hi, thank you for providing the brief history of your mother. As by history I can understand that your mom is 78 years old so the Cardiorespiratory endurance will be less. Also, on addition she has asthama so the respiratory system is weak. She has varicose vein and not the foot and ankle are swollen. To assist further a thorough neuromuscular assessment is advised. To understand the situation a little knowledge about the conditions is needed. Bronchial Asthama - as you know when people having difficulty in breathing they will consume more energy and feel weaker with fatigue. when there is bronchial Asthama the patient feels more weaker to perform any activity due to early fatigue and less oxygen supply. they will have shortness of breath, difficulty in doing deep breathing. Varicose veins - this is like the clots obstructing the normal venous return and led to high blood pressure. As sometimes this leads to swelling as well. Age - as she is 78, she will have slow metabolism and the vascular system will also be slow which may lead to insufficient flow of blood to various organs of the body including the brain. In my clinical practice I deal with geriatrics range between 79-107 years of age. I have a strong recommendation for them to perform exercises. The exercises are divided into various forms. for your mother s initial complain of swelling in ankle and feet I will advice to eleveate the feet and perform ankle toe movements. as it will improve the venous return and reduce the swelling & pain. Also, for asthama I will advice doing regular breathing exercises. these include the following - * deep breathing exercises * pursed lip breathing exercises * diaphragmatic breathing exercises * costal breathing exercises * abdominal breathing exercise . For the ageing factor - general body exercises to improve the metabolism and immune system. By doing regular general exercises the vascular system Improves and also the blood supply to different organs which helps the other organs nourish. Also, ageing demands a physical exercise but each case has different way to deal and get helped. In ageing the pain levels are not berable and also due to lack of exercise the muscles and joints become painful. Exercise will also improve the blood supply, breathing ability, functional Mobility etc. My geriatrics patients recover in 4-8 weeks of time and prolong the therapy as long as they can perform. As by doing regular physical therapy exercise they live healthy and mobile. regards Jay Indravadan Patel