Help my parents age safely at home after a series of falls
November 24, 2021 2:51 AM   Subscribe

What modifications (physical or procedural) have worked to help your aging family members stay safe in their house after a series of falls? What strategies have worked best when talking with your loved ones about their deteriorating physical conditions?

My mother and stepfather live independently at their home in the country about 45 minutes from the nearest major hospital, 2 hours away from my sister and I, and with only one direct neighbor that they can walk to. My mother has poor mobility. She has been having falls and is unable to get up without assistance.

I'm concerned that they are not taking these falls seriously and not being forthcoming about when they happen. The last fall, she hit her head hard enough to dent the wall and required my stepfather to get the neighbors to get her up off the floor. They then put off going to the ER for 72 hours after that fall. I'm not sure we would have heard about the fall if we hadn't called to confirm some upcoming plans, as they haven't been forthcoming about falls in the past and have downplayed how serious they were.

Mom has been prescribed a walker, but finds it ungainly and doesn't use it consistently. My stepfather does his best to support her when she is walking. He acknowledges that it's not a good solution. Should they both fall, he knows they would both need assistance getting up.

Neither Mom nor stepfather will have serious discussions about forward-thinking solutions to addressing the falls. It's particularly painful because in our family, we have a therapist who has worked in geriatrics and falls, but they won't take this person's advice seriously (despite having loudly and publicly championed their doctoral education). When we do try to have these discussions, any suggestion is met with my stepfather's explanation of how it would never work or how inconvenient it would make their life.

Ideally, we want my mom and stepfather to age in their home as long as they can safely do so. Their neighbor suggested grab bars all over the house and they thought that was a smashing idea (ignoring the fact that our in-family falls expert had brought that up years ago).

Their current plan is to install grab bars everywhere and get LifeAlert bracelets, which is good, but it's not addressing anything long term.

We've looked for a therapist to do a safety evaluation of their home with no success in their remote area. We have considered trying to hire a live-in/daily therapist/assistant, which might be beyond their means, may not be helpful with the acuteness of falls, and would definitely be way outside my parents comfort limit.
posted by anonymous to Human Relations (32 answers total) 17 users marked this as a favorite
Sorry, my grandma had a lot of falls and didn't take them seriously. She didn't like her walker, she didn't like asking for help, she didn't like waiting for help. We got her a life alert necklace when she was in her late 80s and it got some good use. So I think that's a great idea. Make sure it's on something that your parents will actually wear, every day.

Grandma lived independently (with occasional falls) until she was about 90, then paid a few old (but less old) ladies from church to come help her out during the day. This worked better than a care staff because they could spend time playing cards and gossiping as friends, but then she'd also have help doing chores and going to the bathroom/bathing and someone to cook her meals.

Then when she was 93 (I think) she moved into an assisted living place where she had her own apartment. Staff would drop in throughout the day to help her, but she would still have to call for help with anything specific, and that meant she still had falls. She broke her hip at 95 and only reluctantly did her rehab, and I mean she was 95, so she never really got mobile again.

I guess what I'm saying is you are right to be concerned, falls are a major issue, and people get real stubborn about their declining abilities.

Step 1 get the life alert buttons
Step 2 lean on the local community to find a helper you can pay to "drop in" and help. That was a huge huge help for my grandma. There's no way she would have tolerated a nurse or therapist in her home, but a new friend? Sure we can do that.
posted by phunniemee at 5:35 AM on November 24, 2021 [10 favorites]

I've got mine living on just one floor of the house, to at least eliminate stair fall dangers. And I have moved in with them, which was possible because I had not too much life to give up, after the pandemic. And because there is a bedroom with a bathroom there on the floor that has the kitchen and living room. And because I saw no other choice - they just can't get by on their own any more.

