AmyGrace Asked November 2015

Is it true that a fall can start "the beginning of the end?" Is my Mother heading toward that so quickly?

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Up until two weeks ago, Mom was able to get herself up, dressed, to the bathroom, down to the dining room at AL, to events etc. Although she was weak and unsteady she was pretty much independent. Then she stood up and fell. She bumped her head a little so they sent her to the ER. Although she didn't really hurt herself, she spent the night there, and fell again there. I'm wondering if she didn't have an "event" which caused it all. After that she was so weak she couldn't stand on her own and couldn't stay in AL so for the past 2 weeks she has been in a nursing home. We thought she might be able to be rehabbed and return to AL. But she fell again there, and hit her head requiring stitches this time. She has practically stopped eating, tries to get up every five minutes at night and sleeps on and off most of the day, saying leave me alone, and pretty much out of it (they have to give her a tranquilizer to keep her from being agitated so I suspect that is why she is sleepy). Is this the way it progresses at the end? I'm praying she is not suffering and isn't aware of what it happening. I sit there for hours with her, but she barely knows I'm there and five minutes after I leave she doesn't remember.

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At her age, medication can be over prescribed, too many milligrams. Talk to her doctor. Then try to find a way to strengthen her over time.
It may be towards the end, but she is living with these challenges, a better way to think of it instead of dying from the challenges. Imop, hoping that did not offend anyone.
Best to you and your Mom.
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freqflyer Nov 2015
AmyGrace, the first time my Mom had fallen and 911 was called, she bounced back pretty quick. Then a week later, Mom fell again, and she spent a few days in the hospital having terrible delirium.... her arms were reaching for the sky and her feet were pedaling a mile a minute and that lasted over an hour, I thought for sure we were going to lose her then. The CT scan showed a current and previous brain bleed. Her mind was very befuddled.

Everything your Mom is experiencing now is what my Mom went through for a month. Then Mom got a UTI which made everything worse. The hospital doctor recommended Hospice so we set that up.

Now into the end of our second month and we are seeing changes that really are surprising us. Mom is now feeding herself and eating solid foods. That's all she can do for herself, but that's impressive on its own.

This evening when I went to visit Mom she asked if I was at work today [my gosh first time in 2 months she had remembered], and smiled saying her hair needs to be cut [which it does], and she asked if it had rained today. Even the nurses/aides were remarking about how Mom has improved.

Then she was having some type of delirium, tugging at her clothes, flinging her arms, then fell to sleep. So we quietly left her, and like with your Mom, she won't remember I was even there :(
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She could have had minor strokes which are causing balance problems or the original fall itself. She could have had a minor concussion or a closed head injury.

From your description of her behavior, you may want to have a discussion with her doctor about having her evaluated for hospice.

It's hard...
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jeannegibbs Nov 2015
Falls may come near the end. It is hard to say whether the increased weakness toward the end causes the falls or whether the falls trigger the decline (especially if they include blows to the head.)

But not every fall starts the beginning of the end. My husband fell repeatedly in the BEGINNING of his journey with dementia -- and lived another nine years.

My mother fell and broke her hip (or more likely her hip broke and she fell) in the nh. In the hospital she was delirious and they recommended hospice care. She returned to the nh on hospice care. She improved and after about 3 months she "graduated" from hospice and is doing fairly well, 18 months later. Her dementia is worsening slowly, but physically she is doing well.

I don't think it is possible to generalize about falls and the end of life.

Getting hospice care in the nh was very helpful as I see it. A huge benefit is that all red tape is cut. They thought she needed a special mattress ... she got it the same day. When she could be transferred out of bed they got a special geri chair for her right now. They wanted to try a different pain med? It didn't have to wait for the nh doctor to approve it and insurance to approve it and someone to deliver it. She had it within an hour. This alone was worth signing up for hospice! Then she got extra attention. The nh staff still cared for her, but there was an extra check by the hospice nurse and there were volunteers who painted her nails and sat with her. Mom's nh is a very caring place, but short-staffed like nearly every facility. Extra attention was worthwhile!

