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He has fallen quite a lot.  Some I know about and some I don't until much later when he told me after the fact. It's not a matter of IF it's a matter of WHEN. I need to work 2 days in a row for 5 hours. I can't afford someone to come and sit with him. He would probably refuse that anyway. Also, he could fall with me here. He fell the other day when I was gone and someone saw him and helped him. What do I do, just hope and pray he doesn't fall while I am away? He won't use a walker. Our one step to the outside is just a plain step but it is there. We are renting so we can't do anything about it. Someone said get a lifeline for him to press if he falls but he may be unconscious. He may forget to wear it or take it off when I'm gone. He is not helpless in any way right now except he needs help with his clothes because of his shoulder. what can I do ? Thank you

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tarajane, my Dad is constantly horizontal with the world, meaning he tumbles over frequently. And he also doesn't use his rollator walker unless reminded. That rollator walker has been THE best thing to help him stand up from a sitting position and to roam around the house. He's an accident waiting to happen whenever he is using just his cane or furniture walking :P

I can understand the refusal to have hired caregivers. My Mom refused the caregivers and after shooing them out of the house, a few days later she had a major fall and has been in the hospital for almost 2 weeks now. Next stop rehab and probably long term care, she is in her mid-90's. The caregivers are back to help Dad as he accepts them :)
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Tara, pending the surgery that may or may not take place, these are some steps you can take:

1. Hire a carpenter to install grab bars throughout the house, insisting that they be anchored into the studs. Mollies can't be used. If you can find a handyman to do the work, it would save money but he has to understand that the bars need to be screwed into the studs.

2. Get rid of trip hazards, stuff on the floor, rugs without backing, etc. Practice walking his routes and see if there are things he can hold onto as well as things that might trip him up.

3. Take him to a DME store and have him test a rollator; I think it's actually more stable than a walker. Medicaid paid for the one we got for Dad.

4. If the one step outside isn't accompanied by a rail, ask the landlord if he/she will at least consider adding a handrail, or if you can add one if you pay for it.

5. If there's any legitimate need for your husband to go outside while you're gone, see if you can make arrangements to switch that activity to a time when you're home. E.g., if he goes out to get the mail, see if you can find a neighbor or neighborhood child who will bring the mail to him on those days, even if it is after school lets out. Buy something for the child(ren) to show your appreciation. I bought a lot of high quality coloring books for our mail children since they enjoy coloring.

5. If your husband wears a motion sensor medical pendant, it alerts the monitoring service providing the pendant when there's a change in posture, whether he's conscious or not. They call him first. If he doesn't answer, they call the backup, which could be you or the police.

These are the kind that activate without having the wearer press a button.

6. If you do get a life alert monitor, also get a lock box with a key to the home so EMS can get in. Buy the kind that screws directly into the studs next to the door; don't buy the kind with an upside down U shaped bar; they can be cut off by burglars.

7. Speak to his ortho surgeon before the appointment to discuss surgery and ask him to give your husband a gentle lecture on cooperating for his own health. Recalcitrant elders sometimes listen to medical professionals before listening to their own family.

There's only so much you can do with someone who isn't cooperative, but these steps will at least alleviate some of the risks.
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Falling is a common problem with dementia, especially vascular dementia. The balance is so poor that the patient can literally tip over while standing still on a flat surface. I've witnessed this happen. Luckily, I was there to help her gain her balance.

You say your husband is not helpless, however, when the patient is unable to appreciate the risks or dangers they are taking by not using proper safety measures, then they are indeed helpless. Someone may be able to bathe, brush their teeth or even make a sandwich, however, if they walk without their walker, cook with no regard for time, handle electrical appliances without circumspection, etc. then they may indeed still be incapable of staying alone.

Often the only protection is to have someone constantly supervise the patient to remind them to use the walker. Even then, they are prone to fall. I was watching my cousin one day as she walked AROUND her walker instead of using it for support and almost fell backwards due to poor balance. It's a horrible problem that often results in frequent falls and fractures. Sadly, that's what happened to my cousin. She never got out of the wheelchair after a series of falls. She took a big decline as a result.