Yeah the resistance thing is hard. The one who was worst off this summer wanted to keep walking with a cane and not use a walker. It took someone, a physical therapist, other than me, telling him that this was no longer safe, and a couple of more falls, before he accepted it. Now the other one doesn't want to start using a cane....
posted by thelonius at 5:36 AM on November 24, 2021 [1 favorite]

My great aunt fell more and more as she reached her late 80s, fell badly enough to go to the hospital multiple times. She eventually died at 88 from pneumonia she got from going to the hospital - thanks to a fall. She had children nearby, so they provided some support, but I'm not aware of other in house help. From my perspective assisted living or in house help are required at this stage of life.
posted by randomquestion at 5:45 AM on November 24, 2021

Its worth checking out if there is a walker that would be less frustrating. My MIL hated the first one that she had. My BIL took her to a store with alternates, and she found one that she actually liked. It was lighter, and had better wheels, so more maneuverable, also handled carpet better. So she used it more.
posted by Ftsqg at 6:11 AM on November 24, 2021 [14 favorites]

Definitely grab bars, especially since they seem open to use them. Also, remove any rugs. They can curl up and are easy to trip on. If their home lends itself to this, perhaps remodel the tub to a walk in type. Maybe install a higher toilet?
What about outside the home? Are the pavements level? Cracks in the sidewalk? Is the area outside where they would walk adequately lit?
Maybe think about how they go about their daily living in terms of bending, twisting, reaching, for things.
posted by jtexman1 at 6:16 AM on November 24, 2021 [4 favorites]

Its worth checking out if there is a walker that would be less frustrating.

A lot of people have recommended to me one called a "Rollinator" I think.
posted by thelonius at 6:22 AM on November 24, 2021 [1 favorite]

Their current plan is to install grab bars everywhere and get LifeAlert bracelets, which is good, but it's not addressing anything long term.

No, but until your parents are willing to take additional steps, this is all you can do. Having been in this situation multiple times, I think it's important for your own health to remember there's only so much you can do at the moment and that your parents are adults who can still make their own (unwise) decisions.

I had one grandmother who suffered a bad fall and vowed to take every precaution. We helped her rearrange the house, she always used her rollator, and she embraced everything we suggested. I had another grandmother who also suffered a bad fall, but she was a bit more stubborn and cavalier and refused to make any significant changes. Guess which one had another serious and entirely preventable fall? (Answer: they both did).

The grab bars are a great idea. Can your in-family therapist scout out the best locations to put them? Your parents seem to trust their neighbor, is there any way you can reach out to this neighbor, explain the situation, and get them to endorse other suggestions from the therapist?
posted by RonButNotStupid at 6:24 AM on November 24, 2021 [7 favorites]

I have been in the past with my mother where you are now. All the comments above are good. I just have a couple things to add -

- In my experience, the reluctance to share information about falls is probably out of fear that they will be "put in a home." Repeating frequently that you are on the same team and are committed to helping them stay where they are for as long as they can might help them to trust that you ARE in fact on the same team.

- Your original question included a comment about a long-term plan. I suggest you let that go. There are so many ways this could go and trying to prepare for every contingency will make everyone crazy. Instead, focus on solutions that work for their currently level of functioning (grab bars everywhere is indeed a great idea.) Then when something happens, you can make a new plan for that situation. There is an inevitable decline that happens at the end of life, but the path has so many twists and turns that are unique to the individual that coming up with a grand strategy is unlikely to be the actual path followed.

- Keep in mind that supporting your parents through these coming months/years may be your last meaningful expression of love toward them. Take comfort in that and let it give you patience.
posted by eleslie at 6:28 AM on November 24, 2021 [22 favorites]

- Keep in mind that supporting your parents through these coming months/years may be your last meaningful expression of love toward them. Take comfort in that and let it give you patience.

This is so true. The last 6 months have been difficult for me, but deeply meaningful.
posted by thelonius at 6:32 AM on November 24, 2021 [3 favorites]

I JUST moved in with my mother (81) for basically just this reason. It's unlikely she'll ever be able to live alone again. She's had multiple visits from occupational and physical therapists after a recent hospital visit.

The PT got her doing some leg exercises to help with her leg strength. Memail me if you want a detailed list.

The OT had many great suggestions for safer interactions around the house:

* Get rid of any throw rugs, especially any with fringed edges, or that might not lay flat.

