Q. I’m worried about my mom who is in her late 70s and lives alone. She’s always been a vibrant, active woman with a zest for life. Now, when I talk to her or visit, it’s obvious that she’s withdrawing — sort of from everything. “I can’t do that anymore,” has become a standard excuse for not gardening, not playing cards, not cooking — and the list goes on. I know she has arthritis with a lot of joint pain, and I know she doesn’t see as well as she used to. But basically she’s quite healthy. Where do I start in helping and encouraging her?

A. The most basic starting place, of course, is with your mother’s physician — followed perhaps by referrals to an occupational or physical therapist. There are exercises that can strengthen muscles, and self-help devices to minimize pain and stress and accomplish tasks more easily.

I’m especially impressed with the hundreds (no thousands) of assistive devices that can help with grasping, holding, dressing, reaching, carrying, sitting, standing, climbing stairs, walking and driving. The devices range from simple tools or gadgets to motorized equipment and are used to circumvent a person’s limitations by either changing their environment or serving as an extension of their body.

Among the first such tools were the OXO Good Grips kitchen utensils, introduced in the 1990s. The gadgets have thick, rubber handles that evenly distribute pressure, making many tasks easier. If living in her own home were just a bit easier, perhaps doing the things she used to enjoy outside the home might not be so daunting.

One thing that you might do is explore this burgeoning market on your own — based on what you know your mother enjoys doing and the kinds of difficulty she is having.

I gave your question to Laura Gardner who is an occupational therapist and an instructor in the Occupational Therapy Education Department at the University of Kansas Hospital. She suggested this web address as a starting place: http://arthritis.about.com/library/weekly/aa091199.htm

In summary:

• Get your mom to go talk with her doctor about the things she has difficulty doing. Don’t let her just take for granted that she’ll just have to live with decreased abilities. Suggest that you’d like to go along. Many depression-era folks feel like they can do without and don’t want to bother anyone with minor problems.
• Urge the doctor to refer your mom to a physical therapist and an occupational therapist to have her limitations and lifestyle difficulties analyzed and perhaps improved.
• Do things with your mom. It’s no fun to go alone and do alone. Your sharing the activity might be just the motivation she needs to get out and about more.
• Don’t get discouraged. We all need a little urging. Take it slowly. Your mom is lucky that you care and want to help.