Worried she’ll fall..never listens

[HolidaysDancer]

Mum is 84 and a bad walker due to arthritis in both knees (also has heart failure) but mobile. Recently her arm has been giving her jip but she refuses to use anything that assists with her walking in the house. She does use her walker outside but certainly not all of the time. She won’t listen and I worry she’ll either fall down the stairs or fall trying to get off the settee. Apparently it won’t happen.
How do people deal with old people I’ll never know…advice welcome? Thank you.

Feeling your pain!

My mum's mobility is poor & she has not engaged well with physio or followed the exercises/advice they gave her. Nor with the hearing aid clinic.

She has agreed though to an assessment from the falls team & to wear an alarm bracelet, plus have an OT assessment for bath aids. Small wins.

There's just an elderly mindset which is so difficult- maybe it's denial, frustration, misplaced anger, fear of dying, being scared.

But so difficult. You just have to take the wins when you can.

It's almost inevitable sadly. You can get help towards making safety improvements in the house - grab rail above toilet, in shower, extra banister on stairs, hand grips at the bottom, and rails outside at the front and back door, or replacing steps with a ramp - you can apply for these things or fit a couple of them quite cheaply yourself (B&Q do a range) but if an elderly person won't use their walker, their luck will run out some day.

Get rid of rugs too.

I found duvets dodgy with my mother and got her a smaller one that didn't hang over the side of the bed, because elderly people can take a bad fall over literally anything.

Also no idea. DM has bad arthritis, gets out of breath very easily and is suffering from dizziness and vision disturbance (as well as cognitive issues). She won't go out on her own because she's worried about falling, but she won't listen to any suggestions that she get a walker or similar - she just leans on my dad when they're out together and won't go out alone. In the house, she's got no aids, rails, grab bars or anything. She lives in a house with stairs and is often alone for several hours at a time, and i don't know if she'd know now how to phone anyone if she fell in the house (if she could even get to the phone). Won't consider a fall alarm, mobile, Alexa etc. Tbh I'm just waiting for the inevitable - she absolutely will not entertain any suggestions.

enrol her in a scheme with an emergency button that she can wear all the time. Then at least if she falls she can summon help

Try to get her gp to do a referral to the falls team. Quite a lot of places also do fall prevention classes. Although I expect she will refuse to go. Falls alarm if you can persuade her, some automatically call when they detect a fall.

If it’s any consolation DFIL fell constantly, often more than once a day, but rarely hurt himself even when he fell down two steps onto concrete. We taught him and MIL some techniques for how to get himself up/how she could safely help him up. Occasionally they had to call an ambulance which wasn’t great. Unfortunately his dementia had progressed just far enough for him not to be able to remember how to use his rise-and-recline chair, that the frame was his etc etc.

Unfortunately the conclusion I've come to is that you just have to wait for it to happen. As others have said you can minimise the risk by removing trip hazards like rugs, fitting grab rails etc, you can take steps to ensure that they can raise alarm if and when they fall by setting them up with a wrist or pendant alarm, you can make sure that the mobility aids are there for them to use of they decide to, but if they refuse to use them ther is really nothing more you can do....

You let her fall. She has the right to make poor decisions. Once she has fallen she will learn. It's hard but there's nothing you can do.

I'm with @callmebuffy.
My DPs wouldn't listen.
They both had very unpleasant and sad outcomes.
I don't think you can do too much now you have given your advice.
Just try for POA if you don't have it as she is now more vulnerable.

Yes, do get POA drawn up, witnessed and signed (I think it's a more straightforward process in England if that's where you are). The alarming decline of an elderly parent who does take a fall and maybe requires a long hospital or nursing home stay takes a lot of people unaware. They can lose capacity so quickly after a serious injury.

Yes as @AInightingale suggests, things may escalate.
Your DM unwittingly is placing an extra burden on those around.
At work you might have a 'business recovery' plan.
You might have to have a notional one for DM...
Do you know where she keeps her passwords and paperwork? Are you aware if her utilities come off as direct debits?
I know it sounds a bit of a leap but she's putting herself in that territory.

It’s sad, but this I’m afraid. You can’t be there 24/7 and she’s an adult who still has the right to make her own (sometimes bad) decisions. I’m sorry, I know it’s hard.