* As mentioned above, a different style walker may be more acceptable. My mom has a purple(!) one that we call her "off-roader" because it has four wheels and hand brakes. She uses that one when we go for walks outside.

* My mom resisted her walker for a while because she couldn't easily carry anything from room to room while using it. Who knew they make all sorts of bags and trays for walkers - even with cup holders! Now she feels more "able" because she can carry her water bottle or box of tissues around with her.

* Different shoes? We're still working that out here. My mom doesn't like athletic-style shoes, but I think they would give her better grip on the floor. Ongoing discussion.

* The OT watched her in the kitchen (pretending to prepare her normal breakfast), and gave suggestions on little things, like relocating the toaster to a different counter and such, that minimized how much my mom would have to cross the kitchen back and forth.

* Continuing on with that theme, can they get multiples of items that they might normally have to go to another room to get? Things like landline phone handsets, medications, extra sweaters or jackets, notebooks/pens, etc.

I feel as if I am suddenly becoming a reluctant expert on geriatric mobility, so if I think of anything else, I'll add more comments.
posted by SuperSquirrel at 6:38 AM on November 24, 2021 [18 favorites]

Are they comfortable enough with technology to use Apple Watches? Not only do they have fall detection, but (they have to be paired with an iPhone) you can even make calls from them. So if they're in a situation where they might be reluctant to "call 911" by using the LifeAlert, they might be able to call the neighbors without getting up. My mom is slowly starting to approach this stage of life and I'm glad she has hers.
posted by praemunire at 6:51 AM on November 24, 2021 [3 favorites]

The Employee Resources Center at my job provided a book and counseling for people caring for aging parents. For me, this resource was a good early step in my journey caring for both an aging aunt (died at 83) and an aging father (died at 98).

A fall essential killed my aunt. She was on blood thinners and she hit her head on the last fall. She bled into her brain and - that was it.

Every couple years, I spent winters in the Midwest with my father because he’s fall, break something, need surgery and rehab. Finally, we talked him on to spending winters with us in California. We never said he couldn’t go home, but we wouldn’t help him make arrangements to go back. So that worked out pretty well.

We eventually hired local help to check in on him and do light cleaning and wash his clothes and sheets. Unfortunately, stubborn elders often don’t listen until a debilitating injury happens.

From the time of his first broken bone till he died, my dad stayed an additional 10 years at home - due to help. I pretty much said, “Either you come live with us or you let Cecilia do your dishes once in a while. It’s my treat. Merry Christmas. She starts January 3rd”.

Good luck - and seeif your employer offers assistance. For me, I got help and guidance early on the journey and financial assistance near the end. Ours offered and elder care benefit through, which we used to hire a caretaker at our place after my dad has a stroke. (3 weeks a year wasn’t much, but it helped.)
posted by rw at 6:53 AM on November 24, 2021 [3 favorites]

Also look into adding nightlights and motion activated lighting. A lot of falls happen in the night as a person gets up to use the bathroom. There are LED lights embedded in outlet covers now that are pretty good. You can also get motion activated, battery operated lights to stick anywhere like along the underside of a bed or next to any furniture that needs to be navigated. Of course, someone has to replace those batteries. A motion activated overhead light for the bathroom is a good idea.
posted by amanda at 7:13 AM on November 24, 2021 [5 favorites]

I think that what a lot of this thread is confirming is that your parents do not want to take advice from their children or from other family in their children's generation/age group. Outside people (neighbours, an OT, etc) are better able to give advice your parents will hear.

Work with that, because you can't make them do anything they are unwilling to do.
posted by DarlingBri at 7:40 AM on November 24, 2021 [4 favorites]

Atul Gawande's book on aging (and dying) has a chapter about how having an excellent geriatrician can reduce falls, through things like adjusting the meds that might be causing the fall, or grippier shoes, and just generally understanding the person's day to day life. Just a thought -- do they have a good geriatrician might be able to initially improve stability in a way other than using a walker and grab bars?
posted by cnidaria at 8:12 AM on November 24, 2021 [5 favorites]

Your parents are adults, they want to stay in a place that is familiar to them. Trust me they know they are getting frail, and that falling a lot is a bad thing but what people don't seem to realise is admitting to that fragility is admitting they are going to die so they fight against the changes. It isn't being stubborn or refusing to take advice it has nothing to do with you. See them for what they are which is scared human beings facing the end of their lives and not quite ready to give up and you will probably have a better chance at getting them to change. Make it clear your goal is to help them stay in their home and maintain their independence as much as possible and ask them to help you help them to do that. Get them to be invested in what is happening as maintaining their independence and not you taking it from them.

