MIL fell - what can we do to keep her safer?

[pontipinemum]

My MIL is 73, she had a fall yesterday thankfully DH, SIL and myself were all there. Then BIL came over to help us get her up safely. FIL was also there. She just caught her toe on the join between two floors, I've done it myself. I can still see it in slow motion in my head.

She had a bad stint with cancer 2 years ago (I know it's never easy for anyone) where she spent months at a time in hospital. She has recovered remarkably well from this and can do all her usual things at home. Just maybe a bit slower.
FIL now also has cancer and will be away for treatment during the week.

I think understandably we are all worried about MIL being in the house alone. Not to her complete determent but she is a proud woman who won't accept too much help. She won't live with DH and me during the week while FIL is away and she doesn't want a button around her neck.

I've suggested DH/ BIL take turns in sleeping over. (SIL lives in a diff city and will be taking FIL to treatment). We have 2 young children, 1 who is 11 weeks old and breastfed so I can't really take a turn. But being on mat leave I will go over every afternoon for an hour or so for a bit of company. We are also looking into getting her a watch that makes phone calls.

Sorry this is more of a release. But if anyone has any ideas we would be grateful?

Trips can happen to anyone so don't panic, but it does sound like someone less frail might be able to recover themselves better than she is able to.
Things I would recommend:
Any strengthening exercise she could manage would make falls less likely and serious injuries from falls less likely too. Could she attend aquafit? Or use resistance bands at home?
Balance exercise, is she able to stand on one leg? Her proprioreception could be poor.
Trip hazards, goes without saying
A Zimmer frame for me is something for someone who can barely walk at all, it doesn't sound like she necessarily needs such a radical option. A big downside of them is they're very hard to use outside so someone who becomes dependent on one can become "trapped" in the house. I'd try a walking stick first. A trolley for moving things around the house is a good suggestion though.
Get her to have her vision checked.
There are techniques for elderly people to get themselves up off the floor and for helpers to lift them up, have a look on YouTube.
Does she go out of the house independently?

Your MIL's strength here is that she is cognitively able, so there are things she can do to help herself, unlike those with dementia. You're also likely to be able to sell those things to her, as I can understand her not wanting to adopt measures she associates with the elderly (who would?).

Tai chi is fantastic for balance if there is a local class.

I'm 57 and two years ago I tripped on a kerb and broke my wrist. Noone suggested I wear a falls pendant. 73 is not particularly ancient.

Fix the join!

Apple Watch has a fall alert on it, it recognises if you've fallen or been involved in a crash and will call an emergency number.

But!!!

You either need to be within range of your phone or have a cell enabled version of the watch attached to a SIM card.

AND

They need charging every day, so if she won't be within a phone and won't be inclined to remember to charge it, it won't be of use.

We thought about this for MIL who lives alone and is 89. But she happily admitted that she'd take it off at night and not put it on again.

Ask for a falls assessment at the GP, they will get and OT to asses her and the house and put things in place for her. I wish we had done this for my mum, she had a bad fall recently and spent 8 weeks in hospital - now she wears her fall watch and pendant and has sensors around the house .

Did it take 2 people to get you back up after your fall?

You can get watches that will detect a fall - my fil has one that is connected to the local homeline service, so it automatically calls them if it detects a fall.

I know lots of people are recommending getting in touch with adult social services, and def do this, but as a word of warning, it took them nearly 12 months to come and visit my fil (during which time he had multiple falls, two of which resulted in hospital admissions, others needed a&e, and he is no longer able to walk unaided), and several months later he's still waiting for them to confirm when they'll fit the grab bars they promised (obvs this might be area dependent!) - which was also the only thing they would provide. So just to say, don't rely on that.

The really difficult thing I have found with fil is that he didn't want to admit he was struggling and/or was afraid he'd get "put in a home". It's taken a loooott of discussion, persuasion, arguments to get him to agree to anything. Even the watch he only got because DH said he was getting it for him for our benefit because he couldn't have another evening of turning up at his house to find him unconscious on the floor...

Actually yes! They ran over and helped me up. I don't think i would have needed them though.

