My mother is in third stage dementia. Lately she has been soooo fearful of falling that it is debilitating her even more. What can I do?

Hi chirochick, I am experiencing the exact same problem with my mother, just recently too. One day as she was rounding the corner to go toward the bathroom she grabbed onto the wall, with both hands, and would not let go or go any further, she was using a walker at the time but I literally had to hold her up as she completely let go of it and was leaning around the corner of the wall. Now she refuses to even stand for a few seconds to get the pull-up on her and is saying "I can't" just as your mom is. I suppose it is just yet another stage in the dementia. It is killing my back though! Now we are mostly using a wheelchair and even with that she does not help at all, so I have to do all the lifting and shifting. I wish I had a better reply for you, but all I have is the knowledge that you are not alone in that and I feel for ya. Hope that someone has some advice, for both of us. :)

dementia has stages of mental breakdown often followed by weeks or months of improvement. if it becomes necessary here i plan to get saplings , wood blocks, and a screw gun and run double handrails all thru the house. the cost is zero dollars and the screws hardly leave a scar in the walls or furnishings. the parent will pitch a bitch, thats the bonus..

Capn, that sounds like a good plan - as long as they're willing to Stand. Father is bedridden and Could have walked but refused therapy dute to fear of falling. He doesn't want the hospital bed railing to be down when the govt caregivers come to sponge bath him. But, he must be progressing in his dementia because lately he's been demanding to get off the bed. He thinks he can still walk. When I refuse to help him, he tries to get off the hospital bed. I just stood there watching - waiting to call 911 if he falls off the bed. (He's taller and weighs more than me.)

But Chiro, the one time we were ever got him off the bed, on the wheelchair, in the car to go to the clinic - was within a month of being released from the hospital. We forced him to go because Medicare requires that after a patient is release from the hospital, they must see their primary doctor within a month for home care services and home physical therapy. (I think it was a month.) He grabbed on tightly to anyone handy and also on the car door. It was awful! And embarrassing as we tried to get him to let go both the human body and the car door so that he can SIT inside the car. I told brother that the next time father needs to go to the clinic - I'm calling the private ambulance! We will pay the $200.00 roundtrip cost.

There are companies that sell pants with built-in padding for hip protection, and also they sell helmets that are made for falls. This could give an elderly person piece of mind, knowing that they were wearing this gear, in addition to having a person help them. In addition, while my mother is sitting on the toilet, I give her a tray with her toothbrush, toothpaste, and two cups (one with water in it), and she brushes her teeth while sitting down.

I'm liking the practical suggestions people are giving here. I want to add one thing: if a person is scared, telling them not to be doesn't work. (Doesn't work on you or me either!) All it does it give the message "you are not being heard." When we are unheard -- all of us -- we dig in and ramp up the message in an attempt to be heard. Go with empathy first: "Oh yes, part of you is really scared of falling! And no wonder, falling could awful. You certainly don't want to fall." You might think you are just underlining the fear and making it stronger, but the odds are you will see some relaxation instead, even subtly -- because the fear has been heard. After it's been heard you can speak up for the other part: "And you certainly don't want to be stuck here at the sink [curb, doorframe, whatever], either!" You are likely to get some sign of agreement with that too. Then you can offer the solution: "So let's find a way to get you to the ____ without falling....." It seems like a roundabout way but actually it is likely to take less time. And as a general principle, empathy first gets all of us where we want to go, remarkably faster. Realize that empathizing with a feeling is NOT agreeing with something that's not true. You're not saying (for example), yes you'll fall. You're saying, of course it makes sense that you don't want to fall. Big difference. The first topic is a disagreement between the two of you (they say they'll fall, you say they won't). The second is an agreement between the two of you (neither one of you wants them to fall; you can sympathize with the fear).

Yes, Alwayslearning has given some good advice (as well as the others' practical advice). What Always is saying is something I've learned to practice in dealing w/ a family member w/ a personality disorder. Even though what is happening to the person is often totally irrational, they often calm down and can see things in a different way, if their complaint, rampage, fear, or whatever, is validated. Validation is not agreement, it is just saying that what they are feeling or experiencing is understandable. Once that gets through, it opens the barrier for them to hear something else that can be helpful in calming them, and finding a way to a solution. It really does help. Mental illnesses, dementia....all effecting the brain in ways that make it a constant challenge to deal with, but always worth the effort when we care about the person going through it.

Caregivers- don't kill your back. Look for assistive products that give someone a level of trust. Sturdy handrails, a firmly anchored SuperPole, or other items you can find on AbleData, etc. Skip the typical flimsy stuff as that will do no good and may result in injury. There are even handles made for the car door latch that people can lean on for transfers there. I can offer suggestions- please let me know.

