=>Moving =>Mom

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    I haven't reported here in a long time, mainly because our exercise and moving sessions are much, much more informal now. Frankly, I thought that would mean that there would be no change in her overall physical strength but I was wrong. Over the last three months, which have involved three to four sessions a week of our set of informal exercises, what I have come to call our "Chicken Flap" routine, which involves lots of arm and leg movement while sitting and practice standing and sitting, I've noticed improvements that weren't happening during her much more iformal sessions: Although she walks no faster than before, she is noticeably more confident on her feet. This doesn't mean that I don't need to keep an eye on her, nor that she doesn't need to use the walker when out, nor that her balance doesn't sometimes worry me. It's just better than it was around the time of my last post here. As well she is standing from a sitting position with much less effort and her knees and hips aren't bothering her that much anymore. She still has her days, especially if a low is traveling through (which hasn't happened much lately), but overall she is doing better physically than she was back in late September.
    I am sure, if she was doing the harder, more formal exercises I used to try to get her to practice she might be further along. The problem we had with those, though, was her attitude. She didn't want to do them, I'd have to fight her to try to get her to participate in a session, thus we didn't do them very much. This informal "Chicken Flap" routine, though, is pratcticed much more often. Occasionally we'll get a session in two days in a row. There isn't any physical or emotional prep that needs to take place. I can spring them on her without a drop in her attitude. She considers them a form of play and even likes them, especially the original "Chicken Flap" exercise. She participates with vigor, feels good both before and after, and she isn't waving weights around, anymore, in ways that could possibly allow her to injure her joints and tendons.
    I'm satisfied that we've established a movement routine that is appropriate to my mother at this time in her life. And, best of all, it is not a source of stress for either of us.

Time Session Began:  1800 Duration of Session:  45 min
Exercise	Reps	Sets	Comments
ISL	4	1	Performed sitting. Stopped because she complained of "soreness".
KI	10	1	No pain anyplace besides tiredness in upper thighs.
LU	10	1	Performed sitting.
KNI	10	1	Good.
FO1	10	1	Performed sitting.
SDS	10	1
FO2	11	1	Performed sitting. Extra one done to correct form.
TDS	10	1
BG	5	1	She obviously is understanding the difference between her abdominals and her buttocks.
MIP	8	1
F2S	7	1	Performed sitting.
SSS	5	1	Doing a little better.
AC			Not performed.
FC	8/L + 10/R	1	Performed standing. Her muscles seem to have retained this hard learned technique.
SDST	5	1
IACR			Not performed.
TDST			Not performed.
IACL			Not performed.
STS			Not performed.
SSST			Not performed.
BD	10	1	Performed sitting. Has lost a little of her upper arm flexbility, but it'll come back, I think.
NSGP			Not performed.
SUSD	4	1	This exercise performed first to take advantage of her lack of physical fatigue. She did pretty well! I figured out that it's best for her to perform this and this sitting exercises without the foot platform.

    The important commentary about today's exercise session is at the immediately previous link in a Mom & Me Journals dot Net journal.
    You will also find a detailed description of our first in a long time walkering session that day and the walkering through which I directed her the following day, Monday.

