Mom is 89YO, cognition has been failing last 4 years; she has pretty normal health for 89YO - BP and kidney issues and some arthritis. She fell and hit her head in January, seemed ok, but in early March she started stumbling and was incoherent and markedly more confused than usual. She was hospitalized and they found a brain bleed and her brain had shifted off center.
We were unable to keep her in rehab for very long as they do not allow alarms or restraints and she kept forgetting that she needs help to walk now. We moved her to a lovely adult foster care home with about 10 residents and 2 aides who constantly remind her to get help with walking and standing, but what are our options if she keeps falling?
She is getting physical therapy, but I'm not sure how much she "practices" between twice weekly visits. I'm not sure we can ask the aides to spend extra time with her on this, although any improvements she makes would help THEM spend less time keeping her safe.
She is in Michigan; I am in Florida until early May when I return to my home 2 hours away from her; my brother visits once a week but lives 40 min away and works FT.
Last night she had a minor fall, again seemed ok, but she was taken to ER and the scan actually found the bleed had continued to reduce and her brain shift has improved too. So I'm hopeful, but just wondering what "worst case scenario" is here if she can't learn to stand and walk again.
My 89 yr old mom has dementia and cannot be still. She lives in memory care and is receiving hospice. She gets anxious and needs to move. She is constantly walking and rearranging objects in her room. She has fallen multiple times.
Her walking was becoming more and more unstable and her connection to the world around her fading. We advocated for a medication change and her walking has improved as well as her focus and redirectability.
We did have private aides coming to her facility 24/7 for a couple of weeks after her 1st fall to administer morphine and for fall prevention. Hospice recommended morphine for pain but in memory care nursing is not available 24/7. Only the nurses, family or the private care could give her the morphine. As her injuries improved we were able to remove the morphine and the 24/7 private care.
If your mom needs a higher level of care make sure you understand the medication management in the facility. In my state only nursing homes can meet the 24/7 administration of specific substances like morphine.
In my state the average hourly wage for private care is $37 hour. It's very expensive and not everyone can afford it.
I know my mom will fall again. I cannot prevent it. I expect sooner or later a fall will be the beginning of the end for her. I cannot afford 24/7 private care for her.
Its been very hard for me to accept that I cannot fix things for my mom. I can only strive to make her comfortable and less anxious.
I hope your mom recovers.
Adult care where she is sounds wonderful since minimal other patients. However, talk to them to find out if THEY think she needs to move on or if they can handle her care for now. Even if she goes to NH, it doesn't mean she won't fall again. So if she can stay where she is, better for her. More one on one care with less people needing help
* Hire outside caregivers if you can afford it (to supplement nursing home care).
* Get her in Hospice if she isn't already for extra care. She doesn't need to be terminal to quality for Hospice (depends if MD will do).
* Bed restrains - in San Rafael, CA - 1/4 bed restrains are allowed. They may not be enough to keep a person from trying to get out / falling out of bed though.
* I got a body pillow and put near to the open part of the hospital bed-frame. It worked out very well. The N-Home MD was quite impressed saying "I never thought of that." It worked although by then, my friend/companion didn't move around much although the pillow WAS a barrier between the two ends / sides of the bed-frame. 'JUST' be sure that the staff know what the pillow is for . . . too often I would find the pillow against the wall ... on the other side of the bed.
* My friend likely tried to get up and out of bed forgetting that he couldn't stand-up / walk. I believe this is why he fell out of bed twice (before the pillow although he had the 1/4 rails/bed rails). It may not be 'movement' causing someone to fall out of bed. They may be trying to get up and out.
* Be sure to work with Ombudsman in your area should standards of care be inadequate. I did ... sending her photos and description of situation (no call button and no water available / in reach) ... 3-5 x / week ... only to find that the Licensing board of nursing homes could not use any of my information/witnessed situations due to being 'a third party.'
I find that the best way to get attention and care for a loved one is to create good relationships with management / staff / line staff, CNAs. Of course, it helps if the administrator is on the ball...
Gena / Touch Matters
Can you use a simple seat belt opening in back?
I'm glad the scan was helpful.
http://brainmi.com/
To give context, but not hijack the thread, our elder has issues with dysautonomia, not connected to any disease. This means that when she lays down, her BP can go WAY up (scary), and when she stands up, her blood pressure can drop—sometimes precipitously, because she can faint. The latter has been the biggest issue; she's fainted and fallen four times now, across a number of years. In the process she's torn her rotator cuff, and broken her elbow. The other times, she couldn't get up off the floor and called us to help her.
