MIL constantly falling - we are at our wits end

[FeralNun]

This is mainly a rant, I’ll admit that freely!

MIL widowed this year, has multiple health issues, and is extremely frail. She cannot move safely without a walker, although she thinks she can. Her frequent falls have escalated recently - 4 falls in 5 weeks (that we know of). Hospitalised twice for these falls, and then on Sunday, the paramedics glued her head back together and left her at home. I don’t blame them tbh.

Yesterday she fell again, and this time she’s broken her wrist. So now there is no way she can manage until it’s out of plaster and healed. The lovely nurse is talking about a rehabilitation place in the meantime.

Home is simply no longer viable. She’s got everything / every aid you can imagine l, the alarms, lifeline, the lot. But at the end of the day there are stairs and no downstairs loo.

She won’t be told. She would rather watch DH worry himself to a shadow and drive a 500 mile round trip each time she falls over. He’s had a year of this now, including caring for his dying father 24/7 for 2 months because he was too stubborn for a hospice or carers.

I honestly think my poor DH will die first at this rate.

Ideas/experiences/general advice welcome!

Thank you.

Oh dear, where is she now, if she's in hospital your dh needs to say she's unsafe at home if they plan to discharge her. I'd go for the rehab, does your dh have power of attorney. If she refused to go to hospital the paramedics can't force her. I'd call adult social services, the paramedics may of also done this.

Get her a camode for downstairs and see if you can arrange a bed for the sitting room if she can't get upstairs. Organise meals to be delivered and carers if she can't take care of her needs.

I would contact adult social services safeguarding and get a needs assessment. You might find Age UK helpline useful.

@FeralNun welcome to the world of WitsEnders. Some great people on here and a safe space to vent. It keeps me sane knowing there are others in similar situations but that does not make it any easier.

@FeralNun I contacted Age Uk some time ago at a ‘wits end’ moment and they sent me a prompt response. I will post it as it might be useful to you…..

Thank you for your email about arranging suitable care for your mother and the issues you are experiencing with this. It sounds like a difficult situation for you and I hope you will find some of the information below of interest in addressing it.

It is important to note that providing care for anyone, even a parent, must be a choice. There is no obligation on you to provide support for your mother. Any support she needs can come from other sources.

It is also important to say that as long as your mother has the mental capacity to make her own decisions about what care she wishes to receive she can, in almost all circumstances, decide to reject care.

You can read more about mental capacity and how it is assessed in section 3 of Factsheet 22: Arranging for someone to make decisions on your behalf.

If your mother would be willing to look into support that may be appropriate for her a starting point may be to request a care needs assessment from her local authority Adult Social Care Team. This assessment would look at her care needs and how they can best be met moving forward.

You can read more about how to request a care needs assessment in section 3 of Factsheet 41: How to get care and support. Section 4 of this factsheet discusses what the assessment will look at.

If your mother would be willing to have this assessment to see if she would like to accept any of the support the Adult Social Care Team may propose she, or you, can contact her local authority and request an assessment. You can search for contact details for her local authority using the link below.

Find your local authority

If you feel that your mother’s refusal of support may be putting her wellbeing at risk you can report this as a safeguarding concern to her Adult Social Care Team. They could then make enquiries to see if they felt that your mother’s refusal of support could be seen as self-neglect.

Self-neglect is a difficult area due to a person’s fundamental human right to private life. If someone chooses to live in a particular way, however worrying or upsetting that is, there are limited circumstances when the law can intervene. This consideration must be balanced with the right to safeguarding, which is also based on human rights protections.

You can read more about self-neglect in section 2 of Factsheet 78: Safeguarding older people from abuse and neglect. If you would like to discuss whether your mother might be self-neglecting you can read about how to raise this with her local authority in section 4 of this factsheet.

If you feel that approaching her local authority would not be appropriate at this time for your mother you may wish to see if there is other local support available. A local Age UK can sometimes provide some support services or be able to direct people to local sources of support. If you would like to see if there is a local team in your mother’s area and investigate what support may be available, you can search for a local Age UK using the link below.

Find a local Age UK

It sounds from your email that your mother’s situation is having a significant impact on you. If you would like support for you in your role of trying to support your mother you may wish to contact the charity Carers UK for support.

Carers UK provide information and advice about caring alongside practical and emotional support for carers. You can contact them using the details below.

I'll be honest with my DM I gave up.

Mine falls A LOT. She generally doesn't tell me, or if she does it's a week later.

I do not go chasing home 100s of miles away each time.

She does have a bed and bathroom downstairs. And a cleaner, a key safe and a pendant alarm.

But she is an adult with no cognitive impairment so eventually I just let her make her own choices instead of fighting her all the time.

We are both much happier for it.

Thank you all. We’ve done all the assessments and referrals. She’s had carers on previous discharges for other things whilst she got ‘better’, but basically she can wash and feed herself (when she hasn’t got a broken wrist!) so wouldn’t get them as a matter of course. We could pay privately, (fortunately funds aren’t an issue) but she refuses. And anyway the real problem is that the house just isn’t suitable. She’d do well in warden supported accommodation I think (which is what my mum has), but refuses point blank.

I think we’ll eventually persuade her (she gave in to having a walker after months of exhausting, life draining arguments), but it’s likely she’ll break something worse than a wrist in the meantime..

I’m not too concerned that she’ll be discharged without a plan tbh. The local authority/hospital trust are really quite good! Amazingly..

