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Two years ago my 78 year old mom fell on her face while walking up the driveway unassisted and has been terrified of falling ever since. She refuses to walk outside of the home unassisted by another person (refuses to use a walker, cane, wheelchair, etc., as they make her look old). Any advice as to how to get her confidence back?

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castone, my Mom for the longest time didn't want to use a cane to help her walk because she thought it made her look old... good grief, she was in her 90's.... in fact, when I bought Dad a rolling walker [seat, hand brakes] last year my Mom didn't want him to use it outside, as she didn't want the neighbors to think he was getting old [also in his 90's]. Bet the neighbors were thinking "it's about time he used something safer". Sometimes vanity outweighs common sense :P

I can understand your Mom's fear... what caused your Mom to take that tumble? Or was it just out of the blue, not shoe related or weather related? Or driveway surface related? If it was shoe or weather, then that is easier to deal with.

I took a tumble last month which took me by surprise, I pretty much fell off my sandals when my heel caught a line in the pavement, so now I am wearing sensible shoes and not afraid to walk outside again.

Now there is a question of vision, as Pam had mentioned above. Those who wear bifocals cannot see the pavement as well, I notice that with my parents who are toeing around looking to see how high or low a curb/step might be. Or my sig other stepping on the cat toys that are in his path.
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Has your mother been evaluated to ensure there are no physical reasons for the fall, such as dizziness, etc.? In addition to the vision issues, hearing and balance are other senses that can contribute to falling. Does she have any hearing problems? What about her balance? Was she walking well before she fell?

Do you think she'd be amenable to some PT? From what I've seen, generally the therapists are so friendly, cordial and accommodating to older people that they end up enjoying the therapy in part for the social aspect. Sometimes I had to remind my father it was time to leave!

If she's not comfortable leaving the house, perhaps her internist, orthopedic or primary care doctor could script for home PT. It's not as extensive because she would have access to so much more equipment and varied exercises at a PT facility, but it might give her some self confidence.

I think sometimes the fear of falling outweighs anything else. Perhaps it's the fear that another fall would result in a fracture, surgery and rehab, and by avoiding walking someone can avoid falling.

It's too bad though that she won't use a walker. She may feel it doesn't give her enough protection, and I think generally that would be true. A rollator might be more appropriate. In fact my father walker much more easily once we got one than he did with his walker.

My father and I also worked out a padding system for his back-up regular walker. We used fairly thick foam that's normally used to insulate pipes, and taped it all around his walker. If he fell, the foam would cushion his fall and he wouldn't fall directly against the rungs of the walker.
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You would think that assistive solutions would always be welcomed by people needing help but it is difficult to understand the reasoning of some people. Had a skinny man (in his 80s) visit once and he was at his wit's end. He was using a transfer board to move his obese wife from wheelchair to bed- very difficult and dangerous as sometimes they would lose their balance and both crash. He was excited when I suggested a great solution- but the wife didn't "like how it looked" so nothing happened. How something "looks" in the bedroom was more important than something that would have kept them both safe (and eased the strain to the man who was burned out). Hard to understand people sometimes.
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I would carefully evaluate your mom's other issues, if any. Is she acting odd in other ways? Does she resist meals, medication, etc. The reason I ask is that back before we knew my cousin had dementia, she refused to use her cane. She was prone to fall as she has weak bones and poor balance. Falls were of MAJOR concern, but for some unknown reason she would not use her cane.

Eventually, she had several falls, due to her not using her cane and she suffered some fractures. She still refused to use a cane or walker. It then became clear she wasn't understanding reality. Her judgment was impaired and she was diagnosed with dementia. After a spine fracture, she ended up in a wheelchair where she remains.

At least for a little while, I would ensure that she has constant supervision to make sure she doesn't walk unassisted or fall. She may not be fully appreciating the risks and consequences, no matter what she says.
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I suspect she is losing some of her vision if a walker or cane or wheelchair does not help her. So you continue to assist her mobility. Also look for other signs of vision loss, such as no longer reading books or cancelling the newspapers. If she is living alone, it might be safer to look at home help or assisted living.
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Sorry to hear this news, there are many household aids available out there from various websites. I recently purchased a CallerAlert doorbell from YouSafe for my nan and she loves it. It gives her that extra peace of mind that she doesn't need to rush. here is a link if it helps
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Get to rehab. Can you get her to use weight machines? You want weight bearing exercise, especially the core. The weight will make her much stronger and more confident. Also get the rehab professional to teach how to fall. You want to go limp and slow the fall. Weight machines gave my Dad 2 years of mobility. He was 90 years old with stage 4 Parkinson's. He fell all the time. We never went to the ER once. It works.
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