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.

Best wishes for all of you!

I do understand where you are coming from, and you are right. It was just hard to read that the strongest person I know, who is trying to keep his mum alive because he couldn’t do so for his Dad, lacks balls. He absolutely doesn’t. He’s reached his limit though - we all have!

I'm sorry your mil has had such a scare @FeralNun but grateful that you and DH have time to breathe, and consider this, while she's safely tucked up and being looked after.
This really is an excellent and supportive thread, on a supportive board. Even when there is robust discussion there is solidarity and understanding.

I look forward to the update!

@pikkumyy77i still don’t understand. Surely it’s better to be near the bathroom than the kitchen? Even if it’s just easier to empty a commode. My mum was never going to use the kitchen again but she certainly needed bathroom facilities

In 20-30 years the number of people with dementia is predicted to increase - from around 980,000 now to 1.4 million by 2040.

A heavier population is not a plus - the increase of overwieght/obesity is causing a rise in illness across the board.

Obesity is actually a risk factor for dementia, and many of the illnesses that obesity causes also cause dementia - diabetes, high bp, cardiovascular disease etc.

Encourage your DH to check out care homes near you as well as in MIL’s area. She would be so much easier to visit nearby and you can keep much better tabs in her care. (Where are the rest of the family?)

The elderly relatives I had who went into care homes near their old homes - their friends didn’t actually visit much nor did they visit old haunts much so they might as well have been nearer their families.

I know you're trying to be helpful. To give you some insight, I did become my father's carer. It was a debilitating experience for me. He had mixed dementia, didn't live nearby and I had to take bus and 2 trains to go to him. Until he was deemed to have lost capacity, it was his decision to stay in his own home. Was it a good decision - no, I don't think it was but you can't take away people's right to make decisions about their own lives while they are still deemed to have capacity, even if you think the decisions are unwise. My father did go into a Care Home when a Fire Risk Assessment was done by a firefighter and he was deemed a risk to himself and other residents in the tenement he lived in. This was not long after his Consultant said he had lost capacity. This experience did not teach me that I had to move into a bungalow when I hopefully get to 70. It taught me that my decisions are mine to make but I need to live with the consequences of these and not foist them on to my children

Moving house is always a big step and it becomes bigger and more intimidating the older someone is. And often they leave it too late, then get to that point at 75+ or 80+ when things can start to deteriorate rapidly, it becomes harder to get out (eg have to stop driving but house requires car use) and if they do end up moving it requires a lot of assistance and it's harder to build a new social life in the new location.

My PIL did this and it was a fantastic decision for them.
Im only in my 50's but as a HCA Ive seen how the responsibility can be placed onto DC and I never want to be that person

Stairlift and domicillary carers?

@FeralNun this thread has been brilliant. I love a good thread with robust debate - which frankly many of us cannot have in real life with family members. It helps hearing other people’s experiences, clinical staff experiences. It is hard being strong and saying ‘I cannot commit to that amount of care’. But it is sensible advice.

I had a call today from Dad’s home. They are bloody amazing. Call starts with ‘Hi BlueLegume, absolutely nothing to worry about’ …..then update on what had happened as a courtesy then update on a funny thing Dad had then done.

Some of the system is broken. Some of it is utterly amazing as are the angels who staff it.

Just to be clear, I didn't say people should move at 70 ( that was another poster) What I did say was that we should all take responsibility for our own ageing, and I used my mother as an example of that working well for her. So i think we are broadly in agreement 😊

My mother had SOO many falls in the last 5 years of her life. She had quite a few in the years before that. She was finally unable to go home when she broke her pelvis , cossing the road with her walker after going for lunch with her sister in law (also quite frail)

It was a very very stressful time but she often didn't tell me. I remember calling her once for my usual update call and she said she was fine and chatted away . A couple of hours later I got a call from my sister that mum was in hospital with a broken wrist. When I had called her, she was sitting waiting for the ambulance that was coming after she had fallen and called 999 for help

We spent so much time nagging her to be more careful that she just lied about falling if she could get away with it

I wish I could tell you what to do, it was a very very difficult time though

You can’t take away peoples right to make decisions, but if their decisions are unwise, especially if they are unsafe, you can intervene to support them to make better ones. Why do need a fireman to tell you DF a risk to himself and others?

I think there is too much farming out of responsibility to over stretched services -social services, GPs, hospitals, occupational health, fire - because offspring are unwilling or afraid to take charge of the situation. That can be done respectfully.

Being in the bedroom is socially isolating. People are more likely to visit someone in a living room than a bedroom.

This is what happened to my mother . She had almost 6 months in hospital and rehab and then 2 years on a care home after her last fall. She was in a wheelchair for all that time and never walked again. She was 90 though

She had had a long life of gradual frailty though as she had developed osteoarthritis reasonably young and started falling reasonably often from when she was about 70 years old. She went on to live until she was 92 though and was able to be reasonably mobile with a couple of ususally minor falls almost every year , although one was down a flight od stairs where she miraculously recovered but it took almost a year. This went on until her late 80s with falls happening more often and when her mobility really became very poor. My mother also regularly did exercises to improve her strength and mobility and was very very motivated to keep as strong as possible. So this can go on for a very long time with some people depending on the reasons for lack of mobility

