Is it true that a fall can start "the beginning of the end?" Is my Mother heading toward that so quickly?

I used to feel so sad when I saw my partner lying on the floor helpless. I fell asleep one night on the couch next to his hospital bed. He had slid out the bottom and tried to go to the bathroom. Well, he only got one step and WOW down he went. The carpet was blood everywhere I felt so very bad for him. I had to call 911 as I could not lift 200 lbs of solid weight. I think he gave up that night. Taking care of someone you love can be so hard. So very hard. I will miss him greatly for the rest of my life. But, I am thankful he passed in peace know my Lord Jesus Christ.

My sister and I are thinking that Mother might be better off in a nursing facility, rather than extended assisted living. She refuses baths, and even though dripping wet, refuses to be changed. They try but they say they can't force her. Every night now she is doing and saying strange things. Sundowners? I just know that the confusion is worse at night.
Any suggestions are greatly appreciated. Praying for all of you who are also going through this horrid situation.

They are putting mother on Zyprexa, which when I google it, it clearly states that it's not approved for use with dementia patients.
Confused about this. I emailed the doctor but no response yet.

((((janamark))))) - good to see the humor in it. Don't be afraid of meds prescribed by a Dr. you trust and even then keep an eye on your mother and give them feedback if needed. Most of us feel rather like babes in the woods walking through this.

paradise - absolutely - our LO with dementia of any kind have brain diseases from which they will not recover and they will decline. These diseases are terminal. Of course that does not mean you do not look out for things like UTIs and other ailments that affect behaviours. Mother has vascular dementia and is loosing mobility. Some are saying - she is not using it so she is loosing it, and I say no. She has walked a lot all her adult life and she would be now if she could. She is loosing it due to the effects of the vascular dementia on her brain.

Everyone is giving great advise that I totally agree with. Any & all professionals should be involved with what seems bizarre behavior. What we all have to realize (been there as a professional caregiver) that ANY kind of dementia is caused by something happening in/to the brain. Outside "trauma" to the body also effects the brain. The very definition of dementia equates part of the brain has stopped working & whatever behavior that has changed comes directly or indirectly from that. I had a client who had fallen & hit his head. Fortunately we had a savvy dr. at ER who ended with treatment for traumatic closed brain injury. When we seriously thought about it, TBI hit the nail on the head (sorry bout the pun). The damage had already happened & he did not return to pre injury behavior, but it gave us answers we had not thought of before. Food for thought folks. Good luck to all.

Thank you vstefans and Golden23. I appreciate this more than you know.
Gotta laugh once in a while too. Tonight she called 911. A friend of mine on the police force went by to see her. She told him she wanted a ride home from college. Hoping she doesn't make that call a habit.

agreed about medication - responsibly used it can be very helpful. My mother's QOL has greatly improved due to an antipsychotic and now, hopefully an antidepressant will help her as well.

janamark, sounds like the typical progress of dementia, and anything that helps to calm her without making her worse in some other way is worth a try. It is all about quality of life from here on out - absolutely anything that comforts her or distracts her from her very real distress and confusion could be a blessing.

Just a note, my Dad has had many falls, and I mean many, over the past 7 years and he just recently had his 94th birthday. So not all falls mean the beginning of the end. Dad just doesn't have his balance any more and like most stubborn elders, would try to walk around without his cane or his walker :0

I feel sad for all on this page, as we are all going through this horrid disease with our loved one. My mother fell and broke her hip on August 24, and had surgery, then rehab in a facility for eight weeks, where her progress plateaued, and therefore Medicare would no longer pay. We got her into a very nice Extended Assisted Living, which is supposed to also become a memory care unit ASAP.
She has in the last two weeks been refusing to let them shower her, sometimes she won't even allow them to change her when she is wet. They tell me they cannot force her, which I understand. Over the last ten days, she gets delusional, mostly at night, and starts calling me and my sister to come get her from college, that she doesn't want to sign up for another semester. All sorts of crazy stuff like that. It is so hard to explain to her that I cannot come and pick her up. My stepdad stays upset, worrying about her. He is living with us and has been ill, so he hasn't been able to visit in a week. Her physician wants to up her Xanax, and has mentioned mood altering medications ???? (which I know nothing about).
At what point can you involve Hospice?

I'm not sure if they tested for a UTI lately. She had one about 3 months ago and fainted. She was treated and cured then. She is partially incontinent. Now that she is in a nursing home, they are able to keep her a lot cleaner than she was keeping herself in AL (she refused to shower or bathe and wouldn't accept help and they couldn't force her) Good idea though. I will ask if they will test her, just in case.
I asked about hospice because I was wondering if she was put on that, whether her Tricare health insurance would pick up some of the cost of the nursing home. Its awfully expensive.