Tried and she won’t entertain the idea!

I’ve tried to roll up one rug and found its back down again..so difficult!

Your mum does sound in denial of her age and frailty OP.

My mother had a Carecall bracelet on when she fell in the night, outside (eccentric wandering) and she managed to get help quickly, or she would have lain there for hours. I'd give her the ultimatum that it's either got to be a daily welfare check from a carer or wear one, but it's so risky for an old person to live alone in a house with stairs with limited mobility.

You can put all the safeguards in place but she’s still going to fall. We’ve got the grab rails, the walkers, the emergency buttons, the shower stool, yada yada. Both parents, multiple falls, multiple hospital admissions. Honestly, save your breath. Do your research re Power of Attorney, care costs, how to arrange care and then let it play out how it plays out. You can’t prevent it.

Absolute denial. She tells me she doesn’t feel old inside…yeah but your body isn’t saying this! Total nightmare, no common sense.

I'd recommend radiator covers and no other heaters that someone could fall over/against.

Can she get up again once she's on the floor? Obviously assuming she hasn't broken her hip or hurt herself.

Otherwise there's not a lot you can do, maybe have an emergency plan in place for how to deal with the aftermath and talk that through. Sometimes being blunt works, especially if they wish to remain at home.

If you remove trip hazards, you need to make sure they can't reappear. I have removed rugs, chairs and tables.

I agree with others that if she has full capacity, she has bodily autonomy and you cannot force choices upon her, whether you think it’s common sense or not.

What you can do is set your own bar as to how much help/support you’ll give her with the consequences of her choices. Make this very clear to her and stick to it. If you present it as though you would like her to (for example) engage with falls protection scheme for your sake and to put your own mind at ease, would she be more likely to engage do you think?

It is hard. I can see it from the perspective of dealing with yet another 3am parental emergency call and thinking for fucks sake (and then feeling guilt!) and it’s extremely wearing as well as worrying. I can also see it from the perspective of someone who regularly ends up on the floor due to seizures and mobility issues and I know my (adult, mix of living at home and away from home) DC worry about me and think I probably take unnecessary risks eg. getting public transport instead of taxis, doing things unaccompanied when I could just wait for someone to come with me, use my wheelchair instead of a walker etc. I try and set their mind at ease as much as I can (I have engaged with adaptations team and do have emergency fall alerts set up) and whilst I know they would prefer me to modify some behaviours like the above as “common sense” I also want autonomy and to live how I would like to, as much as possible. I would never expect them to pick up the pieces and am clear on that and I try and reduce my risk to a compromise level for both of us.

I have also made sure they know where my will is (this is more to the reason behind the seizures and shit mobility to be fair, not the falls themselves) and all useful information is in a folder with it, along with Advance Care Plan, P of A etc. I am in my 40s, so decades younger than your mother (I had my DC young) but I think I want to live what’s left of my life on my own terms, and your mother may feel the same.

I would ask her to engage with services etc to put your own mind at ease (without guilt tripping, appreciate it’s a fine line!) as this may make her more inclined to do it for your sake. My DC found a very successful strategy of making a “joke” out of it and “babyproofing” the house. It made me laugh and we did things like putting those guards on the corners of tables etc and I felt less of a liability burden and more of a person humouring her DC - it’s hard to explain. (Actually rugs are good at cushioning falls, you can get bombproof sticky tape on Amazon etc to secure the edges so they stay stuck to the floor).

Good luck, I understand it is hard. Definitely set your boundaries, make them clear to your mum and never feel guilt - they are her choices. (And it’s fine to think oh for fucks sake, even if she’s in her 80s, parents can be really fucking annoying, especially bloody stubborn ones!!)

@unsyncI would lose my shit if my DC took it upon themselves to remove items from my house without my agreement. As I said, rugs can be taped down and can be a safety measure, and table corners etc can be covered. How would you feel if someone took your items away without your consent? Assuming someone has capacity, it’s their choices - you can choose to disengage from the consequences, but they should be free to make their choices.

