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My mom fell in her room in her independent living studio room. This is the 2nd time in two weeks. The facility provides medical alert bracelets, but Mom won't use it. Says she can yell and someone can hear her. Well today she was down for quite awhile before anyone heard her. We also cannot get her to use her walker.

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Shasta, it sounds to me just from this little you wrote us that Mom may be forgetting her bracelet. Does she give you any other explanation? In any case her actions aren't very realistic. I am wondering if your own assessment--you know her best--may not be that Mom is moving to a stage where "independent living" is no longer the best match for her condition? She may require ALF now where she is in her own room, perhaps in a cluster of rooms in a cottage setting, but served meals, checked with some frequency day and night, and etc?
I leave it to you. You know her best. But it sounds like your simply "talking" about this isn't working, and this falling could lead soon to an injury which always means so much more of a slide down in terms of possible complication. My best out to you and wishing you good luck. This is a common problem.
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Well, this isn't really your problem. It's that of the ALF.

My mom and MIL will routinely forget their fall pendants and no matter what we do, they simply forget.

They both live alone, essentially, and there is no one to remind them. Even then, they'll take them off to put on lotion or bathe and they don't go back on.

At an ALF, someone could do a cursory check to see that mom is wearing her bracelet. I'm SURE they'd rather hear the fall alarm than her yelling for help. It could be noted on her chart that she needs to be 'reminded' and that's just one more thing that can be done.
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funkygrandma59 Jun 2022
Her mom lives in independent living, not an ALF. But it certainly sounds like an ALF is where her mom needs to be.
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It sounds to me that perhaps your mom is either forgetting that she has the bracelet on or how to use it, as well as how to use her walker.
Like AlvaDeer said below, it sounds like your mom is now past being able to live independently and probably needs more assistance with her care.
Falling can be quite dangerous especially in the elderly, so it may be time for mom to move into an assisted living facility. That won't prevent her falling, as obviously there is a reason she's falling, but hopefully she won't have to wait so long for someone to find her and help her.
Best wishes in getting the next steps figured out with your mom.
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To be really frank - if she is in the stage where she needs a medical alert bracelet and the walker - I agree with Alvadeer - it may be time to really assess whether she is at the "independent living" stage now or if she is living in an independent living apartment but is propped up with a lot of interventions in order to remain there.

Your profile says that she lives in a connected apartment to your niece's home- and that she can cook and clean but forgets a lot. She depends on YOU to remember a lot of things and you are facilitating a lot of things for her.

Additionally you mention that it is starting to impact YOUR health and she doesn't want strangers doing things for her and only wants YOUR help.

From you post it sounds like she has moved from your niece's home to the IL facility - but has anything else changed? Are you still facilitating everything else? From your profile she was already having issues with memory, with cooking and cleaning and you were already doing a lot for her and she was already dependent on you when she was living in the apartment in your niece's home. IL wouldn't really change that need very much.

It definitely sounds like it is time to reassess and consider AL rather than IL. If you are filling in all of those gaps and it was already impacting your health BEFORE she moved to the IL, that move didn't really do anything to improve YOUR situation, it just changed the view. She needs additional help, but it sounds like you are the one providing all of the gap filling. And it sounds like she needs more intervention now. Moving to AL would help there. (and you mention in your profile that she was refusing then to consider memory/cognitive assessment and it may be time to look into this as well).

Best of luck to you.
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Discuss with someone the issue of using a different med alert bracelet, one that notifies a responder when the wearer exhibits a change of posture. I.e., the one we got for my father alarmed the provider even if he just bent over. The device is position oriented, i.e., when posture is changed, it alerts. That would include when Dad fell.

If the facility isn't responsive, can you afford to purchase a med alert bracelet for her? The service we had was initially a home monitoring system, with alerts provided when homes were breached. Eventually it expanded into monitoring for fall alerts, based on change of posture. That could have been irritating, as it alarmed even Dad bent over to put on shoes. Still, better more alarms than less.

