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Mom is in Asssisted Living, has Alzheimer's, 92 yr old, uses a walker for the last year. She never asks for staff help for ANYTHING. Staff have found her on the floor in her room by her couch multiple times in the last week. We had an ER visit from a fall 7 mo ago to find a bruised tailbone. Should we take her assisted mobility devices away so that she can not get up on her own? She is already incontinent and in Depends.

Mom uses a walker and never asks the assisted living staff for any help. Last week they found her on the floor multiple times. Should we take her assisted mobility devices away so that she can't get up on her own and hurt herself?

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Oh, let me add one more little thing. The gentleman I care for is 90, walks with a walker, and is becoming more unstable by the day. When he is walking I have one hand basically on him, and I am watching like a hawk. If there is a stumble or a glitch, both hands go around him so that he does not fall. It's not like he walks often, though. I have to insist on bathroom trips during the day. A gait belt would be a great idea, and he has one... it might be a good idea for your mom to wear a gait belt while walking, so that a caregiver has something to grab if she starts to stumble, which won't cause injury to her. The caregiver can also lightly hold the gait belt while Mom is walking, as a sort of "insurance policy". :-)
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I wouldn't take the walker away but, like the other lady said you need to work on finding more close care before the 30 days notice will come and get the decisions in a big rush. There are placement agencies for elderly in every state who can work with you and they don't charge you. They get their commission from the provider you place your mom. Every where you go ask for the state inspections, references list and you call the people on the list. Once you find a place you like and afford go one more time announced and check the place out. In my state Wa are called Adult Family Homes. These places are licensed for not more than 6 Residents so, the care and supervision is more closely, small environment and looks like home.
She will feel much better, safer and sooner or later she will feel home again.
Good Luck,
Vali from Wa
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I guess I have one small thing to add to the very good observations of the others. Isn't it great your mom, at this age, is still spunky and walking? Yes, I know she's at risk, and I'm not trying to down-play that, but wow! The only injury requiring attention was 7 months ago. Not bad! I work with just two people maximum at a time. I did take care of one severely demented delightful and spunky lady as a respite caregiver. It was MY job to monitor her, rather than her job to ask for my help... taking away her walker would probably kill her. Literally.
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If you take away her walker, etc, she may find some other way to walk with something in her room that has wheels, or which she thinks she could use as a cane or crutch. Or she will just walk unaided, and will fall. If she is falling because she has a wheeled walker and it is getting away from her (my mother's doctor did not permit her to have a wheeled one for this reason), you could get her a regular walker, if she would have the strength to lift it. With her ALZ and falling so much, maybe the time has come for her to move to a higher level of care. and her doctor would determine this. If she does go to a home, instead of walking with her to meals, activites, or the bathroom, they may just have her sit in a wheelchair and not walk at all. They may say they don't have the time to walk her. Also, because walking may not be safe for her, they may not even allow her to use a walker, and if they do, they may not allow her to walk unattended. If she has therapy and there is no improvement, Medicare will not pay. If she would live with a relative, the relative or caregivers you could hire, could continue doing her therapy exercises with her and seeing to it that she walks. However, when the caregiver leaves, there is the danger of her walking unattended. My mother had ALZ and could only walk with a walker if someone was with her, moving her walker (it did not have wheels) One time, her caregiver stepped out of the room to use the bathroom, mom got up from her chair, started to walk to bed and fell and broke her arm. All this is a lot to consider, and when my relative's time comes, it will be the doctor's decision.
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I say yes. I had to make some difficult decisions against my father's will to to make sure he stays safe. Wouldn't you rather see her safe and healthy opposed to hurt and bedridden?
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Do not remove the walker, the four-pronged cane or any other assistive devices that she uses. Here's the deal: Walking has to be taught, yes taught all over again.
Rule one: Work your legs in a P.T. facility or at the home with equipment for strengthening. When legs are stronger, begin.
Rule Two: Begin the walk on a STRAIGHT, clutter-free, walkway which may be stone or carpeted. I like carpet.
Rule Three: Hold your head up and totally RELAX. This is very important, and no one can "teach you" this.
Rule Four: Wall a SHORT distance by yourself, Look Ma, no handsl Make sure the feet are properly cared for. Foot baths and Foot creams are good. The shoes must be sneakers, Foot Solutions or specially-designed shoes for the elderly. Each day go a little bit longer. If the patient uses a bike, set it at NO RESISTANCE....just rotate the pedals. Find out what is the weakest point in the leg structure...the knees? the lower legs? the thighs? Extra strengthening for these must be recommended by a P.T.
More important: Daily, daily, daily, do not miss a "walk time".
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physical therapy and strength training. You learn some of the exercises and help your mom as well. Repitition. Suggest you also look into checking her meds. As one ages, one usually doesn't need as strong a dose...it does not clear easily from liver/kidneys any more. A few meds with "dizziness" and "sleepiness" as side effects and you are looking for trouble.
Work with doctor or staff gerontologist using the protocol called Beers Criteria. easy to find on the net. I now have mom off ALL drugs cept ativan very rarely. Every single drug she was on cause a degree of dementia (and sometimes outright insanity) that cleared when we stopped it. Some drugs have withdrawal symptoms or should be tappered off gradually.
Amazing how many nurses I talk to who do not know about Beers. Dr. Beers developed the protocol and list to help nursing homes decide what drugs to eliminate in the elderly population. Turns out one can knock back quite a few.

