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cindyann Asked July 2017

How do I get over the worry of mom falling again?

Mom fell at nursing home rehab, fractured her hip and now is back at rehab. She had been in a rehab nursing home since 5/29 after getting a pacemaker at 92. She was doing well but always ignored the bed/chair alarm and got up because she was doing well with the walker. On 6/27, she tried to get out bed, fell and fractured her hip. She had surgery, had the hospital delirium complete with some hallucinations, had a UTI, and needed a straight catheter several times. It was quite rough for 8 days. She returned to rehab last night, not mobile at all yet and she's in a lot of pain when they try to move. Three siblings and myself have been doing shifts to be with her 24/7 since the fall. Now we're afraid to leave her. It's a very good nursing home but they can't be everywhere. Right now we're just with her to get her back to her routine there but with dementia, not sure how much she remembers. Has anyone else experienced this fear of thinking another fall may occur?

freqflyer Jul 2017
Cindyann, when it comes to elders once they start falling they will continue to fall. There isn't anything one can do unless you are glued to their hip every minutes of the day. In fact, you can have a room filled with nurses and aides, and an elder will somehow figure out how to fall in a blink of an eye.

My Mom was very stubborn and refused to use a rolling walker, she tried to use my Dad's but didn't like it. Sure enough Mom had several very serious falls at home where my Dad had to call 911. The last fall Mom was in the hospital, then to rehab, then to long-term-care. Yes, she kept falling. The nurses/aides tried many different things to limit the falls, but Mom was an escape artist getting out of her bed [she could no longer stand but her mind thought she could] and climbing out of her Geri-recliner. They ever tried a seat belt with the Geri-recliner, but within seconds they heard C L I C K... the belt was off... [sigh].

I realize you and your siblings are with Mom because she just returned recently from the hospital. That is understandable. If time marches on, then staying with Mom will have health consequences for you and your siblings.

As for falling and breaking a hip... sometimes the hip breaks, thus causing the fall.

Gershun Jul 2017
I agree with Frequent Flyer. Once my Mom started falling, she just kept falling. I accompanied her to a doctor's appt. once just to prevent this. I was walking right behind her watching her carefully and boom she fell backward and landed flat on her back. I was watching her and it still happened.

I admire your solicitousness to your Mom but you do need to take care of yourselves too. Keep us posted.

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Harpcat Jul 2017
You can't be there every minute nor should you. We just can't provide protection 24/7. As others said, once they fall, they keep falling. Their muscles are weak, they have no core strength to keep balance. Often a fall is the beginning of the end and it's really something I've come to accept as part of his aging. I do feel ultimately it will be the cause of my father's death, that or if he has a massive stroke. I have come to terms that he will die and I can't prevent it. Besides that, he has told me repeatedly he is ready to go. So my advice is to accept it and not worry so much as it will not change a darn thing.

momhelper123 Jul 2017
Sadly, by this age and with those "challenges" ... another fall will occur. My mother is almost 96 and in MemoryCare now (after she was no longer able to function in her condo even though I moved and bought a unit next door to her to help her for many years). In addition to severe dementia now, she is also wheelchair bound and blind (due to a stroke - optic nerve, not her actual eyeball health- which was good before the optic nerve was affected). In CA "restraints" are illegal, in a wheelchair ...in a bed. It becomes a "Sophie's Choice" as far as their quality of life. My mother's Memorycare is highly staffed with multiple loving caremanagers, but as you said, they cannot be everywhere all the time. Her falls (or roll outs from sofa or bed) have not broken bones because my mother thankfully took HRT and exercised daily into her elderly years, so she gets "skin tears" and so far minor konks on the head. (Major fall et al sends her to the ER. I am in almost daily contact .. they contact me or I contact them .. with regard to any issues that arise.) The more "in contact" you are with the Residence, the better the communication (at least in the case where you are paying out of your own funds for the residence; I cannot speak yet to the care from State owned facilities.) As the years go by and my mother lives a very long life (I imagine to 100 years old), you can basically only find solace in the fact that everything is being done, but some things just cannot be controlled, and while we want our loved ones to live a wonderful life forever, no one lives forever and it is these challenges - whether physical or mental - that actually are the reasons that most people die. Very few people live to 100 with great health and mobility and then expire in their sleep just due to old age. Those are the lucky ones, but ever so few. So yes, I have felt the "fear or falling" but have learned to accept it. PS - my husband and I looked at a 6 bed Board and Care in a very fancy house and neighborhood (though it was less pricey amazingly). I looked at the single bed in the beautifully furnished room and said to the owner, "So what happens if she rolls out of bed? Who will find her?". And the answer was very Unsatisfactory; unless it is a 24-hr "night service" home (which of course is more expensive), then that is also not a solution even though many people feel the ratio of two caremanagers to 6 people is superior. My experience has been that this does not solve the problem either.

Countrymouse Jul 2017
First of all, I completely sympathise. I lost count of how long I spent holding my breath and inwardly whimpering with anxiety, but I certainly wouldn't want to go back to it.

So I can understand you and your siblings' decision to do these shifts, and I don't think it's over the top, and there is the valid point that the only way to make absolutely sure your loved one doesn't fall is never to let go of her at all - so that's what you're doing.

But. How long can you keep it up? It just can't be possible to go on contributing the equivalent of a 42 hour working week each to your mother's care. The four of you are going to have to put your heads together, ideally with your mother's doctor or senior rehab nurse in the room, and set yourselves a realistic timetable.

