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My 94-year-old mother has major balance issues. She has had many falls (my brother says 30 over the past year). The last one was bad (last week) when she fell on a ceramic tile floor -- knot on her head and hematoma on her hip. She has strong bones, though, and has not broken anything yet.

She doesn't understand that she is a fall risk. I have tried to explain it to her both calmly and sternly. A walker wouldn't do her much good if steps backwards, but I tell her she needs to use it. She won't. She is still insistent on walking without assistance. (When I am with her, I walk behind her all the time, most times holding her under her arm if she is having a bad day). She only seems to listen after you holler at her a few times. A few months ago, she said that she cannot go downstairs (to the basement) because she will get hollered at (not just from me).

I tell her to stay seated in her chair while I go do something. She doesn't listen. Some days she is up and down every 5 minutes. I am so frustrated. I don't like raising my voice to her. Today, I stood near her, but let her fall slightly against the wall (where I knew she wouldn't get hurt) with the hope that it would click. Nothing seems to work. I am at my wits end. Any suggestions?

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tperri123, in my days of frustration, I have thought about just letting Mom fall, with the hope it will sink in. But, I know it wouldn't click. It did for a while 3 years ago when she fell flat on her face on a sidewalk. She was afraid for a while. Not now.

Yesterday, I found out that when my middle brother spent the night at Mom's on Saturday, he found her in the kitchen (in the middle of the night) making coffee and heating up food in the microwave. (I have a monitor on when I spend the night and hear her when she is trying to get up. He doesn't use it.) All I thought of was that he was lucky she didn't fall. As bad as it must sound, if it is going to happen, I would rather she get hurt on someone else's watch... I do all I can to keep her safe. Two times recently that I didn't stay right behind her, though, she has fallen....
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My husband is also a denier at times. But on the advice of my children, I am to tell him that I won't take him anywhere unless he uses his walker. The wheelchair is a different matter. If I say wheelchair, he would rather stay home which means I have to call my son to come over to sit with him which means I don't go out very much because I hate to bother my son. Very frustrating but not taking him somewhere unless he uses the walker works well. At home, I also walk behind my husband when he gets up from his chair to go to the bathroom. I'm afraid the only thing for your situation would be to let your Mom fall and when she breaks something then your solution would be solved. It's sad but there is not much else you can do unless you want to keep yelling at her.
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There are people who are NOT diagnosed with dementia who can become very stubborn about walking with their hurri-cane or walker.

I have a neighbor, 89, who insists on walking around the neighborhood with her cane in her hand, but not actually using it for support. Just holding it. She does not have dementia and is still quite sharp, but she just hates feeling dependent on the cane.

The neighbors years ago used to call her the "quick-step lady" because she used to walk around the neighborhood like a race walker.

As a result of her denial about her balance issues, we have seen her fall several times, and have gone out to help her.

Still, the next day, there she is walking in the neighborhood with her cane held in her hand rather than used for support.

I am sorry you are dealing with this issue.

My grandfather lived to be 98. So it's possible your mother has some good years left, if she will use her walker.
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When I ran into this with my father, I just told him the truth.

He wanted his independence and I explained that by using a cane (later a walker) he was able to maintain his independence. I told him, if you break a hip - you will become dependent on someone and most likely wind up in a NH. He had never thought of it that way and started using his cane the same day. This same explanation worked when it was time to start using a walker.

I 'think' the fear is about looking old. Old is still better than dead. Old is still better than bedridden.
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The aunt(78) that lives with us, for several years now has fallen over a dozen times a day. This summer she pitched herself through the plate glass door wall in her bedroom while trying to move a small piece of furniture! I found her in December standing on a barstool trying to hang decorations from the curtain rod that goes across the door wall. We have said more times than you tell a toddler “NO”, please use your wheelchair or walker. Finally in January her congestive heart failure put her over the top With accumulated fluids and her body weakend putting her to bed and making her acceptable to hospice. She is not on any meds that keep her in bed, she is unable to move her body at all (last stages of Parkinson’s I believe). She no longer falls but she also no longer can feed herself, she’s cognitively mid range dementia so she is able to tell us whether she’s in pain, hungry or needs to have a BM (she has a catheter). In many ways she is a great deal easier to care for, My heart doesn’t race or jolt every time I see her doing something crazy that would send her to an emergency room or into an accident that we would have to deal with.
So this does not sound encouraging for you I’m sure. This stage will pass in the next one will be something different harder or easier, but it will not last forever.
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MaPotter
Thanks for the feedback. Ask the PT about OT when they are there as was suggested.
No she won’t remember but doing the exercise will strengthen her. She will have someone working with her and encouraging her.
We on the forum can’t see how she is but that’s what the evaluation is for.
If it helps great. If it doesn’t you tried.
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97yroldmom I did check with the hospice nurse today about PT for Mom. She will have the PT call me and do an evaluation. She said, though, that it may not be helpful because Mom will probably not remember. I think it will be more like it will not register with Mom... We'll see....
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Oh, Countrymouse, I did get an alarm from hospice... OMG is that loud. Worse than a fire alarm. There is no way to adjust it either....
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Thank you 97yroldmom. Unfortunately, with her receiving palliative care through a hospice program, they don't do much. They just keep the patients comfortable. I recently had to change doctors to use the one in the hospice program because her regular GP told me to just let her go (die). I think if I had been involved in her care several years ago, I would have been able to do something -- OT, PT, etc. But, up until Mom stopped driving at 91, she took care of everything (and didn't want anyone's involvement). She left my older brother as the contact for medical purposes. He is (sorry) clueless, but thinks he knows everything. I know there are things that could have helped her -- like her GP referring her to a neurologist when her MRI showed advanced small vessel disease back in 2016. But, he did nothing (my brother took her to the doctor then). I wanted her to go to a senior center where she could get into an exercise program, but she refused. So, I put some blame on her doctor, but also on her. It didn't have to be like this. Not that she would live forever, but she was always active around the house -doing yard work, etc., so it is hard to see her like this. I often wonder if being in a home where they would have activities would be better for her. (Finances are a problem.) She would need someone with her all the time.