    That's right, folks! The woman walked outside with her walker today! I didn't have to harrass her into doing it. We talked about the possibility yesterday and she anticipated it with pleasure today.
    It was a short trip and a short session. After she'd been walkering for about 15 minutes she complained about her legs feeling tired. She had to remain mobile for about 10 more minutes to get to a place where she could stop and rest while I finished our minimal shopping.
    She did well. I performed all the necessary lectures and instructions in the car then told her that I wouldn't bother her in the store, I'd let her "...walker any way you goddamn well please. If you insist on pushing the thing like a lawn mower and bending from the small of your back and not walking close to it and your back starts to hurt, that's up to you." She did very well, though, considering that she hasn't done any extended walkering or walking for a long time. I knew she'd start mouth breathing as soon as she started moving, so I boosted her oxygen regulator up to 4/lpm so she'd get at least 2/lpm. She walked pretty slow, did a lot of browsing, neither of which bothered me. I expected her to browse; it's one of the activities she loves and does very well. It gives her a chance to rest while in motion, too. When she sat down in the deli area I purchased a cup of decaf coffee for her. By the time I'd procured the last two items, gone through check-out and headed over to get her she had polished off 8 of the 12 ounces and was ready to head out, again, browsing as she went.
    The only real trouble she had was catching her breath once she was back in the car. I repeatedly told her, in increasing decibels, to breathe through her nose. Finally, at a stop sign with no one behind us, I put my hand on her lips to remind her to keep her mouth closed. She didn't believe me when I told her that the easiest way to catch her breath was to breathe through her nose, as the oxygen would work in her lungs' favor until I said, "There's no reason for respiratory distress, Mom, since you've got the oxygen. Use it to your advantage." I think using the phrase "to your advantage" made sense to her. She settled down, stopped gulping air, closed her mouth and within a minute was breathing normally.
    Tomorrow we have a few items to pick up at Costco, one of which is urgent, dishwasher soap. She's ready and raring to go. I promised her lunch at a "sit down restaurant". I know she won't be able to negotiate the entire route to everything we should pick up. She knows, though, she can stop and sit on her walker anytime she wishes and I'll come back for her. That's a good way to people watch. As well, I'll take the wheelchair, just in case her legs or back become shaky on the way out. Then we'll probably go to Red Robin. She loves their burgers and she'll probably be hungry for meat. I'll report on the trip tomorrow.

Time Session Began:  1330 Duration of Session:  35 min
Exercise	Reps	Sets	Comments
ISL	10	1	Performed sitting. She actually remembered to keep her muscles tensed!
KI	10	1	Pretty good, considering that she hasn't moved much since our last disastrous session.
LU	10	1	Performed sitting. Posture still a problem but she's not breaking her wrists as much.
KNI	10	1	I coached her, gently, to keep her thigh aligned with her hip joint. She mentioned that her thighs "really got a workout." Good.
FO1	10	1	Performed sitting. She performed this exercise really well.
SDS	10	1	Feet a little stiff, today.
FO2	10	1	Performed sitting. Did very well.
TDS	10	1	Feet loosening up nicely.
BG	5	1	She appeared to be contracting her ass rather than her belly, so I felt what she was doing, held my hands on her belly and the small of her back, and gently coached her to contract her abdominals. She did well.
MIP	10	1	Well done. Shifting weight nicely.
F2S	10	1	Performed sitting. Did really well! Her arms remained straight through most of the exercise.
SSS	4	1	I coached her closely through this entire exercise, gently. We worked on her using only her thighs. I talked her through each rep with my hands on her thighs and/or calves, reminding her to "use only your thigh for this; lift thigh; move only thigh out; put thigh down; lift thigh out; move only thigh back. Good."
AC	5	1	Performed sitting. Did pretty well. Her arms got a little tired on the last two reps. I asked her if anything hurt. She indicated the muscles in on her outer arms just below her elbows. "Ah, that's because you're moving with your forearms and not with your upper arms and shoulders." She got it.
FC	10	1	Performed sitting. Whoa! She appears to have mastered this one! I think we'll try this one standing during her next session.
SDST	10	1	Very nice. Good weight shifting.
IACR			Not yet.
TDST			Not yet.
IACL			Not yet.
STS			Not yet.
SSST			Not yet.
BD	10	1	Performed sitting. Ability to hold arms up very good. We may try this one standing at next session.
NSGP			Not yet.
SUSD	5	1	She is getting the hang of this, although practicing this isn't improving her normal standing and sitting technique unless I remind her; yet.

    So, yeah, we started again. I hadn't planned this. I just, suddenly, decided, maybe we should try again, about two minutes before we did. The first thing I did was apologize profusely for our last sessions which involved so much harassment I had to stop the whole idea. My initial intention, when I started getting her moving again today, was that I'd just let her do the exercises however she wanted and congratulate her for the effort on each one, whether or not she did them correctly. As I was apologizing, though, an apology that included surprise tears, I realized that maybe the best thing to do is to pretend that she's never done these before and gently coach her, hands-on, if necessary, though each exercise.
    This strategy worked well. I did include a short lecture about attitude right after I called her to action when she gave me that sour look; but it was a benevolent lecture. A couple of times throughout the session I held her back forward to straighten it. I also continued to remind her to carry her sitting weight on the back tops of her thighs and sit forward in the chair.
    We had a very good session. When I suggested the session it was because at 1325 she was yawning and decided she wanted to take a nap.
    "Not yet," I said. "You have to stay up until 1430, at least, since you awoke at 1030." That's when I decided that a gentle exercise session might be in order. It did the trick. She was much revived, stayed up until 1500 and was awake on her own at 1615.
    We discussed walkering sessions, too. I told her that maybe the best way to have her practice walkering was for her to be outside with me when I was doing the shaving back yard work that is necessary this season. She could wander at will with her walker, practice on her own and do it any way she wanted. "You'll finally figure out how to keep your back from hurting, Mom," I said. "If you're watching me and looking around and I'm not coaching you, you'll probably get it faster than with me coaching you."
    So, we've begun again. I've much modified my approach. I had to. My Full Metal Jacket Drill Sergeant mode was torturing me as much as it was her.

