My sister seems to be having anxiety attacks lately. Any advice?

It seems like she needs a complete evaluation of her physical/pain management/psychological needs. Each problem feeds the others, not in a good way. Call her doctor and get some referrals. Psychiatric, pain management for sure.

the worry is based more on her arthiritis and falling. When we do venture out she wants to travel around and visit places.

Semba, your profile states that you're careing for someone with diabetes. I'm assuming then that your sister has diabetes, that she's being medicated for it and that it's relatively stable, but that she has these other issues to deal with?

Has she been diagnosed as being disabled, and is she getting disability payments? I assume she's not working?

As to the other issues, is her limited mobility due to arthritis or other issues, such as diabetic neuropathy?

If you don't have ramps, contact your local community and inquire about HUD funds for emergency repairs. Also contact Habitat for Humanity and Christmas in Action, both of which make repairs for income qualified people. Some churches do as well; you might call 211 to ask about this.

Wheelchair ramps must be installed according to local code, which specifies a certain pitch for the ramp, so it's a good idea to have a charity such as Habitat because they've dealt with these issues before.

Are you her primary driver, and if so, can you physically handle taking her to medical appointments and putting a possibly heavy wheelchair in the car? If not, there are medical transport companies that can help.

Contact your Area Agency on Aging for information on these transport companies. Your sister should not be cancelling doctor appointments given her condition, but rather finding ways she can get there safely.

There are a lot of ways to adapt living space to avoid falls. Ask her doctor for a script for home PT, OT and nursing. They'll be able to make suggestions how to adapt your living arrangements to help her and offer therapy to strengthen her as well. They can also provide information on assistive devices such as grabbers to help pull on socks and trousers.

I'm not sure from what you wrote if her concern about falling is keeping her in the house or if general anxiety/panic are keeping her there. If it is the anxiety, please make her an appointment with a psychiatrist. There are medications that can help tremendously with anxiety and panic. Once the anxiety is in check, it will be easier to leave the house.

If it is the anxiety keeping her in, the worst thing she can do is not leave the house. Agoraphobia grows stronger if someone doesn't work on it. Encourage her to get outside, if only for short trips up and down the block. Agoraphobia and panic will usually clear within a few months if someone is working on it. There may still be anxiety, but at least it won't be crippling.

I think she is afraid that at 58, this is to young for assisted living. Also will her finances be able to cover her costs.

Semba2, Is it at all possible to get her to Assisted Living? At least there she would have a walk in shower and wheelchair transportation. You're not getting any younger either. There are two senior centers in Hyattsville, MD: Langley Park and Oasis. Call them or call the Prince George's County senior services for help getting her to the doctor so they can treat the pain.

SEmba, you don't say how old your sister is. Is she wheelchair bound or is her insistence of handicap accessible sites because there are no stairs, etc? that acutally seems sensible to me at a certain point when you've got mobility issues and you know what damage a fall can do. It's unclear to me if you mean that she will not leave the house under any circumstances, or just that she insists that destinations be accessible. If it's the second, is there a problem with that, for you?

Experiencing anxiety attacks is quite common in those of us who live with chronic pain. Has your sister seen a doctor regarding the anxiety? Anti-anxiety meds can help and calm her down. Pain and limited mobility are difficult to live with - it can cause depression and other emotional problems. Hope you can help her find some good medical advice. Take care.