Thank you, countrymouse.
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:(

Yup. We did all of these very sensible things. Even had the balance exercises as posters, above the hand rail in the hall, so that we'd be reminded to do them every day.

MaPotter, accept the following now so that you do not turn into crazy screechy walker Nazi like I did:

your mother will not remember to use her walker
your mother will not think to call for assistance
your mother, no matter what you say or what she promises, will continue to get up and totter terrifyingly around and fall

Accept these things, and then you can work round them. You can try a pressure alarm, linked to a monitor which you or another caregiver carries around, which will tell you when she gets up from her chair. Do get in an occupational therapist to look at her surroundings and identify possible improvements.

Mother is not being stubborn, she's not even resenting intrusion. The complex brain process required for her to comply with the whole chain of events involved from wanting to get up to calling for help and/or using her walker is now beyond her and just will not be happening. Big hugs to you both, may her strong bones carry her through.
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Ask her doctor to order her physical therapy to help with her balance. They will come out and do an evaluation and work with her. This will help her balance and strength. It won’t help her remember to not get up when you aren’t there but it will strengthen her muscles. They can also show you the safer ways to help her up etc. so as to not hurt her and to not hurt you. Walkers are actually dangerous if the patient doesn’t use them properly. They cause many falls. The therapist might recommend a cane which can help with
balance.
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Oh Mapotter; had I known about her diagnosis my suggestion would have been different. Very sad when we can't reason with a loved one because of a condition. I think you are right; she will probably have a fall that puts her into a nursing home. I hope it doesn't come to that, maybe that 'click' will happen sooner.

I know it's hard feeling the guilt but it's just as bad worrying and watching her every movement, feeling like you have to hover. If you can, do try and make some time where you can do something enjoyable while somebody else watches over her; breaks are important.
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Thank you, Ahmijoy and OneLastStraw. Mom does have progressive aphasia (no way of knowing what stage she is in....) So, there are cognitive issues. I have tried telling her that I am afraid she is going to get hurt and end up in a hospital, or that she is going to have to go to a nursing home. So far, it is all for naught.... I feel guilty sometimes thinking I should just let her fall, hoping something will click. But, I can't let that happen while I am with her. I would feel worse for sure... She is a nurse from way back. They make the worse patients....
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Mapotter I'm so sorry you're stuck in this difficult situation.

I'm worried something is wrong with your mother cognitively, beyond her physical mobility issues. Her behaviour isn't normal or rational. Of course she is a fall risk if she is falling often!

That being said looking at it from her perspective: Yes, it's a scary thing to face, the reality that your body is changing and not for the better. That she might have to "be chained" to a mobility device like a roller or wheelchair. I know you say you have tried calmly explaining but maybe less calm and more emotion might work differently. Give it one last try approaching her from a place of concern and love.

You are scared for her. Tell her how you couldn't bear to find your mother broken on the floor of her home, in pain, or worse. If she can sit through a plea from her loving daughter, who just wants to keep her safe...then something isn't right in her mind and she should have cognitive evaluations done.

I'm telling you this from dealing with my father; who for many years during his physical decline took huge risks that could have killed him. It took me, his daughter, breaking down in front of him and crying that I was afraid to come home and find him dead on the bathroom floor, to 'wake him up' to needing help. He now uses a wheel chair and he is HAPPY about it. I hope something that like might wake your mom up too but if not, at least she will know you love her and want to help.
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I had a stubborn mother as well. She “used” a walker, but would pick it up and carry it instead of rolling it on the floor. She may be trying to prove something, like she can handle walking on her own, even though deep down she knows she can’t. No one likes to deal with the idea of old age. Nothing works and even when it does, it doesn’t work that well and it usually hurts. I’d say get down on her level and talk right to her and tell her that her falling scares the bejabbers out of you. You could say if she really hurts herself she’ll have to leave home and go to the hospital and maybe not be able to come back home. But it probably won’t work. All you can do is constantly supervise her. Your only other option is to get a gait belt and buckle her in the chair.
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