Dad keeps on having falls

[EPankhurst]

I'm at a loss really. He's full of arthritis and shuffles about walking. But his falls are always in different situations. I've had an Occupational Therapist out, trip hazards removed from the house, grab rails and all the disability equipment that could possibly be useful, installed, and he still finds new ways to end up on the floor :( He can't get up by himself, so it's a question of me going round and/or mum finding two neighbours to lift him, because he would wait for hours for the ambulance service.

The latest one was in the shower, where he doesn't use the equipment properly. Neighbours who helped him suggested he get a walk in shower (it's a shower over a bath currently, with a bath seat and grab rails, so he should be sitting at chair height on the seat, swinging legs in and having a sitting shower. From what I could gather about the fall, he slipped because the non-slip bath mat wasn't suckered down properly(!), and he was standing not sitting at the time.) I'm concerned that a) he doesn't cope well with change and the only bathroom in the house being made into a wetroom (which I think it would need) is a big disruptive change indeed, and I could just see him still finding a way to slip and fall in a walk-in shower anyway.

(oops posted too soon) - Sooo... any thoughts or suggestions about a) making the shower situation safer for him, and b) anything else in general I should be doing? He had an Occupational Therapist come out and asses the home 3 years ago and changes were made then, but will they come out again (and is there any point in asking)? People keep on vaguely mentioning falls prevention teams to me, are they the same as OTs or something else I should look into?

a referral to a falls prevention team if you have one would be great. They tend to be multi displinary and include OT and physios as well as other people who will look at the issues in the house but more importantly they’ll teach him exercises that he can do - one of the major causes of falls is a loss of muscle strength & balance. Some very simple exercises can really help redress this. Bluntly the less you move about, the more likely you are to fall when you do. They will also show him how to get up of he falls - again there are ways of doing this that most ppl can manage even if they think they can’t.

referrals ti a falls team usually have to be done by the GP

My council do a helpline. You get a unit and a neck pendant that you press, if you fall and they come out and pick you up of the floor.

Yes these are really good - my council do this as well.

A walk in shower doesn't need a wet room.
We replaced bath with flat shower tray about 2/3rds length.
Then used half height surrounds from Impey https://www.impeyshowers.com/half-height-shower-doors which are excellent, also got sturdy shower seat from them too.
We already had shower curtain and kept it so other family can use as normal shower still.
(Already had electric shower above bath).

Would post photo but it is too many Mb.

Most health trusts have a falls clinic, some times called some thing different. They review medication, do physical checks, see a physio for personalised exercised programme as well as having OTs all in one appointment day. GPs can to refer to them.

Photo of bath replaced with walk in shower and access for carers etc.

I am such a person that does these type of reviews, both OT for equipment and Physio for falls.
The council is a good shout to ask for a referral to OT but falls/physio should go through the gp, which will then be triaged by the physio clinican and if OT needs are identified, will open the referral from there.
Depending in his financial situation, he may be eligible for the disabled facilties grant which will cover the cost of any major adaptation (level access shower). His long term needs will be assessed to see if fitting a shower would be the best use of public money, and other adaptations can be considered (stairlift for instance) if the facilities are upstairs.....subject to assessment as there are some medical conditions where a stairlift is not suitable and obviously structural concerns (but there then could be consideration of through floor lifts).
However if he is in social housing, the preference might be to move him somewhere more suitable and/or already adapted and the OT can support with a housing needs report for this.
Care input may be something to consider to?
Hope that helps.

Thank you all very much for your input so far. I deeply appreciate it.

@patsy999 and @Theeyeballsinthesky may I ask for clarification on the picking up off the floor thing - do you meant that they will call an ambulance to do it, or that they will send somebody else to do it.. if so, who? A specialist team or something?

@Candyflosscrochet He's in a home he owns, which is thankfully a bungalow. It's also cluttered to fook, but that's a battle I'm giving a rest for now, because I'm not getting anywhere. I think he could do with a carer to help with showers and just general living these days, but I think he will be resistant as hell to it.

