Feeling guilty for not taking mom to the ER after her fall. Can that bring on more TIAs?

I'm so glad that the neuro doc ordered a wheelchair; if your mom is 'forgetting" her walker, a wheelchair may be a much safer option and give her more freedom, and more safety, within her AL.

I'd think that the stress of the ER might do more damage than good at this point.

If she'd had another TIA, would there be a treatment for that? Is she already on blood thinners to prevent stroke?

I would consult with the neurologist by phone if you are worried.

I understand the anxiety, Bella. You sort of project ahead and imagine someone sternly asking you "did you take her to the ER?"and you hanging your head and saying "noooooo..."

But think it through. Number one, you called for assistance immediately. Number two, your mother didn't want to go to the ER. Number three, you watched her closely and if you'd observed the slightest thing you would have acted on it. Number four, even if she had gone to the ER, what would they have done that didn't happen anyway? Number five, sitting in the ER for a couple of hours would have exposed her to infection, not to mention the stress and fatigue of being in such a noisy, brightly lit, confusing environment. Number six, supposing they had rushed her into a scan of some sort, what would they have done about anything they might have found? Number seven, the overwhelming probability is that a scan would have turned up no information but exposed mother to a large and needless dose of radiation...

There was NO good reason to override your mother's preference and take her to the ER.

I know that doesn't stop you feeling guilty. But it does make the decision correct!

Bella7, I really see this scenario as happening sometime in my future. I have accompanied my mother to the ER 3 or 4 times in the past few years. They never find anything. One reason is that my mother refuses to allow an MRI, which would more definitively tell whether she's had another TIA or what. (She has a replacement aortic valve, and even though MRIs ARE allowed within certain parameters, my mother refuses to get one.)

My mother has said no more ER trips for her "dizzy" spells (last one was more concerning, as she had some of the symptoms of a stroke; this was the last time she went to the ER, and now she says no more). The option of urgent care isn't even appropriate, as these events always occur in the evenings. (And then of course you know she's there for hours and hours, and we end up leaving the ER in the middle of the night. Yawnnn.....)

Awwwe, thank you all sooo much.
You all calmed my heavy aching heart. I have been crying bucket loads of tears all morning. When a trip to ER was mentioned, my first thought was remembering everything I have read on here about that, just like you all have you just said. It's so hard watching her fail every day and then get a little better and go backwards again I just have to know I'm doing what's right for her.
Thank you all so much 😭😢😟😘😊☺️ All these emotions have wore me out but I'm very grateful for you all and feel so much better 😍
Big big hugs and smiles I hope your day is beautiful 💜

Hugs, Bella. Our ailing parents really put us through the wringer. We try to honor (what’s left of) their autonomy. We privately gnaw on all the wouldda shouldda couldda. Then everyone else starts chiming in! Rough.

Thank you, yea a CNA said, "I would've took my mom to ER at least for a CAT scan".........
I need to stay strong and believe I am doing the best I can and quit self doubting myself UGG

There always seems to be one CNA at each "place" who likes to make like we're not doing the best for our loved one.

Did you ask her what treatment she thought they'd prescribe?

And if she is not "incompetent" to make decisions for herself, exactly how would you have gotten her to the ER over her objections? The medics won't take her if she is refusing to go. Then what?

And if she went willingly and allowed an MRI or scan of her head and they said "I think you can expect more TIAs" what would you do? What could they do?

I'm glad you are feeling a little better about the incident now. I do understand the overwhelming feeling of responsibility for a loved one. But try to save your guilty tears for things you actually have some control over. You could not force her to go to ER. You cannot change her risk levels for future medical events.

Bella, I'm just here to give you a big {{{hug}}}. You're doing the best you can in a difficult situation. Our parents DO put us through the wringer. Don't listen to the naysayers. Just continue to do the best you can. We're here to support you. Just be sure to take care of yourself through this stressful time. You matter too!

