Ask the Expert: Juliette Kleinman, LCSW, Answers Your Questions on Managing Stress While Caring for Someone With Arthritis
Q1. My mother is 87 and has arthritis in her knees and hips. It’s difficult for her to get around without the use of a walker or wheelchair, but she doesn’t want outside help – only her family members. Do you have any recommendations for how I can better help her get around or possibly introduce the idea of outside care?
Maintaining a sense of independence is important as one ages. Having a family member help in the home may feel more comfortable to your mother, but a professional assessment can provide more specific information on her functioning. Having a physical therapist evaluate your mother’s strength and mobility will provide insight into how to best help her and introduce her to the idea of outside help. A physical therapy evaluation can be prescribed by her doctor. If your mother is homebound, this may be done in her home, or she may be referred to a physical therapist in the community.
Q2. My father’s is going to be undergoing total hip replacement in January because of his arthritic hip. Any tips for making his recovery easier and providing the best support I can?
Getting as much information from your father’s surgeon and the health care team about the procedure and recovery is an excellent start. Your father may want you to join him for his pre-operative appointments to learn more and ask relevant questions. Tips for doctor/patient communication can be found at www.hss.edu/conditions_talking-with-your-doctor.asp. Hospital for Special Surgery provides pre-surgical education classes for patients undergoing total hip replacement surgery. Caregivers can attend too. The HSS website is a great resource for patients and families for further information about total hip replacement and recovery. Your father and family can discuss post-surgery care options with his surgeon and social work case manager.
Q3. My husband has rheumatoid arthritis, which is of course as emotionally taxing as it is physically – for both of us. It’s especially hard during the hustle and bustle of the holidays. What are some ways that I can lower his stress level and my own over the next few months and year-round?
The holidays can trigger stress for all of us, but can be especially challenging for those with rheumatoid arthritis and their loved ones. Make sure to prioritize activities to manage holiday expectations. You may want to find ways to modify holiday related activities to take into account fatigue, mobility and pain levels to make these activities more doable. A frank discussion between you and your husband to decide together what invitations and traditions are most important can be meaningful and clarifying. Taking time for self-care, including relaxation and exercise as feasible — even taking three deep breaths, can help.
Q4. My husband and I are the primary caregivers for his mom. She suffers from bad arthritis, but often isn’t forthcoming with how she’s feeling. We’re worried that things will progress too much and we won’t find out until it’s too late. How can we learn what’s wrong without hurting her pride?
This is a challenging situation and you are being sensitive in anticipating her concerns. Your mother-in-law may feel that by not sharing her worries, she will avoid burdening you. However, you and your husband would prefer to be more involved in her health concerns. You may want to consider letting your mother-in-law know your interest in learning more about her arthritis. Doing your own research on www.hss.edu may give you a tool for opening a frank conversation with her as well as letting her know that you are interested in her care.
Q5. I have bad arthritis in both my knees, but replacement surgery isn’t a viable option for me due to some pre-existing medical conditions. I know my lack of mobility is tough on my wife and children, especially on family vacations, despite my strict medication regime to manage the pain. How can I make it easier on them and myself?
Your role as a father and husband are important for you and your family, and having the limitations you describe must be difficult. Have you discussed your thoughts with them? Sometimes we imagine that we may be disappointing our loved ones if we aren’t what we think they want us to be. Therefore, we may not share what is on our minds. By sharing your concerns with your family, you may learn more directly what they are experiencing, which may be different than what you have already considered.
Juliette Kleinman is a licensed clinical social worker with a specialty in geriatrics and is the manager of the VOICES 60+ Senior Advocacy Program at Hospital for Special Surgery.