The other issue is him refusing. I would consider how I was going to continue to protect my husband and ensure his safety if he defies my decisions and refuses to cooperate. When you can't do it at home, it may require a different setting. Others here have taken that route. I'm not sure what else you can do if there is downright refusal to follow safety measures and to allow outside help in.

Often a crisis due to an injury puts the person in the hospital, then rehab and then a facility when the professionals there see the patient is not cooperative or is refusing care.

This must be so stressful for you. I bet you will get some good advice her about this. Take care of yourself too! Is there a friend or family member who can come and stay or can you take him with you to work? I know that's probably not a good option.
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TaraJ this is so stressful! I just want to drop over with a box of chocolates and hug you!

My husband hated to use the walker at first -- and who could blame him? He fell with it or without it, so what was the point? He was much happier with a wheel chair because he could safely scoot it around with his feet. (We moved furniture to make this possible.)

At first he fell several times a week. How he managed to never be injured is a mystery, but taking a blood-thinner he was always covered with awful looking bruises that at least weren't serious. I was often with him when he fell. I described in detail the fall process to his psychiatrist and neurologist (who worked together) and they said, "Ah-ha!! That sounds like what we heard about at a recent research conference. It is a narcoleptic-like episode. His body is literally suddenly asleep while his mind is awake! We'll test that theory and give him a drug for narcolepsy." Whaddya know? No more falls, at least for several years until his dementia had progressed and he had balance issues. I think this isn't common, and all I'm suggesting to you is to write down as many details about your husband's falls as you can remember and discuss it with his doctor.

I was lucky that my husband accepted that he had a disease over which he had no control, and he was willing to use a wheelchair. My heart goes out to all caregivers who deal with denial in their loved ones. My mother liked a walker and it made walking less painful for her. But she often didn't remember she needed it. So it isn't always just denial, but the memory loss in dementia that makes things difficult.

The lack of control we have is very tough for most of us caregivers to accept. You are right; your husband will fall again. He will fall when he is alone, or when you are there, with or without hand rails in strategic places, whether he is willing to use a rollator or not. He will fall at home, and he will fall in a care center. Falling is part of his disease. It certainly makes sense to minimize the risks as much as possible, and GardenArtist has given some good specific tips. Do what you can. Don't beat yourself up about what you can't do.
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So happy for you that your sister is there while you're at work today. Baby steps, for solutions and for walking.
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I don't know if there are different kinds of dementia, but my dad must have a form of irrational behavior dementia. He ~knows~ he's going to fall, and still uses the arm of the rollator to grab onto ... to pass on his way to his bed. We have chats, "You know you really need to use that, or at least call for one of us to help you, right?" "Yes" ... which goes completely ignored on his next trip to the commode or the chair, and then we find him collapsed on the floor, next to the bed, with one more wound to his poor elbow. It's frustrating and scary. We're getting a bed rail and installing a fall alert for the bed. And keeping our fingers crossed that his new meds regimen will somehow help. Not a lot of help, I guess .. just joining the club.
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UUUUMMMMMMMMMM!!!! how did you know I loved the raspberry crème filled ones.........Now, I know he will fall. Thank you and thanks to everyone that helps me learn about this demon disease. I work today for 5 hours but my sister is here. Will let you know how it goes.
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Yes, being in the wheelchair put the brakes on my cousin's falls. She didn't have any after that. Knock on wood. She can stand up and get in and out of bed, stand as she is dressed,, get on the toilet, and get on the scales, but that's about it. It's actually a relief. She scoots around with her feet in the wheelchair and is much more mobile than she was with her cane and then walker.

Will he try a wheelchair inside the house?
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I suggest you be extra cautious during transfers from standing to sitting, chair to toilet, etc. My dad had great training from his physical therapist how to safely sit down, but he either forgets or whatever. It scares me when his butt almost misses the chair when he goes to sit down. He broke his hip 3 years ago because he dozed off sitting in a chair and fell over. Now we only let him sit in chairs with arms. We learned this the hard way. Nowadays, dad is never left unattended for more than a moment.
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My husband needs knee replacement and so do I. I could take care of him but he can;t me Also, I hear the medicines they give can make me forget., or make us both forget. Is thretr an alternative?marymember
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