Well, therapist came yesterday to reevaluate mom on her physical therapy at AL. I did not go, obviously I should have because mom told me a pack of "fibbs" that the physical therapist "supposedly" told her!! Like the therapist doesn't like my mom's neurologist, the new meds Lexapro and something for tremors she got put on, and that this therapist suspects some other problem going on that the Neuro is not addressing etc etc my mom even told her her older brother died at 80 with muscular dystrophy which is not true!   She said the therapist said, I don't know why he wants to just throw you in a wheelchair .  The whole time MOM was telling me this she was crying, huge anxiety thinking the neurologist is not smart and doing what my mom needs. She said I hated to call to tell you this because I did not want to get you upset, I said I am not upset but I will be calling this physical therapist and visit. Of course it p****ed me off that a physical therapist would tell my mom these things and tell her that something more major was going on with her body that the neurologist knew. Was thinking how dare you to tell her these things without me there or just tell me only!!  I basically believed everything my mom was telling me and didn't even think twice about it.  So, I called up this therapist and gave her a piece of my mind and really let her have it and she calmly said no I did not say those things. Talk about instantly hitting a brick wall, waking up and realizing oh my gosh this is my new mom now, how did I not realize that she could possibly been making this crap up?!?!

Hmmm, new journey, new mom, and I'm shifting to be her mother now... and not believing a word she tells me even when she sounds truthful. How do you know when to believe stuff and not !?!
The therapist thought she only had two small TIA's and when I told her she's had numerous ones in the last two years she was like, "oh my your mom had me fooled too!"   I apologized up and down to this poor girl and she was very very kind to me.
Whew, What an experience !
Her wheelchair got ordered Monday and still no sign of it, so here goes another phone call today just like the last two days...this is crazy.
Any suggestions on how to talk to my mom about the storyline with the therapist yesterday ? I know if I tell her no MOM you lied or whatever that will make her upset and even last night on the phone she said I could've got my story mixed up,
It's so sad because she knows she's losing it and she's losing control of her life, it seems she can be so good one minute and then next stop the next it's so hard to see.
 My dad lives at this assisted-living too...they've been divorced for over 40 years, they use to keep great distance between one another...now they have become great friends and he tries to take care of her just like a mother hen😬  He also walks with a walker with the seat on it whatever it's called and is legally blind so the two of them together is kind a like a circus act 😉

Bella, let the stuff with your mom go. Her brain is broken. She is no longer a "reliable reporter".

((((Hugs))))))

Your Mom is having difficulty coping with all of the changes going on and her decreased independence and ability to take care of herself. I would tell your Mom: "I talked to the physical therapist and we have gotten things straightened out. I am working on getting a wheelchair for you so that you can get around easier." Do not say anything more to your Mom about whether she did or did not tell you the truth, that will just upset you both. Try not to dwell on the misunderstanding that you had with the physical therapist as you are going to have many, many more of them-- with the nursing staff, and other people who are now taking care of your Mom. You want to keep a journal (a Weekly Planner works really well) of what your Mom tells you and what really happened so that you can keep everything straight.

I am glad that you realize that you now have a "new Mom" and that she will make up stories and lie to you. As you stated "new journey, new mom, and I'm shifting to be her mother now". It is not easy and there will be many times that she sounds so truthful and believable. Now you know to take a deep breathe, relax and investigate the situation before reacting.

Depending on who is paying for the wheelchair--Medicare or private pay-- it can take 1-2 weeks before a wheelchair is delivered so I wouldn't get so bent out of shape because a wheelchair ordered on Monday hasn't arrived on Friday.

You need to take care of yourself also. You sound so nervous and anxious and stressed-out that if you do not start to slow down and relax, you will end up with health problems also (and if you have health problems, they just might get worse). Take time for yourself so that you can be there when your Mom needs you the most. God Bless.

😊💜💜💜💜💜thank you so much

I took my dad to the ER when he fell and hit the back of his head because he was walking without his walker. He had a CT Scan done. Everything checked out fine. 

Taking him to the hospital didn't help him. Everything wasn't fine. My dad was on Warfarin that caused a Subdural Hematoma about 10 days after his fall. I took him to the hospital because I didn't like the way he was speaking. I would have liked the hospital to let me know that there was a chance of getting a Subdural Hematoma while on a blood thinner. I don't know if the hematoma was caught sooner if there would have been less damage. Keep an eye on loved ones. 

