Spotting Orthopedic Issues in Your Elderly Relatives (Plus Elder-proofing Your Home)

Now that we’re vaccinated against COVID-19, we’re doing something we’ve wanted to do since the beginning of quarantine — give Grandma a giant hug. Many people are seeing their elderly relatives and friends for the first time in more than a year, and these joyful reunions are a great time to check in on their orthopedic health.

Because the fact is, quarantine took a huge mental and physical toll on the elderly population. OrthoCarolina Occupational Therapist Tanya Crooks says many senior citizens didn’t get their normal amount of exercise (taking a daily walk, for example) for months, causing weakness in their core, arms and legs. That weakness could lead to mobility problems, pain and other problems.

Here are a few tips for checking in on elderly friends and family members:

Look for noticeable changes

Watch your relative move around and see if anything seems different from the last time you were together. Some big cues that something needs attention include:

  • Lack of self-care
    One of the most common (yet possibly unexpected) signs of orthopedic issues is a lack of grooming/self-care, Tanya says.
    “You might find that if your relative hasn’t had a bath in awhile, they might be afraid of slipping and falling,” she says.
  • Change in gait
    Look for limping, shuffling, dragging or dropping a foot, walking with feet farther apart — or any other change in gait that wasn’t there pre-COVID. It could be a sign of orthopedic pain, nerve issues or generalized weakness.
  • “Furniture walking”
    Watch how your relative gets around the room. If they are holding onto countertops, the back of the couch or other furniture, it could indicate a problem with balance, says OrthoCarolina Occupational Therapist Danielle Benoit.
  • Difficulty getting out of a chair
    If Grandpa is having a hard time initiating movements, such as rising from a chair, it could be a sign of an orthopedic problem.
  • Swelling in legs or feet
    Danielle says swelling could just be weight gain from decreased activity, but it also could be something more serious like congestive heart failure.

Ask questions

Unfortunately, lots of elderly people aren’t forthcoming about pain, weakness, or other orthopedic issues they may be experiencing. Call it pride, stubbornness or just a generational thing, but many just try to power through. However, some problems won’t go away without treatment, so you may need to do a little detective work during your visit. Here are some good questions to ask:

  • How are you sleeping?
    “Do they have nighttime pain? If so, they could be an underlying joint or compression issue and they aren’t getting the rest they need,” Tanya says.
  • What are you eating?
    “While you’re at their house, check out the kitchen,” Tanya says. “What kind of nutrition are they getting? Lots of times they’ll say they are fine, but then you go over and there’s no food in the fridge.”
    Tanya said it’s common for elderly people to forget to eat properly, which can lead to weakness and fatigue.
    “For some people, nothing is majorly wrong but they’re simply eating too little and their nutrition isn’t enough to get them through their daily activities,” she says.
  • Have you changed your over-the-counter medication dosage lately?
    Danielle says if Grandma tells you she’s gone from taking ibuprofen once a day to three times a day, it could indicate worsening of an exisiting issue like arthritis.
  • Have you had to stop doing anything you love to do?
    “Ask if they’ve had to stop doing an activity that they love or even one they need to do but no longer can due to pain or swelling — for example, they no longer bake their favorite desserts because of thumb joint pain,” Danielle suggests.
  • Are you having any tingling or numbness?
    It’s not just pain that can alert you to an orthopedic problem. Tingling and numbness can also signal a pinched nerve, especially if they’ve been mostly sedentary for the past few months.
    “If they’re fidgety or constantly adjusting their posture, they may have an underlying nerve or back issue caused by sitting more than usual,” Tanya says.
  • When does it hurt?
    If your relative tells you they’re dealing with orthopedic pain, Tanya’s advice is to try to identify a pattern.
    “Does it come and go, or is it constant? Do you get it only when you bend over, or only when you wake up?” she says.
    This information can be vital to a provider working to pinpoint the source of the pain.

When should I call a doctor?

Of course, aches and pains are a normal (yet annoying) part of getting older. But if my relative is complaining of pain, how can I help them tell the difference between routine wear and tear and something more concerning?