Time Session Began:  1805 Duration of Session:  45 min
Exercise	Reps	Sets	Comments
ISL	10	1	Performed sitting. Each side performed separately for better coaching. Getting better.
KI	10	1	Refuses to believe that holding her legs in alignment will make it easier, even though we demonstrated this.
LU	10	1	Performed sitting. She clearly performs this exercise more easily when she sits forward and up but I had to remind her to do this with each rep. It was exhausting for me.
KNI	10	1	Again, I had such trouble getting her to remain in a sitting forward, upright position, even though it clearly made the exercise easier for her, that I became frustrated and she performed badly.
FO1	12	1	Performed sitting. Performed each side separately for enhanced coaching. Same problem as above. Did it a lot worse than yesterday.
SDS	10	1	What the hell ever.
FO2	10	1	Performed sitting. Each side performed separately for enhanced coaching. Didn't help.
TDS	10	1	This one's hard to do badly. She did it well.
BG	7	1	Did this well, too; standing.
MIP	10	1	No change from yesterday. Okay.
F2S	10	1	Kept her arms straight through more reps than usual, but slumped back in the chair halfway through. I tried to correct her but she just sighed and stayed where she was.
SSS	10	1	She doesn't want to use her thigh on this one. I gave her hell for this.
AC	5	1	Performed sitting. Again, although she did move her arms from the shoulders, she kept slumping back and I kept "coaching her to sit forward and up.
FC	10	1	Performed sitting instead of our usual standing, but she did these without a hitch. Couldn't believe it and complimented her.
SDST	10	1	She did okay on these but there isn't much one can do wrong.
IACR			Not yet doing.
TDST			Not yet doing.
IACL			Not yet doing.
STS			Not yet doing.
SSST			Not yet doing.
BD	10	1	Performed sitting. Did these well, arm held up nicely, but continued slumping back in the chair. This was the exercise during which I demonstrated to her that when she sits forward and upright her back doesn't hurt. She confirmed this, but continued to slump back and complain about her back hurting. Needless to say, I exploded at her.
NSGP			Not done yet.
SUSD	4	1	Actually did well on this. She's got the technique but, as I noticed after the session, she only uses this technique during the session. Otherwise, she does what I call "standing up on her hands". I got after her for this.

