Ideas for improving quality of life for an elderly relative?
April 18, 2023 5:14 AM Subscribe
I have an elderly relative with mobility and vision limitations, but their cognition is fine. I'm looking for ideas to help improve their QoL, more details under the fold.
Late 70's Asian female in Asia, able to to move independently without assistive devices but only at slow shuffle and on flat/familiar ground (has recovered from a bad fall or two). Low vision, but has an iPhone and uses it for messaging and watching (more listening I suspect) to videos. Lives in high rise apartment, no stairs, has domestic help for cooking and cleaning so basic survival needs are being met. Some incontinence issues and will wear an adult diaper when leaving the apartment.
Their social engagement and physical activity is quite limited. They almost never leave their apartment (maybe 1x a week to go grocery shopping, with accompaniment). Every couple of days will go on a short walk in the apartment building's courtyard (maybe 5-10 minutes). No regular interaction or relationship with any neighbours. Social interaction is almost entirely limited to WhatsApp chats with a few old friends and family members. Most of their day is spent sitting in one or two positions (in their bedroom, at the dining table) or lying down in bed. They have a TV but don't watch it, but will occasionally watch videos (e.g. Youtube links shared via WhatsApp).
I'm in a position to spend time with them on a regular basis, and am looking for ideas to help improve their quality of life. To be clear, no one has asked me for this, and I'm aware there is a chance I'm being too "interventionist" where it's not appropriate, but please take it as a given that I will consider that angle when it comes to applying any suggestions.
When I say "quality of life", I am thinking of things like increased social and physical activity, coming from the perspective that what I'm observing seems unhealthily low (I acknowledge I may be wrong on that).
RIght now I feel like the best I can do is just spend time talking to them, which ends up being "listen to the same 10-15 stories over and over, all dating back decades or more". Which.. I get it, they haven't gotten out much or done much for years, and don't have much social interaction or any hobbies.. but that seems to be exactly the problem..
Appreciate general or specific ideas and any related personal anecdata!
Late 70's Asian female in Asia, able to to move independently without assistive devices but only at slow shuffle and on flat/familiar ground (has recovered from a bad fall or two). Low vision, but has an iPhone and uses it for messaging and watching (more listening I suspect) to videos. Lives in high rise apartment, no stairs, has domestic help for cooking and cleaning so basic survival needs are being met. Some incontinence issues and will wear an adult diaper when leaving the apartment.
Their social engagement and physical activity is quite limited. They almost never leave their apartment (maybe 1x a week to go grocery shopping, with accompaniment). Every couple of days will go on a short walk in the apartment building's courtyard (maybe 5-10 minutes). No regular interaction or relationship with any neighbours. Social interaction is almost entirely limited to WhatsApp chats with a few old friends and family members. Most of their day is spent sitting in one or two positions (in their bedroom, at the dining table) or lying down in bed. They have a TV but don't watch it, but will occasionally watch videos (e.g. Youtube links shared via WhatsApp).
I'm in a position to spend time with them on a regular basis, and am looking for ideas to help improve their quality of life. To be clear, no one has asked me for this, and I'm aware there is a chance I'm being too "interventionist" where it's not appropriate, but please take it as a given that I will consider that angle when it comes to applying any suggestions.
When I say "quality of life", I am thinking of things like increased social and physical activity, coming from the perspective that what I'm observing seems unhealthily low (I acknowledge I may be wrong on that).
RIght now I feel like the best I can do is just spend time talking to them, which ends up being "listen to the same 10-15 stories over and over, all dating back decades or more". Which.. I get it, they haven't gotten out much or done much for years, and don't have much social interaction or any hobbies.. but that seems to be exactly the problem..
Appreciate general or specific ideas and any related personal anecdata!
Does she have a strong objection to the notion of starting to use a walker or rollator outside the apartment, and do you feel it would be appropriate for you to introduce/encourage that? Even if someone is physically “able to” get around unassisted, especially after a fall there can be a significant psychological barrier, and a walker (or even just a cane) can make a big difference in comfort level.
posted by staggernation at 5:51 AM on April 18, 2023 [1 favorite]
posted by staggernation at 5:51 AM on April 18, 2023 [1 favorite]
Some small amount of social time every day will help keep her cognition up, and a daily walk will help a lot to keep her mobility up.
Make sure she has very good shoes and look into a mobility device (cane or rolling walker?) to reduce her fall risk.
Assess her home for fall hazards:
time to remove loose rugs,
consider removing carpet as it can “catch” the foot,
make sure no rug edges are curled up,
upgrade her home slippers to something that stays on the foot well (sneakers?),
Add night lighting in hallway and bathroom,
Make sure all railings are easy to reach and firmly attached,
Get a shower bench and show her how to use it
Put a handle in the shower and beside the toilet
Etc.
