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Up until two weeks ago, Mom was able to get herself up, dressed, to the bathroom, down to the dining room at AL, to events etc. Although she was weak and unsteady she was pretty much independent. Then she stood up and fell. She bumped her head a little so they sent her to the ER. Although she didn't really hurt herself, she spent the night there, and fell again there. I'm wondering if she didn't have an "event" which caused it all. After that she was so weak she couldn't stand on her own and couldn't stay in AL so for the past 2 weeks she has been in a nursing home. We thought she might be able to be rehabbed and return to AL. But she fell again there, and hit her head requiring stitches this time. She has practically stopped eating, tries to get up every five minutes at night and sleeps on and off most of the day, saying leave me alone, and pretty much out of it (they have to give her a tranquilizer to keep her from being agitated so I suspect that is why she is sleepy). Is this the way it progresses at the end? I'm praying she is not suffering and isn't aware of what it happening. I sit there for hours with her, but she barely knows I'm there and five minutes after I leave she doesn't remember.

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AmyGrace, the first time my Mom had fallen and 911 was called, she bounced back pretty quick. Then a week later, Mom fell again, and she spent a few days in the hospital having terrible delirium.... her arms were reaching for the sky and her feet were pedaling a mile a minute and that lasted over an hour, I thought for sure we were going to lose her then. The CT scan showed a current and previous brain bleed. Her mind was very befuddled.

Everything your Mom is experiencing now is what my Mom went through for a month. Then Mom got a UTI which made everything worse. The hospital doctor recommended Hospice so we set that up.

Now into the end of our second month and we are seeing changes that really are surprising us. Mom is now feeding herself and eating solid foods. That's all she can do for herself, but that's impressive on its own.

This evening when I went to visit Mom she asked if I was at work today [my gosh first time in 2 months she had remembered], and smiled saying her hair needs to be cut [which it does], and she asked if it had rained today. Even the nurses/aides were remarking about how Mom has improved.

Then she was having some type of delirium, tugging at her clothes, flinging her arms, then fell to sleep. So we quietly left her, and like with your Mom, she won't remember I was even there :(
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At her age, medication can be over prescribed, too many milligrams. Talk to her doctor. Then try to find a way to strengthen her over time.
It may be towards the end, but she is living with these challenges, a better way to think of it instead of dying from the challenges. Imop, hoping that did not offend anyone.
Best to you and your Mom.
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She could have had minor strokes which are causing balance problems or the original fall itself. She could have had a minor concussion or a closed head injury.

From your description of her behavior, you may want to have a discussion with her doctor about having her evaluated for hospice.

It's hard...
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Falls may come near the end. It is hard to say whether the increased weakness toward the end causes the falls or whether the falls trigger the decline (especially if they include blows to the head.)

But not every fall starts the beginning of the end. My husband fell repeatedly in the BEGINNING of his journey with dementia -- and lived another nine years.

My mother fell and broke her hip (or more likely her hip broke and she fell) in the nh. In the hospital she was delirious and they recommended hospice care. She returned to the nh on hospice care. She improved and after about 3 months she "graduated" from hospice and is doing fairly well, 18 months later. Her dementia is worsening slowly, but physically she is doing well.

I don't think it is possible to generalize about falls and the end of life.

Getting hospice care in the nh was very helpful as I see it. A huge benefit is that all red tape is cut. They thought she needed a special mattress ... she got it the same day. When she could be transferred out of bed they got a special geri chair for her right now. They wanted to try a different pain med? It didn't have to wait for the nh doctor to approve it and insurance to approve it and someone to deliver it. She had it within an hour. This alone was worth signing up for hospice! Then she got extra attention. The nh staff still cared for her, but there was an extra check by the hospice nurse and there were volunteers who painted her nails and sat with her. Mom's nh is a very caring place, but short-staffed like nearly every facility. Extra attention was worthwhile!

My husband was on hospice at home, for 5 weeks before he died. That was a very comforting addition to his care, too.
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Every week we all learn something new. Thank goodness for the Aging Care forum, I learned so much about falls and dementia before the fact, how parents can be so darn stubborn, learned about boundaries that I am trying to use now, that when I saw Mom lying on the floor with Dad trying to pick her up, I kept my wits about it as I dialed 911. Yes, my hands were shaking, at least the EMT's thought it wasn't my first rodeo when in fact it was.

At the nursing home when Mom was talking saying things that didn't happen, or thinking she was in a hotel in another State, I just agreed with her instead of trying to correct her.... so much easier that way.

I believe the Staff noticed how I was dealing with Mom and me not freaking out over the little things, that has made it easier talking with the Staff. Whenever the Staff calls about Mom yet again falling out of bed, I take it in stride, I know there isn't much any of us can do, this is just part of dementia process... maybe up Mom's meds a bit to calm her down.
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Amy, your mother's experiences are similar to those of FreqFlyer. Hopefully she'll come along and answer your questions. FF's mother had an intra or intercranial (not sure which) brain bleed, that seemed to precipitate the kinds of behavior you're seeing in your mother.
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Same thing with my Mom. She took a fall one day when I had accompanied her to her doctor's appt. Sad thing is I had gone with her to prevent this from happening but it happened so quickly I'm still not sure how it happened at all.

But things really seemed to escalate with her after that. I think when they start falling thats usually an indication of something. In my Mom's case CT scans did not show any signs of stroke or brain bleeds. Just normal brain decline for someone in their nineties.
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The person who can best decide what you need in your home is an occupational therapist. Genesis, ask her doctor to order an OT evaluation of your home. Before my son was released from rehab after a motorcycle accident, an OT came and looked around his charming old but not terribly accessible house. The bathroom doorway presented a problem. Remove the door and put up a curtain. Use wife's help and a transfer board to get into tub. Also put a bedside commode where he would sleep. Bedroom was a tight turn from the hallway. Have hospital bed delivered to the sun room. Also put computer, etc. in there. OT had Son wheel himself into the kitchen and open the fridge. Yup, he wouldn't starve when home alone. In other words, the Occupational Therapist was very good at spotting the challenging aspects of the home and very clever in coming up with ways to overcome them. He also ordered a temporary ramp for the front sidewalk. (My son fully recovered, btw, but he needed the house modifications for about 6 months.)

Genesis, might the HOA be OK with a temporary ramp (if that is what is needed)? It would be easy to remove when you move.

Does your wife use a wheelchair? After many falls my husband was thrilled to be able to safely scoot around in his wheelchair. It restored a measure of independence. His doctor warned that he should do some walking, too, so as not to loose the strength to transfer to bed, the toilet, etc. It worked wonderfully for him.

After my mother's hip broke in the nursing home she was wheelchair-bound. But an aide came and wheeled her to all the activities and meals. She could even have her hair done in the wheelchair. Mom was content and lived a couple more years.
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Can someone explain the difference between hospice and nursing home? If she went to hospice it would have to be to a facility. My sister can't take her - she just went through a year of hell with her husband dying of a brain tumor. I can't bring her here as my home is not good for any disability. (In fact we are trying to find a home as it is too much for us, too many stairs and levels, etc)
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AmyGrace, hospice can be preformed anywhere.... at home or at a facility. Hospice is usually independent from the facility and are allowed with open arms to work hand in hand with the facility.

My Mom went to rehab after her 2nd fall where Medicare paid for the first 20 days, but since she wasn't responding to any type of therapy, after the 20 days she was put in as self-pay which my parents could afford.

I am the same as you are, my home isn't elder friendly, in fact there are days the house doesn't like me :P Plus my age and my physical health as I am in my own age decline. Heck, if I fall, is Mom going to pick me up???
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