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Up until two weeks ago, Mom was able to get herself up, dressed, to the bathroom, down to the dining room at AL, to events etc. Although she was weak and unsteady she was pretty much independent. Then she stood up and fell. She bumped her head a little so they sent her to the ER. Although she didn't really hurt herself, she spent the night there, and fell again there. I'm wondering if she didn't have an "event" which caused it all. After that she was so weak she couldn't stand on her own and couldn't stay in AL so for the past 2 weeks she has been in a nursing home. We thought she might be able to be rehabbed and return to AL. But she fell again there, and hit her head requiring stitches this time. She has practically stopped eating, tries to get up every five minutes at night and sleeps on and off most of the day, saying leave me alone, and pretty much out of it (they have to give her a tranquilizer to keep her from being agitated so I suspect that is why she is sleepy). Is this the way it progresses at the end? I'm praying she is not suffering and isn't aware of what it happening. I sit there for hours with her, but she barely knows I'm there and five minutes after I leave she doesn't remember.

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Agree with Golden, ask the MD to culture the urine, so often they just do a dip stick and prescribe a common antibiotic.
Any kind of "event" can start the final journey. A fractured hip is a very common culprit.
Is it the fracture, the surgery or the rehab or is it just time? No one has the answer to that.
Concentrate on keeping Mom comfortable and enjoy whatever time you have left with her
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lost -this happened to my mil and it signalled the beginning of the end some months later. The antibiotics didn't work for her anymore. She had diabetes and CHF and her immune system was not strong. Perhaps the md needs to do a culture and see which antibiotic would be most effective for your mil.
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My mil was diagnosed with a bladder infection, I guess that is the same as a uti, and even though I gave her all of the anti biotic, she has not gotten any better, only getting worse. And her son doesn't seem to see it like that. I'm sorry you're going through this and that I have no answers for you.
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There could be a lot simpler explanations. Many seniors were brain washed into thinking pills and procedures would cure everything and don't want to work on their own health daily with exercise or so much as taking vitamins. Throw confidence issues and poor advice from know it friends a senior very well could start thinking this is the end. They rationalize it because they know a lot of people at their age had similar issues and assume it's old age when it fact it's lack of exercise, nutrition, poor conditions etc.
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It is imperative to attempt to eliminate as many fall risks as is possible. My late mother's cardiologist had a tricky "balancing act, if you will," e. g, is her Coumadin intake vs. a fall risk worse?" He chose the later, taking her off the blood thinner, while giving her 81 mg baby aspirin. He lost because 4 months later mother passed away from a stroke. (insert his bad because he failed to realize that one of her carotids was 100 % blocked).
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This is an old thread, but anyone who finds it as I did while searching for information about falls might find this reply to AmyGrace's question about hospice useful.
One doesn't always "go" to hospice, although plenty of hospice services have their own buildings and on-site staff. In our community (outside Seattle, WA), hospice services can come to your elder at home or in an adult family home. Hospice-trained nurses bring different skill sets from, say, home health nurses; they also seem to have wider authority to gain patients access to pain-relief meds and so forth.
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Mojorox my neighbor had normal pressure hydrocephalus. He had surgery and is doing well years later. When he had it, he was wheelchair-bound and showing dementia-like symptoms. If you go to Youtube and google "normal pressure hydrocephalus + 60 Minutes", you'll see a piece they did on it about eight or nine years ago. It was the first time I'd ever heard of it and the shuffling gait that people with it have. Good luck and as Jeannegibbs says, keep us posted.
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Mojorox, when you get the test results, come back and tell us about them. Perhaps more people would see it if you start a new thread.
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Normal Pressure Hydrocephalus?