The medics did ask about blood thinners. She's only on aspirin now. Thank you for the advice and I'll keep a watch still.
Mom didn't seem bothered by the "visit" from the PT the other day...only said she believes she'll just rest for several days. I didn't mention a word about it either other than agree with her to rest...and yea, to watch the Royal Wedding AND Fox News. I'll be hearing about that wedding for several months I bet.

Her MRI mentioned "possible" Binswangers disease, a form of vascular dementia. Anyone heard of this?

Been reading about Lewy Body...sure describes my mom plus the Binswangers.
She has hand tremors, leaning forward, shuffle gait, shaking voice and sometimes no symptoms.

...this is what happens when I wake at 12:00am and start thinking too much...mind wanders down paths I don't need to...curly, backward paths

Bella
My mom has had many falls and nearly every time I've taken her to the ER - I kinda suspect her dementia was brought on from hitting her head so many times - but except for the falls which resulted in broken bones, there was not much to be done

Just last week a woman in her facility fell backwards and hit her head and had a big bump on the back of it - staff put ice on it and monitored her during the night -

The thought of spending 12 hours in the ER is nearly unbearable now - it was actually a bit of relief when mom went to a wheelchair from her walker

Mom told me today she wants to go to a NH. 
 
A CNA told her that it's cheaper in NH than where shes at in assisted-living.   That was how she started this conversation by talking about the cost and then went on to say how she thinks she's going to keep getting worse and needs more help.   Still  waiting on a wheelchair... she has trouble getting up and down and around with her walker, is afraid she will fall again. Has trouble with her pajamas when she needs to go to the restroom ( the way she describes it is she's taking her pajama pants clear off and then has trouble getting her legs back in them) and does not want to use her call button. She thinks the staff at her AL isn't capable of helping her with what she needs.
Do I brush this off as her dementia talking or try to grant her wish. She hasn't really even gotten an official diagnosis yet of dementia  although the MRI kind of suggested it.  She has always hated this assisted-living and complains about something every day.  Even at the neurologist the other day I told him that she wanted to go to a nursing home and he looked at her like WHY?  And then asked her, what makes you think it will be any better there? (as far as care).   She said, well I probably won't but she think she needs more care than what assisted-living will do.

If nursing home is what she needs I don't even know where to start.

Can you bring in an outside caregiver for a few hours to reassure her that care is available where she lives?

With the TIA situation, they just come and many times cause the fall as the person loses consciousness. My mom recently fell at AL. The injuries suggest, to me, that she got up to visit the restroom (didn’t call for assistance) had a TIA and fell on her face. No reflex of the hands to catch herself and cut her forehead and injured her pelvis. She’s doing better now.

TIAs happen. BUT, a severe blow to the head might cause coma or death. It’s best to take the fall victim to the ER. Better safe than sorry. But your incident happened a while ago? Just take this as a lesson. Your actions won’t cause a TIA. Stop the second guessing and guilt!!!

HolidayEnd ... The OP did immediately call in the paramedics, and *Mom* refused to go to the ER. The paramedics had no authority to force the issue. Short of physical force on the OP's part (dangerous from both a medical and a legal standpoint), that ER trip wan't gonna happen.

Thanks all!
The bump on her head went down fast that same day...no soreness anywhere...got lucky... next time I will push for ER but if she refuses it what more can I do?   Since I am POA, will I be in trouble if I don't make her go ?   She is still competent although sometimes I think not!   Has good days and bad days.
Still waiting on wheelchair...yesterday I called the medical supply store and they still haven't got the proper information from the neurologist stating all the reasons why she needs a wheelchair in order for Medicare to approve! If I hadn't of called yesterday to inquire on status of wheelchair  the order would still be just sitting there doing nothing. I called the neurologist office again to send over the proper information yesterday, and today I will have to call again to make sure that got done. Aggravating!
I'm about ready to go buy her one myself !
 I looked at them at Walmart for $150, looks kind of junkie.   At the medical supply store they are  $350  or rent one for $30 a month.
Any suggestions?

