity, but they don't see  it like I do. I see the real issue here, I really do and I know where this is going if she's not removed from that chair one way or another, and I really don't want to see you get in trouble for elder neglect when really this may not be the case. Don't let this happen to you, do whatever it is absolutely necessary to get her out of that chair so that you can clean her up even if it means calling in the EMTs who can get her to a hospital and get her the help she needs. Don't let yourself get in trouble over this it's because you can't get her out of that chair. Don't let this be a mistake in case of elder neglect that's really not. You can't really hurt her if you must drag her out of her chair if you do it right. Even if you can't do it on your own, help is available but it must be done one way or another whether she complies or people who are trained in this must remove her from the chair themselves

A couple of people have suggested dragging your mother out of her chair. I think that would be a mistake. You'll end up hurting her or yourself.

I think you have to make the hard decision on whether you intend on this being your way of life from now till your Mother dies or look into Home health care or transitioning her into care outside of the home.

I might hurt your feelings, but you have a situation that requires your mother to be in long term care, period. No one wants to do this, but when someone cannot be tolited and or changed if they are incontinent, they are beyond a non professional situation. Human dignity comes first. Hard as the entire process is, Medicaid, spending down assets, putting yourself and whatever financial reason is holding you back, you need to do it. You are not qualified to take care of your mother in this setting. I knew what my limitations were and the process of putting my mother in long term care was and is still is a h*ll, but she is making it a heck of a lot better than if I was trying to pull it off. I physically could not do it by myself. Yes, I still bear a financial and emotional weight, but I will take that over what you describe. I visit her five times a week and bring her and provide the good stuff I know how to do.

Here in NY my mom was 'lent' a hoyer lift as well as a medical bed when she was in hospice care at home. It was a Godsend! She was way too hard to lift and move as she had no control of her body by then. The bed made it easier for us to change her diapers (with the tapes) and the lift allowed us to change her bed and her clothes as well as lifting her so we could bathe her in the bed. If your mom will not allow you to change her or move her it's time to get a hospital bed and to get rid of the chair. She needs to be kept as clean as possible and it appears she is not letting you. Dementia patients cannot think well enough to make these decisions and that leaves it up to you to do the right thing. Many people are not equipped to handle the end stages of dementia and a placement is the best for their loved ones. Please don't feel guilty about this. You would be doing the best thing for your loved one. Blessings, Lindaz.

I haven't read the other answers so someone may have already said the same thing. Yes, I would recommend a Hoyer lift if you can get one used off of craigslist. They are easy to use and she just has to turn to her side two times for you to slide the sling under her and then you can do the rest. I'd also suggest a hospital bed. I don't know if that's realistic but I've seen them on craigslist and they do help in terms of being able to change a person.   Are you using the kind of disposable underwear that have the tape on the sides? Much easier to deal with than the pull ups. Especially if she refuses to stand up. Again, you just need her to turn to her side twice. And have pillows on each side for her to turn to so she is comfortable with the idea of turning. I hope that helps. Good luck.

When they get to that point, they belong in a facility. I hope when *I* get to that point I am in a facility... I would DIE before I got to that stage, demented or not. I did not raise a child to have them change my stinking diaper. And when my mother got dementia and needed diapers, I filled out Medicaid papers and got her into a nursing home where they took care of diaper changes.

This is a big problem. Sitting "in it" all day can contribute to a UTI. They have this problem with Mom at the AL. They r not allowed to force her. I was there one day when they were trying. I spoke softly in her ear and told her she needed to go with the aide because she smelled. She went. I think the lift chair is a good idea if it hurts her to get up. Would it be possible to put a commode near her. Maybe get a screen for privacy.

Years go my grandmother did the same thing. Eventually my grandfather called in the social workers, and they said she need to go to a hospital. She also had very bad edema in her legs. She stayed there for 2 months and then had to go to a nursing home because they couldn't keep her there any longer. Unfortunately, she died within a month from heart failure. Well I've been going through old hospital papers of hers since my mother just moved out of her home, and as I was reading the notes that were written about her, they said she had a broken back. Now, I'm not sure if this happened when she was at home or not, but it could be that she already had some vertebral fracturing. So what I'm saying is that sometimes they don't want to move because there is some serious pain going on, and with dementia may not it even realize it ir be able to express it. Hope it's not the case with your mother, but it sure was an eye opener for me. Now after all these years, I realize why she didn't want to get out of her chair.