I came across this while researching the same type of issues. Mom is in hospital for tests and I'll be asking if this common/possible and is it something they can/will test for.

webmd.com/brain/normal-pressure-hydrocephalus
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That is hard, Lucy. Poor lady! I hope she feels better soon.
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Just reading these posts has made me feel better about my mum. She is 90 and has dementia of a type that gives her paranoid delusions, but her memory is mostly unaffected. She had a fall yesterday at her care home and has a nasty cut to her lower back. I am so worried about her, I live in New Zealand, she is in the UK; we are half a world away from each other, not easy.
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Maybe and maybe not. In some cases yes but not in all. In the case of one friend who since died, a fall from the attic due to a faulty grab bar that came loose did start the beginning of the end for him. At the time I just didn't realize it despite having that feeling inside I thought was just in my head until one night I went to visit him and there was no answer but all the lights were on and the car was in the garage. I found this rather odd and even called into the house to see if he was OK but no answer. I sat there for quite a while hoping that maybe he went out with some friends and they would be returning anytime, but that never happened and I had to end up going home puzzled because for him it was highly unusual to leave all the lights on in the house, the car in the garage and the door locked when company was coming, and I visited him regularly. I didn't know he actually had a stroke in his home until much later, and that stroke killed him. I didn't see the obits until someone sought in the paper and brought it to me for me to read. Now I know why everything was unusual that one night. Now I also know that feeling I thought it was just all in my head was not imagined at all, it was right all along because it was God telling me my friend was going to die, and shortly after that feeling it happened.

What I must warn everyone of his that if you have an attic that you sometimes visit, if you installed a helpful grab bar to help pull yourself up the rest of the way into the attic from the top of the fold down steps or ladder, make sure to use proper installation and not just big thick heavy spikes that can give loose even 25 years down the road. My friend made this mistake and it cost him his life resulting in an early death that could've otherwise been prevented. If you install a safety rail in your attic, please, install it properly and best yet, let a professional do it
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The person who can best decide what you need in your home is an occupational therapist. Genesis, ask her doctor to order an OT evaluation of your home. Before my son was released from rehab after a motorcycle accident, an OT came and looked around his charming old but not terribly accessible house. The bathroom doorway presented a problem. Remove the door and put up a curtain. Use wife's help and a transfer board to get into tub. Also put a bedside commode where he would sleep. Bedroom was a tight turn from the hallway. Have hospital bed delivered to the sun room. Also put computer, etc. in there. OT had Son wheel himself into the kitchen and open the fridge. Yup, he wouldn't starve when home alone. In other words, the Occupational Therapist was very good at spotting the challenging aspects of the home and very clever in coming up with ways to overcome them. He also ordered a temporary ramp for the front sidewalk. (My son fully recovered, btw, but he needed the house modifications for about 6 months.)

Genesis, might the HOA be OK with a temporary ramp (if that is what is needed)? It would be easy to remove when you move.

Does your wife use a wheelchair? After many falls my husband was thrilled to be able to safely scoot around in his wheelchair. It restored a measure of independence. His doctor warned that he should do some walking, too, so as not to loose the strength to transfer to bed, the toilet, etc. It worked wonderfully for him.

After my mother's hip broke in the nursing home she was wheelchair-bound. But an aide came and wheeled her to all the activities and meals. She could even have her hair done in the wheelchair. Mom was content and lived a couple more years.
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Correction: Yes, I have heard of many people (even people in their 50's) deceasing after a fall.
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Genesis, I think that under the fair housing act the HOA must allow modifications required to accommodate a disability... you might want to check about that.
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My wife also falls a lot. She has a form of dementia and a weak knee and ankle. Physical therapy helped but when she stopped improving, Medicare stopped paying. Now she is getting worse. She now uses a special belt that we can use to help hold her up. We have also made our home more accessible friendly but unfortunately there does not appear to be any government service to help decide what we need. The company that put in hand rails had sharp edges on them so we angle cut them to avoid sharp edges. We hav put rubber cushions on many of the sharp corners. Kids R us sells kits or this purpose. We also put a railing on her bed to keep her from falling out at night.Our real problem is the exterior because the home owners association does not allow any modifications on the exterior
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Good advice. Fortunately this is not the case. Mom has been on only antidepressants for a few years (otherwise she is is gloomy she is intolerable and doesn't eat at all) They don't seem to affect her. She has no other meds which is amazing for someone 101 years old. Her falling is due to age and being weak due to starving herself and dehydration. She has been unsteady for years. The NH tried to get her up and onto a walker, but it is too late. She can no longer walk without falling, but she still tries. They have her padded, her floor around the bed is padded, and she has an alarm on her bed and wheelchair to let them know if she tries to get up. Its sad. With her dementia (and before that refusal to cooperate) she has put herself in a situation where she can't be left alone for a minute because she insists she can walk, when she can't. Its an awful existence.
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Be alert to the possibility that the facility is giving sedative meds w/out permission - - illegal, but it happens. Blood pressure meds can cause falls, UTIs, anything that lowers blood O2, vertigo, etc.
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Any kind of break only means demise if that person gives up and doesn't try to get well. Other than that, the person should be fine long as they put forth a very serious effort into getting well again.
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Any type of fall where an elder has a head injury that is when complications starts. I know I was surprised after my Mom's [97 at the time] first fell where Dad [94] was unable to get her up that the hospital found Mom had a brain bleed. Who knows how many falls my parents kept from me.