If I recall, there were 3 options of alerts: I was the first, EMS the second, but I don't recall the third. You could list someone at the facility as first, you as second, or vice versa. EMS could also be listed, as it would probably call the facility and alert the appropriate level of staff for response.

Does she dress herself in the morning? If not, someone could be assigned to add the pendant or bracelet? Or, could you bribe her to wear one? Little treats such as a bouquet of flowers, or special food?
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Shasta99, my Dad was living at a senior facility in their Independent Living building and he was fall risk. Dad did use his walker and his emergency button that he wore around his neck. Dad kept falling, and in some cases 911 was called.

Eventually the facility said it was time for Dad to move to the next level. Yes, the room was much smaller, Dad called it his college dorm room, but he got more hands on care.
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I understand this concern. I have been referring people to AloeCare because the older adult doesn't need to wear a pendant. The device is voice activated so your Mom can call out and get emergency help or call you directly. Time is of the essence when it comes to being on the ground after a fall.
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I wonder if the bracelet isn't fitted properly, or is uncomfortable??? What about a pendant? Would she wear that?

As to the walker, have you considered decorating it, so that it's not just a plain walker but something lovely (that might even evoke compliments)? Someone I met on a forum several years ago painted walkers in themes related to the wearer's interest. I decided if I ever get to the point of needing a walker permanently, mine will be painted and decorated with flowers.
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PatsyN Jul 2022
Wow. Individualized walkers. What a neat idea.
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Is there a way you can put the bracelet on and it cannot come off. When I had an ID bracelet for my daughter when she was young the clip on it was very hard to take off or like a medical alert bracelets.
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Since your mom is either unwilling or unable to remember to wear her alert bracelet and to use her walker, it is time for her to move to either assisted living or memory care.
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Maybe your mom is afraid that 911 will respond and thinks she doesn't want that big of a fuss. If the bracelet can be set up so that it just calls someone at the facility to help her, she might not hate using it so much. You might try showing her what happens when you push the button. Elderly people forget things, so she may not remember even if she's been shown in the past. As for the walker problem, maybe installing hand rails every place she walks would at least help her not to fall. Nobody wants to feel old. If she would use handrails and safety bars, she could possibly forgo the walker for a while and maintain her sense of dignity. Good luck to you both.
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Talk with her about the limits she is creating for herself. If she falls and no one hears her - say overnight - there's a good chance of going into shock if something happens to be broken or she simply can't get up and has to lay there too long. Not using the walker to help with balance issues creates the bigger risk of fall and puts her on the floor.

Ask her if her plan is to remain in IL and what precautions she can take to remain there. We all reach a point where it becomes common sense to stay off ladders - she has reached that point. Time to do some things that we don't want to do in order to maintain current mode of living as long as possible.

Let her know that a broken leg or hip could land her in a bed for the rest of her days where she has no choice but to give up the IL facility and be totally dependent on others just to pee or eat. Like any habit (good or bad), repetition creates the habit. For the medical alert and for the walker.
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Not sure how old mom is but setting up some physical therapy through
her primary will help with the walker. Also PT can access her studio to determine what safety measure are needed like hand rails, etc. Another idea is installing a monitor for safety check ins.

We have a monitor system for nights that connects to our smartphones. Its very convenient and has audio & visual.
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It's maddening, isn't it? Yet, this is what they do.

My grandmother was exactly the same way. She had a life-alert pendant. She took it off in the shower and at bedtime - the two times she needed it the most. She also walked without her walker, saying "I just need to get over here."
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My mother is in assisted living, and they have the call buttons all over her apartment, as well as the one she wears around her neck. The first time she broke her hip, and did NOT use the button. They found her the next day when she did not show up for breakfast. She then had a hip replacement. Her dementia was not as advanced, so we impressed how important it was to use that button. She agreed, but still did not use it the next time she fell. Fortunately she was not hurt. Now her dementia is more advanced, and soon she will be ready for memory care. These falls (she has a walker, but does not use it when she "putters" around) add to her dementia. My point is, as much as we care, as much as we worry, as much as we try to anticipate, there is only so much we can do. I love my mother very much, but I have to make myself realize that I am not omniscient, and there are some things out of my control. I hope you know that your situation is not unique, and all you can do sometimes is react and not proact. As long as you listen to your loved ones, and tell them you love them, and do the best that you can without harming yourself physically or mentally by doing too much, then you have to trust that whatever happens, happens. I may sound incoherent about this, but I hope you get the gist.
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Let go and let god .. There is no way you can change her .. She may also not remember how to use it . If she has dementia, in her reality she may believe there is nothing wrong with her .
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I was told by my Mom's MC staff that people with memory issues typically either don't know, forget, or can't figure out how to use those things around their neck to call for help. Hence they don't bother getting them for individuals.

