Falls

[myss]

I have read on TP a few times of PWDs experiencing falls, is there a general reason as to why this happens? Is it because they have just lost their balance, forgotten how to walk/sit/etc, etc?

My family and I care for my dad and beginning to notice that the falls are becoming regular. He's been checked out by the GP a few weeks ago and he was ok but the GP noticed how advanced his dementia had become since a previous appointment and we've had a visit from the OT as to what they can do (which was nothing more). Is there anything else we should do?

 

[karaokePete]

Falls can be common as dementia progresses. My wife experiences falls.

It's important to rule out any obvious cause like failing eyesight of side effect of medication.

In my region we have a Falls Prevention Service and use of that got my wife on a strength and balance course which helped. It may be worth checking if this is available in your area.

 

[Andrew_McP]

Balancing a complicated, flexible, wobbly, top-heavy 'object' like a human being requires an awful lot of subconscious processing power and muscle coordination**. As the brain randomly dies, so does its ability to handle all sorts of things efficiently or, eventually, at all.

My Mum was pretty strong and fit. Up until the last 12 months we'd have several dog walks a day, and for a few years had many, many, many days when we'd be out 'walking home' for hours. But in the last 12 months I've watched her become a shadow of her former self. She'd stooping, more and more, and now it's as if the whole of her left side is fading. The hand, then the arm, and now the left leg are weakening, no matter how I try to stimulate her. We have good days... well, hours, but we'll start a walk ok and I'll end up almost carrying her home as she leans on me.

She's now falling regularly at home. She'll topple over when getting out of bed. She'll get up from her seat and just fail to find any balance. She'll trip over her own feet because she increasingly slides them rather than lifts. And even the slight step up onto a dropped kerb can catch her out. So I hold her arm all the time while we're out walking our increasingly short walks. And in the house I encourage her to keep her thick wooly hat on in case I'm not near enough to catch her. I try to minimise the risks to her, cushion corners etc, but... But dementia's out to get her one way or another; I can't wrap her in cotton wool.

I understand now how folk on here often pop up to say their PWD has fallen not long after being institutionalised... I can hardly keep one person 'safe' and I'm on constant watch. How carers manage when they're spread over a group of folk with dementia, I've no idea.


**Which is why we're only just getting some humanoid type robots capable of acting in a pretty human-like fashion, despite decades of trying.

 

[Andrew_McP]

I can hardly keep one person 'safe' and I'm on constant watch.

Not constant enough. 25.5hours after writing that I got distracted in Mum's bedroom, trying to sew some more velcro onto her coat when there was a godawful bang from the kitchen. Looked like a 'normal' fall when I dashed through, but it hadn't sounded like one and I knew pretty sharpish it wasn't.

She'll have surgery some time tomorrow -- all being well -- because she broke the top of her left femur, the side that's been of increasing concern for a month or so. She was weak on that side, now...

Now, home after being persuaded she's in safe hands (safer than mine anyway), I have the opportunity to get six whole hours of unbroken sleep for the first time in forever. But instead I'm typing my guilty incompetence into the internet. My brain knows it's stupid to think like that, but if ever there was a time for a 'you only had one job' meme, it's now.

Oh well, a new stage in this roller coaster begins. Meanwhile I have to convince myself that the bedroom motion alarm isn't about to go off again for our next loo visit. It's been so much of a routine of late that the disturbance pattern is etched into my subconscious.

Right, back to trying to sleep and not fret about the poor lost little soul a mile and a half up the road. I left one of her little teddies to keep an eye on her, and to be something familiar when she wakes, but... fingers crossed the catheter and pain relief will allow her to sleep a bit better than me. Can't help feeling it's cruel to leave someone with advanced dementia in strange hands in a strange place when they're in pain though.

Grief, this cr@ppy disease always finds new ways to mess with your head, doesn't it?

Mmm... now I need a wee again. Even my own bladder's conspiring against me!

 

[Kuiper27]

Hi @Andrew_McP

I'm sorry to hear about your moms fall. I hope she makes a speedy recovery. Please try not to beat yourself up too much. It was a rotten accident. You're only human. You're doing your best and when I read you're sewing Velcro on her coat, well all I can say is you're doing a marvellous job.

Yes this wretched cruel disease messes with our very being. You're so right on that. Insomnia seems to be a side effect.

Please take care and I'll watch out for news of your mom

All the best
Kuiper27

 

[Sarasa]

So sorry to hear that @Andrew_McP , but don’t beat yourself up about it. It could well have happened if you were standing right next to her. I hope the operation goes well, and that you get time to rest and re-group while you mum is in hospital.

 

[Izzy]

I’m sorry to hear about your mum’s fall. Wishing her a good recovery.