Put a bell and phone beside her bed so she can call for help if needed without getting up if she isn’t feeling well
Every fall increases the risk of the next fall as it causes loss of confidence and wear and tear on the body. Minor falls (even if the head isn’t hit) can jar the brain inside the skull, causing small tears in the brain and blood vessels inside the skull which can lead to strokes a few days later - so decreasing her chance of falling is probably the number one way to keep her quality of life good for as long as possible!
posted by nouvelle-personne at 6:39 AM on April 18, 2023 [7 favorites]
Make sure she has very good shoes and look into a mobility device (cane or rolling walker?) to reduce her fall risk.
Assess her home for fall hazards:
time to remove loose rugs,
consider removing carpet as it can “catch” the foot,
make sure no rug edges are curled up,
upgrade her home slippers to something that stays on the foot well (sneakers?),
Add night lighting in hallway and bathroom,
Make sure all railings are easy to reach and firmly attached,
Get a shower bench and show her how to use it
Put a handle in the shower and beside the toilet
Etc.
Put a bell and phone beside her bed so she can call for help if needed without getting up if she isn’t feeling well
Every fall increases the risk of the next fall as it causes loss of confidence and wear and tear on the body. Minor falls (even if the head isn’t hit) can jar the brain inside the skull, causing small tears in the brain and blood vessels inside the skull which can lead to strokes a few days later - so decreasing her chance of falling is probably the number one way to keep her quality of life good for as long as possible!
posted by nouvelle-personne at 6:39 AM on April 18, 2023 [7 favorites]
When you spend time with her, can you try and spend some of that time in the courtyard rather than in her apartment? It's nice to get outside (even just into the courtyard) and depending how busy the courtyard is it could give you and her an opportunity to meet some neighbors (this might be difficult for her to do alone with low vision - hard to recognize people, hard to read whether people are interested in talking, etc.). If that goes well, maybe you could progress to a nearby park (or wherever the old people in her neighborhood hang out), if applicable. Hopefully there's a bench or something in the courtyard for you both to sit on? Otherwise one of those rollator walkers with a seat might be great.
posted by mskyle at 6:48 AM on April 18, 2023 [2 favorites]
posted by mskyle at 6:48 AM on April 18, 2023 [2 favorites]
Is there something she could teach you that involves being outdoors or social or both? Whatever the local equivalent of tai chi and majong is.
posted by Iteki at 6:57 AM on April 18, 2023
posted by Iteki at 6:57 AM on April 18, 2023
I know someone whose elderly relative's quality of life improved greatly when she started walking around her kitchen table ten times a day. Even a very small amount of activity can make a huge difference. The suggestions to try to get outside are excellent, but if that isn't possible, is there a way for you to encourage a small amount of walking inside?
posted by FencingGal at 7:01 AM on April 18, 2023 [4 favorites]
posted by FencingGal at 7:01 AM on April 18, 2023 [4 favorites]
"listen to the same 10-15 stories over and over, all dating back decades or more". Which.. I get it, they haven't gotten out much or done much for years, and don't have much social interaction or any hobbies.. but that seems to be exactly the problem..
FWIW, I think this is partly a function of getting older, not just a symptom of being underactive. It's an age when reflection and memory become really important. So don't underestimate the importance of listening to those stories, even if it feels tough because they're so repetitive.
Another Country by Mary Pipher was a previous Ask recommendation I think, has been on my to-read list for a while so I can't comment directly on how good it is, but might be useful for helping work out what would be useful for her, at her age, in ways that those of us who are a few decades younger, might find hard to intuit. It's great that you're doing this.
posted by penguin pie at 7:41 AM on April 18, 2023 [3 favorites]
FWIW, I think this is partly a function of getting older, not just a symptom of being underactive. It's an age when reflection and memory become really important. So don't underestimate the importance of listening to those stories, even if it feels tough because they're so repetitive.
Another Country by Mary Pipher was a previous Ask recommendation I think, has been on my to-read list for a while so I can't comment directly on how good it is, but might be useful for helping work out what would be useful for her, at her age, in ways that those of us who are a few decades younger, might find hard to intuit. It's great that you're doing this.
posted by penguin pie at 7:41 AM on April 18, 2023 [3 favorites]
How is she safely getting down stairs in the apartment? Depending on the country and the building situation, improving that accessibility would help - stair rails, having step edges, and extra lighting added to stair wells and a fall button for example.
Ditto for the bathroom - you can get funded here for someone to come in and fix up safety rails and anti-scalding and so on.
