MIL keeps having falls

Discussion in 'Middle - later stages of dementia' started by Trini, Mar 31, 2016.

  1. Trini

    Trini Registered User

    Dec 7, 2015
    39
    MIL came out out of hospital last week after fracturing her elbow. Carers in place four times a day as she is doubly incontinent and cannot cook for herself or wash etc. Only two days later she was found on the floor three times in one day by carers. This has happened before but not this frequently. She is now back in hospital but they do not know why she is falling. Her blood pressure is fine. She has vascular dementia so takes pills to keep blood pressure down. We know from our Just Checking system that she hardly ever sleeps. She obviously can't stay in hospital for ever. There is nothing the NHS can really do for her. Family insist she goes back home with carers. We continue to disagree on this. I think she should be in a CH. Latest idea is to give her an alarm for when she falls. Great if she remembers to use it and one of us can rush round there every few hours when it happens and during the night because she does not go to bed! At the end of my tether. Every time she comes out of hospital they say this is the last chance saloon except it never is and the rest of the family have to suffer the consequences of poor decisions of others and get no say in the matter. If they are so determined to keep her at home then fine but put 24 hour care in place. Oh but that is too expensive. I really believe she would be better off in CH. she would have company, regular meals, kept clean and somebody on hand immediately if she falls over. Is it just me. Why do they just not get it? So frustrating. Anybody else had experience of falls like this? On the plus side she has no idea she keeps falling. Doesn't know why she is in hospital.
     
  2. Canadian Joanne

    Canadian Joanne Volunteer Moderator

    Apr 8, 2005
    16,192
    Toronto, Canada
    I haven't had that experience but I understand your concern about your MIL's health. Why is the family so adamant that she stay in her home? Are they all agreed on this? If so, there isn't anything you can do. You can gently point out it might be better for her to be in a supervised environment so that if she falls again and breaks a bone or two, at least she wouldn't be possibly lying on the floor for hours.
     
  3. Jessbow

    Jessbow Registered User

    Are they checking her blood pressure when she sits or when she stands? My mother fell lots, her knees just sort of buckled, and its was to do with her blood pressure when she was standing, her heart just didn't have the 'Omph' to push the blood round when she stood/walked.

    Aortic stenosis was the eventual diagnosis.
     
  4. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,953
    Could you have a discreet word with her Consultant and see what he / she thinks?

    Judging from what you've said, I think you're talking about Nursing Home care (not care in an ordinary residential home). I also think the NH would be using motion sensors to alert staff to whenever your MIL wishes to move.

    There's no 100% way of preventing falls but the idea of leaving someone so vulnerable with only intermittent care horrifies me just as much as it does you.
     
  5. Chemmy

    Chemmy Registered User

    Nov 7, 2011
    7,592
    Yorkshire
    My MIL was lying on the floor in her bungalow for over twelve hours overnight, due to a fall. She said it was the most terrifying experience, being unable to reach a phone. She said afterwards that she honestly thought she was going to die.

    She went to a CH from hospital and hasn't looked back. She has fallen there too, but was found very quickly. That's the difference.

    Is money the real issue? Would she be self-funding.? If it is, a timely reminder that it's still her money - and therefore should not be treated as someone's inheritance until after her death - might be necessary. Apologies if that's not the case.
     
  6. Heyes

    Heyes Registered User

    Mar 31, 2016
    2
    My Mum kept falling, her knees seemed to just give way, it took many many months to eventually work out the cause. a long story short her heart was checked, it was working at below 30%(which I believe contributed to her diagnoses of vascular dementia) a pace maker was fitted but is still set low due to her health, sadly much to late to help that much, but Mum is a little more lively and has pysio to help her walk but its only from chair to stairs that is manageable on a good day. She still has a lot of falls but mainly due to the fact she is unaware of her positioning before she sits down on anything.
     
  7. Mrsbusy

    Mrsbusy Registered User

    Aug 15, 2015
    356
    Are there any other symptoms of decline, speech not as clear,, grip not great, dropping things? Tremors in hands worse, ...

    I only ask because I have had an exhausting week whereby my Dad kept falling, bought a Zimmer frame, still keeps falling. Having recently had a course of antibiotics for a UTI put it down to this, as I knew doctor would. Never improved, thought maybe more pills needed.

    Found him yesterday on the floor again for the fifth time this week. Cut a very long and tiring story short, hospital doctor asked for ct scan. I then find myself following his ambulance to Addenbrooks after they find he has two brain hemorrages! So have spent all night up there, and most of today, whilst they drain the brain by drilling holes in his skull. These hemorrages were due to him falling out of bed two weeks ago and have been bleeding ever since. As he fell he hit his head on his bedside cabinet.


    So maybe look at other reasons not so obvious, as well as the obvious. My Dad described it that his legs just kept going from under him, and I thought maybe a stroke, but please be aware of this very easy obtained injury.
     