Getting that type of insurance to cover something may prove difficult if not impossible, especially when you're dealing with Medicaid or Medicare. When I needed a knee brace, getting that brace proved so difficult that I finally called them to find out why and I ask them if they even cover such braces and they said yes. I then told them everywhere I looked and could not get a brace so they gave me the names of companies they cover equipment through and I finally got the brace. Another thing I found even more difficult to get was a theraband and and no one in my town even had it except for the hospital physical therapy building and the nursing homes. It was impossible to get a theraband because the physical therapy building didn't give them out despite a prescription and definitely nursing homes who had them by the spool wouldn't even help despite the prescription. Finally, at some later point I ended up at the therapy building for some shoulder injury and I told my therapist how I was prescribed a band twice, and twice I couldn't get it and I told the only places I knew that had them and no pharmacy had them. I explained I went through this twice. I told him what color band was that I was prescribed and I ended up walking out with two of them that day for my therapy shoulder exercises. I don't know what kind of issue you'll have with a Hoyer lift, this may prove impossible from my opinion. If I had such a hard time getting small items, I pity the day I may need bigger items. Being on medicaid can prove very difficult or even impossible to get stuff prescribed for you, but I've heard downright nightmares about Medicare recipients not being able to get what they needed either. What you may want to do is see if someone has one of those lifts on eBay or best yet see if a local private person may have one they are getting rid of because it's no longer needed. Not all medical equipment is rented, some of it is owned out right and can be sold by the private person if it's no longer needed. This can happen if someone dies and the family is left with available medical equipment. Sometimes though, families may decide to keep the medical equipment for when they get older and need it. Sometimes having used second handed medical equipment comes in handy because you never know when you may need it. During summer, people actually have sales. I personally would check the flea markets, yard and garage sales. Sometimes around here though, people set stuff out for sale with a price on it, so keep your eyes open specifically during summer. You may also want to see if your area has a free cycle or you may also want to see if your church can help you find a Hoyer lift or something else you may need. You can also check your newspaper want ads. If you go to the laundromat, you can put up a notice on the noticeboard where people post flyers. These are just a few ideas to get you started in your search

Does anyone know if Medicare or supplemental insurance would cover the Hoyer lift? Amazon's price is over $450. I am having the same issues with my husband. He does not have dementia but is immobile.

It sounds to me like this is a regular chair and definitely not a lift chair. If the lady is not going to move for getting herself cleaned up then yes it's very obvious that the only alternative left if she just won't cooperate is going to require some muscle to get her out of that chair. This will definitely require getting in the home help to get this done. If she's not going to move on her own, then yes, it will require physically getting her out of that chair, plain and simple, hook line and sinker! It sounds to me like you've already tried every other resort with only physically removing her from that chair as being the last option, especially if this is not a lift chair. Removing someone from an armchair especially a deep one will be rather difficult, Especially if the chair happens to set a little low. I'm all for physically removing her from the chair as long as it's absolutely positively necessary with no other way around it, just get some good strong physical back up, you'll need it! I wouldn't call on the rest of the family unless some of them happen to be in the healthcare field. If not, call in-home healthcare right away and they will get her out of that chair even if it means dragging her out of it, trust me, they will get her out of it! If she has a medical emergency and she won't cooperate with even the EMTs, even they're trained to physically remove people from any location, even a chair. This would be most effective if you happen to have guardianship of the person because then you can make even medical decisions and force her out of that chair with the power of the help you're going to need to do it. I'm all for getting her up in any way absolutely necessary.
If she doesn't already have a guardian, why not? If this has been going on for quite a while and she happens to be demented, someone should've gained guardianship of her by now if she happens to be that bad. Not getting guardianship of her leaves her sitting duck for predators. Anytime someone has mental decline, guardianship is absolutely necessary. I actually didn't even know my bio dad was even still alive until I got a notice from a life insurance company stating his death. There's a strong possibility he may have been taken by a predator himself because the death certificate specifies something about Alzheimer's for a number of years but they didn't say how many. Oddly enough I found out through probate there was no listed guardian despite Alzheimer's. I'm currently in the process of finding out who dad's POA was because someone I found out got the house, and someone also got his life insurance policy money when he left behind a daughter he abused. Anytime someone mentally declines to the point of needing a guardian and no one takes that guardianship over them, they are sitting duck for predators who will steal from the elder, which in the end is actually stealing from rightful heirs.
Definitely get guardianship of the person you're caring for or have someone else do it because if not one day everything will be gone and it'll be too late. You actually may not know it until after the person dies and you must clean up everything and remove all their property. Please, someone needs to do the right thing and get guardianship of this person.

I am an occupational therapist and I work in a long term care setting, primarily with dementia patients. What you are experiencing is very common and difficult. I am assuming she has been diagnosed with dementia? You didn't say. Either way, you are a caregiver and often times the last thing you want to hear is that you should put your loved one in a facility. Please know there are options apart from this! Working with a geriatric care manager is one way of getting in touch with the right agencies to keep your loved one in her home as long as possible!