Mom is not going back to AL. She is no longer strong enough to walk on her own, even with a walker. She is at the point she needs 24/7 help and her memory is very bad. Sometimes she has hallucinations about things in the past. They had to reduce her tranquilizer dosage because she became too lethargic, although until she adjusted a little they had no choice because she was trying to get up every five minutes all night and most of the day.
They took x-rays and a CT scan of her head when she fell about 10 days ago. She seems to be improving over the past few days and eating a little. Its hard to know with her. They tell me she is very very stubborn. At 101, the doctor has advised she is not strong enough for any surgery and we have a DNR and DNI. Of course we have authorized she be given antibiotics, etc for illness but no extreme treatments. The woman in the room with her is also 101. She has been there for a year. She lies in bed and makes noises and jabbers all day, making no sense, not seeing any of us. We don't want Mom to end up like that.

Falls,even the young die from them. I myself, at 56 years young, took a bad tumble in the shower, it was a close call.And it was just because I was in a hurry.I have tried to fall proof my house as much as possible but gravity can be a harsh mistress.My mother accomplished her 6th fall in 3 yrs, actually all things considered that isn't too bad,just a few days ago trying to "chase" after her 4lb. yorkie.5 have been at the house but her worst one was actually at the oncologist's office.She freaked out as she had just learned she had breast cancer and the md was explaining treatment options. I had a gown in my hand that I was going to help her change into but she suddenly, and I mean suddenly! grabbed it from my hand and took off. Next thing I knew she grabbed me by the shirt on her way down and took us both to the floor.I just try to do the best I can, but falls are going to happen.Just take a deep breath.

From personal experience, I know that UTIs can cause falls. Has she been checked for one? The last UTI I had, I could not keep my balance and fell three (3!) times in one afternoon. Good luck, however it goes.

Amy, you realize that as long as she is falling, AL may not take her back. At 101 falling could be caused by anything. Have the doctors run scans?

Amy Grace, never knew a hump would effect your balance. Mom has one and awful balance.

Sounds similar to what happened with my mom. She had 2 falls back to back, on second day when I got home from work, she couldn't stand up and was kicking her legs and arms were flailing. Scary. Called 911, went to hospital and they did all the tests. They found a "mild" uti. She couldn't feed herself either. I thought it was the end, but after fluids, antibiotics and making sure we got her out of the bed, I was able to bring her home. She can walk, but wobbly, and she can feed herself, but noticed that she tends to want to use her fingers more than the fork or spoon. This disease is just awful (an understatement).

Her her BARK not back

Well, I do not normally agree with visits after death. BUT, My dog died shortly after my partner.. I HEARD her back yesterday morning and again this morning. It is SO weird. Her ashes are in the dining room. As for my partner, I have not heard from him. I would love it. I miss his greatly. I have not been the same since his death. I feel myself going down and I am fighting it. I knew my doctor was concerned as he has really been paying attention to me lately. I hear many men and women die shortly after the love of their life dies. I refuse to go yet. I just need to get through this time. But, I love hearing my dogs bark. I

It can be. My mother lived for 13 years with cancer. She fell the first week of Oct 2013 and died 11/23/13. It was her first fall. She did not break anything, just bruised her leg, and she could no longer go up stairs. We put in a stair lift. My father insisted on having it removed after she died, and we lost about $10,000 on that. He sure could use it now since he can barely walk!

Amy, I was also wondering if a blow to the head could worsen the symptoms of dementia. My mother's condition seems to have gotten wose since she had a fall in July. She was only in the hospital for 2 days and came home directly upon discharge, but has needed more meds and more attention from me. No way to know for sure, but it certainly seems like there could be a connection.

My best to you and your mom.

That is such a general question that there is on all encompassing answer. It relies on all the possible variables, most of which can't be identified until after the fall itself. Age, physical strength, severity of the fall, physical results of the fall, the victim's mental state, etc. Too many variables for definitive answer other than yes, it COULD be the beginning of the end but then again, it could spark a sense of needing to be more careful and a need to take better care physically. You have a different scenario for most everyone that's had a fall as to the direction of their being after the fall. All you can really do is guard against a fall the best you're able and hope for the best if/when it does happen.

I've seen this happen more times than not, and therefore I believe it to be true. Almost all the deaths of the sick or elderly in our family have been preceded by falls two days to a few weeks before death.

My Mom has severe osteoporosis and has had several falls over the years. The last time (May 2014) , she fell on her back, cracking a lot of her ribs on her upper left back. This resulted in a short hospital stay, then four weeks in a NH because she was on heavy pain meds and needed supervision. She's had home care aides for 2 1/2 years (since a minor fall in Aug 2013) and uses a walker, but we know she's just one fall away for going to a NH for good. Just had a brain scan, and nothing beyond normal aging, so I'm glad there doesn't seem to be a brain bleed or blockage like others mentioned. As others mentioned, a loved one can fall just as easily in an AL or NF facility as at home. At least at home, she has carpeting in her bedroom, so when she's slipped getting in/out of bed, she wasn't hurt. If she'd fallen at a NH, she would have landed on a hard linoleum floor. After viewing the previous posts, I think we've made a good decision to keep her at home, as long as her mild congitive impairment with short term memory loss doesn't progress to dementia.

