After falls, mom is afraid to stand with therapists on each side of her. Says, "I'm going to fall!" How do therapists gain trust?

I completely disagree! Your mother could live another 5+ years. Without weight bearing through the legs and out of bed/ chair activity you are setting her up for increased pain in her joints, risk of joint contractures, skin breakdown, pulmonary disorders, decreased sense of self worth, impaired awareness of night and day.....etc. etc. While I do agree that it is highly unethical to force someone to walk/ stand if they don't want to, you need to exhaust all efforts first.

First, try a different therapist. Some people feel more comfortable with males as they feel they are stronger; some prefer female therapists. Also, in general, your mom may respond to the personality/ attitude of a particular therapist. Often times people with dementia will respond to someone because they may remind them of a grandchild, friend, etc.

Second, there are plenty of interventions to increase confidence. Use of parallel bars, mechanical lifts, standing frames that can decrease that fear of falling. Unfortunately, once someone has fallen, that fear will probably never go away completely but these devices can help.

Third, utilize familiar activities. Standing & walking are familiar. Introducing a device like a motorized wheelchair is challenging & can be overwhelming.

Fourth, be aware of the environmental stimulus. For example, make sure 4 people aren't screaming "you can do it" all at different times. Keep the atmosphere calm & non-distracting. Music often works. For standing, walking & transfers I have oftened "danced" with my patients and led them to where we need to go.

Fifth & finally, encourage consistency & routine. Establish a schedule for daily tasks & for therapy sessions.

Best of luck!

Shortcake is under the impression that 5 yrs. of having dementia is desirable. You can try many avenues, but the end result will still be the same - death. She will be unable to walk as the brain is robbed of the ability to communicate with the muscles. Also when you break a bone IT HURTS! I have fractured both wrists and it took many years of therapy and I still cannot function as I used to. So I accept my limitations as a 91 yr. old has learned to do. May she rest in peace! Remember folks, NOTHING you can do will change the inevitable.

I agree with Veronica91 about letting a 91 year old do what feels comfortable for her. However, electric wheelchairs can be kind of dangerous for patients with dementia because of difficulties with attention and judgement. (It's like letting someone with dementia drive a very slow car.) We decided not to get an electric wheelchair for my husband for this reason. He can wheel himself around a bit in the house but needs to be pushed outside.

Mom has dementia. Her brain can't make all the logical connections we take for granted. She fell and that had dreadful consequences. She doesn't want to do anything that would make/allow her to fall again. You know, and the therapists know, that she will not be allowed to fall while the therapists are working with her. But that is a logical conclusion she apparently can't make. It may not be simply about "trust." It may have to do with the logic of cause and effect that just isn't operating for her.

Could the therapists do exercises with her that would help strengthen her legs so she can continue to assist with transfers, but without her walking? (They had my husband use a foot pedal thingee.) Perhaps given more time she'd be more willing to try walking, but I understand the need to build some strength now.

And as far as "she is quite capable of standing" ... maybe she has the muscles to do that, but all muscle use is controlled by the brain. And at the moment, it sounds like the brain is not "capable" of getting her upright.

In my experience, medical professionals who do not specialize in dementia do not have a firm grasp of how that disease manifests itself.

What is the worst that can happen if you left her alone about standing? At 91 yrs. and mod-severe dementia, she will die from it or something. Why not let her live her life just as she is and there will be more peace all around. You cannot change this diagnosis. This is a terminal illness. Keep doing things for her and maybe one day she will decide to walk or not. Let her decide what she wants. At this late stage she will forget what she wants too.

If a 91 year old woman with dementia doesn't want to walk, for whatever reason, why are people pushing her to do that? It is just likely to make her quality of life worse because it causes her to feel fearful and unhappy. Perhaps they can just do seated exercises with her or - just leave her in peace!

Demented patients tend to stop walking about six months before they die. I think I would listen to all the above advice and just let a 91 year old do what feels comfortable for her. Maybe it is time to get an elecric chair for this lady which would be easier for her to manage

My Mom fell and broke her hip in 3 places. They did surgery & screwd her back together and she is a strong willed woman who was proud of the fact that she could walk on her own.
She contracted Cdif and pneumonia and was in isolation for 2 weeks. She was so weak from those infections that she just cant get up the strength for walking. I had to spoon feed her.She also did physical therapy and after 1month they said she had to go to continuous care. She is happy there ( I wouldn't be). For once in her life, she is free from getting dressed up , etc as there no one cares and I just let her be. She goes out of her room which makes me very happy, but someone has to push her. It broke my heart to see her struggle to get up walk etc with a therapist. The only thing I get upset about now is when she says she doesn't want a shower. It's hard to let go of them but like a child going off to college, you have to let them be and be happy as many have said here.
Surprisingly, it has lightened my hold on her and I feel free and can just enjoy her in another part of her journey.

Well, I agree with Shortcake, for this woman may live 5 years anyway, and it will be harder on her physically, if she sits most of the time, instead of walking. I think it's a matter of balancing caregiver stress and letting go - just because one tries repeatedly to help her walk, doesn't mean one has to be tied to the result that she will walk. One is only tied to making a repeated effort, and making that process enjoyable, not one of worry and focus on any end result. Changing therapist could be a good idea, especially to one who knows it can take many tries, and applaud her briefly after each day for trying, then move on to other things. Not too big a deal, but keep trying. Nothing to lose, make the effort part of the visit, and enjoy the rest of the visit. Have a therapist who can enjoy it all too, pass or fail, and one who can note and celebrate any small movements along the way.