    Yes, third day in a row for an exercise session. My plan was to take a break tomorrow and take her with me to Costco for some walkering.
    That was my plan, anyway. I don't know. I'd like to say what happened during today's exercise session is that I'm expecting to much of a typically lethargic, arthritis ridden 88 year old woman. I'd like to say this but I'm not sure that's accurate. What I can say is that Mom approached the session with her usual sour attitude and I exploded. Got nasty. When she started complaining about her back hurting I came back at her by telling her that of course it was hurting, she wasn't sitting correctly during the weight exercises, which was true. And, in fact, when I harassed her to sit correctly, her back stopped hurting.
    As the session continued I became more and more frustrated and didn't hold back my frustration. I castigated her about not listening to me, not believing that I know what I'm doing, not believing in herself, that she can do these things, refusing to work in good form when she's capable of good form (and, she is); I got after her for her attitude; I used the fact that I knew what position would relieve the tension on her back against her when she refused to hold this position; god, I don't believe there is anything awful I didn't say or didn't do. In addition, on the weight bearing exercises I insisted that we work both arms separately so that she could concentrate on good form. Instead, probably because she was angry with my attitude, she performed worse instead of better.
    Finally, after the session, I told her that I give up. Part of my job is to try to keep her in the best condition I can; to make sure she moves, exercises, does as much as she can so that she doesn't prematurely atrophy. But, I said, I guess it doesn't matter. I can't do what she refuses to do. I can't continue exercise sessions when her form is so bad that we risk injuring her instead of strengthening her. I continued that if she wants to atrophy I refuse to take responsibility, but I wasn't going to stop pointing out that she doesn't "need" to shuffle around, she doesn't "need" to be as stiff as she is, she's making that choice every time she sits "badly" instead of "correctly"; every time she's goes to bed because it's habit; every time she chooses bad form habits because they're habit, as though she has no choice. She has a choice, I told her, and she's making it. And I give up.
    After I exploded I sat sullenly off to the side and remembered that I was feeling so, so good before the session. I had this image in my head of Mom's attitude toward movement just a year ago: Fists clenched, arms moving as though she was power walking, ready to go, ready to conquer the world. I had been thinking, yes, we're going to get her there again. Maybe I'm wrong. And maybe I'm not accepting it. Maybe I'm wrong about everything. Maybe she's in a decline I'm refusing to acknowledge. I don't know. All I know is that I can't continue exercise sessions that may be hurting her and I'm having a hard time, a very hard time, accepting that she may be beyond exercise sessions, now.
    At any rate, we'll both get a rest tomorrow. Not exercise session and no Costco. I need a day of emotional rest.

Time Session Began:  1830 Duration of Session:  45 min
Exercise	Reps	Sets	Comments
ISL	10	1	Performed sitting. Worked each arm separately so that she was able to concentrate on tensing her muscles to keep her form.
KI	10	1	Worked on keeping her legs properly aligned. She tends to relax everything so that her legs raise and lower diagonally.
LU	10	1	Performed sitting. Each arm done separately with close coaching in order to see to it that she kept her mind on what she was doing and tensed her muscles appropriately in order to maintain proper form.
KNI	10	1	Worked on leg alignment.
FO1	10	1	Performed sitting. Worked each arm separately to induce proper tensing and form.
SDS	10	1	Good.
FO2	10	1	Performed sitting. Worked each arm separately to address form and tensing.
TDS	10	1	Worked on leg alignment.
BG	6	1	"Since you're getting so good at this one, we're going to do six today."
MIP	10	1	She seemed a little iffy by this time; her body was getting feeling what it's like to actually work. I made her do "the whole thing", though.
F2S	10	1	She always does this one well, and did it well today.
SSS	10	1	No complaints. Very nicely done.
AC	5	1	I think, tomorrow, we'll work each arm separately so she begins to understand that movement, with this one, generates from the shoulders and the straighter one keeps one's arms and back, the easier and more effective the exercise is.
FC	10	1	Whoa! She remembered what we talked about yesterday about tension and form and did this one correctly! "Very, very good, Mom!" We performed this one sitting, even though we usually do it standing. She was tiring.
SDST	10	1	No complaints.
IACR			Not doing yet.
TDST			Not doing yet.
IACL			Not doing yet.
STS			Not doing yet.
SSST			Not doing yet.
BD	10	1	Getting better. Hold arm higher and straighter.
NSGP			Not doing yet.
SUSD	5	1	I announced that I was going to have her do four, but we got a fifth one in to practice technique.

    My demeanor was a bit gentler but the work-out was harder. After last night's session I realized that we need to perform each weight bearing exercise separately on each side while I closely coach her and verbally work on her to make sure she keeps her muscles tensed. I discovered that she simply hasn't been doing this. Again, we talked about the purpose of the weights. She thought the nursing home introduced them as "fun", "for decoration". I corrected this. I also gave her several mini lectures about physiology and how holding one's arms, legs and body wrong can not only undermine the benefit of the exercise but harm the body. I also went after her attitude and cautioned her that her mind must be present while she's working out. I told her she is perfectly capable of not becoming distratcted. I badgered her when I noticed her attention wandering. She understood. She worked really, really hard. During the session she drank water several times, which she's never done. At the end of the session she was sweating (she's never sweated after a session; previously, I've been the only one sweating) and breathing a little hard. I congratulated her for this. Later in the evening I teased her by pointing out that she was beginning to develop, "little bitty baby muscles." She laughed. Good. Maybe, this time, we're on our way.