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.

I love that the vast majority or maybe all of these posts are supporting OP and understanding, rather than "have her live with you", "he should keep doing the drive etc"
That's the way to a breakdown or harming our own health, when we have so many other responsibilities at this age.
Carers are available, it is their job. I arranged care for mine after him being stubborn for a long time and all of us run ragged, I don't drive and had to get buses and trains and managing a job and small kids. Whilst juggling frequent long a&e visits and care. It's hard not to feel angry at them for being so selfish, it's usually our busiest times of our lives. When there are places and people there especially employed for all this.
The soft part of me knows they want their family and are scared, but it just can't work.
Also the comments "so and so's child visits every day" "so and so stayed at a&e the whole time"
Yes well they don't have a job, or they are a boss so can take off whatever time they like, don't have their own kids etc.
The people you love more than most in the world can really make you feel bad and they know they're doing it, which is upsetting.

When he decided to stop his care, we said "okay so you don't need it anymore so we don't need to come either" he relented after a few weeks and started it back up again.

These are hard times OP and it can't carry on like this, your husband needs to be insistent, firm.. unfortunately I had to get like that even though I've never been like that with my parents before so felt strange. I had to almost be the parent.

Safeguarding isn't a thing for someone who knows what's going on but is making their informed decisions about what's best for them.

Her decisions are not informed and she’d ending up in hospital repeatedly which is no way shape or form what is best for her.

She’s frail and couldn’t possibly manage a move or organise a care agency herself. That’s when relatives have to take responsibility and step up. Otherwise she will die from a fall or the consequences of one and it will be on DH.

At this point she either needs live in care 24/7 or residential care.

@Disturbia81 I've found with mine and the "so and so neighbour's daughter visits every week" comments that she's completely ignoring very different life circumstances.

So and so neighbour is a few years older than DM, had her child(ren) younger so the daughter is in her 60s, retired, own children grown up. I don't envy the daughter but she must have far more flexibility with her time than I do in my 40s with a full time job and children at primary school.

I just have to grit my teeth and remind myself of this!

Wrt decision making - it’s important to bear in mind that most elderly people have some degree of cognitive decline. And most people living with dementia do not have a formal diagnosis. In high income countries only 20-50% of dementia cases are recognised and documented.

People who are very frail are emotionally and mentally fragile too. They find it hard to think things through properly, to make decisions, to get their head around complex issues, they may not be able to use the Internet so they can’t research options. Even without dementia elderly people can become very childlike - anxious, demanding, stroppy and slightly out of touch with reality - thus they are not necessarily in a position be making the best decisions for themselves.

DM has probably lost touch with just how far 500 miles round trip is. All she knows is that she needs someone.

A commode would be better, with a care worker twice a day to empty it. They can also prep food if necessary, check she's taken medication, etc. And make it clear that if she won't accept paid carers in her home, she'll end up in the care home.

Exactly, and keep reminding them too. I say it after every comment "yes well they don't have a job" they always go quiet but then say it again another day..
It's infuriating, and makes you feel guilty and like you're not doing enough even when you're on your knees. No way am I doing that to my kids.
Can't tell you the instant relief I felt once the carers were involved, like literally felt lighter the moment it was arranged.

I take the point that some think people should adapt their life when they reach 70 and I know it's a well intentioned thought but moving house is a big step. The retirement age is increasing towards 70 and many people work beyond 70 these days. If they want to continue in their own home, I suppose it's a personal decision except where the person loses capacity, but that can happen younger or older than 70.

Rates of dementia and physical frailty are decreasing as both sexes work now, people are getting heavier and diets are getting less fatty.

I know Mumsnetters tend to have a Daily Mailesque attitude about weight gain - but a BMI of up to 30 is often protective for older people as they retain more muscle mass.

So a person who turns 70 in the next 20-30 years is going to much healthier in comparison to someone who turns 70 in the next 10 years.

I don't understand why people always suggest this. My mum would have been far better upstairs in her bedroom near the bathroom.

Wonder if the increasing use of HRT in mid life will have a beneficial effect on women's bone density as they grow older? It would have been less common for the women now in their 80s and 90s to have used it.

My mother was on Tamoxifen for five years and never had HRT at all and her bones are pretty fragile now, although she has never been underweight.

Ask the ward discharge coordinator and/or her medical team to talk to you about capacity and if they feel a best interests decision may be required. If she is deemed to have full capacity though there is very little that can be done. Good luck

Sounds so like my MIL, all the walking aides but she knew best and 'didn't need them'.

The final straw was falling and breaking her hip which left her in hospital/rehabilitation for months then straight into permanent care.

