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My MIL lives in her own home on her own. She is 89 and dealing with some cognitive decline. She frequently crawls due to back issues. She is not falling as far as we can tell. My husband took a picture and sent it to me and my sister-in-law. I am a teacher and therefore a mandated reporter. I don't think this is ok. My sister-in-law, who is the medical POA, thinks it's ok due to it not being a result of a fall, but instead because of back issues. She is really entrenched. If we do anything, there is a strong likelihood that the relationship will be damaged beyond repair. She does a lot for her mom. She is the primary caregiver.


So, is it ever ok to let the elderly crawl?

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In one sense, it is okay to "let" the person do whatever comes naturally to her - it's certainly overstepping matters to stop her against her own wishes, at least.

But you're right in supposing that eyebrows would shoot up all over the place. Why is MIL crawling? - from where to where, for what purpose, involving what risks, and isn't there surely a better way of supporting her mobility?
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I personally would leave this to the biological daughter and her. She’s not your own mother after all.
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This would be truly awful for old knees, already much impaired by age. Speak to her doctor this week to see what might be done, or what he thinks of this option. There are some knee pad things but unfortunately they constrict and bind in the knee area with an increase in clots, something you also cannot risk. Best of luck.
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Who's to say what's 'right' or 'wrong'? And who cares what 'eyebrows' get shot up in the process of mother crawling around? Your SIL is the POA here and as such, in charge of her mother's care & management. If you want the relationship destroyed beyond repair, start pointing your finger at what she's doing 'wrong' here, not really knowing all the details except for 'MIL is crawling' and getting worked up over IT.

My mother fell 95x while living in Assisted Living & Memory Care. If she were able to 'crawl' to avoid having taken those 95 falls, I would have been very, very happy to have agreed to having her crawl, to be honest with you. So there you see the other side of the coin: were you to know ALL of the gory details of this situation, you may in fact change your mind about MIL crawling around.

When my dear father was wheelchair bound, he would fall out of bed once in a while........and he'd crawl to the bathroom rather than call for help. He'd do that out of embarrassment & in an attempt for independence. Was I 'happy' that he was crawling to the bathroom? Not really. But I also understood why he was doing it, so I didn't make a big deal about it.

So, unless you want to take over the care & management of your MIL, I'd back away from this situation and let your SIL deal with the matter as she sees fit. Unless you see your MIL being openly neglected or obviously suffering in some way, I'd let it go. Don't fix it if it isn't broken.

Best of luck.
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This case confirm my theory that human beings begin their life bald, with no teeth and crawling, and that their life's end is the same, bald, no teeth and crawling.
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Isthisrealyreal Mar 2022
We come into this world in diapers, if we leave in depends, we stayed too long!
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Needing to crawl at age 89 speaks to surely your Mil should no longer be living on her own.

Your husband should ask APS for a welfare check and recommendations for her care. Have him show them the photo, and/or send it to her doctor.

You can advise him, but do not do it yourself.

It does not need to be an adversarial action between your husband and his sister.

It is just not right for Mil to be crawling because there are so many less harmful modes of mobility available. Be sure she has been offered the durable medical equipment her doctor suggested, and that she has the means and ability to acquire it.

There is also a cognitive decline or mental condition that may be causing this behavior, so get her evaluated a.s.a.p.
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Keep your nose out of it, do not make your SIL life harder, she already has a lot on her plate. Last thing she needs if for people to get involved and have them interject their opinions and solutions that may result in your MIL falling and potentially breaking something then leaving it up to the sister to clean up the mess. I highly doubt you guys take much of your time to help, as you said you are working and busy.

Busy bodies are the worse, mind your life and let other mind theirs. Unless some abuse is taking place do not make your SIL life harder by getting APS involved. Caregiving is hard enough as is, no need to do it with a agency looking over your shoulder, having to do month checks and what have you. Please.
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lealonnie1 Mar 2022
The armchair critics, I call them, are THE worst! They have all the answers with 10% of the information and NONE of the boots-on-the-ground caregiving under their belt!!
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I would not say anything for sure but I don't see harm in questioning it.

