My mom is 94, has lived alone in the house since my dad passed away 4 1/2 years ago. My brother and I went there every evening and called her every afternoon to make sure she was ok and to make dinner. Last Summer she fell two separate times requiring separate hospital stays of a few weeks each time. She broke a bone in her foot one time and the other time hit her head, along with other bruises. She insisted on going home and continuing the same routine. I wanted to place her in a nursing home, where she would be watched 24/7, but my brother was against it. She's gone downhill, forgetting pots on the stove, staying up all night watching TV, unable to deal with bills, only taking sponge baths, etc. A few weeks ago she fell again, on the carpet by her bed. My brother found her and phoned me to help lift her into bed. She's only about 90lbs but I have osteoporosis and arthritis so it was pretty awkward getting her off the floor. I think we should've phoned 911, but she said she wasn't in pain and my brother said he'd stay with her to make sure she was ok. She was shaken up but by the end of the week she was alot better. About 10 days later she was just starting to use her walker again, when he left the room for a minute to get her something, and he heard a thud. She had fallen from standing by the foot of her bed to the floor. This time someone working in the backyard helped my brother lift her back to bed. Right now (this happened 8 days ago) she's got a badly bruised, swollen upper arm, shoulder, bruised knee. Last night she told me the back of her head also hurts. But maybe that's because she's been lying flat on her back for a week and refuses to get up even to use the commode, we have to use the bedpan. She mostly just goes in her Depends. She said she's afraid to even sit because she may fall again. It's worse everyday, even eating soup flat on her back, her head just on one pillow. I think she should be in hospital. This 2nd fall was 8 days ago and she absolutely refuses to try to get up, she sits up on the bed occasionally, with my brother right beside her. He's been staying there 24/7 since this happened and now I'm worried about him because of the stress and lack of sleep. She won't accept outside help, only wants us to be there. I'm only there every 2nd day now, because of my own health problems. Even though she's 94, she's very stubborn and will not get up. She's got some degree of dementia, takes donnepezil, which I suggested my brother ask the Dr for, about 3 years ago, also she has a pacemaker, takes diuretics, and thyroid meds. I wanted to put her in a nursing home when she came out of hospital last Summer, but my brother felt she'd be happier at home, and she was, until a few weeks ago. I'd really like any advice on what to do now, since we, mainly my brother, do everything for her, and she refuses to get up out of bed. Should we call an ambulance? What should we say is wrong with her, because last time the hospital discharged her last Summer, they said it was because she had recovered and no longer had an a acute condition. Is this refusal to get up and 2 falls in 17 days acute?? I think she should be in hospital.
If it's determined by a dr. that your mom is fine, then she should be kept out of bed as much as absolutely possible until her actual bedtime. If there is absolutely no medical reason whatsoever for her to stay in bed all that time, then get some help and drag her out of bed and make her stay out of it. I would definitely get her to start exercising if there's no physical reason why she can't because it sounds like she's probably pretty weak and needs to rebuild some muscles. The first step though is to get her evaluated and maybe even some tests run to make sure she's OK. If she is, she doesn't need to be in bed all the time. She can actually choke trying to eat and drink laying flat on her back whether she realizes it or not. If she insists on eating in bed, she should add very least be properly propped up to a certain level in order to be able to eat in bed safely. She should be propped to the point of sitting at very least halfway up if not almost straight up if she's prone to choking. If not, then she needs to be at very least propped halfway up into a sitting position to eat in bed. This may require getting her a hospital bed so someone can set her up with ease if she won't prop her self up for meals. It may turn out that she would probably do better off in a chair then she would in bed. It's sad to lose someone, but that's no reason to just give up on your own life. She probably needs psychiatric evaluation to help her cope with her loss because it sounds to me like she's doing more than just grieving, she's dwelling on the actual loss. This is a huge mistake some people actually end up making. I know someone right now who became lazy at some point and even downright hateful. She lost two people within a week and ended up losing her mind. I'm surprised she was able to stay home as long as she did, her son ended up taking care of her and doing nearly everything for her, she ended up just sitting around pretty much all of the time. Her son has often complained about this and your description sounds very similar
Your bother should also call a nursing and/or home care agency second thing and sign up as a client. A reputable agency will do some sort of needs assessment, and he can take advice on what services would be helpful. The key thing is that this support is not so much for your mother, who is refusing it, but more for *him*. Because as you correctly perceive, he cannot possibly sustain this level of care for somebody as frail as your mother on his own. So he doesn't need her permission - he needs help, and he should buy it in immediately.
If your mother wants to die at home she has the right to make that choice and it is do-able. However, I would be surprised if her doctor did not insist that the injuries sustained after her latest fall are evaluated in hospital: the swelling in particular could well mean that something is broken or dislocated, and for heaven's sake that's *treatable*. If she's determined to come home again then so be it, just agree: the last thing you want is for her to refuse medical assistance for fear that she will be locked up, which is what seems to be happening.
With or without your mother's consent, your brother MUST seek professional advice. If he doesn't, with those obvious and visible injuries, he's going to be in the frame for neglect.
They will take her to an ER and evaluate her condition. If she has a dr I would also call her dr. If she doesn't want to go to the ER, ask her dr for hospice to come evaluate her condition at home. Going to the ER will give brother a little while to recover. At 94 they will most likely put her in the hospital for a few days to check her out. Give them a list of all her problems to go over at time of check in. Dizziness. Falling. Etcetera. Then ask for rehab so she can regain her strength. Then make a decision on home with help or NH.
My mom's horrible fall at home was straight back in the kitchen - she hit so hard the hardware on the drawers were bent - she spent 6 weeks in rehab - came home with caregivers while I worked and began running away from them and fell twice more breaking her ankle and injuring her knee
It was a difficult decision but after another hospitalization I moved her to a memory care facility last year - she's nearly 94 and after several falls there she no longer walks
Depending on mom's finances you may try assisted living - better quality of life than a nursing home but I'd be concerned she may have a fracture based on the bruises you describe - you and brother need to take action
My mom only wants me to help but I can't be her sole caregiver so I do the best I can by her and try to remember that she is god's child and trust I'm making the right decisions for her
It's not " you need to be in the hospital". It's a matter of " we need medical professionals to evaluate".