  8. Trini

    Trini Registered User

    Dec 7, 2015
    39
    Thank you for all replies. All useful. She has no other particular symptoms other than usual dementia stuff. She forgets words and sometimes talks gibberish. She says she wants to go home which is why the family ( and they are all agreed) want to keep her at home. But she does not understand what is wrong with her. She thinks she is fine. She can be sat in a pool of urine and not even realise it! I am seen as the wicked witch trying to put MIL away in a home when in fact I seem to be the only one who would actually like to see her somewhere safe 24/7. I do not think it is a money issue although I have had my suspicions. I cannot see why else you would not want to provide the best possible care. They lay too much store on what she says she wants.if it was left to her she would have no carers at all! She simply does not have the mental capacity to understand her needs. I will pass on all your various suggestions and see if it makes any difference. Been battling for two and a half years with relatives saying there was nothing wrong with her when there quite clearly was.
    I will keep you posted.
     
  9. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,291
    SW London
    A pendant will only be any use if the person will remember a) to wear it, and b) what it is for, both of which are often highly unlikely by a certain stage of dementia.

    It does certainly sound as if your MIL ought to be in a CH, but if her family have all set their minds against it, there probably won't be much you can do, except wait for the almost inevitable crisis, which will finally make up their minds for them - and try not to say, 'told you so'.

    Just to point out too, that a CH will be unable to prevent every fall, since unless there is one to one care they simply cannot watch everyone every minute. But at least the person will be found and cared for quickly. My mother still fell regularly during her first years at the CH - she still had a 'need' to wander day and night and it was impossible to prevent her without either restraining her or drugging her into a stupor.
     
  10. Trini

    Trini Registered User

    Dec 7, 2015
    39
    I am not sure I understand the distinction between CH and Nursing home. The homes the family have looked at and shortlisted specialise in dementia care so presumably would provide whatever care was needed.
    .
     
  11. Chemmy

    Chemmy Registered User

    Nov 7, 2011
    7,592
    Yorkshire
    #11 Chemmy, Apr 1, 2016
    Last edited: Apr 1, 2016
    Interesting. Although my OH had seen first hand what was involved in me being responsible for my mum who had Alzheimer's for ten years, when it became clear (to me at least) that his mother wasn't coping, he and his sisters seemed unable to admit to themselves the problem was really serious.

    Like you, I kept flagging up her problems - malnutrition (all the signs), hygiene issues (filthy house but clean bath) and increasing paranoia with anyone other than immediate family. The classic list.

    I don't know who got more frustrated - him, with what seemed my perpetual nagging - or me, for what was clearly a refusal on their part to face up to the situation and leaving their mother in squalor.

    In the end, it was the falls that caused the crisis that resulted in MIL ending up in hospital and me sitting them all round the table in the hospital insisting that they talked about their mother's future care. When I mentioned 'care home', one SIL was in tears of relief, the other stormed off, angry and crying :confused:

    Once again, I was the bad guy for stirring it up, but it did clear the barrier of denial once and for all.

    But it's their mother, not yours, so ultimately, they are the ones who have to decide what to do and live with the consequences of that decision. As the in-law, you are slightly more detached than they are and that does make a difference.

    My advice would be to give them access to the facts (I used to email suggestions to my OH as that solved the verbal 'nagging' issue - he could read or ignore them but at least my conscience was clear)

    Then step back and resist the temptation to say 'I told you so' when you are proved right ;):)

    And you will be.
     
  12. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,291
    SW London
    A nursing home has to have a trained nurse on the premises for those who need actual 'nurse' care. An 'ordinary' residential home, whether for dementia or not, does not. Some CHs have different wings, e.g. for dementia/nursing/ordinary residential, so they cater for all eventualities and the person will be less likely to have to move later. My FIL had to move to an actual nursing home after his physical health deteriorated.

    From what you say about your MiL a home that specialises in dementia care would probably be best. In the earlier stages someone might be fine in an 'ordinary' residential home for a while, but may be asked to move later, if their behaviour starts to bother the non dementia residents. This was the case with an aunt of ours, but in fact it was no problem and she settled at the new place very quickly.

    I am not surprised if you weren't clear, TBH, since it's quite common for people to refer to any sort of care home as a 'nursing home'.
     
  13. Trini

    Trini Registered User

    Dec 7, 2015
    39
    Thank you. So good to hear I am not the only one to have been in this situation. I could just cry with frustration at times. Every I time I think finally this will make them see and they don't. I really connect with your story of the house squalor. They just did not see it! They put it down to being old! Hoarding dog poo in the garage - how can that be normal? These are supposed to be intelligent people. I just pray that my boys will take better care of me than they are doing of their mother.
    QUOTE=Chemmy;1253515]Interesting. Although my OH had seen first hand what was involved in me being responsible for my mum who had Alzheimer's for ten years, when it became clear (to me at least) that his mother wasn't coping, he and his sisters seemed unable to admit to themselves the problem was really serious.