At that time, my Mom was quite capable of knowing that she needed to call someone. The problem was that my Mom didn't know that she fell. She was most prone to falling when getting up at night to go to the bathroom. After the fall, she would just stay on the floor until someone came. I suspect she was sleep walking because she is capable of all kinds of behaviors like having a very productive conversation with someone and be totally asleep.

Before she went into MC, we got an Apple watch with fall detection. and when it detected a fall, after a period of time, it will start calling down the list of phone numbers identified as "emergency" in the phonebook. I got the generation that did not require the iphone to be nearby.

She almost never falls when she is awake due to the coincidence that someone is almost always there.

To deal with the nighttime issue, MC installed a bed alarm on my Mom's bed. At home, we had caregivers who watched and ensured that she didn't fall at night.
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1. Falls: was a reason found for these falls?

Poor balance or legs giving way shouldn't effect Mom's ability to press a call button.

But dizziness, feint, blood pressure issues, TIA etc could cloud judgement.

In the shock of a fall, many just forget the call button. It's a more natural response to call out help. But Mom is saying she won't even try to use the button. Hmm.

2. Walker: what reason does Mom give for not using her walker?

Is it HER walker to her? A useful tool & she has accepted she needs?

Or an embarrassment she doesn't see the need for.
Classic lack of insight with dementia "I'm fine". I'm don't need that! I can manage".
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Your mother is not capable of living independently and/or in Independent Living if she has a poor memory and is refusing to wear the alert bracelet or use her walker. She needs Assisted Living with Memory Care attached, so she can segue into MC if/when it's necessary to do so. In AL, you can sign up for a service whereby a caregiver checks on her every 2 hours; that way, if she falls b/c she's refusing to use her walker, the caregiver will find her when doing her 2 hour check in's. The AL will do an assessment on her before entry to see if she's a good candidate for AL or if she's required to go straight into Memory Care instead. In Memory Care, it's routine for the caregivers to check on the residents every 2 hours, and to toilet them on that schedule as well. There is just a higher level of care given in MC than in AL in general. Short term memory loss is the most dangerous type, b/c that's when the elder can get into REAL trouble when they're living independently. Sorry mom, it's no longer safe for you to live as you are so now it's time for you to move.

Good luck.
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Annie65 Jul 2022
Just want to point out that not all MC facilities do the routine checking of residents (most are understaffed) and toileting(found my ma laying in her own piss at her expensive MC). So if you put your mom in one ,you dang sure better spend some time there to see what really goes on! If this a higher level of care than it is very sad. And in our case, took mom out after 2 months and $9000. wasted on pitiful care!!!!
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I can share w/ you my experience of my Mom when she was in Mem Care:
I paid extra for a pendant she would wear at all times. She wasn't using it!
We did a test: I had her press the button - what is a normal button press for you or I was anything but for her.
First off, she had arthritis in several fingers including her R thumb. Thn you add cognitive issues & bam.
She couldn't physically press the darn thing!

I really examined it, and it really was a poor design for ppl like her. Hard to press due to its recess.

Good to test even if your loved one is in AL vs Mem Care....at some point, they'll likely cross that line...
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Shasta99: Your mother is no longer suited for an Independent Living facility due to her avoidance of using the medical alert pendant and/or bracelet and her failure to use a walker, resulting in fall events. She requires a higher level of care in managed facility living.
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Seems like she no longer can use independent living and needs assisted living. She will most likely have less falls and more reminders to use her walker.
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