If Mom is seeing a neurologist I may say to SIL "thats weird, have you asked her doctor about it?" I say this because crawling is something we ALL have to do. If we don't we need to be made to. It has something to do with the development of the brain. You literally must crawl before you walk. My nephew did not crawl but was shown how to. He made fists with his hands and his Mom was told she had to make him keep his hands flat.

Me, I have a bad lower back. Arthritis but I do think some pinched nerve. The last thing I would do is crawl around on the floor. I would question this. It may be a neurological problem. Dr may say don't worry but I would at least ask.
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I have a comparable problem with lying down flat on the ground or on the floor. It’s the most comfortable thing for my back when it’s bad, much better than a bed, but it upsets people because it ‘doesn’t look right’. If I’m out shopping or something, I have to find a place out of sight, because otherwise I’m bound to have people running to ask if I’m OK.

I’m surprised that the lady can crawl comfortably (my MIL’s knees would never have allowed it), but if she can I wish her luck! It’s safe, falling is not an issue, no-one’s forcing her. Let her choose.
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Cashew Mar 2022
I have AS and sometimes I cannot sit upright but need to lay flat...or stay on my feet. It is exhausting.
However, an elderly person should never be crawling around! Their skin is paper thin and prone to tearing.
The muscles are generally weak, the fat pack is gone at the joints (even if they are fat around the stomach) and a pressure sore can be developed very quickly.
Back pain that forces an elder to crawl around isn't about what "doesn't look right". It is an incredibly dangerous situation.

P.S. I've found that I cannot go to restaurants because of my need to stand and not sit upright, except Japanese sushi bars. Standing is ok there without waitstaff freaking out.
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Can your Mil walk if she needs to?
Can the back pain be treated?

There are exercises and treatment programs online that recommend crawling as beneficial, and state that crawling can rewire the brain. Maybe that is what is happening?

So maybe, don't panic. Be part of the solution by getting more information and talking to your husband.
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Katefalc Mar 2022
I am struggling with Sciatica right now and it’s NOT possible to “ crawl” onto a toilet or to open the fridge from the floor to get food and the lady is elderly, not a young woman with more strength.
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I had terrible sciatic pain when I was pregnant with each of my kids. I actually planted a new lawn with plugs of grass when I was eight months pregnant with one of them, and it was the only time I wasn't in pain because I was on all fours with no pressure on my back.

I would suggest to Sis that there might actually be a remedy for Mom, but you won't know unless you get her to the doctor. She might benefit from a Cortizone shot, or some painkillers or physical therapy. You won’t know until you have her evaluated. I would really question Sis as to why she’s so adamant about not getting Mom any help. Back pain is excruciating, and even if her problem is spinal stenosis and nothing can be done, at least you'd know.