    Like you, I kept flagging up her problems - malnutrition (all the signs), hygiene issues (filthy house but clean bath) and increasing paranoia with anyone other than immediate family. The classic list.

    I don't know who got more frustrated - him, with what seemed my perpetual nagging - or me, for what was clearly a refusal on their part to face up to the situation and leaving their mother in squalor.

    In the end, it was the falls that caused the crisis that resulted in MIL ending up in hospital and me sitting them all round the table in the hospital insisting that they talked about their mother's future care. When I mentioned 'care home', one SIL was in tears of relief, the other stormed off, angry and crying :confused:

    Once again, I was the bad guy for stirring it up, but it did clear the barrier of denial once and for all.

    But it's their mother, not yours, so ultimately, they are the ones who have to decide what to do and live with the consequences of that decision. As the in-law, you are slightly more detached than they are and that does make a difference.

    My advice would be to give them access to the facts (I used to email suggestions to my OH as that solved the verbal 'nagging' issue - he could read or ignore them but at least my conscience was clear)

    Then step back and resist the temptation to say 'I told you so' when you are proved right ;):)

    And you will be.[/QUOTE]
     
  14. Chemmy

    Chemmy Registered User

    Nov 7, 2011
    7,592
    Yorkshire
    :D

    Perhaps you should talk about it with your sons, assuming they are adults. Giving them your blessing to do the right thing in advance will allay much of the guilt they might otherwise feel should the need arise in future. I have already told my two that they are not to let me get into the state Grandma was in, regardless of what I might say further down the line.

    Assemble the facts, even research CHs in advance, so that when the crisis comes, you, at least, are prepared. I had a look round the CH where MIL ended up months earlier without telling the rest of them, so when SIL said she'd been to see it whilst her mum was still in hospital, I was then able to offer assurances that it would have been my choice too.
     
  15. Trini

    Trini Registered User

    Dec 7, 2015
    39
    Oh her consultant said just because she has fallen over once ( actually it is now five times) does not mean she will fall over again! No help at all. MIL does have Aortic Stenosis. This was diagnosed years ago. Nobody seems to have made that connection!
     
  16. Pear trees

    Pear trees Registered User

    Jan 25, 2015
    441
    My OH's family were arguing with one sister over whether their mum should go into a care home or have increased care package. She was having increased falls. Their mum had a very bad fall between visits and broke many bones including cervical vertebrae. She died in hospital two weeks later.
    If OH's sister had agreed to a care home sooner she probably would have lived comfortably and happily for a few more years. Sister is now arguing that she is due a bigger share of mum's estate and wants to contest will!
     
  17. Owly

    Owly Registered User

    Jun 6, 2011
    538
    If she's taking pills to "keep blood pressure down" then surely that will make things worse? Those pills will be widening her arteries and making it less likely that when she gets up, her blood will still be rising to her head.:eek:
     
  18. grove

    grove Registered User

    Aug 24, 2010
    7,723
    North Yorkshire
    Morning & Welcome.......................

    Trini , tho I read your first Post have not replied until now , am sorry you have had all this worry & family upset :( But am glad you have found TP :) & glad you have had lots of supportive replies :)


    No real advice am afraid except too add about the difference in a C H & Nursing Home , as another member said a Care Home is just that a Home with no qualified Nurse's ( which means any Nursing Jobs that need doing you might have too wait for the District Nurse too come & do them ) Tho saying all that I think most Home Manger's are RGN trained but this does not mean they can do Nurse Jobs > only give out Drugs > A Nursing Home tho has 1 or 2 RGN's ( qualified Nurse ) on Duty which means if a resident needs **Nursing Care** it is better that they are in a N Home


    For many year's I have worked in both as Support Staff ( House Keeper then a change in Job as a Catering Assistant ) Have also worked in what i call a **Care Complex** = That had 4 Units ( hate that word) prefer Home :) Each *Home* looked after the resident's depending on their needs when they moved in So if JM (example only) was more independent etc she would move into the C H type Unit , how ever if she ever needed Nursing needs she would be allowed too live in the Nursing Unit
    ( which is good as less risk of any upset etc as it is only a minor move )

    Think ? tho they are in good in some ways these Care Complex's are sadly higher in fees ? BUT am not 100% sure ( hope the above helps :) )


    Sending you lots of supportive hugs & love & hope things improve soon ( sorry your M-in-Law keeps falling :( )


    Looking forward too seeing **you around** on TP


    Take care


    Grove X X X
     
  19. Trini

    Trini Registered User

    Dec 7, 2015
    39
    Agreed but historically she has had high blood pressure and hence the pills. They have reduced dose slightly but stuck between rock and a hard place.
     
  20. Trini

    Trini Registered User

    Dec 7, 2015
    39
    Sounds dreadful. I am convinced it is just a matter of time and this will happen to MIL. She is unable to tell us when she has hurt herself. She does not seem to feel the pain. She has already fractured her elbow. A day after a fall we noticed how swollen her arm was.
     

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