Mom recovered from that fairly quickly and she was back being the housewife doing all the chores [refused outside help or moving to Independent living] but a week or two later, another fall where she hit her head again and the hospital found a second brain bleed and a blood clot. That was the fall that did her in. There was no coming back from that one. Serious delirium, accelerated dementia, unable to stand up, etc. Sad.
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Hip fractures may not be the end if they get surgery and do rehab. (And maybe get Rx for osteoporosis! - my mom did well for years after her first hip fracture, and then had another one but recovered and lived at home for a few years more.) But if they are too frail for that, and end up bed-bound, it is the frailty that signals the end is near, and the falls may be more of the sign that things are going downhill rather than the cause.
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At first, I responded to your question in the bold letters. Now that I've read your entire post, I believe your mom might be having T.I.A.'s (Transient Ischemic Attacks).
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It is true that a BROKEN HIP usually means the demise of the person. I have not heard of a fall being indicative of the person's end of life.
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I'm so sorry you are going thru this with your mom. We've had falls with both my MIL and FIL. Both were thrown off their stride for weeks to months, but both have also improved since then. One thing I learned with my MIL (who has not been dx with dementia, but may be soon) is that delirium is very common with hospital stays in elderly patients. A delerium is different from dementia and can last hours to days, weeks, or even months. My MIL had a hospital induced delerium at each of two hospital stays within 2 weeks of each other. It was frightening to see her turn from an independent well-functioning individual (still driving) to someone who couldn't remember her birthday or what had happened just a couple of hours before. The first delerium was relatively short-lived (just a few days), but the 2nd last more than a month. She stopped eating and drinking and we were terrified. Now she's doing much better, is back to driving, and her memory has improved again. So I guess what I would say is just love on your mom, but don't assume that what you see now is forever. What she's exhibiting may be dementia, or it may be delirium in conjunction with dementia. There's lots of great tips on how to battle hospital-induced delirium, including putting familiar objects in their room, making sure someone they love is nearby a lot, etc. I hope you are able to see improvement in your mom. Watching our loved ones slowly decline is one of the most painful things I've experienced to date.
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Talk with the doctor about hospice. Requirements may vary state to state, but I was told by our doc that a doc must certify in writing that the patient has 6 months or less to live in order to qualify for hospice. Also make sure you check all Medicare & health insurance requirements as far in advance as possible.
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All these stories sound like the experience with my Mom & Dad. Dad has passed. Nobody can leave parents without some guilt. Fortunately, my Dad left enough funds for awhile to hire sitters for my Mom. She had hernia surgery, then 2 leg breaks later in AL now & wants to leave. I say delusional not dementia or alzheimers (maybe at 1st-drug induced). Now she is better after 1 on 1 PT for 2 months thru home health & round clock sitters. But she is still a fall risk & wont admit it. Irrational-now doesnt want to take meds so I'm at a loss. Still in wheelchair for the most part. As long as the PT guy is there, walking with him with walker is great but she is still not strong enough to even manage with sitters. They dont get paid enough to be that responsible to be sure Mom doesnt fall for fear they will be liable. It takes 6 people & me to manage her. She wears a pendant if emergency-buzz it someone from AL facility comes 1st to check her before calling 911. There is a nurse i signed up for & be aware that laws have recently changed & another comp pkgs meds & another company that comes in that administers meds twice a day. This is Louisiana requiremt so I've been told by AL facility. So monthly apart rent, pharmacy co pay & difference that medicare & private ins. doesn't cover, & fee to have nurse come into administer the meds. So even tho it is less than NH-Assited Living fees do add up. But when she got sick, I called Nurse Practioner (which is billed to medicare), they come out & can get meds &/or shot quickly & she got immediate relief. But she still trys the guilt trip with me, the sitters as well as my brother & sister. Her line is you just dont understand what I have to go thru...she is 88 yrs. I am POA & executor of my Dads estate & that ain't fun either. He passed end of April this yr & he would maybe still be here if I could have taken care of both of them but I was so overwhelmed, he had 95% needs so I located him to Memory care in good NH & he did well until at his earlier request to be moved to a war Veterans home Memory care--MISTAKE-that was a BIG MISTAKE! With so many obstacles, his chances would have been better in a smaller NH Memory care where I had him at 1st. Me..made the best decisions I thought at the time but you as a child, grown adult have to keep on top at all times. My lady sitters keep a notebook for them & as well for me so if I need to get something done for my Mom I have documentation. Nursing homes, VA facility didn't in my observance even come close to having enough people on all levels to care for each & every resident. Most shifts are there to get a pay check to cover their bills just like most people. So my moto became "Trust No One". Drop in as often as possible at any & all times of day & night. you still wont be able to manage or catch everything but that is what I've found. Workers at facilities don't know how much we pay or Medicare/Medicad pay, they only know what their job is & how to get home. I actually had one young girl tell me she went to college..& when I worked there was the phrase & anyother...didn't matter if I went to college or had a degree or certification to do the particular job given...JS..ya'll have a Happy New Year!
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AmyGrace, I found out after the fact that my Mom and my Dad were saving their used Depends and had them on the clothes drying rack. Apparently they were reusing them, don't know if it was a cost measure or the fact they were children of the Great Depression.

