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Hello. new here.


My mom lives with my family. She's 83 and has always been susceptible to falls, for at least the last 20 years. Many ambulance rides and hospitalizations.


The last few months she's been somewhat depressed (grieving) and hasn't wanted to exercise. She just walks around her part of the house (3 rooms) and into the living room and kitchen. If I get her out to the park, she can only use a walker and go about 200' and can barely make it to the bench. But we were trying.


Now she's had two big falls in a week. After getting her up, she could not return to her room. We had to carry her. She's not light. She had no injuries and was shaky afterwards (as I would be!). She can't seem to even get out of her chair or off her bed to get to the toilet. I have the walker in there, but it's almost it's own hazard.


So, my concern is I want to get her into the doctor but not sure I can even get her out into the car, much less into his office. I have calls in for help, but don't feel comfortable risking trying to get her into the car until I have help on hand. Is this a 911 issue? Do you think I could get physical therapy at home until she is able to be transported to regular PT?


She doesn't like being told what to do, but I feel like I have to push harder to keep her up and moving. How do I do that if they refuse? She's going to go downhill fast unless we can keep her active.


Thanks in advance,


C

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Hello and welcome to the forum! You stated she has had 2 "big" falls this week...but no trips to the ER or doc for an xray? 911 is for life-threatening situations. I understand your challenge with getting a bigger person up and into a vehicle. We had the same issue with my 180 lb MIL. I would call you mom's doc and ask for guidance. If they tell you to bring her for an xray, you can hire a medical transport van. They will get her into a wheelchair and into the van, to the appointment and back. They will give you an estimate for this service. You can't keep her active if she's in pain. You can't jump to PT without a diagnosis. You don't give a medical reason for her lack of balance. These questions should all be answered by a doctor before you can effectively help her. While she is at the doctor pass him/her a note telling them about the depression and also ask them to perform a cognitive test and check for UTI for good measure. They do this all the time. Are you her durable PoA? Is anyone? If no one is, this is an issue that needs to get taken care of. Also while at her doc's office ask them for a Medical Information Disclosure Form for both of you to fill out (it may be called something different but they'll know what you're talking about). When your mom signs this form naming you, it gives the doctor's office permission to release your mom's medical info to you and for you to be able to give them medical info on her behalf. Without this signed form their office will not discuss her case with you no matter what, unless she is physically present. Good luck!
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Me? I'd call 911 immediately and get her a FULL workup at the hospital. How do you know this is NOT a life threatening situation shes facing after 2 big falls?? One stop shopping is MUCH easier than 20 trips to different places for different tests. She's obviously in need of a medical evaluation before you can determine if physical therapy is even warranted. If she can't even make it out to the car, she's in pretty bad shape, it sounds like. And if you don't feel comfortable getting her into your car, an ambulance is the only logical answer, in my experience with 20 trips to the ER with my 92 year old mother. Sigh.

If physical therapy is the answer here, you won't be able to force her to cooperate if she's stubborn and doesn't want to stay active. Thats what happened with my mother and now she's wheelchair bound. You can remind your mother that you'll have to consider long term care placement for her if she refuses to do the work and winds up in a wheelchair.

One step at a time though, right? First get her to the ER as she may have broken her hip, who knows? Good luck!
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Home health does help. My mom did it several times. If she goes to the hospital after a fall and they admit her and she stays for three nights then she qualifies for rehab which is more intense and in most cases helps tremendously.

You may be surprised at what an elderly person can do. My mom has Parkinson’s and is in her 90’s. The occupational and physical therapists can get her to do things that she would never do for herself or me. It’s amazing how much therapy helps to regain strength.

I can testify to therapy myself. I was paralyzed after a severe accident. They moved my arm for me at first. It was painful but it works! I got just about all of my range of motion back. I do have some permanent damage. I lost most of my grip strength but I would absolutely go through every bit of pain again to be able to heal as much as I did. If she will cooperate with therapy then go for it!

The transportation issue is a pain. Getting in and out of cars is hard. Call 911 for rides to the hospital. The EMT’s are used to dealing with handling immobile people.

As far as going to the doctor there is a gadget called the car cane that aids with getting in and out of a vehicle. Find someone to help assist you bringing her to the doctor. If she is unable to do this then call her doctor and see what they recommend.

The doctor can then tell you the next steps in preparing for future care.

Do you think she should be placed somewhere? A nursing home? Do you want to ask her doctor about palliative care/hospice?