My husband was on hospice at home, for 5 weeks before he died. That was a very comforting addition to his care, too.
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freqflyer Nov 2015
Every week we all learn something new. Thank goodness for the Aging Care forum, I learned so much about falls and dementia before the fact, how parents can be so darn stubborn, learned about boundaries that I am trying to use now, that when I saw Mom lying on the floor with Dad trying to pick her up, I kept my wits about it as I dialed 911. Yes, my hands were shaking, at least the EMT's thought it wasn't my first rodeo when in fact it was.

At the nursing home when Mom was talking saying things that didn't happen, or thinking she was in a hotel in another State, I just agreed with her instead of trying to correct her.... so much easier that way.

I believe the Staff noticed how I was dealing with Mom and me not freaking out over the little things, that has made it easier talking with the Staff. Whenever the Staff calls about Mom yet again falling out of bed, I take it in stride, I know there isn't much any of us can do, this is just part of dementia process... maybe up Mom's meds a bit to calm her down.
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Gershun Nov 2015
Same thing with my Mom. She took a fall one day when I had accompanied her to her doctor's appt. Sad thing is I had gone with her to prevent this from happening but it happened so quickly I'm still not sure how it happened at all.

But things really seemed to escalate with her after that. I think when they start falling thats usually an indication of something. In my Mom's case CT scans did not show any signs of stroke or brain bleeds. Just normal brain decline for someone in their nineties.
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Amy, your mother's experiences are similar to those of FreqFlyer. Hopefully she'll come along and answer your questions. FF's mother had an intra or intercranial (not sure which) brain bleed, that seemed to precipitate the kinds of behavior you're seeing in your mother.
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AmyGrace Nov 2015
Terry, pretty much we know the main reasons for her falls: 1) she is 101 next month 2) she doesn't eat (she has anorexia and is emaciated so she is weak from lack of food and is dehydrated because she doesn't drink either) 3) She refused to use a walker for years when told she needs one 4) she has a hump on her back so she is unbalanced 4) she refuses help on any sort and even before the dementia got a good grip on her, she would never cooperate with the doctor. She fell in the hospital and the nursing home because she won't stay in bed and keeps getting up every five minutes. Despite her age, she is pretty fast and even though they use alarms, she got far enough out of bed to fall (she has dementia) before they got there. She is so agitated and combative they have to give her something to calm her down.
That's a good idea to talk to her doctor. We now have to use the NH doctor and I haven't met him yet.
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AmyGrace Nov 2015
Can someone explain the difference between hospice and nursing home? If she went to hospice it would have to be to a facility. My sister can't take her - she just went through a year of hell with her husband dying of a brain tumor. I can't bring her here as my home is not good for any disability. (In fact we are trying to find a home as it is too much for us, too many stairs and levels, etc)
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freqflyer Nov 2015
AmyGrace, my Mom is also quick to fall artist. One day the nursing home had her in a wheelchair and placed it in the nursing station so they could keep an eye on her. And in a flash she fell out of the chair, probably trying to pick some imaginary object up off the floor. The staff couldn't get to her quick enough. Eventually Mom was placed in a Geri recliner and still was trying to climb out but the way that chair is, even you or I would have a hard time getting out of it.

Mom frequently falls out of bed, and her room-mate is able to buzz the nurse. The bed has been lowered as low as it can go, as Mom is on an air mattress... and there are fall mats on both sides of the bed. There are rails up near her head/shoulders. So far Mom hasn't hurt herself, never has had a broken bone, so maybe all that calcium she was taking paid off.

Any time Dad hears that Mom has fallen, he wants to bring her home.... like she's not going to fall at home??? Falling at home and getting a head trauma is the reason she is at the nursing home. But I can understand he misses her.

Same here, if only Mom would have used a walker. The caregivers have Dad's pretty much trained to used his walker. Guess coming from them he will take notice, but not take notice if I said the same thing :P
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