Normal: Joint stiffness that comes on gradually.
Has your granddad been using his knee stiffness to predict the rain for years? That’s normal. And so is decreased mobility as he ages.
“As long as it’s not associated with a fever, chills or vomiting, all of that is normal,” Tanya says.

Not Normal: Anything sudden or severe
If you arrive for your visit and your relative talks about a sudden shooting pain, for example, call the doctor right away.
Also worth a call: any kind of breathing difficulty, chronic headaches and profound fatigue.
“If they don’t have the energy to get up and do anything, it’s time to call,” Tanya says.

In general, any pain or stiffness that significantly interferes with your relative’s functional performance is worth a doctor visit, Danielle says.

Elder-proofing your home (and theirs!)

You’ve heard of baby-proofing: removing items that are unsafe for little hands and mouths to reach in your home. But when an elderly friend or relative with joint or mobility issues comes to your home, you may need to make some simple changes to make things safe for them as well. Here are a few tips:

  • Roll up your rugs
    Yes, they make a beautiful statement in your home, but they’re also a tripping hazard. Tanya suggests rolling them up for the duration of your visit.
  • Make sure no cords are near/crossing a walking path
    It’s another tripping hazard you may take for granted, but that could be tough to navigate for your elderly relative.
  • Consider your furniture arrangement
    “Simplify the furniture placement so there are not lots of obstacles to maneuver around — like maybe keep your furniture on the edges and leave the center of the room clear,” suggests Tanya. “Also watch for coffee tables or other low things they may not be able to see and could trip over.”
  • Remove clutter from walking paths
    Danielle suggests removing clutter to leave a clear path (between the living room and kitchen, for example) so they can easily get where they’re going.
  • Add extra lighting
    “The number one most common cause for falls is poor lighting,” Tanya says. “You could get extra plug-in lights to light the path when it’s dark.”
  • Be flexible with what rooms they’re using
    Danielle suggests making intentional choices about which rooms your relatives will use if they stay with you — have them use the bathroom with a walk-in shower instead of having to step over a tub, for example.
  • Make their bedroom easy to navigate
    Tanya suggests limiting the number of areas your elderly guests would need to stash their stuff at your house.
    “Give them an organized section so they can easily access their stuff so they won’t have to do too much walking around and looking for it,” she says.
  • Make things easier to reach
    Danielle says it’s a good idea to move frequently used items from the higher shelves to mid-height shelves or to the counter to avoid overhead reaching (or the temptation to stand on a stepstool to reach).
    “Many older parents don’t like to ask for help and will always try to do it themselves even if they shouldn’t!” she says.
  • Be aware of any medications they’re taking
    “If they’re taking sedatives you want to be aware,” Tanya says. “In some cases they might take a sedative at night and end up roaming around looking for a bathroom, which may not be safe.”

Adaptive equipment

Grab bars, shower chairs and other equipment can make elderly and mobility-challenged peoples’ lives easier, Tanya says.

“I’m very much into adaptive equipment that helps make things easier for your joints,” she says. “We can’t take away the arthritis and wear and tear that’s already there, but we can protect it from getting worse.”

And don’t wait until your relative has fallen down to have the conversation about adaptive equipment.

“Gradually implement it into the home as they start to report things that are difficult. Say ‘This might make it easier,'” Tanya suggests. “Help them see ‘I don’t have to have it, but if I don’t feel good or if I’m tired, it’s nice to have.'”

This equipment can also help convince your elderly friends and relatives to do the things they used to do.

“If they start saying they’re too exhausted to shower, suggest a shower chair — tell them it would help them rest in there and decrease their energy use by 50 percent,” Tanya says.

Some small changes, like replacing traditional doorknobs with lever-style knobs, are so simple but can help relatives maintain their independence.

Other adaptive equipment ideas include:

Bathroom: Grab bars, shower chairs, non-slip strips on the bottom of the tub, elevated toilet
Kitchen: Ergonomic utensils like peelers and knives
Whole house: Long-handled grabbing sticks so people don’t have to bend over

“It’s amazing how some little adaptations can make a huge difference for a family member,” Tanya says. “Most of the time they won’t get offended when you’re asking these questions, but you do need to approach it delicately.”

Need more information on how to help make life easier for your elderly relatives? Call the pros at OrthoCarolina.

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