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My mother lives in an assisted living home where she gets excellent care, she gets medication every two hours and an assistant will come within 5 minutes of Mom pushing a button suspended around her neck to assist her in going to the bathroom and getting in and out of her recliner.. She has Parkinson's with severe mobility issues where she is confined to a wheelchair. She also is incontinent and wears diapers. She is almost 86 and has started having memory and judgement issues. My brother, sister, and I get frequent calls from various caregivers that our mother forgets to use her call button and tries to walk or transfer herself which results in a fall, The facility where she lives will not allow an alarm that alerts the caregivers to when she stands up as it will disturb the other residents. She fell again yesterday and her physical therapist told me that she needs 24/7 care. My sister figured it out that she has enough money to live where she is for 5 more years. Where she is now, she has her own furniture, planned activities, and three meals a day in the dining room in beautiful surroundings. We have moved her several times to increasingly more assisted care and she cries and is miserable when this happens. Should we move her into a convalescent care facility where she will only have the money to stay for two to three years or leave her in her present situation where she is now basically happy.

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If you are going to move her, try to find a place that will take Medicaid. If your mother outlives her funds, that is the next step. Some places will not take Medicaid from the beginning, but will for residents who have been self-pay more than x length of time. Find one of those and then there will at least not be another move when the money runs out.

If the ALF where she is now feels she is beyond the care level they can provide, they may insist on some other arrangement for their own liability reasons. You should discuss this in detail with them. Are they willing to respond to a silent alarm? Could you bring in a PCA to provide supervision for at least part of each day, (and reduce the funds available for the facility)? What would make it feasible for her to stay there?

I'm afraid that my views about safety are something of a heresy. Definitely, we all want our loved ones safe. But does that come ahead of happiness? Here is a bitter truth. No matter how "safe" we keep them, our loved ones are going to die, and probably long before we are ready to let them go. Once I accepted that, it was easier for me to try to balance "safe" and "happy." My husband would be "safer" on the dysphagia diet prescribed for him after a swallowing test. He would also be miserable. And would it be so much more terrible to die by choking or from aspirational pneumonia than live a little longer and die a lingering gruesome death from his dementia? Yes I want to keep him safe. But my number one goal is to safeguard his happiness as much as I can for as long as I can. I told you it was a heresy -- but I hope it is at least thought-provoking to help you clarify your own goals.
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You are doing just fine, bickering. Try not to get defensive with your relatives. You have the responsibility to make good decisions for her, and you are doing your best to act in her best interests. And if she is not mentally incompetent (in the legal sense) I don't see how the relatives could force her into a nursing home in any case.

She could fall in a care center. There are no guarantees.
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Ask the Care Assisted Home if they can suggest a way around this concern, as it is sad to have to move her. If no solution can be found then ask yourself if she is still aware of her environment, if she is not then a move would be less painful. If your Mum is still orientated in terms of time and place then find a solution, such as can she be visited more frequently or can someone live in with her. Sadly, sometimes we have to make difficult decisions and safety has to come first, even if that means emotional pain. I am in a similar situation and suffer with decisions that I have to make, but the elderly need a safety net when they become unaware of their own safety. I wish you all the best. You can only do what is possible in the circumstances, there is no 'if's' and no 'buts' , it is purely what works!
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Dear Marianne, thank you so much for your good advice. One of the first things I will do is talk to the management of the assisted living place where she lives. She is totally oriented to her living arrangements, just has a few memory lapses. We just can't seem to get her to remember to push her call button when she needs to change chairs. You are very kind to help. Sincerely, Holly
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Falls! Falls are scarey. I also dealt with falls on a regular basis with my mom. She has a parkinsonium syndrome. I also no the pain of changing her living environment. She has dementia. My mom entered a nursing home for rehab after a hospital stay. Very hard to do but we had no choice it was drs orders. Then when her rehab was coming to an end we made the difficult decision to move her to long term care. Hardest decision of my life. Her mobility was bad, memory was bad, she also had copd and is on oxygen. But she knew where she was and she wanted to go home, because her environment at home was what was familar and safe to her. Really hard to deal with on a regular basis. But.... My biggest fear was her falling and never recovering from it. My dad fell a year ago in his bathroom, had hip surgery and died 5 weeks later. Same thing with my uncle. He fell hit his head and died 48 hrs later. Falls are scarey and the elderly have a harder time recovering from them. Safety is our biggest concern. Our job as caregivers is to keep them safe even if its hard. I am struggling with this also. My mom is very sick and in the hospital right now. We are trying to get her into a different rehab/ nursing home to better suits her when the time comes. I hope it makes a difference. My prayers go out to you. I think its wonderful that she has the funds available for assisted living care. My mom did not. I took care of her for 5 years. But unfortunatetly there always comes a time when they need more care. Not an easy thing to decide. Best of luck to you and your family
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I’m a fall/mobility expert the USA. I can suggest a few things. Why is your mother getting up? Need to go to bathroom? Hungry or thirsty? Bored? Etc? If you can determine the root cause, you can come up with a solution. Second, they have fall alarms that are ‘silent’ (no noise to disturb others) by the patients but alert the nurses via a paging system. Contact me for more ideas. Thanks; Good Luck!
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Dear ddrein65,
Thank you for your input, it is really appreciated. Although lucid (but not all) of the time, my mother just does what she wants to do whether it is going to the bathroom or rearranging her dresser drawers. She even wheeled herself to the laundry room around the corner of her room with her laundry and hand soap on her lap. She managed to start the load, but of course couldn't change the laundry from washer to dryer--luckily my sister happened by to see her. She just doesn't get it that she cannot do what she used to do--talks about getting her driver's license, baking a turkey (she only has a microwave), and walking to the shopping center which is about half a mile away from her assisted living home. The silent alarm that you mentioned sounds like a good idea--where can we get them? I am not sure that the assisted living home where she lives will allow it, but it couldn't hurt to ask. Thank you again,Holly
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Is there a pattern to your mother’s periods of confusion (such as occurring in the late afternoon, etc.)? If so, then staff can provide her with suitable activities during these times. Please contact the Personal Safety Corporation about the