Docs can't regulate her pressure. There's nothing wrong with her heart. Neurologists won't see her; even at Hopkins, they're so specialized they only see folks with dysautonomia adjacent to something else, which she doesn't have.
So, we've done all the things we can (and that she'll let us do; she's 83 and fully competent to make her own decisions) to help her stay as safe as possible. She insists on aging in place. She decided on her own not to drive, we have a chair lift to help her navigate the stairs, one of her sons lives in the house (but isn't there 24/7) and takes care of the house, does shopping, etc., there are bed rails to help her get in/out of bed, a commode that's bedside every night, and she finally agreed to wear an alert button.
All that to say that we, like others here, are doing what we can to help her live as long as she wants to, while having to make peace with the fact that something bigger than all of us is *clearly* in charge of this journey.
We know that she's likely to either die from a stroke, or from a brain bleed after falling and hitting her head. And, chances are she's going to be alone when it happens. That hurts my heart.
People, trying to be helpful, tell us we should "place her in care" where she can have someone always with her. Some of them have been medical professionals, with the most vocal of them being a visiting nurse who was freaked out by her BP. I'm often astonished that more medical folk don't come from a place based in reality, or who judge and react without understanding the fullness of the situation.
But, as others have said, someone can be with her every moment of the day and every step of the way, and she can still fall.
Short of confining her to bed to "keep her safe"—which, for her, would be a kind of death in and of itself—there's nothing we see that can be done.
So, for as long as we have her, we help her live the best life she can, we love on her as much as possible, we show up for anything she needs or wants, and we're letting go of trying to "fix" things, or push radical ideas to "protect her" or "keep her alive."
Sending you such big love as you navigate your journey.
My mother has Dysautomania and Dementia. It makes it a struggle. But she has my father and he fights for her daily. I fight for him. But they have been together for more than 55 years and I don’t know if he knows what to do without her.
That breaks my heart too.
Your response helped me remember that her time is near. No matter what, at 83 years old, everyone's time is relatively near, isn't it? Don't get me wrong, I believe modern medicine is wonderful, but I've thought for some time now that perhaps it has done too good a job of preserving our bodies. I'm thankful she is in a great facility with excellent staff who keeps tabs on her - much to her consternation, but my relief. I think perhaps that's the best I can do to protect her dignity.
Wishing you the best of luck with this and hoping for continued good news about the brain bleed continuing to improve. 🤞
Case and point...I was my late husbands 24/7 caregiver for the last 4 years of his life, which meant I was home with him all the time. He fell a lot. And usually I was somewhere near by.
There was a span in July and Aug. of 2018, that I had to call 911 nine times so the EMS folks could come get him off the floor and back into bed. And yes I was often in the same room as he was when he fell.
So unless you want someone to be glued to your moms side 24/7, you're just going to have to accept that falls are going to happen.
It's the sad truth.
It was almost a blessing when my husband became completely bedridden as I no longer had to worry about him falling anymore.
Just bring in hospice so mom can get a hospital bed and other useful things to TRY to keep her safer. Hospice brought mom a bolster pillow type thing for her hospital bed that cupped her body a bit. It cut down on her falling out of bed a little. A new wheelchair that tipped backwards also stopped the falls from reaching 200. The toilet was another story. 9 out of 10x she would roll over to it in her wheelchair w/o help, climb on and fall off. Once she fell 3x in 4 hours.
Let go and let God direct this show for mom now. And get hospice on board If she qualifies. My company used "Senile Degeneration of the Brain" as the Medicare qualifier for mom's dementia to get services approved.
Best of luck
Falls WILL happen
There could be an aide standing next to her and she could fall.
This might even continue if she were confined to a wheelchair, she would try to get up and fall.
This may be the start of the slippery slope that will eventually end your mom's life.
The fall in January probably did more damage than thought. She may now be having mini strokes and if it is not a fall it will probably be a stroke
My Husband had Alzheimer's and I suspect Vascular dementia and I suspected that each fall he had was a mini stroke that would cause a steep decline. (literally overnight there would be a marked decline)
This all is your probable "worst case scenario" But do expect the falls to continue.
((sorry))
As with Geaton, I've lived this. My friend could escape any restraint the hospital had, and she'd fall or leave the ward.
The admins of your Mom's facililty need to help you come up with some solutions, none of which will cover her 100% or perfectly. For instance, she can be seated in a wheelchair and a "tray" can slow down her ability to get up out of the chair. Her mattress can be put on the ground (many facilities do this); or there are concave mattresses that make getting up and out much more difficult. There are alarms, as I mentioned. The best is to hire an aid to be with her during the day. I wish you peace in your heart as you do the best you to protect her.