Sorry that she is suffering and sorry that you are having difficulty as well. Hard for each of you.
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lealonnie1 Dec 2019
Not all Medicare plans require a 3 night hospital stay to qualify for rehab. My mother's Blue Cross PPO plan, for instance, does not.
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Also, please consider that if your mother is on the heavy side, it is much more difficult (and physically dangerous) for you to care for her at home by yourself. Even if we were willing to care for my MIL in our home, we could never transfer her from bed to wheelchair and back without needing 2 people and risking back injury. In her NH she needs the Hoyer Lift plus 2 staff to move her.
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Hello: I echo what most people have said. #1-do NOT try to lift or move her on your own any more, call the doctor's office regarding an ambulance service recommendation if you need one, you do not need a hurt back or to fall, yourself. #2-She needs to go to urgent care, or the ER to get X-Rays, and orders for physical therapy. #3-They absolutely DO have physical therapists who will come to your house to work with your mom. And they are usually great. You have the right to schedule them when it is convenient for You. They are trained to do all of the lifting, etc., so that lets you off the hook. #4-Don't assume she won't cooperate about exercise. Just because she says no to you, doesn't mean she won't say "ok" to someone else. Try not to take it personally, if/when she does. They have special training and jedi mind tricks they use that mere mortals can't know about ;-). #5-If she is grieving she might need a counselor or even a support group. Usually local hospitals or churches have meetings called something like, "good grief," or other support groups that your mom might find useful. #6-Always take her to the ER or Urgent Care after a fall if she is bleeding, hurt or has a head wound, especially! At her age, this is critical!

Last word, be sure to take the time to take great care of your sweet self, FIRST!
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Awww, I'm crying here, you all are so nice! I'm so overwhelmed that reading it made me cry.

So, yes. She did have a workup for another fall a month ago. It was bigger and she knocked a hole in the drywall with her head. Did all the medical stuff and the ambulance and the hospital. The word was they were ordering PT. She saw her doctor after and he didn't seem to think it was that urgent.

Yet at home, she sort of plays games. If I ask her to walk with me at the park, she resists to the point of not even wanting to move out of her chair. Thing is, I don't know if it's a control issue or depression but she pulls in the opposite direction from what I ask. Even if it's for her own good. This morning I wanted to do some of the PT exercises she had printed out. She said no, too soon. But I need her to get in the shower as well. It's been a week. So she promised tomorrow I could help her shower. I'm 100% sure she'll make up an excuse.

The grief issue is very complicated. Her religion doesn't like 'outside' help, but provides none of its own. No one from her church visits as she seldom wants them to. She wants her own space and life and choices, but at the risk of me losing my mind. She doesn't 'believe' in psychology.

With my TBI and messed up shoulder, I'm overwhelmed just figuring out what to do (I did take a shower, so yay for that). I have a husband and a young son and I need to take care of all of us.

In one sense, it's easier for me if she sits in bed or a chair all day. But easy for me is not best for her long-term. Once she loses that muscle, it will be a downhill slide. I saw that with my Dad who passed in 2017. Once he lost it (in December) he was dead by April. It was fast. In my efforts to help, I feel like I'm teaching the cat to balance my checkbook: he could probably do better than me, but he doesn't care about things like that, so I'm wasting my breath.

In other notes, I do have the medical disclosure form done. They are somewhat helpful. I'm calling again today.

thanks all!
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My mom tried to pull that stint of not needing a walker so I had the nurse and doctor tell her it was necessary. I got tired of arguing or debating issues with her over things for her own good. They usually will not argue with others like they do with us.

My mother has falls too. Falling in the elderly is serious. Walkers are more stable than canes. My mom thought she could continue using her cane. Once she became used to the walker she loved it!

It is a vanity thing. My mom wouldn’t even go to the mailbox without lipstick! The woman wore makeup for surgery. That’s another story!

She also thought it would be a burden to me. The burden was the constant anxiety over a fall, not what she considered to be a burden which was, me having to place the walker in the car.

Reading through your post. I respect all faiths and people without any religious beliefs but it is disturbing to see a religion that doesn’t want people to have ‘outside help.’ Not believing in psychology? Is that part of the religious practice too? That isn’t a religion. That is control over a person. That has to be upsetting to you.

Best wishes to you and your mom.
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So she told me she doesn't want to use a walker as it makes her look 'like an old lady'. Pride is what is preventing her being careful.

So I reminded her that if she were in the hospital she might be taken for an old lady, and if she wants to be youthful she needs her PT and to use the walker until she gets back to 'normal'.

Sigh.
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