Our loved one fell multiple times in a matter of months in her home, but the only time she went to the hospital was the last and final time she fell - when her alert button called the medics FOR her and we strongly suspect she lost consciousness as well. Most of the previous falls were more like sliding down to the floor - as opposed to falling off of something. Oh yes, we were guilted into "why" we didn't have Mom checked out each time, but we felt like she was not injured & her falls were more due to her carelessness/recklessness as opposed to having a medical reason for the falls. Honestly, our biggest problem was getting her up off the floor after these falls - not truly whether or not she was hurt. She would become a dead lift in these situations and it would take hours to get her up off the floor. She did not come home after she was taken away by ambulance after the last fall. She's now in a facility in a wheelchair. Like your family member, ours is too unsafe with a walker to have one anymore. Extreme fall risk & she's even managed to fall out of her wheelchair - but she always has an excuse as to why that happened & why having the walker would be better. She is only allowed to use the walker in therapy under close supervision. She, of course, does not understand this & believes once she gets her walker back she can go to an apartment.

Sooo, visited with mom today. To my surprise she just returned from a trip to Walmart with her sister...full of energy, not using walker or wheelchair ( that I've been fighting to get for 2 wksbecause she has a great fall risk)...getting the neurologist to write down the correct diagnosis to get a dang wheelchair was ridiculous, it took 10 different phone calls back-and-forth between him and the medical supply store!  She was  buzzing about in her room like she had new legs on! Her bed needed clean sheets on, I offered to help, she refused and did it herself! For the last month she has been acting almost totally helpless...could hardly get out of her recliner without help or to navigate with her walker. No sign of the tremors that she was having, she starts that new tremor medicine on the 28th and her voice does not sound shaky either.
I'm confused. She almost seems a bit manic and I have noticed this cycle before and this was also before she started Lexapro, this manic behavior. I get exhausted worrying about why her body is acting the way it does, her moods, paranoia...I know it's probably from the TIAs!?!?...and then yesterday when I seen her it's like nothing is wrong... it really messes with my head.
I think I have become a control freak,  trying to figure out what is exactly wrong with her and getting every little thing that she needs.
 Not liking myself for wasting so much time and energy this last month on this.   How do I know when to just step back and know that I have done enough...

Bella, you're going to have see the funny side.

"Sit down! Where's your walker? Stop rushing around! Give me those pillows! What's *wrong* with you today?!"

I am afraid that the difficulties and risks you've noticed piling up will be back quite soon enough. Meanwhile, as far as you can, enjoy your mother's good days as you might enjoy good weather in the fall.

Uncertainty is very stressful, I do feel for you. If everything followed a smooth, predictable path at least we'd know what we need to do to help.

Yeah, you're right.
Having hard time understanding the fact that one day she's practically disabled and the next us quite capable.
Is this how vascular dementia works??

No, it isn't how vascular dementia works. Au contraire.

Alzheimers is the one that does a bit of a descending roller coaster act, with good days and bad days being part of an overall downhill trend.

Typically, vascular dementia is described as going in steps. Level periods of months, weeks, with no real change, then a marked deterioration in one function or another, or several, and then the next plateau; but no real recovery of lost abilities.

Having said that, energy levels can vary a good deal. That might have something to do with it - she'd had several good nights' sleep in a row, plenty of rest, enough to eat and drink, maybe a bit of sunshine, just happened to wake up full of beans?

In case you have read a bit about my moms symptoms and medical history (numerous TIAs), I was wondering if you may suspect Alzheimer's? I don't understand why she cannot make her legs work or get out of her recliner one day and the next day be fine...it does not make sense to me. I cannot get any answers from her doctors, still waiting from a referral for a psych visit... her MRI said possible Binswanger disease

Well. From cursory reading of Binswangers information - you learn something every day, eh - the fact that the symptoms come and go seems to rule it out, don't you think?

Bella, I do think you could quite easily drive yourself round the twist trying to give your mother's condition neat, tidy labels. Sometimes, you know, doctors just don't have all the answers. It's best to handle what's in front of you - enjoy the good days, be there for her through the worse ones.