I would hope reporting it to APS would be a last resort, and a conversation with your sister would be the more effective route to take.
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worrieddil- Why report to anyone? If you think you can do better at taking care of MIL, then take over the care. I'm sure SIL would love to have a big long break from the stressful caregiving.
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Katefalc Mar 2022
Sounds like theres not much “ care giving” going on if she is crawling around the house fending for herself. Are you SERIOUS ? The “ care giver” NEEDS to think about what is happening here and place this woman where she will be SAFE and cared for.
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I'm impressed that she can crawl at that age, I'm even more impressed that she can get up off the floor again, especially with back issues. This is obviously not a sustainable way to live, if her pain doesn't allow walking then I have doubts that she would be able to function well enough to dress, prep and eat her meals, bathe, or toilet. MIL is at the point where she needs more help and as others have pointed out there are ways to deal with this. How close are you and your husband to his sister, would a family meeting to brainstorm alternatives be seen as helpful or intrusive?
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I am a teacher too and mandated reporting is for when you suspect abuse or extreme negligence. I don't think this falls into either of those categories. I would, as others have suggested, have a family meeting to brainstorm what would be the best way to help her. Then you aren't stepping on toes and creating a rift that won't help anyone.
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Katefalc Mar 2022
You don’t think this is negligent ?? As a retired nurse, I can tell you this is DISGUSTING. How does she get on a toilet, get access to food, get dressed or washed?? There’s more “ horror” to this story than what’s being told. This woman needs care. It’s not about “ feelings” or “ causing trouble”, it’s abusive to allow this to happen . Sorry, just my personal and professional opinion. It’s not ok to “ report” anyone in the family behind their back. Why cant you be the big person and have a family discussion and express concerns. Also helpful to offer help.
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elderly crawling is dangerous as their skin is paper thin and prone to tearing.
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Crawling seems unnecessary if she was in the right setting. Sounds like she needs, at minimum, assisting living or a nursing home. In 27 yrs of clinical work in a nursing home I never saw a resident crawl around. They were put in wheelchairs with assist. Sounds very sad to me.
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BurntCaregiver Mar 2022
I can't even say it sounds sad. It sounds horrifying. There is no excuse for the elder to be crawling around. The MIL either needs a caregiver/companion to move into her home to help her or she needs placement in a care facility for her own safety.
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Is she living alone?
If so with the cognitive decline that might not be a good idea.
Does she have a walker that is sized for her and does she know how to PROPERLY use it?
Maybe an assessment by a Physical or Occupational Therapist might be a good idea.
It actually sounds like she needs more help, assistance than she or the rest of the family wants to admit.
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Its easy on the outside to sit and criticize. Instead of feeling like it's necessary to file a report why don't you offer to go spend the night with your mother in law a few night a week. If you can't do that then maybe set up a home care aid to stay with her at night. I'm curious to know why you didn't go with your husband to check on her? Whether you like it or not, your mother in law is your husbands family too and you should be offering better solutions not trying to make things more complicated.
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Just a different thought on this, my mother has mobility issues as well and is still on a walker. Even though she can definitely afford all sorts of things to aid her and make her life easier, she can’t bring herself to spend the money or allow me to. It seems ridiculous at this point in her life but I think it’s just her generation that lived through the depression.
Maybe your MIL is worried about the cost of a wheelchair or modifications to the home.
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BurntCaregiver Mar 2022
If the elder is worried about the cost and expense, you do not give them a choice about it. Safety must always come first.
Never tolerate stubbornness. If they have access to her money, get the modifications to her home done and hire a live-in caregiver/companion.
If the elder won't go for this, the other option is a nursing home.
They tend to be more cooperative and less worried about spending when a nursing home is brought into the equation.
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She is 89, my gosh, how old is her mom? Maybe she could get some help with her back issues and with care for her mom. Occasional crawling may seem alarming to you, but it seems like she has a lot of responsibilities, some of which probably irritate her back problem. I think it is okay too as long as it is not because of a fall.
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Katefalc Mar 2022
It’s NEVER ok !
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I misunderstood, she is not taking her of her mom. Sorry.
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And if there was a fire? That just sounds bad all the way around.
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No. It is not okay to let an elder crawl around on the floor like an insect because they are in pain or for fear of falling.
Your MIL cannot be left living alone in her house anymore.
Sorry, but your SIL is not her primary caregiver. If your MIL had one of those she wouldn't be crawling around her house to get from one area to another.
Your SIL probably does think her mother crawling around the house alone is fine because it means mom's staying out of a care facility hence preserving future potential inheritance. Or because the crawling keeps mom from having to possibly be moved into her house.
I think you would do well to not worry about potentially damaging family relationships by reporting to APS what's going on here. Your worry would be better placed in some thought about what happens if there's a fire in the house and your MIL can't crawl to an exit to get out. I'd worry more about that.
You know, I've been a homecare caregiver for almost 25 years. I have been in every situation that can possibly happen in a person's home. I have seen and heard it all. I've been on this forum for a long time too and have seen every manner of story here.
I can't believe that someone, a teacher, would ask such a question as "Is it okay to let the elderly crawl?" I am truly shocked and that is no easy thing to accomplish.
So, I will answer your question in the plainest possible language.