Things that will help besides handrails.

Make sure there shoes are comfortable and non slip and easy to get on and off, no slip on slippers or crocs. Good shoes that provide a firm base and that are comfortable. Same with socks. They might need aids to help put shoes on and off.

Remove all rugs, make sure all floors not just the bathroom floors are non slip dry and wet as well as the tub. You will also want a shower chair.

Can you arrange for someone to come out and clean and tidy once a week or so? This can help make sure floors are kept clear of clutter.

Declutter the house. Less clutter is less things to trip over and less things to care for. You might need to remove a few side tables that sort of thing to open up areas too. Try and make a space wide enough for 2 people side by side around all furniture. It makes avoiding a trip easier and moving a walker less of a pain.

Don't forget aids for using the toilet. Getting up and down off a toilet can be difficult.

Make sure there are lots of easy to access spots to just sit if they get tired, make sure they are an easy to get up and down from. If you get a walker get one with a seat and a means to carry items.

Don't just give them a walker, take them to choose any aids themselves. This will not only make sure it meets their requirements, it gives them buy in which will make them more likely to use the items.

Find ways to make sure they are drinking enough. A worrying amount of elder confusion and balance problems can come simply from dehydration. Old people do not feel the urge to drink as strongly as young people. It's hard to get up to go get a drink, glasses are hard to hold and carry that sort of thing. Dehydration causes confusion as well as lack of appetite which leads to under eating neither thing helps. Easily refillable water bottles, with easy to screw on lids for older hands, that are easy to carry can help. As can making sure they are stocked up on things they like to drink.

As cnidaria mentioned above also look into their meds. A lot of meds can lead to balance issues or 2 harmless meds together can have unexpected side effects on balance or by causing confusion.
posted by wwax at 8:28 AM on November 24, 2021 [3 favorites]

Get them something like MedicAlert or Alert1 call buttons... Or carry a fall detector. I believe Apple Watch has them built-in nowadays, but that's kinda expensive. There's a range of options, some that works with a mobile phone (basically remote Bluetooth), some work with landlines and subscription, some works outdoors and has built-in GPS... (which they don't need).
posted by kschang at 9:26 AM on November 24, 2021 [1 favorite]

Emphasizing the need to yeet all throw rugs, area rugs, basically anything that's not wall to wall.

Even area rugs with padding underneath can curl up at the edges over time and snare your feet, especially if you're wearing shoes.
posted by Sheydem-tants at 9:42 AM on November 24, 2021

The CDC has a really good fall prevention site.
posted by neuron at 9:57 AM on November 24, 2021 [3 favorites]

My sympathies; this is really hard. Unfortunately I have found that people are just not ready until they are ready, and it's hard to predict whose advice will actually land. But advice from kids is the trickiest of all. Everyone can kind of see the role-reversal coming down the pike and that's a very sobering, mortality-facing kind of role-reversal.

If they are amenable to grab bars and life-alerts right now, that may be, first off, very helpful, and second off, all you can really do right now. At this point, focus your energy on listening to them, and managing your own stress and fears while you prepare for the harder stuff down the line. Don't burn yourself out now with worry and find yourself with an empty tank in a couple of years when you are confronting an injury and recovery, or looking at supported living situations.
posted by We put our faith in Blast Hardcheese at 10:04 AM on November 24, 2021 [2 favorites]

If you can possibly figure out how to help them move to someplace with one floor, completely without steps and closer to potential medical help you will likely lengthen their independence. This doesn't necessarily mean selling their home, which is a very daunting project for older and frail family members who shrink from the prospect of going through all the stuff they have collected, all the furniture they love, etc. I'm suggesting a first floor or elevator building apartment closer to a hospital and medical assistance. If this were in the direction of either you or your sister, that would be a plus.

