Falls and needing a wee in the small hours

[Topsyturvey10]

The challenge is my elderly mother had just had her knee done, she wants a wee regular as clockwork in the early hours of the morning. I’m worried that this is the time she might fall, I’ve already got Alexa’s in the house and am looking at wristbands to notify me but I wondered if there is any advice out there about reducing the need for a wee?

I'm changing her to decaf tea bags and stopping her having them after 8pm. I don’t really know what else to do?

A general question, how does everyone else manage elderly parents who live alone? I’m not far away but I work FT and I can’t ever see me being able to have a holiday or trip away again. There are no other siblings that can help.

Can you fit a commode by her bed so that she doesn’t need to go far?

This would be my suggestion too

She will need to be assessed for help and or pay for help
She cold look at renting out a room to a lodger who gives back time for free rent,?

Live-in low cost service for elderly people to remain independently living https://share.google/1aHJt9x2MzaHoOgFi

I hadn’t though of a commode, I’m not sure she will like it but it would reduce the risk. Thank you

Re the nightime wee, I'd agree about getting a commode. Also,make sure she keeps her leg up during the day - if not, it will swell up and then she'll pee out the extra fluid overnight. Does she take water tablets? If so, she still needs to, first thing in the morning so that work to reduce the fluid build up during the day. Cut back on caffeine, as you have - and on alcohol, if she drinks!

If you can't get a commode then you need to look at how to make the trip to the bathroom as safe as possible. Does she sleep on the same floor as the toilet? IS the route adequately lit? (remember that older eyes need more light to see clearly!) Any trip hazards along the way - flexes, rugs etc? Will she go barefoot - it's safer than slippers which can slip off all too easily! I'm sure other people will have other ideas.

Re longer term, maybe you need to look at getting a social services assessment? At the very least, if you feel you can't safely leave her, then you should look at attendance allowance for her and carer's allowance for yourself. If nothing else, they will make a small dent in the cost of paying for some care now and then so that you can go away. That's if your mother will accept that, of course!

But hopefully if she's had a new knee, and does her rehab, then she might actually eventually be better than she has been? That's the point of the surgery, after all!

Not sure reducing liquid consumption is a great idea - could lead to kidney problems. Mil wears a nappy but still insists on getting up. We have a fall monitor on her wrist and we have sensors around the house, so if she didn’t move around when she should be moving we’d know about it.

If she won't get a commode, you can get raised seats for the toilet so that it's much easier to sit and then stand up again. Do you have a shop near you which sells disability aids?

Top tip - if you're buying aids for personal use, you don't have to pay VAT so make sure that you point this out to any salesperson.

Sorry, but short of dehydrating her to an unhealthy level, you are unlikely to prevent her needing a wee in the night. As we get older the need to get up and pee overnight increases.

Mine lives next door, only sibling 7hrs away. We have a CPR Guardian watch and she’s got Alexa too. She’s got an ensuite so doesn’t move far in the night. We do manage to get away but it takes some organising. Her cleaner and gardener both call weekly on different days and I’ll arrange a home appointment with the chiropodist for a third day of someone popping in. I’ll arrange for friends to drop in on the other days. My DH will prepare meals she just has to reheat and we contact her daily. She’s pretty good at using Messenger for quick check-ins and I can see what she’s up to on her watch. DS will also FaceTime her and my DB will contact her too. It’s a juggling act but it’s doable. We never go any longer than a week though.

Thank you so much for this information

My husband always gets up during the night but I never do, I’d rather turn over and go back to sleep :)

How recently did she have her knee done and how mobile was she before? My mother had a knee replacement, she was mobile on crutches from the day after the operation, but I’d say for the first couple of weeks she struggled and needed direct help (or at least, supervision). After that, she could get around a fair amount on the crutches. I stayed with her in her home for the first two weeks to make sure she didn’t fall going to the toilet etc, then visited a few days on/a few days away for another couple of weeks to help with meals and housework.

Different situation but we found my elderly MIL was being a little too enthusiastic with the liquid morphine at night which was definitely contributing to her instablility, so do make sure she’s taking pain meds properly and not self-dosing because she’s waking up in pain.

Also do go over and do a through clean and tidy and make sure there’s nothing in the corridors, even things like side tables that have always been there need moving, at least temporarily.