NO! IT IS NOT FREAKING OKAY TO LET THE ELDERLY CRAWL AROUND ON THE FLOOR LIKE INSECTS TO GET FROM ROOM TO ROOM!

IT IS NOT OKAY FOR AN ELDERLY PERSON WITH DEMENTIA WHO CRAWLS TO GET AROUND TO BE LIVING ALONE UNSUPERVISED!

None of this is okay.
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DrBenshir Mar 2022
I think you used remarkable restraint in replying and explaining why. (Pardon the alliteration.)
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Do her back problems permit her to use a wheelchair or a scooter (4-wheeled for safety)?
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A lot of professional opinions being thrown around, problem with professional opinions they often do not take the caregiver into account. The lady is 89 she pretty much already has one foot in the grave anyways. We do not know the entire story, nor does the OP.

If I followed professional opinions I would have given up my entire life to care for my mother instead of having her placed in a SNF for her own safety. I would have listened to many professionals that told me I should do what I can to keep her home since AL is out of the question only viable placement is SNF and that is not where she belongs yet.

OP do not put your noise in this situation unless you are 100% ready to do the leg work and field all the phone calls. If not turn a blind eye and ignore it, it is easy to make a phone call, and be whelp I did my good deed. While you let the caregiver deal with the actions of your choice.
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BurntCaregiver Mar 2022
Sigh,

No one should ever turn a blind eye when a person is mentally incompetent be it from dementia, mental illness, retarded (I'm sorry I don't know what the current PC term is for that, and living in a dangerous situation.
The OP is a teacher and cannot just turn a blind eye. She's required by law to report any kind of abusive or dangerous situations. The same way a doctor, nurse, social worker, cop, officer of the court, or licensed caregiver is. Someone should of course use their own discretion too. Many times a situation can be handled and corrected without reporting upon it.
Would you turn a blind eye to a child or animal living in danger or abuse?
So yes. You do the leg work and field the phone calls. Especially when the person living in danger is family and you care about them. Even when they're not, do it anyway. That's just plain human decency.
I've made my share of enemies over the years and lost positions with care agencies and a few private ones for reporting to the state on an abusive or dangerous situation. My conscience would not let me do otherwise. When the state, the police, or APS have questions they must be answered truthfully. I've had to deal with the phone calls and paperwork too. It doesn't always come to that though.
The OP should not just call APS or the cops and leave her SIL to deal with the consequences. That's a d*ck move and you don't do that to family even if you hate them. She should have a talk with her SIL and husband and tell them she's going to do it. The MIL cannot continue living alone and crawling on the floor like an insect because it's dangerous. The OP, her husband, and the SIL are adults. I'm sure the three of them together can find a solution for the MIL.
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I posted about my problems with people thinking it ‘doesn’t look right’ when I lie down flat on the floor or the ground. But it is NOT DISGUSTING, it’s my choice of what’s best for me at the time. And to point out the blee**ing obvious, of course in that position I don’t try to “get on a toilet, get access to food, get dressed or washed”.
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cwillie Mar 2022
I haven't read most of the latest comments Margaret but I expect that what posters find "disgusting" is that people are seeing this and just shrugging their shoulders as though it's not concerning at all, just a lifestyle choice🤷. And I imagine that anyone that age who must resort to crawling as their means of mobility quite likely isn't spry enough to be popping up to their feet to take care of their other ADLs easily.
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As I see it there are two very critical questions:
1. Should your MIL be crawling? The clear answer is NO, and all physical, cognitive, and psychological evaluations should be done to determine why she is crawling, and to create a treatment plan to stop it.

The second question is more complex: WHO is the responsible party to ensure the first issue is addressed?
In the eyes of the law, your SIL has that legal authority as picked by her mother and agreed to by her through the Medical POA.
I am not sure of the exact laws for mandatory reporting in your state, but in some states simply being a teacher for children does NOT make you a mandatory reporter. The reasoning is that child educators are not elder care specialists. Here is the wording I pulled from a quick Google search on elder care mandatory reporting "A mandated reporter is anyone who is responsible for the care or custody of an elder or dependent adult. These include caregivers, health practitioners, clergy, social services staff, and those who work in financial institutions."

