Fell Out of a Chair

[Ted]

That is exactly what happened to my grandfather (dad's dad). He stubbornly fought any kind of assisted living and then one morning a few months after turning 90 he slipped and fell in the bathroom, knocked himself out and never woke up. Passed away a couple weeks later in the hospital.

I'd rather go out in a Duke, but that's not a bad 2nd.

 

[Everskyward]

Done. She ignored it. Next?

Yup. Sometimes even younger people stubbornly refuse to do things that might be good for them for whatever reason. Look at all of us posting on POA. We want our autonomy. But when folks start to have cognitive problems they may not be able to put together action and consequence. Pleading doesn't help. They have the impulse to get up unassisted so they do.

 

[Bob Noel]

Done. She ignored it. Next?

I wish I knew.

For several years I encouraged my mother to use the cane - eventually she started to want to use it and later the transport chair.

For some elderly (most?), using canes or chairs is something they have to want to do... no amount of wishing/hoping/demanding from us will matter. Very frustrating, but there is it.

 

[steingar]

Done. She ignored it. Next?

Try again and again. If you can't do any of that stuff I told you to do then consign yourself to the eventual tragedy and move on. There is a limit to what you can do, since you can't have her declared incompetent and don't want to anyway until she's sufficiently out of it to not know what's going on.

I still think the key is reversing the relationship you've had your whole lives. You will either succeed and be able to help your mother or fail, in which case the tragedy will happen and there is little you can do to stop it. I've done this twice now and am going to have to do it again sooner than I like. I wish experience was a better teacher but I am unconvinced.

I really and truly wish you luck.

 

[Ted]

then consign yourself to the eventual tragedy and move on.

Done. So will people stop telling me I need to convince her to do anything now?

 

[garyb]

I wish I knew.

For several years I encouraged my mother to use the cane - eventually she started to want to use it and later the transport chair.

For some elderly (most?), using canes or chairs is something they have to want to do... no amount of wishing/hoping/demanding from us will matter. Very frustrating, but there is it.

I don't understand old people. I actually want to carry a cane. It makes you look so dapper!

 

[Ted]

I want a Dr. House cane. Useful for smacking people over the head with.

 

[AdamZ]

Ted, three words Tilt Table Test. Could be stroke, could be Cardiac lots of stuff. Here is your carrot or stick as it may be. "Mom you may not hold the grandkids until you get this checked out"

 

[PaulS]

Get her checked for a UTI along with other issues mentioned. Been through this with 3 elderly relatives and that became one of the first things we would check, male or female. As they become older a UTI causes many issues including mental issues and dizziness. (I am not a doctor)

Not much you can do if she doesn't want to cooperate beside going to court and having her declared incompetent.

As a side note, my mom is like yours, absolutely refused to go to assisted living or live with anyone else in spite of advancing dementia. Anyway, she fell and broke a bone which required weeks in rehab, that's when we moved her to an assisted living that specializes in memory issues. Long story short, she really likes it. Many of her medical issues have lessened and she feels pretty good.

I hope you can get some peace and your mom is ok.

 

[PaulS]

Oh, and don't feel bad about lying to her to get her to the doctor. Call the doc and tell him what's going on, make an appointment, then tell your mom she has an appointment an hour or two before you have to go. Tell her she'll have to pay if she doesn't go. Get yourself as her healthcare proxy and see if she'll do a Power of Attorney. They are very vulnerable to bad people when they get impaired.

 

[Henning]

Done. She ignored it. Next?

Not a damned thing you can do besides.

 

[JoeSelch]

Done. So will people stop telling me I need to convince her to do anything now?

Good luck with that.
It's PoA - where you can't expect an answer to the question you've asked unless you're willing to let everybody take you all the way back to the beginning so you can relive all the work you've done so far (only this time by committee).

So ... Have you had a talk with your mom yet? ;-)

Maybe let her fall in a safe environment to evoke a different sort of learning opportunity - one where she's right and in control of her destiny.

 

[bflynn]

Done. She ignored it. Next?

You've talked to her doctor?

At some point you have to admit that she is an adult and you cannot force her to do anything. It hurts, but she makes her own choices.

 

[Fearless Tower]

I'd rather go out in a Duke, but that's not a bad 2nd.

Ya gotta get the Duke in the air in order to go out in one!

 

[Ted]

Not much you can do if she doesn't want to cooperate beside going to court and having her declared incompetent.

Which I won't do simply to get her to a doctor. When she gets lost coming home from the grocery store, yes.

Good thoughts, thanks.

Not a damned thing you can do besides.

Exactly my thought, and I'm fine with it.

So ... Have you had a talk with your mom yet? ;-)

Maybe let her fall in a safe environment to evoke a different sort of learning opportunity - one where she's right and in control of her destiny.

I hadn't thought to talk to her! That's next!

