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Mom is 89, still sharp, but in rehab now after falling. Doc says she can come home with in-home help but family and friends firmly want her in AL. Mom wants to come home! I know she is a fall risk but is it better for her to spend her last years as she wants, even if she doesn't socialize as much? I hate the thought of tricking her into AL, as others have suggested. She'd wear a medic alert fall detector device. Maybe elders just don't *want* to socialize as much anyway? Mom had been quite content in her chair at home.

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As my daughter said to me "she is going to fall". My experience with an AL, they can't keep them from falling either. They have less staff than a NH. My Moms careplan said she was to have a walker at all times. Many a time I walked into the AL and she was walking without her walker, once right in front of the LPN. In the home she was in a Geri chair because she was a fall risk.

Go with your heart. If Mom is sharp then she can understand that she needs to be very careful because a fall could be the end or a home. We have a friend who owned a local business. His wife had died and he was caring for his MIL in his home. He got her up in the morning to eat breakfast and dressed. She had a lounge chair she sat in and her TV. He left her with water and a snack. Whatever he thought she would need while he was gone. At lunch he would come home to feed her, get her to the Bathroom, etc. Back to work until dinner. It worked for him. It all depends on what you are willing to do for her. I agree, she may be better in her home but she has to be willing to cooperate. You may aporoach it that way. Say there are those who feel an AL would be best but you want to show them that she is capable staying in her own home. But, if you find this is not the best situation she will need to try an AL. You can see if there is someone who can come in and evaluate her home and see what is needed to assist her. My neighbor had railings down the hall for him to use. When you to make your decision you need to tell thise concerned relatives that this is what you are trying and they need to except it. Mom can make her own decisions, good or bad.
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Read Atul Gawande's book "Being Mortal: Medicine and What Matters in the End." It wouldn't give you an answer, but it may give you some insights in what to factor into the decision.

Fall risks fall. Sigh. It is what we do. We fall at home and we fall in public and we fall in care facilities. Kind relatives and medical folks can reduce that risk. But no one can completely remove it.

If Mom does go home, have her doctor order an evaluation of the environment by an occupational therapist. You may get some helpful advice about furniture placement and other improvements that can help minimize risks. The OT that came out to our house even made some suggestions about shoes for my husband!
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not saying one is a better choice than the other.
but my mom is in assisted living with dementia. she is very mobile, but does lose her balance. she fell during the nite, probably trying to go to bathroom. but don't know for sure, since she doesn't remember. but it sent her to the ER at 3am with a gash in her arm, requiring staples.

I see lots of residents in my moms AL that I know have fallen in their rooms/hallways etc. some may or may not have dementia.
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My dad is in a similar position. Mentally sharp but physically very frail and a definite fall risk. The falls so far haven’t injured him but he well knows one fall could change everything. Each time the subject of moving to assisted living comes up he insists he’s not ready yet. Despite me getting many calls from family and friends saying I should move him from his home I don’t feel like I have that right while he’s still mentally fine and managing with lots of help in his home. He does wear a fall detector, uses a rollator, and is very careful in moving about. Socially he is isolated in some ways, but he’s also on the phone a lot, and has family coming over and taking him places. I’m at peace with it because he’s very attached to being in his home. If your mom and you both are at peace also then let her come home, put the supports in place, and hope she can do it for as long as possible
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Who is going to provide the in-home help the doctor wants?
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It's a tough choice: quality of life vs safety, stress for the family vs your mother's wishes. Unless she is clearly unsafe at home I think I would make a bargain with her to give it a trial period - 3 months? Throw in as many conditions as you can in order to make it work for your peace of mind and then reevaluate.
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