Mom keeps falling. What can I do or how do I come to terms with this?

I've lost count of how many times my 93.5 y/o mother has fallen; I think she's up to at least 46x now. She's been wheelchair bound since May of 2019 which I too thought would help stop the falls, but nope. She's still as stubborn as hell and determined to do things independently that she has no business trying to do independently, so she falls. She lives in Memory Care so I am the one who gets all the calls. One day, she fell twice in one day, about 4 hrs apart. She's broken ribs and sternum bones in her various falls, but has NEVER taken a trip to the hospital for one of them, believe it or not. And yep, she has bed and chair alarms in her room but guess what? By the time the alarm goes off, it's too late to STOP the fall from happening. Trust me, I know; I am an expert on the subject, unfortunately.

It's nobody's 'fault' but my mother's that she keeps falling, in all truth. If she would agree to play by the rules, 80% of the falls could be prevented, at least. But as long as she's living and breathing, she will continue to do things 'her way' and as a result, we all pay the dues. "Tying someone down" to a wheelchair is no answer, either, b/c it's against the law. So just allow your mother to live life as SHE sees fit, while YOU keep visiting her at the hospital and rehab, what else can you do? You can't help a person who refuses to BE helped.

Good luck!

My aunt with advanced dementia has broke 3 bones in 3 falls in 2 years all while under the watchful eyes of her many relatives and hired agency caregivers. I do not think any facility can "restrain" a person, even in a wheelchair and even if they are a known fall risk. Her short-term memory is not allowing her to remember to stay seated. Even with a full leg brace on my aunt kept trying to get up on her own (she's 98). Just writing my experience so that you can know that even if your mom were in your home it may not solve the problem. For some problems there are just no good solutions and this is what I've had to come to terms with.

There is NOTHING you can do to prevent every fall, short of hiring someone to sit less than a foot away and stare at her and be ever ready to prevent her from getting up on her own.

I had guardianship over a relative who was in a Memory Care facility. She fell 3 times in one week, each time requiring an ER visit. She finally broke her kneecap, which was the beginning of the end for her.

Everyone's suggestions of a bed that is low to the ground, padding around the bed at night, furniture with rounded edges and pulled away from the bed at night, geri-chair, etc. You can do things to mitigate the risk, but sooner or later, it WILL happen.

They fall. Initially, they trip and fall. Then they fall because they forget they cannot walk and try anyway. Facilities are no longer allowed any restraints no even wheelchair seat belts so there are more falls. She will fall at home too. It is easy to blame the facility but it is usually not their fault. Falling goes with the territory. There really is nothing you can say to remind them or keep them in the chair. I don’t know if taking them to the toilet every 2 hours helps since they may have to go and that sensation prods them even when they are incontinent. My MIL who tried to get up all the time, was found to have UTI. But other times she fell and there was no UTI.
The Geri chair or even a reclining wheelchair may help since it will take her longer to get up when slightly reclined. Elevating her feet may help in chair. Also, the Geri chairs are big enough that her feet’s won’t touch the ground and again, that makes it harder to stand up. Her bed should be kept at lowest position and padded mats put around bed so she will land on them.

Falling ultimately killed my MIL. She had significant dementia. She was obsessed with going to the bathroom. She would never agree to a walker. She fell and broke her hip on way to bathroom. She had surgery and the bone healed but she was more confused and really never was able to walk well afterward. But she persisted to try to get up with repeated falls out of bed. She stood up suddenly in wheelchair in the dining room while at lunch table and fell over, hitting her head on sideboard. Nothing was fractured this time but she was in constant pain from the fall. She was already on hospice, so her pain was managed. She stopped eating and died within 2 weeks of the final fall.

I only tell that story to illustrate how this progresses. The facility was great with her but she was so determined. She was 92 years old, and only weighed about 95 lbs. I don’t mean to be fatalistic but there literally was nothing we could do. I am a retired nurse, from back in the day when we could used restraints and belts but they would get free of those and fall anyway. So maybe try the chair options even if you have to rent one. And have them check for UTI just in case. And be at peace that there is little you can do. Bringing her home is not the answer. She will fall there too and if family members who don’t understand want to lay blame, they will blame you.

Dear PAH321,

My mom had always been an active and strong person. In 2014, she was diagnosed with Alzheimer's and I moved her into an AL facility in early 2015 at the age of 90. She was completely mobile as well as able to dress herself. I still remember when she had her first fall, I was extremely upset even though she didn't get hurt other than a black and blue eye. Another year went by and she fell again - no injury. Another six months from that fell again - still no injury. It is so common for the elderly to fall. I know my father-in-law would fall and he was a big guy but, it was always upsetting. For me I just hated to think "how long were they lying there before anyone noticed?" - especially for my mom who would never push the "call" button.