 

[Avis]

I was only a meter away from my OH when he fell through, or rather into, a glass topped coffee table. It is a miracle that he wasn't killed but he wasn't even hurt although there were huge shards of glass everywhere. He has also fallen head first and taken a piece of his scalp out, hair and all. He would fall at least once per day as he refuses to use his frame or he just "forgets" he can't walk and takes a couple of steps and over he goes. I have to get him out of bed or he falls out. His physical therapist has observed him and apart from making the house as safe as possible there is nothing I can do to prevent him falling. I am sorry to hear your mother was hurt. I am expecting that my OH will be hurt one day. Like you, I feel terrible each time it happens but we can only do so much. I will be thinking of you as I struggle with a similar situation. xx

 

[Sirena]

Sorry to hear about your mum's fall, Andrew. Please don't blame yourself, there is no way you can prevent falls however closely you supervise. My mother is in a care home and she has had a couple of falls in the lounge when a carer was literally a few feet away - once she fell and broke her hip, and had to have surgery.

Strangely enough, despite becoming more frail my mother hasn't had a fall now for a year (I should probably touch wood now). I'm not sure why - she still wanders around and won't using a walking aid, but maybe she's slower now and spends more time sitting.

 

[Bunpoots]

I’m sorry your mum was hurt @Andrew_McP. I was standing right next to my aunt when she keeled over backwards and I couldn’t do a thing about it. It seemed to happen in slow motion but still I was unable to keep her upright once the momentum had started. Thankfully she wasn’t badly hurt on that occasion.

My dad had the same experience with my mum and, although he was standing right behind her (with a cup of coffee in each hand which he dropped) he couldn’t prevent her fall either. Mum broke her hip and femur.

I hope your mum makes a full recovery. Try to stop feeling guilty...it won’t do you or your mum any good!

 

[Pete1]

Sorry to hear about your Mum @Andrew_McP, you really shouldn't feel guilty, but something similar happened to my Mum and I went through the same process of replaying things in my head and feeling guilty - although with the benefit of hindsight I had nothing to feel guilty about. Falls sadly do happen when our loved ones have dementia. Take care of yourself.

 

[Lirene]

I am so sorry Andrew to hear about your mum’s fall and hope that the hospital are being very kind.
My husband fell 6 months ago and broke his hip. Afterwards, he was home for 7 weeks and fell numerous times, I advised O T’s he was an accident waiting to happen and sure enough fell again same hip but this time a peri prosthetic vertical fracture. Orthopaedic Surgeons did what they could to stabilise but said if he falls again it would be a catastrophe! Since being in hospital, and still there, he’s had 2 falls from his chair still thinks he can get in and out of bed and walk. Last week he said he’d been tap dancing, today he was up and standing on one leg so he said!
At home, I could not count the number of times I’ve had to ‘grab’ him to save another fall and help him to get up after falling yet again.
He’s been in hospital now 14 weeks and I’m still waiting to have a good nights sleep. The worry never seems to leave, he’s in my mind when I do wake and before I do eventually sleep.
Your mum will be in hospital for some time but I have found they are extremely good at looking after people with dementia now as the wards are full of them unfortunately!
My advice is just do what you can, also let the staff do their job but always keep an eye out and bring any concerns to their immediate attention. Make sure they know what they are doing with any medication she is on, they did get my husband’s mixed up which made him 10 times worse!
As for you, rest, rest and more rest - sleep when you can and it doesn’t matter what time it is, go to bed if you feel like doing. And have a little drink and try and relax your mind. Please keep updating us on your mum’s progress and I’m sure you will have some hilarious posts about hospital life !! My prayers and thoughts are with you both xx

 

[Andrew_McP]

Thanks for your thoughts and shared experiences everyone. Caring for someone with dementia is all about learning to let go, but sometimes you wish you could hang on to them -- quite literally -- forever. I like to think I'm mentally prepared to let Mum go permanently... she's kind of already long gone. But the house doesn't half feel empty.

Weird journey, this caring lark.

Anyway, Mum went of to surgery about 4pm today and was back about 6:30 (they still had one last person to operate on as well). The nurses were told everything went as planned, but so far I haven't been able to speak to anyone who knows exactly how bad the break was. I've been told to track down a nurse practitioner attached to the surgeons tomorrow. All that matters is that there are no problems so far, her stats were totally normal and she was out like a light as soon as they stopped prodding her to make sure she was ok.

She's in the dementia part of the orthopaedic ward and they seem to know what they're doing. I've seen three shifts and three totally different bunches of folk though, so I can only imagine how confusing things can be for patients. Can't really be helped though with 24/7 nursing.

The lady opposite Mum had the same op yesterday and they had her up today. I wish them the best of luck trying the same with Mum. But I'll be there so she can get grumpy at me, if necessary. Usually gets her on the other person's side and she'll do what they want.

Right, an early night beckons. Slept for about 3.5 hours last night, then woke and realised I ought to have scribbled out a more easily digested version of the 'Margaret Manual' I have in the house just in case I eat too many burgers and do an Elvis. I was so weary this afternoon that I nearly had a nap! And my body is extremely nap-resistant, sadly.