I was so worried about DH at the time with the stress and guilt, the constant phone calls when she fell yet again etc. Having to leave work, drive to her house, sit and wait anything up to 12 hours for an ambulance (during the worst of covid).

All you can do is refuse to collect her from hospital, get social work involved and try everything to get her moved into a care home. You need to be assertive otherwise they'll try and push it all back on the family.

I think the point is to start thinking about how you are going to cope with your own ageing, rather than assuming that it won't happen.
So consider how well your current property would suit your needs, for example. Think about who will help you, when that time comes, whether that's at 70 or 110.
That's what people who've had to deal with their own ageing parents tend to do.
My parents moved from a large house to a spacious bungalow, from where they continued their active lifestyle. Over the years they made adaptations to make life easier. DF was able to stay at home till he passed away in hospital, but it was relatively easy for DM to care for him as everything was set up ( he was 10 years older)
DM's health and mobility have been failing her since she was mid 70 despite a healthy lifestyle but she's coped well ( recently with daily carers and a gardener and weekly cleaner) We're all local and popped in very regularly too, and dealt with appointments etc.

Now she's had a more serious heath issue, and been in hospital then rehab. She could go home even now as it's so well set up, but she'll still need round the clock care. She's opted for a nursing home now as live in care is so expensive ( bungalow will be sold to pay for the residential care)
But the thing is, she prepared for all this and stayed more or less safely at home a lot longer than if she hadn't.
I still wish she'd done a bit more planning around POA and ReSpect forms, but she was quite sure she was invincible. You can't have everything of course but it would have made our lives a bit easier.
DH and I are having conversations with our families, and considering how we'll plan, and we're not quite in our 60s yet. We're not thinking of moving at the moment, but a bit of Swedish Death Cleaning has been done, to make things easier later ( it's just crap we didn't need that's gone, we retain all the important stuff)
I just don't understand how people seem to think that age and/or ill health will never happen to them! If we don't plan for ourselves, them some other poor bugger ( usually our adult children) has to deal with us when a crisis hits. That's a lot to ask of anybody!

@AInightingale Very good point about HRT

A spell in rehab will involve a planned discharge at the end, where MIL will have support from the team in figuring out what her 'home' options are. This is your chance to say what level of support you and DH are able to offer. You should be open and honest about this, as agreeing to a plan that you can't sustain is unhelpful to everyone, not least MIL

Bottom line though is that if she has capacity, she can make what you and DH might consider an unwise decision to go home with minimal support. Adults make unwise decisions all the time, often with unfortunate consequences

Agree with all this. We have found in the rehabilitation unit, the staff - particularly occupational therapists- are very good at understanding just how well or otherwise the patients understand the consequences of whatever decisions they make. So my mum retains capacity, and she could say she wants to go home. The OT established that she did not really understand that she will not be back to how she was before when she is discharged. The fact that @FeralNun mother in law is in ( or going to?) rehab is really helpful. Hopefully like us, there will be meetings regarding her discharge where you can say how much care you will be able to provide. Then they will make recommendations based on that, and what mental capacity she is deemed to have.

Forgot to add the post i was agreeing with!

I'm an OT 🥰

I'm sorry, I stand by that comment. He isn't helping by not making it clear to her that he isn't an option for her care. It's not fair on her, on him or on you.

I've been where you are. It isn't easy to make it clear what your limits are, but it's vital.

They suggest this so she can move downstairs and be near the kitchen.

I am very grateful to all OTs. Ours have been points of sanity amidst the chaos. Thank you 💐

It's so tricky. I just pray I'm not selfish for my children's sakes. Your DH needs to put in boundaries quickly and get care in place.

She can pay for carers. Your DH can't keep driving that far. He must be exhausted. What if he falls asleep at the wheel? If he can't make that decision, then he needs to talk it through with a counsellor, to learn to give himself permission not to half kill himself in the process.

Because often people want access to the kitchen to prepare food or to open the front door, or other rooms in the house.

When the falls are this frequent, with accompanying hospital admissions, statistics show that MIL is on a rapidly downhill trajectory now with regards to prognosis.

Just popping back with an update: MIL has comprehensively failed the discharge test (no surprise there!) and so remains in hospital. But most surprising of all, she says she doesn’t want to go home. She doesn’t think she can manage!

She has obviously really, really frightened herself, which whilst it’s awful and very sad, might be a blessing in disguise. Of course, she might change her mind when she feels better, but still..

Thank you all so very much for your thoughts and comments. I’ll update again when there is any news, and I hope this excellent thread will be of use to others in the same boat! 💐