Could you afford Pilates lessons for MIL? I took classes for a year with DM (who is only 55 but found it immensely helpful when it came to strength and mobility). My instructor also had a physio degree, so not only she could direct exercises for any specific areas DM was having trouble with, she also knew when to say "this isn't mere discomfort, you should get it checked out". Luckily only shoulder tendinitis, but with her urge DM had it seen and addressed much sooner than she would have otherwise. Pilares can also be seen as a fun activity rather than rehabilitation.

Lots of older people are resistant to things like pendant alarms and their children often feel that they can't push it if they say no. However, it really is counter productive. Often it's about fear that they won't be independent if they rely on alarms, whereas the worse and more likely outcome is that they fall again and are injured and that really does remove their independence.

Ask her what she will do if she falls when she's alone. My dad said 'I won't fall' and by that time he had dementia. His answer was to scream and bang the walls/floor to get the neighbours to come round. I would point out that you can be alerted and get there faster with the right kind of alarm. It is so hard to disagree with them but sometimes it's best.

I don't understand all this "I don't want a neck button, I don't want this, I don't want that etc. while others all around are terrified of something happening when they cannot be present all the time. There’s also the family scared and overprotective because a perfectly fit and able member of their family has reached the magical age of 75 or 80 or whatever.

My son lives alone and he's a bit of a hermit and asthmatic. He's just approaching 40. He is so alone I worry about him. For instance a few months ago he fell downstairs and hurt his knee badly. So I ring him once a day to make sure he's still OK.
He understands it isn't because I think he's incapable, it's for my peace of mind. He's doing me a favour.
Couldn't you propose it like that? If you love someone you worry about their welfare.
Nb. In contrast to what those above have said, completely barefoot is supposed to be best for balance.

Nb. In contrast to what those above have said, completely barefoot is supposed to be best for balance. Not sure what barefoot does for balance if you step on a drawing pin.

DF was hugely resistant to both a fall pendent and wrist button.

You cannot force them to use it, even if you can somehow persuade them to wear one. Even with a wrist type, DF steadfastly refused to use it, even proudly once telling me he'd crawled inside from an outdoor fall, and it took him several hours!

He stubbornly thought that pressing the button would summon an ambulance, despite repeatedly saying if he didn't answer the company would call me first.

By then it was too late to introduce him to using an Alexa, but if he'd mastered that I think he would have been happier to ask it to call me, than press a button.

The falls clinic and later his live in carer helped. Both tried to teach him how to get up using a chair, with assistance. Easier on the arms of both him and carer, to steady himself on a chair seat from kneeling. It is something that needs to be taught or shown, as it doesn't come naturally to offer a chair to someone who has fallen, as we later found from MIL & FIL. They too didn't call us or anyone else and FIL struggled to help MIL up.

If your ILs GP surgery has a social prescriber, they can help with organising OT appointments, who can send a handyman to fit handrails and fix trip hazards. We also found that you can hide handrails, Argos and B&Q offer hidden toilet roll, shower shelf and shower risers handrails that look 'normal' - I installed a few for DF after I caught him hanging off things that were not designed for that!

Have they applied for attendance allowance yet? Again social prescriber can help with this, as can CAB and DWP themselves sent someone out to fill in the form for DF. Again, hugely resistant until he got it, then he lamented that it was free money he could use for a cleaner/gardener/home help who made him lunches and if he knew he would have applied sooner!

I installed a few for DF after I caught him hanging off things that were not designed for that! My DF pestered us to fix the wardrobe firmly to the wall so that it didn't tip over when he used the doorknob to pull himself out of bed. (We managed a solution that was acceptable to him with a bedrail and some rope).

He wouldn't have a pendant because he believed his telephone system, in common with all others in the country, was illegal, and if we allowed someone to route a call alarm via his phone, he would be imprisoned. We compromised by him emailing me every day.

Life's so much easier now he's in a nursing home!

It's so hard, isn't it?

My mother (89 and lives on her own since my Dad died three years ago) had been somewhat resistant to getting the neck pendant. She is not very mobile and not particularly stable on her feet so uses a roll along wheeled walker, which mostly does help her.