She's fallen in my house many times. Hasn't worked.

You've talked to her doctor?

At some point you have to admit that she is an adult and you cannot force her to do anything. It hurts, but she makes her own choices.

I admitted that a while ago. My question (see post 1) was medical, not looking for help handling geriatrics.

I realize everyone is trying to be helpful and I do appreciate that. Obviously this is very frustrating for me to be going through. My mom is also an eccentric person in general which makes any interaction with her a challenge.

Ya gotta get the Duke in the air in order to go out in one!

I can make those TIO-541s work!

 

[azure]

I admitted that a while ago. My question (see post 1) was medical, not looking for help handling geriatrics.

But Ted, if you can't get her to a doctor, then all the medical suggestions in the world aren't worth an inflated plug nickel. The best suggestion you've had so far is to make sure she gets a tilt-table test. But how to do that if she won't go to the doctor? In the end, it does come down to how to induce your Mom to do what is best for her, and that's the hardest question of all.

My dad wouldn't go in for chest pain. He had a script for nitro, and preferred to try that and wait for the pain to pass. Of course it did every time -- until it didn't, and he didn't reach out until it was too late. And he was mentally very competent -- physically too, until he wasn't. Fortunately, he was 93.

My mom was a much sadder story. She fell multiple times in their home, at first minor falls, and then she fractured a hip rolling out of bed trying to reach for something on the nightstand. After that she was disabled for the rest of her life, but kept trying to walk unassisted and fell many times after that as well. She was in and out of hospitals and nursing homes for 3 years before the end. She was 91, but so what? My dad had power of attorney and lived with her, but there was nothing he could do to prevent her living through that horrible existence. The only way to prevent it would have been a permanent nursing home (which we didn't have the heart for) or 24/7 home nursing care (which she adamantly refused).

As long as your mom is legally competent there is really nothing you can do short of an "intervention", which probably won't work without more family members to confront whatever counter-arguments she brings up. You didn't say anything about cousins? Your mom's siblings (if any)?

Can she afford 24/7 care at home? A close friend arranged that for her mom for her last years, but there is no way she could have afforded that except that her injuries were caused partly by an auto accident, and insurance paid for every penny of the care. Sometimes the worst circumstances lead to the best (possible) outcome. But sometimes they don't.

 

[Henning]

In the end she will die regardless, why make the relationship until then into mortal combat? She is an adult facing the end of life, her parts are failing. Be a sweet son, understand your time is limited, and make the best of what you have left, not much else to do.

 

[Ted]

But Ted, if you can't get her to a doctor, then all the medical suggestions in the world aren't worth an inflated plug nickel.

I was asking more for my own interest than anything. And, having several good suggestions, I might be able to get her to change her mind. But...

In the end she will die regardless, why make the relationship until then into mortal combat? She is an adult facing the end of life, her parts are failing. Be a sweet son, understand your time is limited, and make the best of what you have left, not much else to do.

I overall agree with Henning.

 

[PaulS]

....



I overall agree with Henning.

And I agree with Henning too. I made a deal with my mom that when she really needed to go I would tell her and that it would probably be because of some life changing event. In Massachusetts professional caregivers are required to report elderly who the feel are in danger due to failing health. I had to go toe to toe with a few to keep them from reporting her because having them come in and force her would have made her go beserk. In the end she fell and fractured a bone, which was the reason we moved her.

I needed to come to terms with it is what it is and her wishes were paramount. Do what you can and don't feel guilty about it. Hopefully nothing bad will happen, but be prepared that it may and keep your eye on her. I wouldn't wish this responsibility on my worst enemy, but I've been through it three times, and in the end the people you help really appreciate it.

 

[dentonf250]

My father is 80 years old and over the past 2 years had been having balance problems, falling alot, shuffling feet. About 2 months ago he fell while I was visiting him and knocked himself out. Got ambulance to come get him. They did a CT scan and asked us if he had balance problems and if he fell a lot. We said yes and he showed me the CT scan and the ventricles in the brain were very enlarged indicating excessive spinal fluid in the brain. He said this is a strong indication that he has Normal Pressure Hydrocephalus. He had to use a 4 wheeled walker and could hardly stand after sitting down. The Neurosurgeon ordered a Cisternogram and a high volume spinal tap to see if he had any positive affects. 45 min after the tap, he could walk fairly well with not help at all. This was the first time I had seen him walk without a cane or walker. The affects only last a short time and the next day he had to use the walker again. Results of cisternogram were also positive for Normal Pressure Hydrocephalus. A week and 4 days ago he had VP shunt surgery to drain the fluid off the brain. He was home 3 days later. He is much sharper mentally, is lifting his legs much better and has walked several times with no help. He has not fallen since coming home. He used to fall several times a week. Many people diagnosed with Parkinsons or Alzheimers actually have NPH and with a shunt the symptoms can go away quickly. Just an idea for thos of you who have parents that have balance issues. I know there are many causes for imbalance but NPH is often misdiagnosed.

