Mom fell and is now scared of everything. Any advice?

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First a little background: My parents moved in with me 12 years ago when my father was in congestive heart failure and on the transplant list. 3 months after moving in he received his new heart and stayed in the hospital for 3 months. Since then has been relatively healthy we have had some scary times with pnuemonia and infections that have landed him in the hospital but surprisingly he has done very well. My mother has been his main caregiver and I have been here to support and help out. Now the tables have turned my mother was putting on her pajamas while standing up and lost her balance breaking both her hip and her wrist in January of this year. She has had surgery and had to stay in a rehab facility and then came home and had therapy and was in a wheelchair, then walker and now a cane. My father became her caregiver and has been very helpful at first when we brought her home I stayed down with them but taught him what she needed and he very soon took over. Long story short she had a horrible time while in rehab and as a result was only there for one week when the original plan was to stay for 6 to 8 weeks. I was able to get her out due to the home support that she had. Now she is afraid of everything falling, being sent back to "the home" when the therapist came she would be fine while they were here and then when they left she would cry because they hurt her. If she goes to a store and the floor is shiny and looks slippery she will not even try to walk on it she will turn around and want to go home. My dad gets very nervous taking her out because he never knows if she is going to just start freaking out. Other than high blood pressure she is very healthy physically but I worry about her being fearful. I go down to check on her and she starts crying and begging me not to send her back to the home and then other days she is great pays all her bills walks around without the cane and very positive. Is she just getting older and is scared? Is this the start of dementia? I tried talking to my dad and he just says shes fine and then he leaves with his slippers on and forgets his shoes. So of course I worry about him as well and his state. Any advice? I told her physician that she seems to be scared all of the time and he said sure she is who would not be. Any suggestions on how I can make her more comfortable and not so fearful? Also, how do I know this is not the start of dimentia?

Thank you all so much for your support

Answers 1 to 10 of 19
FYI mom is 73
Sorry to hear about your folks health problems. I ordered for my parents about a year ago, pants that have thick padding on the upper part of the pants, which protects the person, in case of a fall. They make them in different sizes, and also they have them in shorts. They also sell helmet type hats which also protect the head in case of a fall. The company where I ordered them from was in PA, but I can't remember the name. I found the company online while researching those types of companies. On another note, in reference to your question about dementia, some medications can cause side effects that could be similar to dementia, but unfortunately, dementia is common as one grows older. Hope all goes well.
Fear of falling can be a vicious cycle as it leads to inactivity which leads to weakness which leads to increased risk of another fall and going downhill from there. I imagine you checked to make sure there were no bruises or injuries after therapy, that it was just fear and anxiety making the usual pain from a good stretching or good workout seem worse than it was. No, this is not just normal fear and caution, its maladaptive from what you describe. Dementia might not be an issue at all at this point, but a good geriatric evaluation (e.g. Little Rock has a Longevity Center and the Reynolds Center on Aging) could help and maybe they can get plugged in to a Tai Chi or aquatics program to rebuild strength, balance, and a reasonable degree of confidence.

Look at hiprotector for info on the products Whitney mentioned. They may not actually prevent fractures, but that's unclear. The other thing is to actually measure and treat the low bone density, a lot of times this step gets skipped after an adult fracture and it should ALWAYS be considered.
i think in my experience , it takes a fall to make the elder more cautious and compliant with a walker. its horrible that the fall resulted in a broken bone. the broken bone is enough to cause extreme fear. broken bones freakin hurt. its not so much the bone break but the tissue bruising and sprain in the tissue surrounding the break.
What was it about rehab that gave her such a negative reaction? Her fear of going back doesn't seem normal to me, so if it was my mom, I'd get her checked out from a neurological standpoint. The anesthesia they use can really negatively impact seniors cognitive function. I assume they used anesthesia when she broke her hip and wrist. Why won't she speak up if a therapy is hurting her? Do her therapists seem to be caring about how much they're pushing her? Is this normal for your mom to be that afraid to speak up?

Could she use a walker when out and about, so that she feels more secure? Or a companion chair, if your dad (or you) are strong enough to use one of those. I have one for my mom for when she's tired and it's great. It's important to keep getting her out, so she's not too fearful and wanting to stay in. I'd also make sure she has good rubber-soled shoes that are non-slip (i.e. not leather soled shoes that can be slick).
I'd start with a new doctor, one who specializes in the elderly. You probably need to have her seen by a geriatric neurologist and/or psychiatrist; her anxiety and possibly depression sound like they are needing to be addressed.
She may have neurological issues that caused the fall. Plus, the general anesthetic can worsen neurological deficits, and the heavy duty painkillers have serious consequences. At this point, the MD should have given her meds for anxiety and/or depression. She needs to continue PT even though it hurts. Try not to wait on her, force her to get up and move around. PT should be repeated every day. She HAS to do this to make progress. Her fear of shiny floors suggests a vision problem as well, and that should be checked. Dad's forgetfulness may simply be distraction over his concern for her. A man in his 70's is not the best candidate for a caregiver, especially a husband who will not PUSH her to make the PT goals. It may sound cruel to leave them in rehab for 6-8 weeks, but rehab will push them harder than family. While they think this is being mean, it is better in the long run. Many a day I dreaded PT when I was in rehab, but looking back, they did what was good for me.
I second Blannie's question about rehab, what was the problem there? There is a lot of diagnostic work up here that needs to be done, both neuro and psych, imo.
Thank you all for the answers Whitney I will look into the pads as that is something I have never heard of so thank you for that. Vstefans yes that is my fear that she becomes more inactive and then as a result weaker. I do have an appointment with her regular doctor next week and I will talk with him regarding the bone density as well as a geriaric evaluation. If I do not get the answers from him I will look into some other physicians I have to do this because my mother loves her doctor and trusts him so my first attempt has to be through him.

