To refuse to help a fallen elderly person

[littlebillie]

I had to help my FIL up tonight he had fallen and my MIL needed assistance getting him back in his feet. My back now hurts and AIBU to refuse to help again as they normally call an ambulance.

I've found it a useful thread, not irritating, as it's raised points I hadn't thought about before - hadn't realised you are not supposed to try to lift someone who has fallen. Also useful tips about how to help someone get up - the chairs tactic - though I realise that contradicts the first sentence!

Also the problem about a hurt back is that it isn't just temporarily painful - it can lead to long lasting reduced mobility, need for surgery, time off work etc. Which is also expensive for the economy, nhs etc. So an ambulance may not be a waste of resources, although I realise they are under strain.

Many areas now have a dedicated 'falls service' - you call them out like an ambulance but their job is solely to lift elderly people and put them back in bed/ on the sofa etc. It would be worth asking your GP if there is such a service in your area, as well as for a referral to occupational therapy as suggested above. These teams are usually quicker than an emergency ambulance and don't divert resources from more life or death situations.

Can he not get a walking frame littlebillie? We got one on loan from mediquip - if you call adult social care and ask for an occupational assessment they will organise things to make his life easier and safer

He has a frame which he doesn't use I think we will all fight it at some point.

Well I suggest before you go 'fighting' for OT assistance perhaps he should start with the basics and use th bloody frame.

Seriously I get that calling for help when someone has fallen CAN be the right thing to do, but if he has a frame that can help prevent the falls and thus more pressure on the ambulance service then please make sure he starts to use it.

FFS

My dad falls a lot and the advice from all HCPs is to call for ambulance to help, both for the benefit of you and also the person who has fallen.

If someone is falling all the time, there are gadgets that can help to get them up. Get them to ask for a referral to occupational health team.

YANBU!! If they cannot get themselves up (elderly or not) then you should not lift them unless you have been trained how to do so and know the signs of back injuries!
I used to work in elderly care and had the training and at my uni there was a girl who had had an injury in the past used to fall down a lot and not be able to get up and the paramedics praised us for not trying to move her whenever we had to call them out. (However after a while when we'd got to know them and they realised that Id had training they gave me permission to lift her in certain circumstances of she herself felt able to 'help me get her up' - I was the only one they said could lift her though.)
If you are untrained you could do more damage to them and yourself if you don't do things correctly. It's just not worth it.

YANBU. Last time I put my back out I couldn't drive for two weeks nor sit comfortably for three months. I also cost the NHS in treatment. My 86 yo DF falls a lot despite a whole range of equipment because of a progressive brain disorder with no treatment. A couple of weeks ago he laid in the street in a puddle for an hour and a half waiting for an ambulance that never came, he thought he might have damaged his spine. In the end he had to be helped up and just go home as the risk of the cold seemed greater than the risk of other injury. There was no ambulance for my mother a few months ago either when she was having a suspected heart attack. I don't know what the answer is other than trying to get people to help themselves more and better funding of the NHS / social care.

Reality I read that as OP saying that they had a fight on their hands with FIL to make him use the frame despite his current refusal, rather than fighting for further care when he's not using what he already has.

Perhaps.

Obviously you CAN help them get up by providing a sturdy piece of furniture or something for them to push themselves up with if they are able to before/instead of calling an ambulance, but you shouldn't lift them yourselves under any circumstances really (something many people don't know and has probably caused no end of injuries) unless they are in immediate danger of course.

I have never worked on a ward where a person who has fallen would be left for an hour , if that's a genuine occurence I'd be making an almighty complaint.

Equally have never had to call a 'manual handling team' (whatever they are - we just have H&S trainers who would be aghast if we called them in an emergency!)

The correct procedure would be to notify the most senior nurse on duty as well as the designated doctor, gather 2/3 staff as quickly as possible (by pulling emergency bell) and hoisting the patient off the floor if it is safe to do so. If there are known issues (and the only one I can think of is morbid obesity) then you have an action plan in place before a fall can happen.

But I'll say it again, no one needs to be falling at all and most falls whether in the home or in the community should be preventable.

I don't think it's that uncommon to land up with a fracture either - if that was the case my work would be a lot quieter..

It is a lot easier said than done to make sure that someone uses a walking aid. In theory we all think 'well, it's obvious, the elderly person isn't stead on their feet, hand them a walking frame and they will use it'. But in reality it is not that easy. They often resist using it because it feels like a final 'no going back' admission that they will never be independent again. Or they think 'ah, I'm only going to the toilet, I'll be fine without it, it's not that far' and bang, they are on the floor.

My MiL has fallen a few times recently, she has very impaired mobility. We were told by her GP not to lift her ourselves under any circumstances and to call paramedics in case she has an injury (dislocated hip etc). She now needs 24 hour care but at present there is no nursing home available for love nor money.

She has walking aids, no trip hazards in the house but sometimes she gets out of bed during the night without my FiL hearing her, he is deaf. Horrible situation right now.