Joe

 

[Alexb2000]

Ted-

I just wanted to say that I really empathize with you. Watching your mother go downhill is a really painful process. Definitely explore the options for treatment, but not at the cost of damaging your relationship. I still have mixed emotions about the decisions I made before my mother passed. There are no perfect answers, just do the best you can.

 

[tmyers]

Ted. Do you have a medical POA for your mom? I am guessing not because she doesn't sound willing to let go of any control. Just curious.

 

[Henning]

Ted. Do you have a medical POA for your mom? I am guessing not because she doesn't sound willing to let go of any control. Just curious.

They aren't particularly difficult to get from a judge if/when needed.

 

[PaulS]

They aren't particularly difficult to get from a judge if/when needed.

Much easier to get a POA and a healthcare proxy which is given by the subject willingly. It is also much easier to manage as it does not require supervision by the court. A judge will give a conservatorship or a guardianship, not a POA, at least around here.

 

[tmyers]

That was my experience with my dad in his final months.

 

[Henning]

Much easier to get a POA and a healthcare proxy which is given by the subject willingly. It is also much easier to manage as it does not require supervision by the court. A judge will give a conservatorship or a guardianship, not a POA, at least around here.

True, but if it's not an option, it's not an option, no need to worry or start a fuss about it. There are other options should the need arise that will serve the same result. This is everyday stuff.

 

[PaulS]

True, but if it's not an option, it's not an option, no need to worry or start a fuss about it. There are other options should the need arise that will serve the same result. This is everyday stuff.

You said it is not difficult to get, that's not true, you need to prove the need, and rightfully so. It's better if they cooperate, and sometimes, I think it's better to live with imperfect conditions than to force someone to do something. It's a personal choice, but needs to be made with the patient's will and well being in mind, not the convenience of the care giver. My experience is that as cognition gets worse the patient won't know the difference about a court order. If you do it too soon, it will make the patient miserable and take away the last feeling of independence or control over their life that person may have.

After writing that, I just want to point out that from what he has written, I think the OP is dealing with this well and should trust his instinct as to what is right for his mother.

 

[Tristar]

I feel what you're going through Ted. My grandma told me recently that she fainted while picking nuts off the ground. Little did I know until my mom told me is that it wasn't the first time. I've confronted her about it and she tells me she's had these fainting spells since she was a kid but I don't remember this ever happening before. She told me what the name of it was but I don't think she's seen a doctor about it since she was younger. It's one thing to fall on your face when you're 5, it's another when you're 77. She says she tries to sit down and take Dramamine but I think there's got to be a reason she gets dizzy and faints. Thankfully my aunt is just as stubborn as my grandma and she's moving in with her to be looked after. It worries me still though, I know two sweet elderly ladies that fell and passed away with head injuries just within the past 3 months. Not to scare you, it's just not something to mess with.

 

[Henning]

I feel what you're going through Ted. My grandma told me recently that she fainted while picking nuts off the ground. Little did I know until my mom told me is that it wasn't the first time. I've confronted her about it and she tells me she's had these fainting spells since she was a kid but I don't remember this ever happening before. She told me what the name of it was but I don't think she's seen a doctor about it since she was younger. It's one thing to fall on your face when you're 5, it's another when you're 77. She says she tries to sit down and take Dramamine but I think there's got to be a reason she gets dizzy and faints. Thankfully my aunt is just as stubborn as my grandma and she's moving in with her to be looked after. It worries me still though, I know two sweet elderly ladies that fell and passed away with head injuries just within the past 3 months. Not to scare you, it's just not something to mess with.

To die of a head injury is not a bad way to go. One moment you're good, the next you're gone.

 

[azure]

To die of a head injury is not a bad way to go. One moment you're good, the next you're gone.

IF the injury is immediately fatal, yes. But most of the time it isn't... TBI is a real destroyer of quality of life.

 

[Henning]

IF the injury is immediately fatal, yes. But most of the time it isn't... TBI is a real destroyer of quality of life.

This is true.

 

[Ted]

I just wanted to say that I really empathize with you. Watching your mother go downhill is a really painful process. Definitely explore the options for treatment, but not at the cost of damaging your relationship. I still have mixed emotions about the decisions I made before my mother passed. There are no perfect answers, just do the best you can.

Thanks, Alex. That's more or less the attitude I'm taking. My mom and I don't have a great relationship and never have, so that makes things easier in some ways and harder in others. My primary goal is to try to have memories as good as possible for me and especially for my kids (i.e. her grandkids). If she lives long enough for them to remember her, I'd like the memories to be pleasant. I don't really have many pleasant memories of my grandmother, but as I grew up I did come to truly appreciate the things she did for me. They weren't hugs, but long term what she did helped me much more.