She then had a fall while opening her living room door and catching the front wheel of her walker on it. My sister and I live nowhere near her but she was able to use the Alexa we installed to call my sister, who was able to phone my mother's neighbour to go round and help her up (she fortunately wasn't injured, just shaken). She was still on the floor for over half an hour though.

Suddenly any resistance to the neck pendant evaporated. She now has one and is anxious never to forget to put it on in the morning. I set it all up for her during one of my weekend visits.

I'd also previously mentioned to her that insisting that the living room door must always be shut and then tugging at it (it sticks quite a bit) with the walker in front of her was potentially a hazard but she wouldn't take it in at that point because according to my parents all doors always had to be firmly shut. Since the fall she has now decided that that door and certain others must remain open so that she can easily and more safely get around with her walker.

For your MIL it would be useful if she could have a couple of Alexas dotted about because then she could shout out to them to call one of you. Sell her the idea that not only could she speak to family on the Alexa, it can also play her her favourite radio stations (my mother is now very into The Archers 😃) and audio books. It can also play her favourite music, tell her the weather forecast and read the news. Anything she might really want.

Failing that, you might need to be more insistent regarding the fall alarm neck pendant.

Good luck.

Gosh that's only 10 years older than me- I can't imagine not wanting WiFi.

I couldn't ever have imagined my mother wanting WiFi either, and she tended to think that "it's not for people my age!" She's 89.

Then, after my Dad died my sister was sometimes visiting during the week and would need to be able to work from my mother's house, so we had to insist that WiFi was put in.

After that, I was on a weekend visit there when my mother piped up and asked me whether or not I thought she would be able to use an Alexa? Of course, once it's set up you just call out Alexa and tell it what you want it to do. She then very suspiciously asked me whether or not it would mean she would be forced to listen to heavy rock music. 🤣🤣 Err, no. Ask for whatever you want to hear - Radio 4, Radio 3, Classic FM etc. etc. 🤣🤣 We got there in the end and she now wouldn't be without her Alexas (she has two, a living room one and a bedroom one). She's also used them to call my sister occasionally.

My MIL was too proud to be seen with a walker and holed herself up, became isolated, sad, depressed and unconditioned.

Slightly ot but this is where we are with FIL. He’s determined to stay at home but unwilling to put in place any help or accept any changes that would enable him to do this - because he thinks that admitting he needs the help will result in him being taken from his home! 🤷‍♀️. And yes - isolated, sad, depressed as a result: he seems to be spending most of his time in bed which is where he feels safest.

My parents dragged their heels about getting a ramp installed for my DF even although he'd had a couple of minor falls because my DM didn't want it taking up space in her garden. He ended up having a really bad fall. It sent off an awful chain reaction of events where he had to wait hours for an ambulance, got covid in hospital so then nearly died and couldn't get physio, then was stuck in hospital for months and didn't ever recover physically or mentally.

The thing about not wanting unglamorous aids or adaptations to help with aging is understandable but it can come with massive consequences.

I'd also be wary of offering a lot of support now when you're on mat leave that will be unviable when you're back at work; it can cause a lot of resentment if you need to wind things back, no matter how unrealistic it is to keep every plate spinning.

My DM hasn't had great mobility for a number of years but was able to walk unaided around the house and for short distances. Didn't have any mobility aids apart from a walking stick which she sometimes used outside.

When she moved into retirement flats in mid 80s she gave up the car. Shops were very local and most of the other women had shopping trolleys that could be used as walking aid and seat. My DM quite happily bought the model most people had, although to start with saw it much more as something to carry shopping in rather than mobility aid. As years went on, very rarely went outside without her trolley but could walk unaided in doors. Then a few months a go had problem with a hip for a few weeks and has lost all confidence in walking, although actual physical issue is now sorted. Used her trolley to get round her flat and never went outside. She got very depressed. We broached the idea of borrowing a wheelchair to go outside. 6 months ago that would have been a definite no no. But she realised this time that she wouldn't be able to go outside again if she didn't accept it. The first time we had to sneak her past any other resident, but now quite happy for people to see her out and about in it. Got a walker for indoors (again that would not have been acceptable earlier this year). Slowly but surely some confidence is coming back and not so depressed, but it has been a hard few months and not sure whether she will ever be independently mobile out and about again.