It’s only been a week but I’ve become more aware of her ‘tottering’ gait the last few months. She had a fall a few months ago and prior to that probably a year ago. The problem is she cannot get back up (both knees are now replaced) and doesn’t have much upper body strength so literally she has to just sit on the floor until I can get to her.
I wondered about asking the GP to refer her for some sort of physio where they could have a look at her gait?

Realistically - any efforts to prevent needing to get up are either going to be unsuccessful, or result in dehydration which causes a long list of issues for the elderly. So I’d suggest giving up on all those tactics now before you make things much worse.

Instead, fall prevention. An OT assessment may be helpful, but you can do a lot of basics yourself. Getting rid of all rugs. Clear floors, open space. Zimmer frame next to the bed for giving a solid platform for use to get up. Clear path to and from the toilet. Eufy lumi night lights. Little, battery powered motion and light sensitive. Come on at night when detect movement and give low level lighting so can see the floor better (unless she already puts the light on properly anyway).

If just had a knee replacement then should be getting physio input. Talk to them about fall prevention and also working on getting back up. There are tactics to use and also room set ups that make it easier.

You can go away, frail people live without family support. It might mean a long wait for an ambulance, but with a suitably heated home and a way of calling for help that works. A key safe may be a good addition at this point.

Physio sounds like it would be good for her. Ask for a referral but there are loads of videos on YouTube if she’s tech savvy enough to follow them. She presumably has crutches for the knee recovery but once that’s done would she consider still using a walking stick, at least in the house? That might help give her stability when walking to the bathroom. Waking in the night, sometimes you are a bit wobblier because of tiredness.

Something else I did was arrange a handrail to be fitted on the landing, so when my mother goes from bedroom to bathroom there is a handrail to hold on to if she needs it. That might be good for your mum too.

Seriously: your mum needs a commode next to her bed. Otherwise, sooner or later, she will fall.

I would not want what happened to my stubborn mother on her worst enemy. Fell as she got out of bed, the rug which we had told her to get rid off x number of times slipped, and she fell.

Broke her hip and never walked again. 16 months in a nursing home before she passed away.

I'm having a new hip in the autumn so am buying one of the raised seats. I'm moving into the spare room because it has a small en suite with shower. But would use a commode rather than wet the carpet.

"Homecraft Raised Toilet Seat 4 Inch (10 cm) – Toilet Riser for Elderly, Disabled and Post Surgery Recovery – Lightweight, Hygienic Bathroom Aid – Fits Standard Toilets – 190 kg Capacity, White : Amazon.co.uk: Health & Personal Care" https://www.amazon.co.uk/Homecraft-Elongated-Elevated-Handicapped-Disabled/dp/B000EA3PH6/ref=mp_s_a_1_3?crid=2VC8ZI2X1KUT5&dib=eyJ2IjoiMSJ9.6F6fRkKIK8aIt9Lav_tx1i6yKBhSjnkIez88cPXc68EWzSn_DmneUozC-yqIGNao-CitV4EFh1HdGYrgsWUuIgq_lRnGw1brql_BsElwk23HFCdgfYVkVvTrOpiSNcaqtEXA4QwBaBPgqFfoDKY2L2YrAHmpzaJc9A36ytK5_A3_u8tkC1E9cxI4MfAXuK-jgWoDgCg2pCKTjY7LTI04ng.whGFiocfpZlL9tpwQOLz-t-iz61zYkiZy92YmIP2xdU&dib_tag=se&keywords=raised+toilet+seat&qid=1755039275&sprefix=raised+toilet+seat%2Cwishlist%2C75&sr=8-3

A walker might be a better idea at night.

Sounds like she’s home so probably a bit late but mine went into a residential home for ten days after a hip operation.
Similar to you, she lived alone and I work FT so it wasn’t practical for her to go home immediately.
The home had staff available 24/7 and a wet room with grab rails etc, plus no trip hazards around.
Longer term, buy in as much help as you can.

A keysafe is a good idea too. That way if they need to call for an ambulance but can’t get to the door, the paramedics can be given the code and still get in.

Is there a falls service in your local area? They send someone out with the right equipment to get them off the floor. If you’re doing it yourself you’re putting both her and you at risk of injury.

This. Lots of older people don't keep hydrated and still need to get up in the middle of the night anyway.

Like others have suggested, a commode by the bed is probably the best option.

you could consider overnight carer? So a carer comes just for whilst she's sleeping to help her to the toilet when she wakes.

maybe you already know providers in your area, but I've used https://lottie.org/home-care/search/? to compare home care providers in my local area