Of course, you would make sure there were no throw rugs and there were wide doorways to accommodate walkers or potential wheelchairs, walk-in showers (preferably without a threshold so a chair or walker can be wheeled right in) and grab bars. My 88 year old aunt adamantly refused to dispense with throw rugs - or really any accommodations to her age and diminished mobility - and tripped on her way to the bathroom in the middle of the night. She fell and lay on the floor all night until she could finally shimmy herself to her bedside phone to call me. I called 911 and took her to the ER and she never came home again, because finally she understood that the stairs were beyond her and her home was no longer safe. I had wheedled and done what I could to tempt her for many months into an assisted living home, some of which were lovely, but the $5000.00/month price appalled her, who had paid off her small two story house decades earlier. That's why I suggest a rental apartment set up to support a safer environment, with the plus of being nearer to family, less of a worry for you, and closer to medical help. I also endorse consulting a geriatrician to review all the meds they take to see if their independent safely can be optimized.

Also, I'd lean heavily on how worried you and your sister are about their living so far away from you and medical assistance. And what if one of them becomes disabled in some way. Do they have a plan to work around that possibility?

Good luck. I know this is really, really hard.
posted by citygirl at 10:09 AM on November 24, 2021 [1 favorite]

Don't forget aids for using the toilet. Getting up and down off a toilet can be difficult.

Three options that I've researched:

1) Toilet seat riser. (Walgreens link) We tried one - Mom did not like it. We probably will give it another try at some later date.

2) Toilet safety rail (Walgreens link) This is what we installed. She's still getting used to it. It's not quite as "solid" feeling as I would like, but she's fine with it. The OT recommended this be used in combo with the seat riser above.

3) Bedside commode (Walgreens link) This is like what she used in the hospital. The nurses explained that the bucket can be removed, and the whole thing positioned over your regular toilet. You would have to buy or rig up some kind of "chute" (for lack of a better word) from the seat to the toilet water, or you'd have a lot of splashing. We decided this would be a last resort, because my mom really disliked it. Be sure to measure the toilet area - some are wider than others.

And luckily she already had a grab bar. Be sure it is low enough, and is actually attached to studs. Mom's OT is not fond of the suction-style bars, but she said something is better than nothing.
posted by SuperSquirrel at 11:43 AM on November 24, 2021 [3 favorites]

I dont think they should be calling the neighbors for help. The neighbors could hurt their backs. Where I live you can call the paramedics, for free, and they will come out and help, no problem! We have to call maybe twice a year. At first it was embarrassing but we got used to it. I think the paramedics consider this a kind of break because it is a low stress call. Usually. Explain this to them. It is not putting the paramedics out at all.
My husband was taking 2.5 mg of Lisiniprol for high blood pressure. He had a stroke and his gp wanted to put him on 40 mg of Lisiniprol. I said wouldn't that make him very vulnerable to falling? (my husband's greatest fear). He started yelling at me "you are practicing medicine without a license!". We didnt up his dose and he didnt have another stroke and we got a new doctor. My point is you really need someone to look over their medications and make sure they are not being overmedicated. I've found most medical professionals do not take falling seriously as a number one threat to be able to stay in your home. Out of sight out of mind.
Monitor swelling of the feet. This is confusing, hard to gage sometimes, but swollen feet can really affect walking. Compression socks might be in order. This is where having a helper would be great because they are hard to put on. The other option is diuretics.
posted by cda at 12:37 PM on November 24, 2021 [1 favorite]

Seconding the Apple Watch recommendation. My mom is 85 and lives independently and we finally convinced her to get one. Or rather, after many attempts she was finally convinced when one of her neighbors fell and then talked about how amazing it was. I especially like that if she falls and is knocked unconscious or can’t answer the watch, it will give her a minute and then call emergency services automatically.