Is she open to a low-maintenance pet? A turtle or a fish can be handled pretty much weekly by a visitor and there's a lot of enjoyment and social energy in sharing space with a creature. Plants too if there's something like microgreens or herbs or flowers - something that can be checked once a week or watered by the person doing the cleaning.
Physical contact matters too. If they like dogs and you can borrow a dog to come visit so they can pet the dog, or they are possibly open to accupressure massages or footrubs. Even those massage chairs (often available cheaply secondhand) are better than no physical comfort.
Playing games they can pick up and put down like card and puzzle games with other people are great if they have a tablet for that, and often they're multilingual.
If they leave the house 1x a week, can they do 2x a week with you to accompany them to a local coffeeshop or old people's corner (we have them in parks and housing estates here, basically hang out spots for old people) and you do the social chit-chat with the waiter, the other people etc first until she feels comfortable to talk.
Ask her if she can tell you the stories to write down for a memoir or local history. Some places have programs for this. This brought a lot of interest and enjoyment to the people I know who did this, on both sides.
Take over something you can do while you chat - a puzzle to work on, simple cross stitch - something you can do as an invitation to her to join in but not for any pressure.
And definitely consider bringing fresh flowers and little snacks that she can offer to you and anyone else who visits - the flowers to cheer up the space and the snacks so she feels like she has something to offer you when you visit as well.
posted by dorothyisunderwood at 7:54 AM on April 18, 2023 [2 favorites]
Ditto for the bathroom - you can get funded here for someone to come in and fix up safety rails and anti-scalding and so on.
Is she open to a low-maintenance pet? A turtle or a fish can be handled pretty much weekly by a visitor and there's a lot of enjoyment and social energy in sharing space with a creature. Plants too if there's something like microgreens or herbs or flowers - something that can be checked once a week or watered by the person doing the cleaning.
Physical contact matters too. If they like dogs and you can borrow a dog to come visit so they can pet the dog, or they are possibly open to accupressure massages or footrubs. Even those massage chairs (often available cheaply secondhand) are better than no physical comfort.
Playing games they can pick up and put down like card and puzzle games with other people are great if they have a tablet for that, and often they're multilingual.
If they leave the house 1x a week, can they do 2x a week with you to accompany them to a local coffeeshop or old people's corner (we have them in parks and housing estates here, basically hang out spots for old people) and you do the social chit-chat with the waiter, the other people etc first until she feels comfortable to talk.
Ask her if she can tell you the stories to write down for a memoir or local history. Some places have programs for this. This brought a lot of interest and enjoyment to the people I know who did this, on both sides.
Take over something you can do while you chat - a puzzle to work on, simple cross stitch - something you can do as an invitation to her to join in but not for any pressure.
And definitely consider bringing fresh flowers and little snacks that she can offer to you and anyone else who visits - the flowers to cheer up the space and the snacks so she feels like she has something to offer you when you visit as well.
posted by dorothyisunderwood at 7:54 AM on April 18, 2023 [2 favorites]
I think you're on to something with the social element.
I don't know if this is feasible, but is there an activity that you can share with this relative that would also get her out of the house and around others - for one of my grandparents this was bingo, but it could be a religious activity or card games or performances or supper club or book club? What about going to a local coffee shop or park?
Alternatively, could you host small low-key gatherings at her house regularly like a Sunday afternoon dessert + viewing party? It's interesting that they're in an apartment - I wonder if you could invite a few neighbours over once a month for tea or something like that.
If that's all up the wrong tree, I would look for some small house projects that involve a little bit of motion, like making a new picture wall (week one, look for pictures, week two, select pictures, week three, select frames, week four put the pictures in the frames, week five put them on the wall, type thing.)
posted by warriorqueen at 7:59 AM on April 18, 2023
I don't know if this is feasible, but is there an activity that you can share with this relative that would also get her out of the house and around others - for one of my grandparents this was bingo, but it could be a religious activity or card games or performances or supper club or book club? What about going to a local coffee shop or park?
Alternatively, could you host small low-key gatherings at her house regularly like a Sunday afternoon dessert + viewing party? It's interesting that they're in an apartment - I wonder if you could invite a few neighbours over once a month for tea or something like that.
If that's all up the wrong tree, I would look for some small house projects that involve a little bit of motion, like making a new picture wall (week one, look for pictures, week two, select pictures, week three, select frames, week four put the pictures in the frames, week five put them on the wall, type thing.)
posted by warriorqueen at 7:59 AM on April 18, 2023
A friend of mine with a mother in the same situation has found great joy with her mother simply by reading aloud to her. They choose the books together and talk about them (they may even have a theme?)
posted by heavenknows at 8:10 AM on April 18, 2023 [3 favorites]
posted by heavenknows at 8:10 AM on April 18, 2023 [3 favorites]
"...listen to the same 10-15 stories over and over, all dating back decades or more"...
