My aunt is in assisted living with swollen feet and legs.What else can I do?

Ramona, there is a stronger diuretic which is much more powerful: Bumex. In our experience, limited to two specific instances, it was used to force fluid out during an episode of CHF and then for a pleural effusion coincident with pneumonia.

This is not something to be used routinely, but it wouldn't hurt to ask the doctor about this since it seems your aunt's edema is chronic.

My cousin, who has dementia, also has sporadic ankle edema. It clears up with a prescribed diuretic though and may stay away for months. She's in a wheelchair, but is able to move her feet in order to propel herself around in the wheelchair. I would check the med charts to ensure that they are giving her the diuretic, since it normally does clear it up. Maybe she needs a larger dose. I'd discuss it with her doctor. Just have them monitor her blood pressure.

I would also make sure that her socks and shoes fit properly. If she has shoes that lace up, she could be tying them too tight.

The problem with having her put her feet up, exercise, etc. is that with Moderate Dementia, the patient is not able to recall to do that. The staff may put her feet up when she sits to watch tv, but then she may take them down the minute they leave the room. It's not very feasible to have constant instruction regarding her foot positions.

And she may not remember that she should walk more, get on a bike or wear the compression socks. If the compression socks are uncomfortable, I doubt she will keep them on. It's not feasible.

Ramona, I think she could do the bike pedaling by herself, although she might need someone to move the device over to her feet if she has trouble getting up and walking, or especially if she would have to hold onto something while moving and bringing over the pedaler. It is really lightweight though, so the issue might be of balance.

BTW her echocardiogram showed no issues.

Pam stegma.. Yes 24 is nice, but the facility is small, no where to walk. Recliner can go all the way back. But knowing my aunt, she would get out in her own. She doesn't have a problem with mobility. There is no salt at their tables, so that is NOT a problem. My aunt is healthy in body.. Low cholesterol, no blood pressure problems, 110/65..no diabetes, no heart issues, just the edema and the damn Alzheimers. Larger facility actually might have daily activities.

A lighter compression that she will actually tolerate may be better than standard TED hose that she takes off. The rest of the workup for leg pain and edema is being sure it is not due to a blood clot, low protein, renal problems, and/or neuropathy (for which medication can be tried.) Yes, go ahead and "bother" doctor...you'd just be asking them to do their job, you know.

So when you visit do you get her up and walk around?
Did you get the MD to order NO salt at the dinner table?
Do you know "feet up" is inadequate, the recliner has to tilt back so the feet are at the same level as the heart?
How is a larger facility going to make her compliant?
24 sounds pretty nice to me. Avoid any place with over 100 beds.

She's in a very small living center. 24 living there. Most in the memory unit are not able to exercise. She's at middle stage. I work full time.. So visit 1-2 times a week. I know she isn't getting the walking she needs. Do you think she could handle the bike peddle thing by herself. I'm also considering moving her to a larger facility with more activities.. Hate to do that.. Moves are hard

Correction: second statement, lst paragraph, should read:

"But ankle edema occurs more easily when people AREN'T moving around, especially (when someone is not) walking (much)."

She's getting the standard treatment - diuretics, compression stockings, elevated legs. But ankle edema occurs more easily when people are moving around, especially walking.

One thing that might help nominally, if she'll do it, is to get one of the floor exercisers that are essentially bike pedals without the bike. And it's much easier for an older person to use to get lower leg exercise than a stationary bike. They can also be set on a table and used by arms to exercise them. Dad got one for about $10 several years ago; they're around $14 last time I checked.

Another thing she could do is elevate her feet when she's laying down. The goal would be to elevate her feet above the level of her heart. Putting blankets under her lower legs and feet would do that.

But I would raise the issue with her doctor, without bugging him. If he's prescribed compression stockings and she's not wearing them, it's not appropriate to "bug" him for her noncompliance. You could also ask the doctor if he thinks she should see a vascular specialist in the event that some of the edema is due to a vascular problem.

One thing I would ask about though to make sure it's not a problem is lymphedema. How far up her legs does the swelling extend? Is it both legs?

I would also keep track of her food intake to make sure she's not getting too much sodium in her food.

Are there any exercise classes, even if they're seated exercises, that she could attend?

Your aunt probably has congestive heart failure (CHF). He probably also told her to elevate the legs to the same level as the heart. She also has to limit salt in the diet. Compression stockings have to go on before she gets out of bed.
Bet you ten to one she is not doing any of that. If the patient won't comply with the recommendations, there is no point in bugging the MD.