Please let me know if I can provide further assistance. Thanks
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I am the only remaining child of my mother. My father died last April at age 91 and mom will be 91 in November. She is of sound mind, needs no assistance in walking, does her own shopping, etc. However, she is frail and has fallen several times because she is so determined to do household chores. I have quit my job to take care of her but she doesn't want me at her house all the time and I don't want to be there all the time but I spend a lot of time at her house and overnight. In all of her previous falls she just got bruised and so fortunate that she was not hurt badly. Last week I asked her if I could be gone for a 3 day vacation and it was fine with her and I told many of her friends I would be out of town and they agreed to go check on her and call her a lot. I got her the med alert bracelet and taught her how to use it. A few hours after I left, she fell in her driveway bringing in the empty trashcan. A neighbor saw her in the driveway and physically carried her into the house. He was still there when I called, not knowing of the fall, and talked with her and she said she was fine and did not tell me what had happened. Later that day she fell inside the house and knew she was hurt so notified medical alert and they immediately called me. Within 20 minutes of her notifying them, help was in her house. I talked with the EMT and he said she refused to go to the hospital but he was worried about her left hip. He asked me if I could have someone come stay with her for the night. I called a friend who got there quickly and she overrode mom and took her to the ER. Mom has 3 fractured bones in her pelvis. My problem is, my sister-in-law (my brother died in 1995 and she has never remarried) and her grown son and grown daughter and my grown son have raked me over the coals for not telling them I was going out of town. The nearest one lives 3 hours away. I had local people watching after her. When I talked with mom with the EMT there at the house, she asked me not to tell the family because they really want her to go into a nursing home which she doesn't want to. So I did not call them. Mom really didn't want them to come paw and whine over her. It makes her nervous. But they have yelled at me repeatedly for not telling them I was going out of town and for not calling them she was admitted into the hospital. I talked with the ER doctor and her family doctor and they said she would be sore for a while but should heal fine. Now they are pounding her while she is laying defenseless in the hospital about her going to a nursing home. They said they were going to get me for elder abuse and have the courts put her in a nursing home whether she likes it or not. I have medical and legal power of attorney for her and two days before her falls, she paid me for being a caregiver for the first time. I can't take them being so hateful to me about my decisions and my decisions are what my mother has requested. My daddy died at home and she wants to do the same and I am trying so hard to help her live her final years as content as she can. She told me that if they put her in a nursing home she will die and the doctor said it would hasten her death. I have set up home health care which she has gotten for over a year and a PT comes out twice a week. I know she will need a lot of help to heal now but when she does heal, is it wrong to let her try to be self sufficient? Do I have to notify the family when I go out of town? Do I follow her wishes in not informing them?
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