My 90 year old grandmother lives next door with my 66 year old mom. My grandmother has been a major fall risk for years. She can be standing still talking to you and suddenly lose her balance and fall over. She fell several times just last year, and this spring a fall left her with a broken knee that required surgery. Thankfully she has been recovering well, but she still gets her dizzy spells and actually reopened the broken knee at some point (we think because of one of those dizzy spells that led to her falling against a wall).
She also had dementia that has been steadily getting worse, and gets bad bouts of sundowning too. Because of everything I’m about to mention, she also gets bad depression as well.
What has been especially difficult is that my grandmother does NOT like to sit still — she is used to keeping the house clean, cooking, and gardening all day long. We’ve tried introducing lots of new hobbies but she hasn’t been interested: puzzles, books, movies and shows, etc. We mostly watch soaps with her all day and talk to her. As her health has improved and she can walk more with a walker, we’ve found ways to let her continue helping safely — folding laundry at the table, washing dishes with someone standing behind her, etc.
Overall our difficulty has been that even through all this, because of her dementia she thinks she’s perfectly fine. She forgets all the recent dizzy spells and near falls, and thinks she’s back at 100% just with a brace on her knee. If she trips, she says, it’s just because of the brace.
She gets bored (understandably!) and, thinking she’s fine, starts to stand up to go clean, look for food, or do something else. We’ve asked that she let us know when she needs something, but obviously she forgets. My mom or I (we take turns keeping her company and helping her) will then have to jump up before she can fall, remind her to use the walker, etc. This often turns into an argument because she insists she’s just fine, she "hasn’t fallen or gotten dizzy in years," she says.
We try to explain that she can still do things, but with the aid of the walker and someone nearby in case she gets dizzy. But she insists she’s perfectly fine and can do everything on her own. In her really bad moments she’ll start to cry and yell that it would be better for her to just die, or that we want her to just sit in a corner to be ignored, we’re infantilizing her, etc. It’s so painful to hear and takes a lot to calm her down again.
This also means if only one of us is with her and needs to step away for any reason, we can’t because she will get up on her own and possibly fall. So she can’t be left alone at all. And if we ask her to stay while we’re gone she gets insulted and upset.
I completely understand why she truly believes she is fine. I want to find ways to help her still feel independent but using the aid of the walker, etc., but she’s already pushing back against all of that, and we know it will just get worse when the brace comes off. Thankfully we’ve been approved for long-term in-home care but it will only be for a few hours a day and won’t start for another month or two.
I guess my question is, how do we help my grandmother when she thinks she’s fine? She already gets upset that we’ve hired nurses to help now and then (to give us a break) so I know she will only push back more. I know you can’t really reason with dementia. Is there anything else we can do to keep her safe but feeling like herself?
Also as FYI: we’ve added safety railings in the bathroom, and she’s currently using a hospital bed at home because of her knee (she hates it, that’s another constant argument). My sisters live out of the city or state so aren’t available to help in person. It’s just my husband mom and myself.
She needs a caregiver and/or to be in a facility.
No one with dementia should be living alone.
Yes, she will think she is fine.
This is how people with dementia react / think / are.
They do not want change.
They want what they perceive to be their independence (which they no longer have).
Whoever has legal authority to make these decisions needs to.
Otherwise, you are waiting for a fall / accident to happen ... she'll end up in a hospital, then rehab and be miserble. She will then likely not be able to return home-certainly not without the care she'll need.
You want to AVOID making needed decisions when an emergency / crisis happens. You need to take control of this situation now. Talk to your mom. I wonder why she isn't writing us? Does she understand the potential emergency situation 'now' ?
You never listen to a person with dementia.
You keep them calm as possible. Tell them what they want to hear then make decisions in their best interest.
Google Teepa Snow. Watch her webinars.
Gena / Touch
Your grandma will fall, and fall again. You can't catch her every time and you can't prevent it. You and your mum can't be with your grandma 24/7. Don't even try. Your health and wellbeing are equally important.
You could try and decorate your grandma's walker with colourful ribbons, or get her one with a carrying pouch on it. One lady at the sheltered housing complex where my mum lived used to have her tissues and her knitting in the the little carry pouch of her walker, so they were always at hand.
It might encourage her to take it with her when she wanders, but it might not.
To be honest, there's really not a lot you can do. I think you need to resign yourself to that fact.
As far as your grandma not wanting the carers - they're not for her, they're for you and your mum so that you can have a little respite. Make sure you get out and leave them to it when they start coming round.
There can be a walker right in front of her and she might forget to use it. or even using it if she is having "dizzy spells" she will lose her balance.
You mom, you or anyone else can stand right next to her and if she is going to fall there is nothing you can do to prevent the fall. You can help her to the ground but if you were to try to prevent it she may get hurt, you may get hurt.
Even if grandma were placed in a Memory Care facility or a Skilled Nursing facility she will still fall.
Falls happen it is not a matter of IF but WHEN. I can almost bet when she gets to the point of needing a wheelchair she will still try to get up.
Just be prepared for the inevitable to happen. One of these falls will be be the turning point for either her dying because of injuries or she will be confined to wheelchair or bed. (I say this because at 90 with dementia she would probably not be a candidate for surgery if she broke her hip. (and actually most of those are "break and fall" not a "fall and break") Even if she did surgery she may not do well with rehab.
Which is commendable
sh she’s not going still because it isn’t in her nature so it’s a case of working with her
I would say we understand you want to maintain your independence but you’ve had a few falls and if you gave anymore the hospital will intervene and move you into a home to be safe
so we need to agree a plan
you work with the nurses i bring in and you use your walking aid
otherwise the alternative is the law will move you out
into care
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one option
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next option is a day trip and organise it with an agreed visit to caring home for her to see the place
Stigma of old people’s homes is still here
you agree care person come in in a day you’re there and help you!
then increase it to its regular and the care person has established a relationship with her then increase the care visits- then you disappear on sone for a short while to a longer while
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Its unrealistic, and highly aggravating to grandma, to continuously be underfoot trying to prevent her from falling. Falling will happen no matter WHAT you do, it's inevitable, so just let her be. That's my advice. Not every fall will result in broken bones or injury, and those that do will hasten her demise. There is nothing you can do except stay on her like white on rice and STILL falls will happen. Why not let her enjoy what's left of her life without so much angst and aggravation? Remind her to use her walker and let the rest go.
My mother fell 95x in Assisted Living and Memory Care, even when she was confined to a wheelchair. And she still lived to over 95 yrs old.
Wishing you the best of luck.
She is feeble but still cognitively with it. She has balance issues mainly but facility thinks a fall is a fall.
do you have any advice for us?
thank you.