Sure, FriendlyBedGuy, let's have your list of suggestions. I hadn't heard of AbleData, is that a webstore?

My mother in her 80s, with early dementia, was fearful of falling. She eventually did fall several times but thank goodness, usually falling on soft surfaces and didn't break a hip or ankle which would have really set back her mobility. (She broke an arm when she fell in a parking lot during a rainstorm). But, before the falling started, she began walking differently, raising her feet higher before stepping down. She also started holding onto walls, tables and stopped walking in grassy areas, where the ground could be uneven and obstacles hidden. It was a balance issue and I also wonder if feeling in her feet (circulation) may have been reduced. I think she recognized the reduction in balance and/or feeling and was compensating for it, but didn't want to tell anyone. She never spoke of it. But, by her actions, we knew there was something going on. She was told by her doctor, and then family, to use a walker. But, she refused. She didn't freeze-up, refusing to move, as chirochick and others explain it with their loved ones, but there were times that she was reluctant, and would vocally freak-out briefly, to proceed in areas or floors that she did not have previous experience with or looked possibly unstable or uneven. She would proceed if we helped her and assured her we would not let her fall.

Helping her to feel safe by having people "spot" her, using a walker, placing handles or bars on walls etc may calm her fears. It may only be temporary. It may not. Implementing those steps may not have any positive effect on her fear or "freezing-up". But, you won't know until you try. I don't think there is a "one size-fits all" approach when caring for a senior with dementia or alzheimer's. But, it can't hurt to have someone she knows and trusts near her, supporting her and watching over her. The key is trying to respond to her needs and trying to calm her fears & confusion and not rushing her. You don't want her to become so scared to walk that she doesn't want to walk anymore ("it is debilitating her even more"). So seek out tools, words and changes that help her to feel at ease and safe. You want her to feel confident that, she can do this.

AbleData.com is a website specializing in items to help people. I would be glad to offer suggestions- check my profile as I have gained expertise in mobility issues.

I understand and its very common. With dementia it starts affecting the areas of the brain that we use for balance, walking, sensory, speech. One of the first symptoms the show up is the parkinsonism...the change in posture (slumping over), the gait shuffle, and being unable to walk or only walking short distance without feeling pain. This is all part of the dementia. One of the biggest things they suffer with is the fears of falling. I literally would have to pick mom up and rotate her into her chair. She was grasp ahold of something and not let go of it. It was so frustrating. But in their minds its so frightening. The only thing I can tell you is be patient..don't voice your anger or frustration. Try and encourage and be confident in her safety. If you are not confidant..she will sense it. There will be a time when moving her will not be an option any more. Unfortunately there is no going back. The disease is not curable but it is maintainable just make her comfortable as much as you can. This is where you can find help with the Area of Aging and Disabilities if you qualify, I highly recommend it. God Bless you

Bless you all. My husband recently passed away from dementia. The issues are still fresh in my mind. How about getting a porta-potty for Mom. I agree that sometimes we have to agree and validate the patient's feelings. Is is possible that the walking problem is not Mom's imagination? Perhaps she has forgotten how to balance or walk or has dreamed or hallucinated about falling. Whatever the reason, please agree with her. Tell her she's wonderful and that she's doing the best she can. Tell her you're there to help her. Use a bed pan if necessary. Do whatever it takes to make her feel confident, unafraid, and loved. Think of how you would feel if this were you. God bless you. Hugs, Corinne

Her fears may be based in reality. The feeling of being unbalanced and the freezing sounds a little like Parkinson's disease. She should see her doctor for evaluation. I wonder if you have room for something like a Merry Walker, which would allow her to feel safe and to continue walking for as long as possible.