Tightly crossed fingers that your mother will make good progress and solve at least some of the problem that way.

cindyjo50 Jul 2017
Cindyann, your situation is SO similar to what we are going thru (even our first names are the same!), my sister called me early this morning to tell me to read your post. Our Mom was in a very large SNF after a fall at my home where she'd lived for almost 4 years. Nothing broken that time, but too weak (heart, a-fib) to go back home. Rehab tried, but she was still too weak to get herself around without a wheelchair or a walker with an aide holding onto the seat of her pants. So one day in April after an afternoon nap, to make a long story short, she tried to get out of bed, fell and fractured her hip. Back to surgery, rehab again, and this time we moved her to a smaller, highly rated SNF. But, even there, with great care, she has fallen, or nearly fallen, several times. She thinks she can walk, no matter how many loving lectures and warnings she hears from us, PT staff,aides, nurses,etc. (She does NOT have dementia, but gets confused.We have had the Dr.adjust some of her meds. We shall see!) And it's true even in the best nursing home, they can't be watched every minute. My sister and I have been doing alternating daily shifts for over 4 months, and it is taking its toll on us. So we know we have to cut back, and we are planning how to do it, because we don't want Mom, now 92, to outlive us! We are with you, Cindy, and all the others here who are going thru the same things!

Wittm1 Jul 2017
My mother broke her hip, had surgery, While in rehab had UTI which ultimately was her downfall. I lived in rehab for two and a half months, hiring someone to spend the night three times a week so I could go home. It was pretty rough once she got the UTI, but I would not change what I did at all. 

Having said that you need to really look at your situation and come up with a plan that works for the five of you. For one thing, I believe you indicated that at this time she has pain and her movement is compromised - that should slow her down for the time being. In the rehab I lived in the nurses came quickly when they heard a bed or chair alarm go off. For escape artists they lowered the bed as low as it would go, nearly to the floor. This made it harder for residents to get up, allowing the nurses more time to get to the room when an alarm sounded. Additionally, a firm padding was put next to the bed so if they did fall an injury was less likely to occur. Given your mother's situation, these tactics might be enough to make her safe at night. Tell the nurses that you need them to respond to the alarm rather than you, so you can see if she will be safe without you there at night. Otherwise they may assume you (or your sibling) will be handling the alarm situation and not come.  Stay with her two or three nights so you feel comfortable that these tactics are working, then relax and spend nights at home. 

Does one of you have POA? Does your mother have financial resources that would allow you to hire sitters to free you up some? If so, pick a good agency, insist on a caregiver with a significant history of working with dementia patients. A minimum of two years as a HIRED caregiver was my goal. Do not accept a young woman who took care of Grandma or the like. You want someone who has two years as a professional caregiver of dementia patients - not someone who pitched in on occasion over the course of two years.  Require that they assign you one person. Mom may come to recognize them over time and be more comfortable. Additionally, they develop an understanding of her and how to best work with her and communicate in the way that is best for her. Rotating caregivers can not develop that familiarity. Identify a set schedule so the caregiver is committed to your mother on certain days. 

These steps will give you some relief and some breathing room. It will give you some time to calmly devise a plan for your mother's, your siblings and your future. There is a limit to what you can do. You can no more keep Mom safe every moment, than she could keep you safe every moment when you were a child. I am sure she felt very much as you do now, when you were little. The difference is that you were beginning your life, and hers is coming towards it's end. That regrettably cannot be stopped. So share your love, play dominos, make her laugh - watch METV with The Andy Griffith Show, Gunsmoke etc., listen to Big Band music or whatever music was her favorite in her youth. When you are with her, make it count.

BootShopGirl Jul 2017
I can't help with the worry but my mom broke her her pelvis in 2 places and her back. The u.t.I. hallucinations and straight. Cath.'s , rehab and all the rest the same story. She even had a side journey to a geriatric psych. Unit hospital. She has been at home 10 days now at her house. She is up walking and has new meds. Basically I am just waiting for the next fall. After reading many posts on here and answers from the good folks above that just posted, this is common. This road trip has been going for 5 1/2 years. They had every kind of alarm on my mom everywhere she went and nothing stopped her. Alzheimer's made her forget she couldn't walk and even when people were with her she would pop up out of the wheelchair and immediately fall. I have learned you simply cannot watch them every second. You will go crazy trying. Also they told me my mom has severe osteoporosis so maybe something broke first and that caused the fall like someone said above. Most interesting to me is that my mom had pacemaker implanted in March 1 month before she fell. This sounds familiar!

Marianne28 Jul 2017
My dad was falling and hurting himself a lot. His was due to all the medications he was on. When I became his full time caregiver, I took him to an Iridologist.
He is 93 and has been under the care of an Iridologist for over a year. He has gone from 13 meds to 2. He is more coherent and says he hasn't felt this good in 30 years. Sometimes too many meds or a lack of proper minerals in the body can throw everything off balance. I hope this helps.

chrismsherman Jul 2017
Both my parents have had falls. My dad fell more frequently went he was taking Xanax- probably not the best choice for a senior with dementia who is frail. My mother also has had her share of falls. Both are in assisted living now with pendants and nursing 24/7. I feel so much more secure as opposed to when I stayed with them and every thump caused me to roam the house seeing who fell.

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