IMO, your SIL is the person responsible for your MIL. Then, your husband is responsible. As an in-law, I do not see you having much personal responsibility such that it makes you a mandatory reporter using the wording above.

THAT SAID, it does seem you are passionate about reporting this. Perhaps passionate to a fault given how many other adults bear much more legal responsibility here.

As you stated, you will destroy family relationships with even a threat of mandatory reporting, so I would get crystal clear on the law in your state. If the wording is similar to what I quoted above, I would get crystal clear on your boundaries and your interactions with your MIL. Personally, I would make it clear that I do not enter the house, receive pictures, or over hear any stories about her care in any way as long as she is not receiving the care she needs (clarified in question 1 above).

This situation is not acceptable.
But, it is not your mother nor are you the POA.
The boundaries are yours on what you will and will not be privy to given you have little to no legal interest here. Beyond that, you will destroy a family and may risk your marriage over what you perceive to be mandatory reporting, but may not be mandatory at all in your state as a teacher.
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I wanted to add something to my original post b/c I missed an important point in your post: you said, 'My MIL lives in her own home ON HER OWN.' That's the part I missed; I thought your SIL lived with her and was her 'primary caregiver.'

Any elder who's 89 with COGNITIVE DECLINE should not be living alone. She should either be placed or have help coming into the house 24/7 or something close to that. Living alone with cognitive decline AND crawling on the floor due to 'back issues' doesn't sound like a safe or healthy idea to me, so I wanted to change my original comment. While I wouldn't get up in your SILs face about this and ruin your relationship, nor would I involve APS, I WOULD speak to your SIL about your concerns. Your concerns being that she lives alone with no help and nobody to oversee her activities and help her with her showers, meals, everyday life happenings. THAT is really the crux of the matter, and when the crawling is thrown into the mix, it's a different kettle of fish IMO.

Is your DH her son? If so, HE is the one who needs to speak with the SIL who's medical POA about a solution to this entire situation. She can move into Assisted Living with a Memory Care annex so she can move in there if needed. But be forewarned: the crawling may not STOP in managed care, either! If she's a stubborn woman and that's how she likes to get around, then that's what she is likely to continue doing! So don't move her JUST b/c she's crawling.......consider the whole picture that she's an elder of 89 with cognitive impairment AND she has mobility issues BOTH. Perhaps a physical therapist can help her learn to use a walker, or a wheelchair may be the safest option for her. You don't say if your SIL takes her to the doctor regularly and what sort of medical equipment has been suggested for her? My mother used a walker with wheels and then wound up wheelchair bound when her balance issues became severe.

I hope you can interject your concern here w/o wrecking the relationship with your SIL. I also hope there's a better answer (medically speaking) for your MIL than crawling around, like physical therapy for instance. My mother who lived in Assisted Living for years did get PT and OT on a regular basis, which was available inside the AL building. There's a lot of services on site in AL, including docs that come in to see the residents. It may be a good answer for your MIL.

Good luck.
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worrieddil: Imho, I would think that crawling would be hard on her knees as well as detrimental to her spine. Individuals walk on floors. Ergo, the floors are dirty unless they are cleaned every day. Think of your MIL being within a nose reach of dirt.
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Just another thought on here, and this has been bothering since I read it.. and I will admit I watch alot of horror films.. LOL If I walked into a house and saw an elderly person CRAWLING on the floor I would totally freak out! This bothers me on so many levels I cant even. Floors are dirty,, no matter how often you clean them. No one over 1 YO needs to be crawling on a floor,, and I do not believe it feels better,, her knees must be killing her. Someone said what would a home do.. I have been in many NHs and ALs and I have NEVER seen a resident crawling on the floor for gods sake. ( sig hop) Yes they would get her off the floor! Is your SIL unable to get her off the floor? So it is easier to let her be? This is crazy and horrifying to me
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sp19690 Mar 2022
Reminds me of the movie The Visit when the old woman is chasing the kid in the crawl space under the house. Totally creepy and scary.
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