Yikes nursing homes are expensive. I thought the cost of $306 room rate per day was reasonable, but then there are the general costs not provided in that room rate... such as $900 per month to have an air mattress.... $540 for incontinence supplies.... $120 for Geri-recliner rental.... $5 per Boost... etc.

What is sad is that my parents were always very frugal with their money, saved big time. So the money saved is now going into the nursing home. If my parents had shopped until they dropped and never saved, Medicaid would be paying and Mom would be having the same identical care. Too bad Medicaid isn't available for all elders... but I know that would bankrupt the States.
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janamark: My mom wouldn't bathe either, or let AL help her. She would stick her dirty depends in drawers. Unfortunately AL is bound by laws and they can't force a resident to do what they don't want to do. We understood, but it was embarrassing that Mom was so irrationally difficult. I don't know much about drugs but if there is something out that that might help, it would be worth a try. Mom was on an antidepressant which helped her agitation, but didn't help memory or make her more cooperative.
AL is less than half the price of a nursing home, so if drugs will keep her there longer, I'd try but it does sound like your mother needs some oversight. AL will tell you when they think your mother needs more care than they can give. With my mom, she refused to use the walker and fell a couple of times. At that point, they realized she needed someone with her all the time and shouldn't be liable if she fell and really hurt herself all because she refused a walker or help. Mom would still be there if it weren't for the last fall she took which weakened her. Also, she wasn't eating so she was weak from that. In the NH she is watched constantly to keep her from getting up and falling and given nutrient drinks, etc all day (which an AL doesn't do - it is for people who need some assistance, not 24/7 oversight) But, a NH is really expensive!
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Oregon girl, bittersweet memory, I'm sure.
Falls are terrible. So many friends tell me that a fall took the independence from a loved one. I'm very careful myself.
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Janamark, what other meds have they trialed? If nothing else works, you try the non approved drugs, imo.
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