I agree that you do not want to hurt yourself in trying to get her up by yourself, but I don't agree that you need to drag her out of the chair or use verbal aggression. That will work against you. The recommendation of a hoyer/sit-to-stand is wonderful! Depending on insurance, with referral and medical necessity, insurance will participate in these fees. This could greatly reduce your physical stress! If your mother enjoys sitting in a recliner that allows her to be close to laying straight back or enjoys sitting in bed, there are ways to change her brief by merely rolling and manipulating. Learning this technique to ensure proper hygiene would be a great way to start. When this becomes routine, it is at that point you may consider trying various ways to implement alternative physical activity!

Please know you have options!! If you have any questions, feel free to reach out!

Could you tell us what has worked for you before? Does she sleep in her chair? It could be that the next time you get her up you could remove the chair and put her in a hospital bed where you could easier manage her care. You called your mother Mum so Im not sure what services are available to you. In the US Medicare will pay for a bed if you get her dr to order it. Are you using home health? Medicare will also pay for that in some states and if you have Traditional Medicare. I'm not familiar with other plans, they may work as well. You mentioned she won't get up for hours so that sounds like she does eventually get up. Is it meal time when she gets up? Does a favorite person come into the room? Do you stay away and she wants to be near you? Give us more information. It's been 11 days so I'm sure you've gotten her up by now. Let us know how you are managing.

I have said it before and will say it again and again......if someone simply will not do anything that they should be doing and you are doing everything humanly possible to help them and still get no cooperation - you will soon find it will destroy YOU. If YOU are willing to be destroyed, keep doing what you are doing. If NOT, then they have to be removed and put into a facility. Heartbreaking? Yes, but there is NO other alternative. And I don't care why they are doing this behavior. You must think of YOU first. Good luck.

All the answers above offer excellent advice. I waited too long to place my husband in a facility, damaging my own health. Take action now.

I wouldn't continue trying to get her up. It is too hard on both her and you. I would look for a place that she could receive the care she needed. As much as we may want to keep our parent at home, there can come a time that they need more help than we can give them.

It sounds to me like you're going to have to take it up a notch. If talking to her doesn't help then you may have to get physical and just drag her out of the chair. They do this at the nursing homes a lot, but it may take hiring some in-home healthcare workers to get this done. If she won't listen to reason then yes, it's going to need some physical effort behind it because she can't just sit there like that. I don't know how long this is been going on or how you eventually get her out of her chair, but this one sounds like it's going to need some muscle behind it.
If she's demented, then she's probably at a stage where she's probably going to have to be put into a proper facility. Not all cases require a facility, but some do. You just can't do this all by yourself (if this is what you're trying to do). Definitely get some good strong help and drag her out of that chair to get her cleaned up. If you ever wonder where a majority of infections to the area come from, this is only one good example of a cause of where so many infections come from, especially for women. Definitely get some help on this one

A few ideas--
#1 If you can afford it, buy a chair that is able to automatically put the elder in a standing position.
#2 Tell her that she is ruining you furniture.
#3 Get someone from the VNA (Visiting Nurse Assn) in to get the job done.
#4 If all else fails, use lots of concentrated room spray.

Trying to get her up if she is resistant and has mobility problems may result in you getting hurt or her getting hurt. (Or both of you)
Have you tried a Sit to Stand or if she can not support her weight you may have to use a Hoyer lift.
I used a Sit to Stand for my Husband for quite a while and the CNA from Hospice suggested several times that a Hoyer would be easier. I resisted but it came time and once I got used to the Hoyer it really was easier to move him.
It just might be easier to change and clean your Mom while she is in bed this is where the Hoyer came in handy. I could place him on the bed, change him then lift him back up into his wheelchair. It was shortly after we got the Hoyer that I came to realize that bed was actually the safest place for him. I could change him easier, roll him if he began to cough or choke and since he was sleeping most of the time the hospital bed we had was an alternating pressure mattress so I did not need to worry about moving him, changing positions extremities.
So consider getting a piece of equipment to help you both.
If you think she is eligible for Hospice contact one of your choice and they will set you up with all the equipment and supplies and help you need.

Sometimes, people who suffer with dementia are resistant to care and it may be very challenging to take care of them. That's why often the family members are not able to handle it singlehandedly at home. You may need some professional help or have you considered placement? Pulling and lifting people can be risky for both parties. I don't have any experience on how to do this for a person who is completely physically resistant to being toileted. I think I might discuss it with her doctor.

Also, you might check out some of the Teepa Show videos on You Tube. I watched one yesterday on Late Stage Dementia and it was very informative. Sometimes, when a dementia patient is in pain, they may not be able to verbally tell you, but, they may act out, refuse to move, etc. The speaker demonstrated a way to hold the person's hand and gently survey if they have an pain spots on their body. I might check that out, just in case she may have pain that she can tell you about.  She may have gotten a fracture that you weren't aware of.  I might discuss it with her doctor to rule that out.