Yes Captain I want her to be careful but not fearful.

The Rehab was not a pleasant experience first of all she did not want to go at all and my dad did not want her to but I was the one that insisted on it because she was so weak and was on so many pain meds I wanted her to come home safely. I went and looked at 3 different rehabs near my home and chose one that I could get her a private room with a table 2 recliners a bed and 2 tv's as well as got cable installed right away trying to make her as comfortable as possible. I made sure someone was with mom from 7:00 a.m. until she went to bed which is about 9:00 everyday that she was in if I was not there my dad was there if he got tired my sister went. She was severly constipated after surgery which I know happens and they gave her meds for it as well as had her drinking prune juice anything to get it going. It happened in the middle of the night and she rang the bell for the nurse and no one came she tried to get up to get her wheel chair and ended up going on herself. The aide came in plopped her on a toilet and left her there she called over and over again and they would just come in and shut off the nurse call button. They left her there for an hour she got herself to the sink and cleaned herself up and crawled back to bed. When I got there in the morning I was as you all can imagine furious. I went to the head nurse, went to social services, the administrator and stayed for the night nurse supervisor. I did not yell or scream but was very clear and stern that I put her in the care of the Rehab and family is with her taking care of the majority of her needs during the day but that I expect nothing less but to have her basic needs cared for when we were not there which I believe was very reasonable. What if she had fallen? Was she not in rehab because i believed it was safer for her than to go home? After the investigation someone lost their job and the staff was told that if my mom got up in the middle of the night to go to the bathroom they must stay with her the entire time. The staff then had comments like why was she so special, the little princess cannot be left alone etc., This she did not share with me until she got home for fear I would say something and it would make it worse. After that she had it in her head that the therapists worked for the state and could send her back so she would do all the therapy without complaining and then cry afterwards that they hurt her. I reassured her that no one can take her away and had a discussion with the physical therapist which resulted in me letting her go because she was too aggressive. I called and asked for another therapist which she was better one week and then the next week she would cry. If my father was not with her during therapy than I was so no one was intentionally hurting her they were just doing the strengthening exersices. I guess what bothers me the most is that she has always been so strong and not afraid to speak up but now it is completely different. She is scared all of the time if she is upset she will ask be to deal with it because she just "can't" anymore. She still uses the wheelchair at night to go to the bathroom because she is afraid not to (the bathroom is literally 5 feet from her bed) She puts her shoes on the wheelchair so she can put those on when she gets up too.

The doctor said she should use her cane over the walker and get exercise, I have a wheelchair I have a walker but want her to get stronger not weaker.

Wow very long winded sorry folks just trying to put some content to this. I just am afraid that her fear in not rational yesterday she was crying because dad tried to run her over with the car. I talked to dad he let her out at the store she went behind the car and when he started to move the car she was still close to it. I told her to go around the front of the car and told dad not to move the car until she was out of the way. She went to 3 stores and was great and then we went to JC Penny the floor looked slippery and she needed to leave now, she would not wait in the car she would not let me get what I needed she just had to leave. It is so inconsistent; she is fine one minute and then not the next very confusing to me as well because I do not know how to handle this extreme change.
A healthy respect for the risks of falling is generally a good thing. A paralyzing fear is not so good.

Would Mom be able to use the riding carts provided by many grocery, department, and discount stores? Or would she feel more confident with a rollator when she goes out, so she can stop and sit down if she feels stressed? Many places also loan wheelchairs to their customers for use in the store or museum, etc. My thought is that it is important to avoid isolation, so anything you can do to help her confidence level and allow her to enjoy going out is a good thing.

I wonder, with other posters, what was so terrible about the rehab center?

Nothing you've written sounds like dementia to me -- but obviously I am not an expert and even an expert couldn't diagnose from a few sentences. Are Mom and Dad both seeing a good geriatrician in addition to any specialists who might be following them? A geriatrician is an appropriate primary care physician for folks in their 70s with chronic health issues.

Best wishes to you all. Please keep us informed of the progress here.

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