@Mirabai The Mental Capacity Act (2005) does mean that people can make decisions that other people deem to be unwise. I feel that it can be difficult to get a person's capacity checked. There are threads on here where people are desperately trying to encourage their loved ones to make sensible decisions, but are overruled due to this act. We've seen this play out in the hospital recently with my mum, and I know there are other current threads running about this very thing.
Sometimes it takes a committed professional to talk to them, but it's extremely difficult in many families when the parents just won't be told by their offspring. @WTF99 has commented above, as an occupational therapist.
The Act is a mixed blessing as we do want our elders, and us when the time comes, to be able to make their own decisions when possible. But it can make those of us looking out for them feel very unsupported when we're trying to look out for those we love. It can make us vulnerable, or feel vulnerable, to allegations of neglect if despite our best efforts, our stubborn loved one does something we would deem unwise, and gets hurt.
It's a very fine line.
And this is why these robust discussions are so useful. And as the pp said upthread, we do need to be opening conversations about our sunset years, and stop ageing and death being taboo subjects.

This is a bit if a ramble, but I just want to say I often read the Elderly Parents topic to get different perspectives as I get older. This is such an informative and thoughtful thread. I hope I’m not derailing. I totally agree with the idea of thinking of ways of adapting the house and making life easier, and getting affairs in order as I approach my seventies.

I’ve noticed some cognitive decline over the past couple of years. I don’t retain much of what I read online. I shop online, but can’t face online banking. My memory for passcodes is very poor, and using keychain just seems to make me more forgetful, as I don’t then practise my memory.

As far as falls are concerned, about ten years I fell down the stairs at home. I didn’t “have a fall”, I was hurrying and hadn’t bothered tying my shoes. The long-lasting damage to my mobility has increased isolation which in turn has taken its toll on my mental health.

I didn’t think I would really feel old, but now I’m doing my best to declutter and get everything in order. I often ask my adult children if I am asking too much of them, and I feel both guilty and relieved when they say it’s okay mum.

DH and I have promised each other to say “unsafe discharge” if anyone tries to persuade a child to take on care of either of us.

The Mental Capacity Act (2005) does mean that people can make decisions that other people deem to be unwise

No shit. So not the point of my post.

No-one can be over-ruled by an act. They can be overruled by a person who still has the ability to make their own decisions, but if that person continually makes decisions that put themselves in danger, a case can be made for not understanding the consequences of those decisions and lacking capacity in that area.

Capacity is not cut and dried - people can have capacity to make one type of decision but not another.

Crossed wires here I think. I was pointing out how hard it is to make that case when your 'person' manages to convince everyone around them ( except family who know them well) that they are of sound mind. I totally agree that we should ( and most of us do) try to influence them to make wiser decisions than they do.
It was only when the OT paid attention to me and my mother over the course of over an hour, that she realised that my mum did indeed have a fragile grasp on reality.
I would have had no chance of getting my mother assessed for dementia for example.

It's just so much easier said than done to get professional help when a person doesn't want it, and that is why exhausted and frustrated posters take to this board for a bit of advice, or to have a rant. None of us want our parents living in unsafe surroundings, but what do you do when they keep sacking their carers or refuse to call a doctor? You generally muddle along the best you can, knowing that sooner or later a crisis will occur and they are forced to accept help ( like @FeralNun's mil) Mine did have a couple of fall which caused hospital admissions, after which she accepted a bit of help. And we were 'lucky' in that she was safely tucked up in bed where her carer found her after her most recent stroke. No actual injury, thankfully. 'Just' her brain.

Thanks for the update OP. Sometimes it does take things to approach a crisis point before a significant change will happen. I'm glad to hear that your MIL has made a decision which does seem to be in her best interests. That's a brave thing for her to have done. And relieves your poor DH of having to explicitly say that he has reached his limit, which can be such a difficult thing for loved ones to do. There are still decisions to be made though, so having a good think about your boundaries is worth doing at this point.

The task now is to help her find or create the right environment so that she can rebuild her confidence and remain as independent as possible, whilst being safe and comfortable. That will keep you busy! Use the team. OTs are good at this kind of thing (but I am biased) and hopefully you will have access to a good social worker too.

Capacity is a tricky thing, but the principles are very clear, and available to read up on. It came as a revelation to me in my early HCP days that it wasn't my job to rescue everyone (thank goodness!) and that adults are allowed to make unwise decisions. I have spent a lot of my time though going through options and scenarios with people so that they can have the info they need to make good decisions, and putting in safety plans for the inevitable times when 'I'll be ok' turns out not to be the case. And celebrating the successes too of course, sometimes unexpected ones.
Wishing you all the best OP.

Thank you so much, @WTF99

And all of you..

Because he was a very obstinate man and something had to be done to take the decision out of his hands. And it worked so it was the right course of action to ensure his safety. I mean to be polite but you weren't in my position and I will hope you don't intend to be judgy but it comes across that way unfortunately

Anyone can be assessed for dementia, you just have to ask the doctor. A fragile grasp of reality could signpost a dementia or mental health assessment.

What you do when a relative refuses to call a doctor depends on the nature of the complaint. If it’s a head injury say one is obligated to intervene.

I’m not judging you - I’m making a general point. Elderly people are commonly very obstinate. When my obstinate aunt started turning on the gas hobs in the middle of the night, I don’t need the fire brigade to tell me that’s a fire risk and even if I’d got them in she would have just denied what they said. So I still had to take charge of the situation.