She lives alone in her house but it is clean and she can feed herself and enjoys her independence. She does have incontenence and wears undergarments but otherwise very healthy. We are concerned she may fall again and get serioulsy injured. Fallen 2x in last year, The last two falls required a trip to ER and she may have had other falls that she didnt tell us about.She is currently staying with family and using a walker for balance. We are considering senior proofing the home with alert monitoring, rails, toilet rizer etc. She begs to go home and for another chance. We want her to be safe but do not want her last years to be miserable and she makes the point that she could fall anywhere, even at an assisted living facility or family members home. Also her 84 y/o brother and family physician feel it may be time for her to not live alone because of the fall risk. All of this complicates the decision. We are torn...any advice?

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GA, thanks for all of the ideas. My FIL (93) is newly widowed, clear minded and very capable. We're trying to do whatever needed to keep him in his home and safe.
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Senior proofing would be mandatory for your GM to return to her home - you're on the right track!

This is my take on AL vs. living alone for persons at risk of fall. Someone can fall anywhere, in the kitchen, bathroom, living room, and in the AL common area facilities. AL can't prevent falling even with assistive devices and 24/7 staff.

Much as I try to be careful, in the last year I've fallen several times - off a ramp at my father's house, in a grocery store, over the lawnmower, on ice ...all when I wasn't paying attention to what I was doing.

IMHO, the best fall prevention tactics are preventative ones which include exercise and muscle strengthening, especially if your GM is already active.

Falling is a function of at least these factors: balance, strength, endurance, cognitive issues, hearing, common sense, muscle strength, and vision.

My 95 year old father has fallen at a gas station and at home in his bedroom. The only thing that could have prevented the falls other than medical issues (osteoporosis) is that someone would have to have been there, right next to him, to catch him. AL will and cannot not provide 24/7 companionship right next to your GM.

My father has suffered 2 fractured hips from falls, yet he still insists on living alone and my attitude is that I will support that unless he falls again and becomes bedridden.

What we've done is address all the issues we can think of to prevent falls, and provide for immediate assistance if he does fall.

In addition to my involvement, church members periodically check on him. Neighbors generally see him daily; one family brings in his mail; 3 families bring food periodically; he also gets Meals on Wheels.

They all have my number in case anything happens. This contact isn't just for monitoring purposes; it provides a social outlet and lets him feel he's still a part of the neighborhood.

Dad wears a Medical Alert pendant on his belt. I researched suppliers before ordering this one and am pleased with it. The locally based monitoring service has already called several times when the pendant has been dropped, Dad's changed his position, or some other type of alert activated.

We installed a key lock box on the exterior of the house, one that installs directly into the studs and doesn't just slip over the doorknob (those can be jimmied off). Some church friends know the combination and it's also been given to the local EMS staff. In addition, a few of the neighbors have a key to the front door.

Grab bars are inside and security light/motion sensors are on the outside.

Dad's had therapy at outpatient facilities as well as in the home. He tries to walk (with a walker) outside when the weather is nice.

Still, I recognize that in an instant all that could change, but there's a trade-off, especially for a man.

I think your GM is a strong candidate for this kind of home living. Set up the mechanisms, add 911 and family numbers on speed dial for a land line phone (don't use a cell phone; in an emergency it's quicker to use a land line phone than wait for a cell phone to come as well as have to recharge it). Simplify life for GM.

Make sure paths are cleared, remove throw rugs, install grab bars not just in the shower but in doorways or anyplace a handhold could be used.

You're very fortunate that at her age she didn't suffer any fractures. Build on that by asking her orthopedic doctor to script for therapy. Help her with her exercises by doing them with her. Then treat her to a special lunch, dinner, or something else to encourage her to work out.

Dad also created a padded walker by using foam insulation wrapped around the legs, hand holds and front bar. We got small baskets and a neighbor made a cloth carry-all which help transport small lightweight objects from one room to another.

If she goes to church, contact the pastor/bishop and see if a ride can be arranged for her.

Get her vision and hearing checked - those according to a neurologist who spoke at an AAA Expo on this issue are two of the fundamental inputs for balance.

It's very fortunate that she's still able to take care of the her and herself. Support her by doing whatever you can, and go for it!
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My Dad's mother was just like that, very independent and was quite healthy for her age. Even after she broke her leg falling down the stairs, at 90 years old, she still wanted to go home, and her sons took her back to her home. My Dad's brothers were able to check on her several times a day [Dad couldn't because he lived out of state]. And this was before the invention of those fall alert monitors, rails, etc.

The only way my Grandmother was placed in a nursing home was when she had a stroke, a year later. No regrets.
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