She is now 95. After she nearly died from severe dehydration and getting the COVID virus in April, she has fallen at least seven times in two months. She is too weak to walk so now she has a wheelchair but, always requires assistance. They can't restrain her. Maybe it's so no accusations can be made - I don't really know. But, the problem is when she as well as your mom are trying to get up on their own either because they don't use their "call" button or they don't want to wait for someone to come and assist them. In my mom's case, they pushed one side of her bed against the wall so that eliminated one way of falling out and then hospice provided a "fall" mat which they place beside the other/open side of her hospital bed at night. That's when she fell most often - I suspect she wanted to use the bathroom even though she wears depends. However, now that hospice has given her a low dose medication to help take some edginess off (as she would get agitated/combative occasionally) and to help her sleep through the night, the amount of times she's fallen has significantly decreased. She has fallen maybe once or twice during the day but, I know my mom - she's a very independent person who was the oldest of 8 siblings - so she gets up even when she knows she shouldn't! But, I don't think I will ever come to terms with this aspect so I feel for you especially, because your mom has broken her hip and leg which as we know can cause a quick decline or worse. I'm sure there are a lot of others on this forum who will be able to help you and I wish you and your mom the best!

PAH: I see by your profile that your mother suffers from Alzheimer's. With the disease of the brain, she is not going to remember that she shouldn't rise up out of her wheelchair by herself. Place an alarm on the WC.

You simply cannot prevent falls. Stand up from the chair you're sitting in. Took like 3 seconds right? That's how long it takes a senior to try to stand and fall. It's inevitable unless you literally have someone sitting within meter of her starting at her 24/7, or strap her to the chair which is usually illegal.

With dementia, it is hard to keep falls from happening if the client has poor balance and/or muscle weakness. All facilities try to avoid falls but have come to the conclusion that some falls will happen and strapping people down leads to other problems. So fall management is more the current trend: beds really low to the ground, thick mats on both sides of the bed to absorb impact, no tables next to the bed, keeping clients in high visibility areas with staff nearby, keeping clients pulled up to tables, toileting schedules, exercise classes...

We used to think that people fell and then broke their hips. Studies have shown that many of those falls are the result of osteoporosis; the person's hip fractures under their weight and the person falls afterwards. The same may also be true of falls with leg fractures. Please have your older loved ones evaluated and treated for osteoporosis.

My mother has a custom reclining W/C with seat belt and is very comfortable. I know it is considered a restraint, but try discussing it with her primary. Medicare will pay for the W/C if she qualifies. My mother has severe spinal stenosis so she qualified. The doctor needs to fill out a form and sent it to Medicare. Once they review it, you will be notified. The W/C is high quality and is a life saver for my mom. Doctor should speak to the administrator initially before moving forward. Good luck!

As XenaJada (and others) said, there are ways to reduce the risk, but there is no 100% method to eliminate falls. Until they are fully bed bound and can't get up, falls are a risk. There isn't a whole lot any of us, including staff, can do to eliminate this issue. For those with dementia, this is a higher risk, because they forget they can't stand or walk.

"My brother was convinced Mom’s facility was not providing proper care because she fell so many times. Although possibly the care could have been better at times, we are learning that she may (and probably will) fall where ever she is."

Hopefully the WE in 'we are learning' applies to your brother. As many have stated here, there is no foolproof way to eliminate falls. They happen in their/our homes, even when family is care giving, they happen in NH, AL, MC, rehab. It just goes with aging and especially when dementia factors in.

Hopefully when rehab is done you will consider moving her to MC, not back to AL. AL can assist with some needs, but isn't geared to watching anyone all day every day. There should be more staff per person in MC, so she would have more eyes on her, but there is no guarantee that she won't fall there either. IF she is still in the early stages of dementia, perhaps you could get PT/OT set up after she moves to MC. Mom had knee pain, interfering with standing and walking, and they were able to get her mobile again, for a bit. Once she started fearing standing and walking, they tried again to work with her, but she wouldn't do anything they asked her to try - their last attempt was met with YOU do it!

There was a woman in mom's MC who was still able to manage her TV, use a computer and phone, and walked with a rollator. She was 99 when she moved in and almost made it to 101! I interfaced with her a lot when visiting with mom. She was a lot more "with it" than many in the MC area. Clearly as she neared 101 I could see some decline, but the last time I saw her, a week or 2 before she passed, she had a terrible fall. The side of her face and down her neck was badly bruised (I think she hit some furniture in her room on the way down.) She had other medical issues ongoing and was on hospice as well, but this fall was certainly a catalyst in her passing.