Very old age is rubbish. As people age they can lose so much - cognitively and physically. Their friends become unwell and die and their social life becomes non existent. Life can be much less than it was when they were younger. I’m not being ageist here - I’m being realistic. Lots of elderly people will be able to reflect on many happy memories, but realise than everything for them is shutting down .
They know that death is round the corner. Their loved ones want them to be happy and to live as long as possible so reducing risks becomes important. But maybe for the person themselves they feel that living life they want to is more important. Because they will die soon anyway. So evaluating risk is not a priority to them - they are happy to take their chances. And maybe as a society we need to recognise this a bit more.
Everyone dies. I would rather die living as I want to. If that means I fall, or I wander out my own house and get lost because of dementia, and then die of hypothermia, that still seems preferable to me than dying a couple of years later in a nursing home .I do appreciate that many people may not agree with my opinion

I'm talking about an elderly person with limited mobility and poor cognition and decision making. One of the items was removed following a fall onto it. So yes, I will remove things which are a trip hazard. Taping does not work, it gets removed. Kitchen cupboards had corner protection added many years ago now.

My parent wishes to stay in their home for as long as possible. If removing items that are hazardous enables this, out they go. I have a duty of care and a legal responsibility for their wellbeing. We had many discussions about wellbeing, care and welfare before the onset of older age.

So lose your shit all you want, I'm sure it will help when you're lying on the floor with a broken hip that will speed your demise.

As I said in my post @unsync
there is a difference in situations whether the vulnerable person has capacity or not.

There are some specialist rug tapes that can't be removed easily, especially by someone with limited mobility btw, DIY Doctor sells one that is like glue, even my strong weight lifting DH would struggle to pull the rug off the carpet! We just use double sided Gorilla tape as it's strong enough for our purposes.

I'm with you @RunnerDown. I'm not actually elderly but I'm in the situation you describe where my world is getting smaller and more restricted and my choices are being shut down due to physical and mental decline. I'd like to keep hold of whatever choices and control I can have, whilst recognising the impact on my loved ones. Like you say we are all going to die but when you know your odds are much shorter and death is a lot nearer than you'd expect, your worldview definitely changes. So yes I'd rather keep my nice items like my velvety rug that matches my curtains and gives me pleasure to look at. I appreciate my families efforts to source a specialist item to enable me to keep it as long as possible rather than unilaterally remove it and then guilt me about a "speedy demise lying on the floor" I can't imagine my DC saying or writing anything like that about me.

People wish to live out their lives on their own terms, we should live out our deaths on our own terms too. I'd like my DC to remember me with affection and no guilt - they do joke now about my stubbornness but they respect it and I ensure they feel no guilt and fully understand my choices are mine. The same as if I wanted to do a really risky hobby (I bloody wish!)

In fact a fall, and said "speedy demise", is a really attractive option faced with the alternatives. When I fall I am more likely to injure my head as I can't break my fall with hands etc as one would normally. Maybe I should go remove all the corner protectors from the table I can imagine my DC saying "god mum was so fucking stubborn with that bloody coffee table/rug" and then squabbling (hopefully politely) over who gets to keep it themselves

"If that means I fall, or I wander out my own house and get lost because of dementia, and then die of hypothermia, that still seems preferable to me than dying a couple of years later in a nursing home"

I so agree with this @RunnerDown. (As long as I don't cause any inconvenience like not having ID on me for the paramedics). And I'd be more likely to die quickly as I don't own a nice warm cosy dressing gown, I have a selection of silk robes and totally impractical gowns I'm sure my family would love me to wear a zipped up cosy gown but instead they would say "ummm okay well errr that's a nice silky fabric. Why don't you put a short ribbon tie on the front so you don't trip on that long trailing slippery belt and perhaps hem the whole thing so it's not trailing on the floor?" (While thinking "bloody hell you can't wear that, you absolute melt" )

I may die of hyperthermia but it'll be quick and stylish (and my DC all know how to sew!)

@FloorhuggerOlympicGold I know you are joking, but please keep your corner protection. I have had to deal with de-gloving caused by falls against furniture edges. It is a very traumatic injury with a lengthy recovery and I wouldn't wish it for anybody. 🙏

On a lighter note, we follow a gentle balance exercise regime called 'Able like Mabel' if anyone is wanting to help improve or maintain stability.