My 84 yr old father is living with me for the second time in 15 months due to fall in Sep 2019, and most recently last month that resulted in staples to his head.

My dad has mobility issues due to a stroke. He has no use of his left hand and drags his foot. A cane helps him walk, but he uses it incorrectly by placing it in front of him instead of to the side not to mention off the ground.When I correct him he says he's using it properly. He only has sight in one eye due to a childhood accident.

I have stressed to him as well as other family members and doctors that it isn't safe for him to get up unassisted especially at night. His last fall was because he got up in the wee hours of the morning to use the bathroom. Mind you he wears depends at night. When asked why he got up he said he couldn't hold it any longer. Even after the staples to his head he continues to get up at night. I am at my wits end. I let him know if he falls again he'll have to go to whatever facility meets his needs

I love my father, but the stress of the falls, his disregard of how it affects others, and his safety has me STRESSED.. Any advice is welcomed.

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My dad has little use of one arm, drags his feet, and often can’t get to the bathroom in time. He uses a rollator much more efficiently than a cane, and has a portable urinal bottle at his bedside at night. No trips to the bathroom. Falls will happen whether they are compliant or not. Do what he will cooperate with to prevent them, but know it will still happen
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Have they mentioned if he suffered cognitive decline with the stroke? I ask because, when people refuse to use canes or walker, it might be that they don't have the right cognitive function to remember. When memory is poor, judgment declined, it creates the right environment for falls. You can try to get an alarm for his bed to alert you to get up when he does. Or sleep near his bed, so you awaken when he gets up. I'm not aware of any way to get him to get it or make him consider others and how his injuries impact the family. Even when in a facility, falls are common. Once they start, it's really difficult to prevent. My LO had such poor balance, she'd let go of her walker and fall straight back. I was right there and caught her, but, other times, I wasn't and she got multiple fractures, before going to a wheelchair. I know it's stressful. So many falls and trips to the ER, then to orthopaedic doctor, etc.

If you can't monitor him around the clock, I'd consider getting help or placement, though, I know that's a scary prospect right now. You might get a cognitive evaluation though, so, you have some idea of where he is on that.

Oh, you might explore a sleep aid. If he's sleeping, perhaps, he wouldn't be as inclined to get up during the night. ALSO, check for UTI. It might make him feel urgency.
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Urine bottle or bedside commode for his night-time needs. People don't like to pee in Depends if they can possibly help it, of course.

If he won't use a urine bottle and can't safely transfer unassisted to a commode, then the remaining option is a pressure pad under his mattress which will alert you when he gets up at night. The drawbacks are twofold: 1. not even the best alarm will warn you *before* he gets up; and 2. you won't get many unbroken nights' sleep.

I feel for you about the "correct" use of the cane. This is a conversation that not only I but also my Physical Therapist colleague had with our lovely lady client this very afternoon. "In one ear, out the other" isn't quite it - it's not really making it into her ear to start with, I don't think. First I brought her walking frame to her this morning. Then later the PT did. Then again I did. Then our paths happened to cross at lunch time, and we both fixed our eyes on the client, who laid her ears back defiantly. She can't be *bothered* with it, is the truth of it, I suspect. If she finds she's halfway back to her armchair and happens to have forgotten it, she ain't going back for it and that's flat. I'd quite like to tie it to her, but Deprivation of Liberty Safeguards forbid.

Have you had a look at any walking frames with your father? Have you consulted an occupational or physical therapist about his mobility? Especially as he has vision in only one eye, a frame might be very much easier for him to use properly; plus, if you get one with a carrying tray or basket, it won't take him long to find out how useful it is.

Now then. Safety. Falls risks turn a caregiver's hair white faster than anything else I can think of; but. The risk is HIS, and not yours. The best philosophical yet practical guide to this and other stressful aspects of aging is Atul Gawande's book "Being Mortal, Medicine, and what matters in the end." Very good for reminding you, too, of which are your decisions to make and risks to take, and which properly belong to your beloved elders.
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