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I am fearful about my mother returning home after a scary fall she had due to low blood sugar levels. This time when she returns, mother will have home health. I fear she will fall again but I guess seniors run the risk of falling no matter wher they maybe. They live in a rural community and it takes at least 30 minutes before the EMTS can arrive. It is her wishes that she returns home. Comments or thoughts?

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Falls:

You're right; seniors fall. Actually we fall from the time we start learning to walk but seniors are more vulnerable, bones aren't as strong, and we're often more weak.

To minimize falls, either do some online research on that topic, or follow some guidelines:

Have a carpenter or a qualified contractor install grab bars so Mom has handholds on the regular paths throughout the house. They absolutely have to be installed in the studs, no anchors or other adaptive devices are appropriate - that's what my contractors have told me.

Add grab bars especially in the bathroom, at horizontal and diagonal levels. Get a slide transfer chair for the tub so she doesn't have to raise her legs to get in.

Get a walker if her doctor thinks she needs one; rollators provide a different type of support. Both should be adjusted to her height.

Add grab bars on exterior areas right next to the doors. Add railings if the porches have none.

You might be able to get some assistance from the local community; contact your city or township office. Some communities have HUD grants for repairs, although sometimes they're only for "emergency repairs." However, I would think a fall would constitute an emergency and prevention is appropriate.

Balance, heating and eyesight are important fall preventive factors as well. Speak to the physical therapist with the home care agency and learn the exercises to strengthen arms and legs for fall prevention.

If you need elaboration on any of these aspects, please feel free to ask for more information. Many of us here have fall experience and others will chime in to help.
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Diabetes issues:

If you're handling her affairs, choose the home health care agency of YOUR choice; don't rely on the hospital or rehab center to make the choice - they have their own preferences, and their choice might not be the same as yours.

If this is your first go-around, let us know and we can offer suggestions on what to ask and what to look for in agencies.

There are a lot of differences between home health care agencies and staff. Some are good; some are not. Some provide consistency in workers; some make assignments the night before, depending on who's available. The patient/client never knows who's coming - it's like a revolving door.

In addition, my experience is that some of the independent contractors don't meet standards of an agency with its own staff. We had one physical therapist who was not only a lousy therapist, she had poor hygiene, dressed like a slob, and was clearly disinterested.

I suspect these are the agencies that hire independent contractors. This is a poor, and bluntly said, a very lousy arrangement that in my experience does not benefit the patient/client.

When the home care nurse comes for the first assessment, be present, and ask specifically about glucose monitoring. And learn as much as you can about this aspect of care, especially how to recognize a potential crisis and what to do before EMS comes.

Ask also if there's any kind of hospital "nurse navigator" or helpline for diabetics that you could call if another event occurs. In our area, some hospitals have "nurse navigators" who offer limited advice, but can also suggest support groups and other avenues of self education for you and your mother.

These might be available only in the larger cities though.

You might also get some of the diabetic magazines and convert her menus to diabetes compliant.

Some home health care agency nurses will draw blood and deliver it to a lab of the agency's choice for analysis.

There are also home glucose monitoring machines by which you could get the readings and chart them yourself. A nurse can show you how to use the machine. You will have to get used to the "little poke" concept of poking your mother's finger to get a drop of blood to be analyzed. It's not like inserting an IV though, and is in fact just a quick poke.

If you do this, make sure her hands are warm first. The anticoagulation clinic we used had a heating pad always on to warm their senior patients' often cold hands before drawing blood.

And play music she enjoys, or put on a nature program, or something to distract her so she's not focusing on the "poke". Then follow with something she enjoys - again, more music, perhaps a walk, playing a board game, ....just something to create the anticipation of pleasurable activities after the "poke."

I think home monitoring might be the best way to go, but that depends on whether you're able to be at home often enough to get readings.
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Where is home, does she live alone? What is the plan to ensure her blood sugar is stable and is she able to follow it?
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