Obviously do all the things above to prevent the falls in the first place, too.
posted by thejanna at 1:33 PM on November 24, 2021 [1 favorite]

As a preventative thing, get them a copy of Better Balance for Life by Carol Clements?
posted by spamandkimchi at 1:46 PM on November 24, 2021 [2 favorites]

The fall alert buttons are great, as is getting an amazon echo for each room (or the most-used rooms). The echo can be set up to "call kid" or "call neighbor" or "call 911" so that if someone is on the floor they can call out and still get help alerted.

I second the need for better walkers. Mom's has wheels and a soft basket and a seat and brakes and can be narrowed to go through tight spaces and she Loves it. Also her shower chair, raised toilet seat, grab bars, etc.
posted by ldthomps at 2:03 PM on November 24, 2021 [1 favorite]

My 92 year old dad is having regular falls even though my sister is there for hours every day, but he's stubborn. She just told me he refused to go in for hospice care while she's away visiting her son. She figures he'll fall while she's gone. As others have noted, even when you take precautions, or even when you're in a skilled nursing floor as my mother was, you can fall (she did, even though she was monitored constantly and was in a wheelchair).

Just a heads-up that the Apple Watch thinks I've fallen* when I've just bumped into something or even when nothing in particular happened so I can't figure out why it thought I fell. It did pick up when I fell off a chair but it's more likely to give a false positive than not.

* I'm an athletic 70-year-old and I fence sabre, and practice is usually where it thinks I've fallen, so I can see why. YMMV.
posted by Peach at 3:16 PM on November 24, 2021 [1 favorite]

Falls in the bathroom are common. Grab bars at the toilet, in the shower, and 1 for entering the shower. Shower/ tub combinations are a hazard; if you can have a walk in shower installed, it's better.

Throw rugs and the edges of rugs or flooring are a hazard. Even thresholds are a hazard.

Employee Assistance Program(EAP) - great idea.

Every community in the US is served by an Area Agency on Aging, and they should have expertise and resources.
posted by theora55 at 6:11 PM on November 24, 2021

Falls can be caused by, or can cause, strokes and TIAs (mini-strokes). Might be worth getting head MRIs for both of them to assess, that might help scare them into taking better precautions.
posted by nouvelle-personne at 6:34 PM on November 24, 2021 [1 favorite]

I've been on this journey with my mother for the past couple of years, so I know how hard it can be. My Mother (now 84) was also stubbornly independent and, it turned out, was also falling regularly and hiding it.

We went through all the grab bars, life alert necklaces, walkers (echoing that there are lots of different ones and a better one can be an amazing improvement) etc. In the end, after a very serious fall that landed her in hospital for several weeks, we had to have 'the conversation' with her about an assisted-living facility. This, after promising multiple times that we wouldn't 'put her in a home' against her will. She flatly refused at first and said she'd rather die in the hospital and just wanted to go home. In the end, we had to tell her that the doctors opinion was that she could not go home and they would intervene if we didn't arrange something suitable, so she agreed to a trial period on the proviso that she could go home if she didn't like it (which was never going to happen). We were lucky to get a place in a very modern, beautifully appointed facility that looks (and smells!) nothing like the traditional aged-care facility.

The improvement in her quality of life has been amazing. She has been weaned off most of the medications her idiot (but well-meaning) doctor had her on, at least some of which were probably contributing to her falling. She's eating better. She's much more social. She looks five years younger. She's happier than she has been in years and even admitted she prefers it to home.

It's a tough thing to do, but the only way your parents can avoid something similar is if they are willing to take the necessary precautions to protect themselves - not just things like installing grab bars, but actually being honest about how they are doing re falls etc and always always always using aids like walkers. Getting some 'drop-in' help can assist while they're at home, but they need to not lie to the carer (as my mother did) about how they're doing. Tell them the hard truth - co-operate and be sensible or decisions will have to be made by people other than themselves.