Your mother may have a blood pressure problem when she first stands...stand up...light headed...down she goes. Getting acclimated gradually...sit...rest...stand...get stable...then move. You might get one of those seat walkers...something to catch her part way down.

In other words do not give up yet. See if any of the above helps her. Getting stronger helps the senior maintain balance, just helps them stand and walk.
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She should Be in the HALL and NOT in her room. At night she should have the RAILS locked UP and a Long Thick rubber mat along the bedside where she gets up and down. She probably doesnt hear and cannot speak very loudly. Get her a wheelchair she can Push or Sit in.
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it is hard to fase for the caregiver and the love one to see it just may be time to go to the next step of care. ask yourself , if i don;t take it away can i live with knowing this fall could have not happen if i have taken away the item , also may be time to move to a nursing home where she will get more one to one care. Faceing this myself with my mom.
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My Mom has ALZ and she just forgets that she needs the walker at times. I agree with the others that she is ready for the next level of care. I personally chose to bring my Mom to live with me, but not everyone is a caregiver. I have a monitor with a video that I move from room to room with me so that I can see and hear what Mom is up to. I try to give her as much independance as possible, but I am able to "show up" when I see she is about to do something she is not able to and can give her a gentle reminder. Good luck. I know these decisions are very difficult to make.
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I would have to agree with most everyone on the board. Looks like your mom just doesn't realize what she's doing. Assisted living is not enough care for her (I don't believe she's being stubborn in not asking for help, I think she may not realize she has the option to ask for help).

Run this past her regular physician and he/she will guide you, but I think she's ready for next level of care. :)

Deep breaths!
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If she started falling there is a reason, she needs to be evaluated by physical thereapy. if your A.L. facility does not have onsite PT contact your physician to get home health in to do an eval. pulling her walker without an eval will not stop her she will just fall more often. most falls are preventable, you just need to find out why she is falling. it may be that she has progressed past the assisted living phase and needs supportive living or intermediate care.
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Wheel chair and total supervision I think maybe...
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I would not recommend taking the walker away I think that will cause more problems. I think she needs more care. If she is falling frequently she obviously needs more supervision. She is probably at a place (in her mind) where she does not understand to ask for help or she may just forget how. I would be very concerned that she is going to fracture her hip or hit her head at sometime when she falls. I would make differant arrangements for her and soon... take care, J
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Seems she is ready for the next level, which would be skilled nursing care or "SNF" aka "sniff". Her doctor will need to evaluate her and provide a letter for this - with her history this won't be a problem. You just may be able to speak or email the doc to get this done. But it can take time especially with the Holidays upon us - get multiple copies as you will need for medicaid if you're going that route for SNF payment.

Is her AL a tiered system that has a SNF component? If so,
you need to start the paperwork for moving her there.
If not, speak with the placement counselor or social worker on staff at her current AL as to where they have had other residents move into. At 92 this isn't going to get better.

You need to be proactive about this and contact her AL to tell them you recognize her needs have changed. You don't want to find yourself getting a "we just love her but can't have her
her anymore and this is your 30 day notice" letter. If they know
you recognize the situation and are awaiting an opening, they
will work with you on having mom stay a few more weeks if need be. You have to realize that if she is falling often or daily,
and this involves a runaway walker/wheelchair, she is becoming a liability for the AL and for the other residents - this is a huge issue for the AL and they can make things speed up as far as placement into a SNF. Her AL may take her device away from her because of this and restrict her to a traditional
walker (the metal kind "U" frame kind) as she does not have
the cognitive skills needed to "drive". So this all may just
be out of your hands........

IMHO not all of us are caregivers nor do we need to be for our parents or elderly relatives. There are good facilities out there.
Good luck!
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Your mom does need more supervised time and maybe she can't come up with the right words to ask for help. I would have a physical therapist to evaluate her ability to walk unaided, as well as maintaining whatever strength she does have through physical therapyl Follow up on finding out if this facility can provide one on one time to walk your mom, and if not, a more skilled nursing facility might be the next step. I have been doing rehab with my mom with last stage Alzheimers. I was able to obtain Medicaid home care and she has one on one care in her home. Your mom can still get one on one care if she lived in your home is she is eligible. If that is not an option, start looking at options that would still give your mother the exercize through walking with another caregiver. That is so important. If you don't use the leg muscles, they atrophy, and weaken, and then your mom is stuck in bed or in a wheelchair. Physical therapy, exercize, really helps so your mom so that she can be more easily transfered from chair to bed, etc. Find a place where she could still be allowed but helped to walk and exercize. Check out mom's hearing. She may not be asking, because she may not be able to hear the response.-Just a thought

Good luck.
H.
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By taking away her assistance she may be more determined to get up more often just to prove you wrong. This would depend in what stage she is in her ALZ. She may think she is of certain age, and feel she can walk and move again, not realizing she can't. Why punish her? I think you must first really understand what her mental illness is before you make any decisions.
Blessings, Bridget
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If your Mom is 92, having severe mobility/balance issues, and is incontinent, it may be time to consider a nursing home facility. The other alternative is to move her into your home and hire skilled in-home care. It would be cruel to take away her walker and will just cause more falls as she tries to do without it.
Personally, I am not a fan of facilities - not much personalized assistance. No facility can provide the care that you can give a loved one in your home.
Good luck...I hope you find the best placement for your dear Mother.
Lilli
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