90-yr-old mother with Positional Vertigo fell again resulting in a concussion. How do I get her to stop bending over to do things?
She has a catheter that she must empty several times daily. She bends over the toilet to do so. I put a hospital chair in her tub so she can empty into the drain with hot water running. The night bag works great for this.
The day bag is more challenging, so we added a fold-up stool to the tub. She can put her foot on the stool and empty the bag into a urinal while sitting in the chair, then pour urinal down the drain. She says it’s faster to bend over the toilet. This is how she fell last time.
I tried to explain that it will become faster to empty the bag into urinal/tub the more she does it. She is now very lightheaded from the concussion. She just won’t do whatever is necessary to assure she won’t fall again. I’m at my wits end. She is in independent living. I’m her only caregiver.
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There was no Fairy Godmother, just a nagging daughter that kept on & on about a Plan B, downsizing, a new stage. Whatever title she thought may work. Made like 30 attempts, probably more.
Eventually wore one down.. after another chat of "So if you HAD to go to an AL, would you prefer the one UP the hill, or the one DOWN the hill? One day Mrs Stubborn forgot to say "Neither!" but said "I guess.. down the hill".
From that day on, light little *jokes* were added.. "You'll get used to it when you move down the hill". "Imagine not having to cook? Or do the dishes?"Or "what lovely trees" everytime they passed by.
Chip chip chip.
Forward to 2024, when the chips DID fall. Crises arrived. Mr Calm & Ready Now made a swift decision & a lovely place was chosen on instinct. But as the crises deepened so fast, 'down the hill' was available first.
The end of the tale arrived for one. Skipped the nursing home stage - straight to endless peace.
The other likes their home down the hill! Enjoys the meals, the activities, the view of the trees.
As happy an end as could be.
💙🕊😊
What score did mom get on the cognitive exam she was given? I assume it was not a good one or a referral to a neurologist would not be necessary.
That said, your mother likely has dementia which is why it won't register with her why she shouldn't be bending over. My mother was about 90 when she developed vertigo. She started falling and wound up falling 95x between then and when she died at 95+. I took her back and forth to the ENT for the Epley Maneuver more times than I can recall. It'd help for awhile, then she'd be back to "dying" with vertigo. Back we'd go.
You can't expect a 90 year old with more issues than Newsweek to take proper care of herself in Independent Living. She belongs in a wheelchair if the vertigo cannot be managed with medication and an ENT. My mother went into a wheelchair at 92 because of the falls and the fact that nothing stopped the vertigo for any length of time. Except the wheelchair. She NEVER experienced another round of vertigo after she went into a wheelchair, btw. Physical and occupational therapy didn't work bc of the dementia. They cannot follow instruction, remember what they're told, or follow up with daily exercises needed to improve their balance.
My mother lived in AL until her dementia and mobility issues got too bad, and then she went into Memory Care Assisted Living.
My father had a catheter and by the grace of God, I was able to find ONE AL that would accept him. But, they wouldn't care for his catheter except to empty the bag once in awhile. I had to take him to the ER every single time he needed a Cath change or had an issue.
If mother tests for dementia and you have POA, you CAN place her against her wishes if the danger becomes too great. Independence is a facade at 90 when all these health issues exist.
Best of luck making good decisions for mom.
You won’t teach them the maneuvers to be safer, they will not remember, but you teach their caregivers.
That is why I require every patient to have a written plan of care from PT/OT so all the caregivers can follow it.
You can't force a resistant adult to do something against their will easily -- even if you are her PoA. Therefore, you can move things along more quickly if you pull out completely and wait for a crisis that will land her in the ER or hospital and from there no one takes her back to her home: talk to the discharge planner to tell them you aren't her legal caregiver and she's resisting care in her home. Then talk to the hospital social worker to see about having her transitioned directly into a facility.
If you keep being The Solution you will do nothing but constantly orbit around her ever increasing needs. If you are not her PoA then this will be very difficult if she doesn't see why she has to pay for anything and you have no power to have her funds cover anything. You are on a track to burnout.
Step away completely and report her to APS. The longer you insert yourself the longer it takes for appropriate care to happen for her.
She probably has dementia. This means she is not able to learn new things. In fact, she is not able to retain what she already knows. She needs a diagnosis to confirm it, but doesn't sound like she'd cooperate. Therefore, step away and report her to APS. It will feel very difficult to do this, but burnout is even worse.
If she’s not seeing a neurologist, she should. She may need to move to Assisted Living.
I am so sorry that this is happening.
No other plan means we are left with *Await a crisis* as the plan.
LO's regular Doctor is aware.
ER Doctor said next admission will start the new journey: ER-hospital-rehab-*not home*-some type of care facility.
ER Dr advised speaking up early to Hospital Social Worker. PT & OT will work on building strength & assistive equipment for a safe discharge where possible. If not, Social Worker helps with next steps for an alternative.
Having a location planned would help smooth things. I reasearched locations, care level & costs for another relative. When a temporary stay had to tranisition to permanent (due to crises) it was difficult but not impossible.
With the next one, I lack any authority to make a start. It will take a crises.
TannD, would you Mother be open to the idea of a Plan B.. a Backup plan?
At this point..a 90 year old Stubborn person is not going to change. (I kinda know, I'm not 90 but I am stubborn and I wanna do things the way I wanna do them.)
Or you just let her do what she is going to do.
Honestly if it isn't this it will be something else and she WILL fall again.
My dad (who had dementia and a lot of other issues) had dizziness and saw flashing lights upon standing up (sometimes but not every time) and it led to falls and injuries. He could not or would not comply with medical advice around that including he could not or would not drink anywhere near enough liquids so he was constantly dehydrated which also made him light headed and contributed to kidney failure. Even with an aide sitting right by his side, falls were inevitable when he was living at home on hospice. The last few days, he was at a hospice facility where they put his air mattress all the way on the floor with alarms on it and bolsters on either side. He could not fall while trying to get out of bed because he could not get to a standing position. All he could do was crawl. They put him in a padded wheel chair / lounge chair kind of thing during the day and he was corralled in with barriers so he could not get out of that either without aide assistance. None of those means were possible at home.
good luck.
Are you her PoA?
She doesn't seem interested, willing or able to do what it takes to keep herself safe in her home. So, if seasoned caregivers here tell you that she won't change and therefore is a danger to herself *and* is overwhelming you with concern and needs... what will you now to do? You're the only one able to change concept of what a solution will look like. She's not going to change and is heading toward the cliff named "Medical Crisis".
If she lands in the you may have the opportunity to transition her directly into a facility at that point, but not if she's still legally making her own decisions. You can try to convince the discharge planner that she's definitely an "unsafe discharge" and she is refusing appropriate levels of care. Talk to a social worker at the hospital.
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