Good luck.
posted by dg at 9:22 PM on November 24, 2021 [3 favorites]

This has come up in a couple of comments but it bears repeating: ALWAYS examine the medications when there is a change in capacity, especially any sudden decline. Get blood work done too.
posted by thelonius at 2:25 AM on November 25, 2021 [1 favorite]

Falls can be a sign of out of control substance abuse. There is a distant possibility that there is a drinking problem involved. Mom's after dinner glass of sherry may now be two-thirds of the bottle. The reason your parents may be covering up is because it's awful hard to tell anyone Mom is now getting falling down drunk.

Sometimes people can't figure out how to get up because they can't get up the way they used to, using their arms to push themselves into a sitting position and then using their arms to push themselves off so that their legs can do the rest. If you are feeble the easiest way to get up of the floor is to flip onto your front, get up on hands and knees and then crawl up a chair. Legs are stronger than arms, so efforts to get up should be using leg muscles much more than arm muscles. If your dad is in better cognitive shape than your mom make sure he knows how to coach her to do this, if she can do it but doesn't think to do it.

If she has any possibility of doing so, it would help a lot for her to practice getting up as much as she can and retaining the strength and mobility to crawl. If she can crawl a little she can potentially keep a non serious fall from turning into a critical one. If she can crawl she can move enough so that your father can get covers around and underneath her, or get her pants up so she is willing to have aid summoned instead of resisting him calling anyone, or prevent circulation problems that could be caused by lying immobile when it takes forty five minutes for help to arrive.She can maybe get into a sitting position while she waits for help and drink a cup of tea to make the experience less traumatic. Crawling can be practiced on a large bed, if getting on a floor to crawl would trap her there.

Sometimes people can't get up because there isn't room for them to roll over or to crawl and even if they did there isn't anything for them to crawl up. The walker might be in the way, but it rolls away if they try to use it to stand. Rearranging the furniture and make sure there are sturdy suitable chairs in range can make a big difference. If the house is cluttered and she falls between the coffee table and the couch someone, possibly someone a lot stronger than your Dad has to move the coffee table.

De-cluttering is also critical. Often when someone is feeble they tend to pile things around them conveniently close so that they don't have to get up to get things. Then when they do fall they are wedged between all this stuff and they can't use the coffee table to help them get up because it is covered in tippy stacks that will landslide off, if it hasn't already done so. You can easily end up with a scenario where Mom is keeping all her important documents and daily things beside her bed, and then the stack tips and the floor is covered in the papers and she can't pick them up, and then she walks on them and they slide under her and over she goes. It's a no win situation. Either she falls because she has to go fetch stuff when she isn't up to it, or the stuff is so close to her it causes her to fall. For this reason you want to make sure that anything she doesn't need on hand is put away or is fixed firmly so that it can't cause a fall or come down with her. You may want to move all the ornaments from the side table onto a display shelf on the wall so she can still see them, and have the side table clear for TV guide and the notes from her occupational therapist.

You can put pressure on them by indicating that making changes in the furniture and decorations are an alternative to having constant strangers in the home, or not being able to stay in it any longer.

N'thing looking into their medications and if there are issues with their feet.

Keep in mind that even having a live-in caretaker will not prevent falls if the person is at a stage where their balance is gone and their legs are getting too weak to support them. The caretaker is not going to put them in a harness and follow them around lockstep. Any fall could be the result of a mini stroke, and any fall can cause neurological damage. If the person cannot successfully get into an exercise program that restores strength and balance they are going to end up in a wheelchair very soon. They maybe should be in a wheelchair already. Walkers are to prevent falls. If the walker isn't preventing falls then it could already be time to move to a mobile scooter. Mobile scooters are fun, and could massively increase your mother's quality of life. If there is no dementia making a mobile scooter impractical give it serious consideration.

Finally, the fact that your parents have been hiding the falls is a judgement error on their part. Your parents not being forthcoming could be an indication of dementia. It's worth checking if other misjudgements are occurring, missed appointments, unpaid bills, unwise purchases, hygiene issues (especially those that lead to uti's) spoiled food not being thrown out and even being eaten, fender benders, denial about the need for house repairs, excessive fear of strangers...
posted by Jane the Brown at 1:52 PM on November 25, 2021 [1 favorite]

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