Thank you, @BlueLegume That is so helpful!

Can you get her a wearable tech that will call 999 every single time she if she falls?

In my area if an elderly person who lives alone is admitted to a hospital 3 x due to a fall it automatically triggers a care home referral. But some areas will trigger it after call 1.

Thank you, @AnnaMagnani I really hope I can get DH to that place.

He’s not only worried sick, he’s getting angry. I hope that is actually the start of a healthier response..

@FeralNun no problem just thought it would save you doing it. All great information but our mother is doggedly refusing any external support….lots of ‘I don’t want that’. She is happy enough us having to run ourselves ragged though as she seems to get a perverse buzz from it. Always been the same frankly. Your Mum’s set up sounds great but ours is averse to being around ‘old people’.

Thanks for this - she’s got the wearable tech (when she puts the bugger on!) which connects to a line to assess and call the ambulance. And DH!
No automatic referral, might be something to check out..

Oh absolutely this! She’s replaced her DH with mine, essentially.

Mum’s set up is great and what’s more she thought about it, planned it and accepted reality. I mean she’s a complete nightmare generally but I can’t fault her there!!

Can you perhaps explain to her that, sooner or later one of her falls will result in a broken hip. Given her frailty, a broken hip will result in her never walking again unaided - quite possibly she will never walk again full-stop.

At which point she will end up in care/in a nursing home. At that point she will have very little options or say in what happens to her.

Right now she has capacity, choices, ways of coping without being totally dependent on strangers to look after her. But at the end of the day it is her choice.

(My mother broke her hip, ended up in a wheelchair, in a nursing home. Her last 16 months were utterly miserable. It's scary.)

Ah yes, the doesn't want to be around 'old people'. I get that all the time. Coupled with the stubbornness. And then when she gets 'told off' (not quite told off, but when I'm trying to explain why I need to weigh her, have her take this med etc) she sits there staring down and staying quiet, like a child getting scolded

An urgent referral to the falls clinic would be helpful, in my experience they are brilliant.

She’s not being fair to you. It must be scary being alone and frail so she’s clinging onto her son and shutting her eyes to necessary things which have to be faced. Some elderly people are expert at guilt tripping. My sharp as a tack but frail (fell twice with fractures) mil has to have carers even though she doesn’t like it and complains about them-trivial stuff not poor care or anything. Her own daughter has had to keep the fact she’s recently retired from her to avoid the pressure to move 150 miles back to her childhood home to look after her-mil keeps mentioning it how nice it would be to have her back at home. My mil’s family love her but you need firm boundaries about what you an and can’t do.

When she says 'I dont want that' ....

.....what does she say when you reply- no, we don't want to be driving 100's of miles at the drop of a hat every time you fall either...

I understand @FeralNun

unfortunately, it took me having a nervous breakdown for mum to accept some things

it can't all be what they want unless they have a 24 hour robot helper

in the meantime, has she been asked if she's falling due to dizziness? I know sometimes it's hard to get an answer about the cause of the fall though. But there are meds that might help with that one and it's not been a suggestion that medics made. I only realised it was a factor with mum because I know her well enough. Sometimes the knowledge isn't easy to come by if no one lives near the person.

@MrsJoanDanvers oh yes to the ‘we just thought you would eventually move home’…..so firstly you ‘assumed’ without actually asking and secondly what planet are you on? I moved an hour away 35 years ago and built a life here.

In all honesty @Paganpentacle she just stares at us but you can see her seething but too clever to say anything. She has this knack of saying ‘ well Mrs So and So’s son is at hers every day’. He well maybe but perhaps Mrs So and So doesn’t criticise absolutely everything done to try and help. Grrr. Feel your pain @FeralNun

If she has got capacity then I’d encourage your DH to have a firm and frank conversation with her, putting boundaries in place, do not be afraid to tell her if you think she is being unfair. Ultimately, as others have said, it is her choice what happens if she does have capacity until the point that she doesn’t.

If funds aren't an issue would a stair lift be helpful? At least minimise the risk of falling on stairs.

It sounds really tough.

I’ve dealt with a number of elderly relatives and now carer for elderly parents.

DH needs to step up to the position of a parent to a demanding elderly child.

Her health is now a safeguarding issue. Not just falls but fires, break ins etc. Would she be able to get out if there was a fire? She is no longer safe in her home and unless your DH has the courage to take charge of the situation and organise a care home for her she may well die from a fall. That’s the reality. She may complain and make a fuss but she will come to terms with it.

In one relatives case they visibly relaxed once they were in a home with carers around them all the time, despite having resisted for a couple of years. They actively enjoyed it. That experience changed my views of the wisdom of keeping people in their own home until the bitter end. Like your DH we left it until they were a safeguarding risk and then did it the move for them.

OP we had an elderly next door neighbour like this who had frequent falls, house very unsuitable with steps and different levels and her eyesight was failing. Eventually after one of her falls, social services decided that she wouldn't be allowed to go home (she was always adamant that she wanted to stay in her house) and she went into a local care home. If your MIL is having frequent falls, she isn't capable of taking care of herself. I hope social services will step in and make the decision or that you can persuade her that it's no longer safe at home.

Not really. Once they’re using a frame it’s hard to get from the frame onto the lift.

Your DH needs to grow a pair and tell his mum and Social services that he cannot help. When she calls him, he should just call her an ambulance. If he won't do thst, nothing will change. Sorry.