What do I do now?

Dad is 96. Tired says “if he “BREAKS anything like a hip/arm/leg, this can mean a long term care IN a hospital ..with all of the therapy involved”. But probably not. He would probably be bed bound and facing a quicker death. Would that be such a disaster?

I routinely visit a church member of mine in a NH. She had a brain tumor removed and the surgery was not the raoring success they'd hoped for. She's been in a NH for almost a year now.

She has 'forgotten' that she cannot walk, nor get out of bed. It's not her fault, and sadly, no amount of therapy is going to restore that. She's had 2 bad falls and one resulted in a broken hip.

All they can do is make it safer for her--but even with eyes on her 24/7 she will try to get up. I took her for a little spin in her wheelchair last week and everytime we stopped, she tried to get up. It was exhausting, and I was only there for an hour!

She is now in a reclinging wheelchair, for her own safety. She wants to go home, too, talks about it all the time and it's very sad. She will never be able to go home.

If your dad's in memory care, he can't REMEMBER that he can't walk. It's not his fault.

You might want to have him re-evaulated and placed in a place that is more aware of and considerate of his deficits. You have every right to be worried.

The staff needs to know your concerns immediately, AND you need to be able to be honest with your father (if he's cognitive enough) and let him know that when he demonstrates behavior like this, it stresses you and the staff. Let him know that when there's a fall, it's documented, and that ambulatory issues fall under Dr.'s discretion going forward.
Other than that, you can explain to him that if he BREAKS anything like a hip/arm/leg, this can mean a long term care IN a hospital in a DIFFERENT environment, which will REALLY make him unhappy with all of the therapy involved at that point.
Hope this helps.

You can try saying “No “ like Alva suggests or the delay phrases . You just have to see what works . People with dementia are all different . You never know which phrase will satisfy them even if you have to keep repeating the same one , or which phrases will cause them to try harder to prove they can walk . It’s trial and error and it can change as his disease progresses . Right now we do a mix of No and delay tactics with my FIL depending on what’s working that month .
He may continue to fall . My FIL is determined not to give up walking ( with his walker ) even though he would be safer in a wheelchair . We’ve accepted the big fall is coming .
My mother in law is ridiculous . She does not have dementia that we know of , she’s just stubborn . She has finally given in to using a cane when she goes outside . Inside she holds onto furniture and walls . She needs a walker . She is putting a lot of her weight on the cane to hold her up as if it was a crutch . And blames her falls on the cane getting in the way . 🙄.

They all fall, it is part of the many challenges that must be accepted. As with wanting to go home, a regular verbiage.

Personally, I have never heard of a one to one facility and if there was one it would probably cost $35,000 a month.

Some acceptance is required on your part, this will not get better. Now if there is negligence that is a different story.

Keep posting it will help!

So instead of telling him he can go home when the doctor says or when he's strong enough or whatever instead tell him you will reevaluate in 3 months time (or two, or whatever) - give him a date if he wants one. Obviously he wont be any better at that time and you will have to set another 3 month recheck, but it may buy you some breathing room.

Well, hopefully he proved to himself that you are right.
As to falls, they are a given. Sick or well, demented or not, in care or not, falls will happen to the elderly due to musculoskeletal issues, but primarily due to balance issues. They are a given.

Of course he wants to go home. We do not see anyone here who wants to go into care, nor do we EVER see anyone who doesn't wish to go home. A more adamant no is needed. "No, we are sorry. You can't go home". It is hard but necessary, and it is necessary you accept you will be hearing he wants to go home, and you will feel grief for that. This is the end of life in which grief and loss is the same sort of given that falls are. I am sorry. I am 81. I identify with the losses. But they are a certainty.

I'm so sorry, but glad your dad is okay. He really is safer there, even when he does fall, because someone will be there to respond quickly. Especially if the facility provides and monitors medical alerts that detect a fall. You couldn't get to him as fast as they can, nor could EMS at home.

Keeping him from trying to walk will be, in my experience, nearly impossible. My aunt had serious foot surgery a year ago. She was in the hospital for a week, and then in skilled nursing for 8 or 9 more. She was under strict orders NOT to put ANY weight on that foot until cleared to do so, which would be WEEKS into her rehab. She was told over and over again NOT to try to get out of bed without assistance, or she risked ruining the surgery. Did she comply? No. From the first day in skilled nursing, she was trying to get to the bathroom by herself. We told her to go ahead and "go" in bed if the staff couldn't get to her fast enough. Better to mess yourself and have to be cleaned up than to wreck this delicate surgery! Nope. She has not been diagnosed with dementia. She definitely has some mild cognitive decline, but is still scoring in the mild memory loss category. She just refused to believe that these orders were serious, or that she wasn't completely capable of "tiptoeing" on that bad foot. Insert swearing here.

I think the advice by waytomisery is excellent. Divert him by offering the possibility that the doctors may allow that in time. Get through each moment and let the future take care of itself. It will.

Poor guy. triple whammy. NH, memory care and confined to a wheel chair.

There is no such thing as a "one on one" facility, and even if there was, elders will STILL fall. Especially with dementia when they can't remember they're unable to walk, or trying to prove their strength. Falling is part of the program, unfortunately, with advanced age and dementia at play. My mother fell 50x in Memory Care Assisted Living while wheelchair bound, insisting she could do what she couldn't and forgetting she was unable to walk. None of her falls caused real injuries or killed her.....she died at 95 of advanced dementia and CHF.

You can't "do" anything about this because you cannot insure dad's total safety ANYWHERE he lives, at home or in MC. Tell him when the doctor feels he's strong enough and able to go home, you'll talk about it. Look into physical therapy for him at the MC, if available. If his doctor writes an order, a certain number of sessions are paid for by Medicare. He may have a co pay depending on his supplemental insurance.

Good luck to you

I am sorry your Dad fell. Hope he was ok?

I haven't met your Dad, or know why he fell, but the oodles of elderly people I meet who fall don't tell me "I was trying to walk, to prove I can walk, to prove I am independant in every area I need to be in able to go home & live fully independantly again".

Ok yes it's reasonable to make all those connections if you are very cognitively sharp. That's maybe a leap you took in guilt? But really, the odds are he just overestimated his abilities.

These are some of the replies I hear to What happened to you?

I was just trying to reach that.. I was going to the bathroom.. I just leaned over.. I don't need that wheelchair/walking frame/stick.. I am just fine on my own.. I am very careful you know..

With memory &/or cognitive impairment comes lack of insight. Add any vision problems, loss of field, seeing shadows, hearing impairment, hallucinations, balance problems, stiffness, pain not knowing the time, lack of good sleep, medication effects - see what I mean? Falls risk goes way WAY UP.

I’m sorry that your dad fell. Falls are scary for them and upsetting for family members.

Has he ever done this type of thing before? Wanting to prove that he can walk?

Please don’t second guess yourself. Your profile says that your dad is 95. He shouldn’t be alone at home.

I have known people who have hired sitters to act as a companion in their parent’s facility but that is costly.

What did the staff tell you about this incident? Are they going to try to watch him more carefully? It is impossible to prevent all falls.

Is he a new resident in the facility? Maybe he will settle down and accept that he cannot go home.

Wishing you peace as you continue to advocate for your father in his facility.

What if you tell him
“ When the doctor says you can “
or

” I’m not sure yet , we will have to ask the doctor “.

or if his memory is pretty bad and he does not know days, weeks , time .

“ next week “.

and repeat , repeat , repeat .