Maybe if I didn't type so much I might sleep more? Night all.

 

[Sirena]

Glad to hear your mother has had the op, Andrew. My mother was in hospital for 12 days, the matron said the average is 14 days for hip fractures. The lady in the bed opposite had dementia too, she had the same op and was about a week ahead of my mother, the day we arrived they were getting her to use a rollator. My mother refused to co-operate with the physios (I am guessing either she didn't like them or they approached her the wrong way) so the CH manager went in after a week and got her up and walking. As soon as she was back at the CH she had forgotten there was anything wrong with her and refused to using a walking aid (she'd hold a carer's arm) but they successfully rehabbed her with physio and liberal use of alert mats and 30 minute checks. With in a month she was back to baseline and mobile again. She's 84.

Opposite-bed-lady was still in hospital when my mother left. Although medically fit, she lived at home with her husband and it wasn't suitable to rehab her. They were trying to find a temporary rehab placement for her.

 

[Bunpoots]

I hope you’ve managed to get some sleep @Andrew_McP and that your mum is making a good recovery.

 

[Lirene]

Thinking if you and your mum Andrew xx

 

[Izzy]

I’m glad the op went well Andrew. I hope things went well for you both today and that you get a good night’s sleep tonight.

 

[Andrew_McP]

Daey three in the big bother housepital...

Well, it took a while (and then some!) but Mum drank a little independently and ate jelly babies put in her hand this afternoon. But she had to be painstakingly fed anything else a tiny bit at a time... uncooperative Mum is back, as the physios found. She wasn't getting out of bed for love, money, a charming smile or jelly babies. I think they'll be a bit more insistent tomorrow... or I will, and bear the brunt of her grumpiness.

At least I got to talk to the nurse practitioner attached to the surgeons and she got me some before and after photos. She didn't snap the thick bit at the top of the femur, but the crack went all the way across in the initial x-ray. Four screws down the bone and a pin up into the head should have sorted that out, but only time will tell.

I'm working on being adopted by two of the other three ladies in the ward-let. They're not visited during the day so I nag them about taking their meds (one is old school and likes to suffer, the other has a broken arm but doesn't like her sling) and have threatened to take my guitar in if they don't behave.

No nurse/assistant/sister/unclejohncobleyandall has yet decided I am cluttering up the ward outside visiting hours. Anyone would think they liked free help or something. I do think some are starting to think I'm a bit too good to be true, but I haven't stood behind a curtain and shown them my Psycho impersonation yet.

Only cloud on the horizon so far is that Mum's lousy white cell count (historical and she's miraculously healthy) has nosedived. They don't see a reason, so are monitoring. My thoughts is that maybe a lot of her bone marrow was damaged in whatever caused the initial drop in the early 90s and maybe her femurs were the ones supplying most of what was left. I've kept my gob shut though, because I know more about bone marrow dog biscuits than biology.

Ok, empty washing machine, kick dog out for wee, sleep. Managed 6.5 hours in a row last night! Woke up feeling cr@p and with back ache, but you can't have everything.

Thanks again all. It's very useful to hear about other hospital experiences and get an idea of what might lie ahead. Night.

 

[Donkeyshere]

Hi @Andrew_McP I would suggest when you decide to do the psycho impersonation not to use a real knife.

 

[myss]

Thank you for the replies to my initial query. My apologies for not responding sooner, I had fallen ill myself and had to rearrange my work and appointments to get things sorted.

It was an odd question to start a thread because as carers there is only so much we can do when our loved one fall and fall and continue to fall again despite things we implement to try to make them as safe as possible.

Not constant enough. 25.5hours after writing that I got distracted in Mum's bedroom, trying to sew some more velcro onto her coat when there was a godawful bang from the kitchen. Looked like a 'normal' fall when I dashed through, but it hadn't sounded like one and I knew pretty sharpish it wasn't.

She'll have surgery some time tomorrow -- all being well -- because she broke the top of her left femur, the side that's been of increasing concern for a month or so. She was weak on that side, now...

Now, home after being persuaded she's in safe hands (safer than mine anyway), I have the opportunity to get six whole hours of unbroken sleep for the first time in forever. But instead I'm typing my guilty incompetence into the internet. My brain knows it's stupid to think like that, but if ever there was a time for a 'you only had one job' meme, it's now..

Hi @Andrew_McP I'm sorry to hear about your mum. But like said above, and as others have exchoed, there is only so much one person can do in any one time, so please do not beat yourself up over this. I can so so empathise with the 'turning my head for that second to do another needed task then hearing that bang/seeing that rip/noticing the smell/etc" moments.
I'm glad to read on to see that your mum's operation went well and she appears to be on the mend (aside from the blood count which I hope will improve).

Also pleased to note that you've taken on the opportunity to get some well-deserved sleep and from the humpur in your post that you seem to be in good spirits considering what happened and how you felt before. All the best to you.