chirochick02 She may not be able to communicate the words... possibly dizziness. Ask why she's afraid but softly, calmly. Is the floor slippery, can you see well, are your feet steady???
Confidence on your part as mentioned by others is key. My Mom will not get into the elevator "with me", she's scared insecure. BUT... the Activities Pro. at the NH (smiling ear to ear ...happy guy) say's come on winks and she doesn't think twice just follows him no question no excuses!!! I have said this before like E.T. and Elliot if I am scared my Mom is scared if I am happy she's happy. They tend to read feelings and body language clearly with dementia. You may not realize your showing fear but you might be.
As a hairdresser I get children who are scared. So I get to know them first, I treat them like lil' people, not that they have to do it, I make like it's a fun thing. Then I explain what a haircut is for, how good it feels, and how fun it is. I show them the instruments I use and tell them what's coming next. I often find that the parents who project good energy and not demand the process or act as if it's something to fear, make a child more confident. Like children our parents know how to manipulate us with feelings and get what they want using our weaknesses.
I used to wait until my Dad was into a sport on TV & didn't want to listen to me... Then ask to do something he normally would have put a lot of thought into. He yessed me so I'd go away. Then later he'd say I didn't say yes... I knew he wasn't listening so I'd say you did so.... puzzled he was like Oh I did???
The point I'm trying to make here is your parent may be afraid for obvious reasons but they may know how to get you to stop forcing them to do something they don't feel comfortable doing. Manipulation runs deep in Dementia.
The fear may be real ...I'm not saying it's not... but there's a logical reason for the fear. It is sometimes an obvious but overlooked insecurity that can be solved.
My Mom was afraid to go to the bathroom, she kept telling me but the other door is opened. "I am scared that someones going to come in the other door". I didn't understand. Than one day I realized there was a reflection of the door in the mirror in the bathroom. I knew it was a reflection but she saw two doors not one real door and the other a reflection. I realized this when a friend came to my house for the first time and walked into the bathroom and said "you have two toilets?." At first look that's really what it looked like!!!! I was like DUHHHH,!!! That's it!!!!
I explained it to Mom and after that then she wasn't afraid anymore. I had two show her that there where two of me and her etc....
P.S. She really got mad when I didn't get that "she" saw and I acted as if she was afraid for nothing!!! This is one of the reason's I share this stuff, to save someone else a month of aggravation over an "obviousness overlook" breakdown!!! LOL

This subject came up with my mother's OT. The OT said that probably they will fall if they are afraid of that. She said the best thing that we can do is just wait it out. It did change recently and I think it is a matter of trust. My Mom has recently had this with me but it changed.

Fear of falling is pretty common. But the reasons why are not necessarily easy to determine. Some are real, some are psychological. Either way, it's just as real to them.

First take a look at what issues really might be there. There are many physical reasons why someone might be uneasy, and people with dementia can't always even diagnose their own symptoms, let alone convey that to others.. Are the floors slick ? Get footwear designed with traction in mind. Could they be having some inner ear issues causing dizziness? Are they having joint weakness or pain issues? Address with supportive structures. Are there floor hazards? Get stuff out of the way. Are their eyes giving them the messages they need or are is the prescription wrong and need to be adjusted? Do they have numbing or neuropathy that is causing them to not sense the floor or their own weight. Most of these things can be remedied if diagnosed, but diagnosis isn't always straight forward. Ask all the questions you want, but you won't always get accurate answers..

What other amends might be made? Do they have a walker for stability? Are they using it correctly? My dad got to leaning forward on it and his arms could barely support his weight. His arms would wear out quickly, he'd start to shake and be afraid. I'd have to remind him 2 or 3 times on the way to the bathroom to not lean forward and get his weight over his feet so that he'd be comfortable and safe. Sometimes I'd have to help him reposition himself next to the walker.

It can also be that they've at least temporarily forgotten how to move what they want to move. My dad said he couldn't. That didn't mean he didn't want to move, it meant he couldn't. His brain wasn't sending messages to his legs as to what to do next. His legs just sort of forgot how to move forward. After I realized this, I would help him move his leg, and then it would remember again and he'd be okay.

The basics are sometimes so basic that it doesn't seem possible that mom/dad wouldn't know this and you feel foolish for even suggesting things to them. Sometimes like with having to guide Dad's leg in the right direction to get started, you just have to guide, not get frustrated. Frustration is normal, but it does not help.

Aside from the process of assistance, what you can offer most is support and reassurance. I can't tell you how many times I told my dad, "I'm here Dad, I've got you." Grab ahold of his arm, around his shoulders or waist, let him hold my hand, and make him feel like there's no way he could fall.

My mom has kinda the same problem. She has senile dementia. I figure that as the brain continues to deteriorate some parts continue to function, but at a depleted condition. Emotions are controlled in the deep part of the brain by the part called the amygdala. Altho the brain says she/he can still walk, sit, stand, and other functions. The inner functions become altered due to the dementia, how I don't know, but, it causes the person to develop an irrational fear about doing these things. It's like Obsessive/Compulsive Disorder, a person develops an irrational fear about something which causes him/her to develop a compulsive behavior to stop the anxiety that comes from having the obsessive, i.e., hand washing. There are meds. to help OCD people. I would suggest talking to a physician or a therapist about your situation, and seeing if there is alternative behaviors that can palliate her situation or perhaps some meds that may help. I wish you the best. I wish I knew more about dementia to tell you more. God bless you.

I agree with the suggestion of validating their fear of falling - so that they know that you hear them and feel their fear. And I also suggest giving them a hug, then looking them in the eye and letting them feel and see that you have them safe, followed by another hug, and then try the moving again. What I found to have the best results with my mother was to calm myself first (essential) and then to move very slowly and calmly. Otherwise it's arguing and tension. My best to you - it takes every ounce of energy you have, I know.