Growing up, I had a great-aunt who spent long periods with my family over the holidays every year. It was such a drag to sit there and pretend to be interested in her dusty old stories, until one day it dawned on me that she was talking about things that happened in the same era and the same city that F. Scott Fitzgerald had written in/about. So I asked her about flapper dresses and when she first bobbed her hair and whether she'd had a drink during Prohibition, and suddenly her stories came to life and led to others she'd never told before.
There's a common assertion that looking back in life is sad and depressing, and that living well requires always looking forward and having more new experiences. The older I get, the less I believe that. Reflection is connection if somebody else is truly listening. And at the end of life, there's nobody more important to connect with than a younger relative. Our boring family stories are the threads that connect the past to the future.
There are tons of elaborate products out there now for recording family stories but all you need is a stock recording app and enough imagination to see your relative in the time/place/culture/historical moment where their stories are rooted. "Tell me more" is often the best way to say "I love you."
posted by headnsouth at 8:14 AM on April 18, 2023 [9 favorites]
Growing up, I had a great-aunt who spent long periods with my family over the holidays every year. It was such a drag to sit there and pretend to be interested in her dusty old stories, until one day it dawned on me that she was talking about things that happened in the same era and the same city that F. Scott Fitzgerald had written in/about. So I asked her about flapper dresses and when she first bobbed her hair and whether she'd had a drink during Prohibition, and suddenly her stories came to life and led to others she'd never told before.
There's a common assertion that looking back in life is sad and depressing, and that living well requires always looking forward and having more new experiences. The older I get, the less I believe that. Reflection is connection if somebody else is truly listening. And at the end of life, there's nobody more important to connect with than a younger relative. Our boring family stories are the threads that connect the past to the future.
There are tons of elaborate products out there now for recording family stories but all you need is a stock recording app and enough imagination to see your relative in the time/place/culture/historical moment where their stories are rooted. "Tell me more" is often the best way to say "I love you."
posted by headnsouth at 8:14 AM on April 18, 2023 [9 favorites]
If they support her language and locality, an Alexa/Google Home/etc. might be worth considering for some variety to the iPhone.
posted by Candleman at 12:43 PM on April 18, 2023
posted by Candleman at 12:43 PM on April 18, 2023
Join her for meals.
Read Being Mortal by Atul Gawande, in which he discusses life and end of life and, most relevant to you, what matters for people as they age and become frail, lose independence etc.
posted by lulu68 at 2:53 PM on April 18, 2023 [2 favorites]
Read Being Mortal by Atul Gawande, in which he discusses life and end of life and, most relevant to you, what matters for people as they age and become frail, lose independence etc.
posted by lulu68 at 2:53 PM on April 18, 2023 [2 favorites]
An old person I know online loves baseball, and takes an Uber to the local AAA team, or to a local brewpub that has the games on big-screen tv. It's a bit of a production because it has to be an Uber that will take her wheelchair, and some drivers won't deal helping her, but it's a major social event. Brewpubs seem more social than most bars. I wish they played more diverse content; I'd love to go to a pub and watch Masterpiece or whatever.
In the US, for anyone here accessing this question, there's an Area Agency on Aging in every area of the US, some are much better about activities.
There are online events that are social, and sites like MeFi, ravelry and others have meaningful communities.
Music. Alexa + a music service is enjoyable, and music is great for improving mood and promoting movement. Alexa and Siri or Google Assistant have safety features. Alexa can be set up so that a family member can listen in to check up. Streaming media on a tablet is engaging. Ebooks are pretty great, audio or print are available. Thanks for caring for her; it matters.
posted by theora55 at 11:07 AM on April 24, 2023
In the US, for anyone here accessing this question, there's an Area Agency on Aging in every area of the US, some are much better about activities.
There are online events that are social, and sites like MeFi, ravelry and others have meaningful communities.
Music. Alexa + a music service is enjoyable, and music is great for improving mood and promoting movement. Alexa and Siri or Google Assistant have safety features. Alexa can be set up so that a family member can listen in to check up. Streaming media on a tablet is engaging. Ebooks are pretty great, audio or print are available. Thanks for caring for her; it matters.
posted by theora55 at 11:07 AM on April 24, 2023
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Large print word searches? You can sit together and "compete" to see who finds each word first.
A book of trivia questions?
posted by bookmammal at 5:29 AM on April 18, 2023