@TeenToTwenties I haven't come across those half doors before, thank you! I don't yet understand why they would be a better option than a full height set of doors, can you help me with that please? But yes, that setup and that website looks good, thank you.

This sounds brilliant, I will get on to GP on Monday.

Half height doors keeps water in when showering but carer can be outside and stay dry.
So just this morning I was operating shower on flexible hose then putting on shower rail (not shown, fitted to left of grab handles) whilst I soaped my mum's back. Then could grab shower again to rinse. At other times mum was holding shower head herself and directing water where she wanted.
But i stayed dry.

If I want to use the shower I fold up the chair and use the shower curtain (which we had before) inside the half height doors. Easy.

Might be helpful - falls prevention exercise programme.

@EPankhurst where I live there is a specialist team that goes around picking up ppl who have fallen - we have a lot of older ppl!! When someone presses the alarm they speak to someone who triages them over the phone and sends round the calls response team who use a Raizer chair to pick them up

My council do a helpline. You get a unit and a neck pendant that you press, if you fall and they ring your daughter and get her to pick you up off the floor

I think he could do with a carer to help with showers and just general living these days, but I think he will be resistant as hell to it. He may be less resistant if it’s presented as a way to keep him out of a care home

My Mum had a care pendant but they wouldn’t send ‘someone’ round. They would call me! If they couldn’t get me it would be the paramedics. Who is this person who will come round 24/7?

Where I live there is a specific team of people contracted to do it from a domiciliary care company

He needs a carer there. One bad fall causing a broken hip could end his life as breaks really set old people back. My dm had to have a carer due to falls and no way could she go in the shower with out this person. It's too difficult for your dm too. Insist. The time has come and he will adjust.

Different areas operate differently. In my area you can self refer to falls prevention, or a go, nurse, physio etc can refer you to- even the fire service! You can certainly ask the council OT for another review, peoples needs change all the time, this is normal. How often is he falling? If several times a week he may benefit from an elk, camel or raizer, his OT can advise on this. A bath seat with rail is the first (and cheapest) option, if this no longer suits his needs discussions may be had over installing a wet room. Has others have said look at dfg, depending on his savings he may get all, part or none of this funded. Care and repair are another good source for support and advice - give them a google for your area. Later life train people to do PSI falls prevention classes, the falls team or physio can let him know if he is suitable. In short basically contact everyone, falls, physio, Care and Repair, OT, GP etc. also ensure he has a fall pendant of some kind.

It is a balance between allowing independence and safety.

We have finally persuaded my parents to have carers come in in the mornings. Not because Dad can't help mum get dressed etc but because it is slow and tiring and hard on the back. We are hoping a morning visit will mean they have more energy for the rest of the day.

It also means we are in the system if we need to add an evening visit or anything else.
It will be circa £200 weekly for the mornings only.

You won't be able to get a carer watching him 24/7. Yes, you can get a carer to help with high risk activities, but falls can happen at any time.

My father stopped having falls once he went into a nursing home - it's amazing what regular good food and medicine on the dot can do.

The local fire service will offer a free home safety check. That could help with the clutter problem if it's likely to be stuff he could trip over or which would impede his exit in a fire.

This doesn't really answer the question of how to prevent the falls though. That said Tigre very lucky that 'someone' goes out to help a fallen relative. My Nanna had the community alarm equipment and all that happened was they called me.

In terms of making the shower safer, depending on age, funding and the huge disruption, would he be open to the idea of not showering and using the sink for a wash? Even if it's just temporary to keep him safe while you work out what to do?

We couldn't make any major adaptations in the house but my Nanna had dementia when she started losing her balance more and couldn't understand new things.

It's hard, I know, you just want them to be safe

It's hard, I know, you just want them to be safe Whereas, if I get dementia, I don’t want to be safe. I want to be carried off by an illness or accident asap.

Illness maybe, but while you may think an accident would be ideal if you had dementia, having seen some of the horrific injures and situations dementia patients have ended up in I would say you absolutely would not want that