I think that falls really depend on the type of fall and the person. Sometimes a fall can indeed start the beginning of the end and I'll explain why:

Years ago a friend of mine who owns his own house had an attic that he only visited once in a while. There was this handrail that was not properly installed, and he used this handrail to pull himself up the rest of the way into the attic for about 25 years before it suddenly detached, sending him right back down the ladder, and hitting the floor below. Of course he was hurt in the fall, and yes he was a little up in age. I used to visit visit him at night, and we used to visit for about an hour. However, right after that nasty fall, he was only able to visit for about 30 minutes because he started going to bed earlier. One time I went to visit him and he was surprisingly on a walker. Something inside told me that he was going to die, but I kept fighting it off because I thought it was just in my head. Lo and behold, I went to visit him one night and the door was locked but all the lights were on. The car was in the garage and the garage light was on. I called him and left a message on the answering machine because there was no answer. I waited for quite a while before finally having to go home for the night. I made a few calls inside while waiting because I figured he may have gone out with friends or family. Little did I know, he really did die just as something inside told me was going to happen. It wasn't until I finally saw his obituary in our local paper that everything clicked, it was God telling me that my friend was going to die and it was not in my head after all. I then went on to pray to God about lucid dreams that people have about their loved ones after they died. At first I didn't believe in lucid dreams because I thought it was all a big wives tale. Lo and behold, one night I had such a dream where I was visiting my friend at his house, it's possible I may have very well been in the spirit. My friend was as he always was and he said that he was allowed to come back for two weeks until he had to go back. We had our usual half-hour visit before we closed. In closing of our visit, he did his usual habit habit of going to the kitchen and he was by the fridge. I was starting to leave before I came out of the experience. Upon awaking I had a piece about me that the world just cannot give, this was God's peace. I don't recall what my friend said during this encounter, but whatever he said let me know he's OK. I did confess to him that I took him for granted because I didn't want him dying without Jesus, this was during that encounter after he died. For quite a while after his death I found myself riding my bicycle past his house when I felt the strongest emotion to go past there. I would ride up and turn around right by his house and coast back down the main street. What bothers me most is he's in the ground while all of his stuff is now in the process of being dispensed. It bothered me that he's in the ground with nothing, and I forgot that his spirit which is what really matters is actually in heaven with God forever.

AmyGrace. It is hard to say as sometimes they bounce back after falling.The first thing I would check into is medication and whether there is a UTI.
My Mom first fell and broke her hip 19 years ago...they did surgery and she lived on her own for 17 yrs.,and drove her car for 11 years after that Then she fell 4 years ago, broke her wrist but was able to return to her home after that and used a walker. Then a year and a half ago at age 91 she fell again this time breaking her arm and she could hardly stand or walk after that. It progressed within 3 months that she lost all ability to walk or stand on her own. Even with a transfer she would begin to go down and a lift machine had to be used. She has been bedridden in my home for a little over a year now and on hospice for 6 months, so falling can just drive the situation down or they can recover. Check the meds and for a UTI first.

http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html

This source will provide the stats for falling.

My son in law in Palm Beach lost his business partner to a fall in the kitchen,He was 55.
I always caution anyone walking on stairs to use the banister (quoting some of the stats) as they continue on.

I had the maintenance folks install shower grab bars in my new apartment. Falls lead to other serious outcomes.

The hidden cause could be depression, which is under diagnosed in the senior population. Late-life depression can be a subtle cause along with other life changes. Tests are available to determine status GDS , MMD have your doctor order the tests

My father fell a few months ago due to medicine. The doctor sent him to physical therapy which has helped some. He has not fell again so we have our fingers crossed. I agree with Sendme that her meds should be checked - low bp can also make you weak and sleepy. Dehydration can cause falls also.
My father is too proud to use his walker in public, so we are on pins and needles every time he goes anyplace - figuring that it's just a matter of time...

I can tell you that my aunt fell in the nursing home several times, and she still lived about two more years.

"Is this the way it progresses at the end?" In my personal experience, yes. Just keep her as comfortable as possible and let her know she is loved alot. Showing and saying the love is very important. She is trying to let go. This is hard to do. Let her know it is OK to go. When I told my mom, "Sis and I are set up and can take care of ourselves" Mom finally knew she could let go.

AmyGrace, did you get an answer to you question about the difference between Hospice centers and nursing homes? I looked back, but didn't find it. I'm sure others have much more info on that than I do, but I did have a friend who was at a hospice center. The patient stays there under hospice care and the entire facility is for that purpose. Many have names like Transitions. The nursing home provides skilled nursing care and yet you can have a hospice team come into the nursing home to provide care to the patient and support to the family while in the nursing home. That's my understanding of it.

My cousin is in a Memory Care assisted living and I observe hospice teams there providing support to the patients. They are not employed by the facility.

Maybe others who have had direct experience with an actual Hospice facility will chime in.

We had a family friend show fell a couple of weeks ago and fractured his hip. He hasn't really been communicative since. He won't eat, drink, etc. I'm not sure which route they will go with him. He was having dementia like symptoms right before his fall.

It just seems to me that they should be able to give your mom some medication to help relieve her anxiety and discontent. I can't imagine them not being able to do that.