Ted. Do you have a medical POA for your mom? I am guessing not because she doesn't sound willing to let go of any control. Just curious.

There's a POA at the lawyer's office somewhere, and I believe it's medical as well. I forget the details. I know I have the authorization to "pull the plug" should she end up on life support.

Either way, it doesn't really matter. Until she's truly mentally incapable or hooked up to life support, I'm not going to even try to activate a medical POA.

I feel what you're going through Ted.

Tristan, I don't want for this to sound rude (even though it probably will), but you have no idea what I'm going through or what anyone else who's had to deal with this has gone through. I watched my grandmother go through this 10-15 years ago and now my mom, so I've seen both. The two experiences are completely different. When it's your grandparent you watch it, but it's really up to your parents to be the active participants/assistants, plus it's 2 generations removed. When it's your parent, not only are you the one who's responsible for assisting, but it's one more nail in your coffin. Once your parents go, you're next. If you're an only child (which I think you are, like me) it's worse because you have nobody to share the burden with. At least if you have parents who are married then you usually share it with the parent's spouse be it your other parent or a step-parent. For me, it's just me.

 

[denverpilot]

There's a POA at the lawyer's office somewhere, and I believe it's medical as well. I forget the details. I know I have the authorization to "pull the plug" should she end up on life support.

Either way, it doesn't really matter. Until she's truly mentally incapable or hooked up to life support, I'm not going to even try to activate a medical POA.

Any siblings? I just ask because if there are, you could be setting yourself up for a nightmare not having it nailed down long before you need it. And knowing mom's wishes.

 

[Rushie]

Find out what she is swallowing, EVERYTHING. Prescriptions, over the counter drugs, alcohol, vitamins, supplements, natural remedies, herbal teas, or does she consume abnormally large amounts of "normal" foods such as chewing gum containing aspartame or foods containing a lot of MSG?

Look for any other route of entry to the body up to and including spreading things on her skin. Creams, patches. (A woman died in my home town a few years back from applying Lidocaine cream to her legs as instructed by a doctor prior to a procedure.) Look in her medicine cabinet, refrigerator, etc., you might not get complete information asking her.

What is her hearing like? Asks people to repeat things a lot? Falling asleep in the chair because she isn't involved in the conversation? Inner ear balance problems?

Have you ruled out low level carbon monoxide in her home? Chronic toxicity is different than acute.

You could check her blood pressure yourself, if your relationship is such that she'd allow it. Sitting or lying down for at least 5 minutes, then have her stand up and take it again. Look for BP drop (it shouldn't much) or heart rate increase to 120 or above. That would point to needing a tilt table test.

You can check her blood sugar with a cheap test kit and a little dough for the strips. Any time of day over 200 is bad. (Fasting 125) That would be diabetes.

That's about all you can do without getting her into a doctor's office, as the others have said, the possibilities are endless. From what you've said about her my gut feeling is she herself knows more about this than she lets on. I'm not saying she has a substance abuse secret, I'm saying she may be feeling health problems and maybe trying to self treat and not want to face them or admit them to anyone else. Not much you can do about that, but at least the above suggestions might help you know you've looked at what you can at this point.

Disclaimer: I am not a doctor, nor am I currently in a Holiday Inn Express. Nothing I say is to be construed as credible. I might just be making stuff up. Use at your own risk, blah blah blah.

 

[3393RP]

If you're an only child (which I think you are, like me) it's worse because you have nobody to share the burden with.

Any siblings? I just ask because if there are, you could be setting yourself up for a nightmare not having it nailed down long before you need it. And knowing mom's wishes.

In threads like this I always cringe when people offer completely unhelpful advice because they didn't bother reading the issues surrounding the OP's dilemma. In this case, the OP's post directly above denverpilot's gave the answer to the question before he asked.

I imagine it's frustrating and upsetting when one shares very personal and painful information while looking for help, and responders don't even make the effort to understand the issues before they type up an answer and hit send. I am somewhat familiar with the issues faced by the OP.

This afternoon my 80 year old father had a second revision to a failed hip replacement. The two failures of his prosthesis are directly related to his behavior and refusal to follow doctor's recovery instructions.

He lives in Albuquerque but traveled to Palo Alto to have the surgery done at Stanford Medical Canter. My sister is a pediatric trauma nurse in the Bay Area, and she was able to arrange having the procedure done there so she could care for him.

He told me yesterday he plans to stay in the hospital X days, the rehab facility for Y days, and have my sister drive him home on Z day so he can finish up engineering drawings he is doing for an addition on his church.

This is exactly the sort of behavior that led to the revision surgeries, and I'm frustrated and scared this time he will not survive the outcome. There's nothing I can do to change his plans, and I am having a hard time accepting that. But he won't listen to me, my siblings, or his doctors.

I wish you peace and equanimity, Ted.