And yes to back problems not being so simple (sorry, I work on a ward that specialises in back problems and spinal fractures so this is my sort of bugbear) . Have looked after countless NHS staff and manual workers and carers who have needed back surgeries to fix herniated discs. What people don't realise is that spinal problems can have lifelong effects and can cause disability, if it's bad enough to cause cauda equina syndrome can lead to loss of bladder and bowel control. Not worth the risk if it can be avoided by following safety guidelines re. moving and handling.

YANBU. A full-grown man who's fallen on the floor is (generally speaking), too much of a weight for a woman to lift safely (unless the woman is very strong and/or the man very light). And if he complains about the ambulance being called then tell him to use his bloody walker! If he's got one and refuses to use it then he'll have to bear the consequences (i.e. an ambulance being called each and every time he falls). Perhaps eventually he'll realise what a humiliating waste of public resources it is and get over his pride enough to actually help himself.

They often resist using it because it feels like a final 'no going back' admission that they will never be independent again. Or they think 'ah, I'm only going to the toilet, I'll be fine without it, it's not that far' and bang, they are on the floor. I think that's about the height of it.

Thanks for your thoughts I'm going to raise it today with mil. I'm not going to lift him again or family will either, we will call an ambulance. I am sure part of the problem is mental health and that is definitely out of my hands.

I used to work within the ambulance service in my area (111 call handler) and elderly people that have fallen can be left for hours. Unfortunately due to cuts and pressures of the ambulance service they get bumped down the queue, it's frustrating for everyone.

Several years ago (long before I worked for 111) my husband fell in the bathroom, I was 9mths pregnant and noway could I lift him, I did try. I rang for an ambulance and they arrived 3hrs later - initially they didn't want to attend they asked if I could move him, could a neighbor move him etc and only agreed once I said I had tried everything. My husband was taken to hospital and had a fractured knee cap.

A lot of areas have dedicated falls team - in my local authority area the ambulance service doesn't come out to lift someone because this was abused for years - now you would phone either your GP surgery or Out of Hours service and explain that someone has fallen and is unable to get up and they will send the falls service.

Alternatively if this is a regular thing a community alarm can be used to summon assistance quicker although there is a small cost with this for alarm equipment.

The falls service will assess for any injuries and will call an ambulance if necessary and will support the person to rise from the floor either using inflatable cushions or a hoist. They know the safest way to do this.

It is difficult for a caregiver to say no to someone who has fallen because it goes against natural instincts to help. However, it only takes one bad lift to wreck your back forever which could potentially mean that you are no longer able to give care.

So in answer to your question YANBU to refuse to lift someone but the conversation needs to be had with your in laws about future episodes of falling - how to prevent falls, assessments for OT/Phsio and investigations into what services are available to assist with this.

Good luck

I am confused about something. If the person falls, surely if they have hurt somethingby falling they can tell you they are in pain? Or does the ability to know if you are injured or fine fade off as you age? Obviously there are a few occasions when you can injure yourself and not realise, but mostly you know if your properly hurt or not. Does that change when you reach your 90s?

My local ambulance service ( EMAS) has a specialist falls unit. They have special equipment and more time to spend sorting things out for people. It's meant to prevent 999 crews being taken off the road. Check if your area has one.

Burn it's tricky. Dementia can impair response to pain, for example. Sometimes the person will be so very desperate to get up that they will say ANYTHING to be helped up. If you've been on the floor for a long time you'll have pains and aches that you didn't have before.

YANBU. Damage your back and they'll have to call an ambulance in the future. If it happens again, try 111 and ask for advice.

My mother had one serious fall aged 87, she was referred for phisio over 12 weeks on her discharge from hospital and diligently attended and did all the exercises, she has not had a fall since. I work in care and am very positive about the effects of phisio and exercise, please try to persuade your father to go down this route. We don't lift anyone who has fallen, not only is it unsafe for our staff but we would be sued to oblivion if we missed an injury or made things worse.

Burn It is sometimes hard to tell if the pain you feel immediately after a fall is the sort of pain that will fade in a few hours with the aid of paracetamol etc, or the ongoing pain which suggests a more serious injury.

OPI agree your FIL should be using all the walking aids available to him but I also know from first hand experience of my dearly-loved-but-incredibly-stubborn-in-old-age-father that sometimes a person will just simply refuse. What are you supposed to do then? You cannot physically make someone use a zimmer frame if they don't want to. You have to be very hard hearted to say to someone in those circumstances 'oh well tough you have fallen, you should be using your zimmer'.

The problem with calling an ambulance is (as a pp mentioned) you're likely to be classed as non urgent and the poor man could be left on the floor for several hours waiting. Also if it's a regular occurrence it doesn't seem practical to be calling 999 several times a day.

Look into fall prevention and do everything in your power to avoid him falling during the visit. If that means assisting him whenever he is on his feet then so be it.