How do I get over the worry of mom falling again?

The rehab center my mom is in has the beds that lower right to the floor. Between that and a "scoop mattress" (has raised edges along the sides), and the fact that everyone knows to put her in the lowest position at night, we have some peace of mind. If your mom does not have that kind of bed or mattress, see if you can request them.

We aware that your elder may not tell you that she fell. My late mother didn't tell me that she fell twice giving me the childish response "I don't have to tell you everything."

cindyann, my Mom was doing the same thing as your Mom, thinking she was falling when she was lying in bed. She kept crying out "help me, I am falling" and failing her arms and legs. I kept trying to convince her I wouldn't let her fall, but she was in a delirium stage thus didn't understand. The hospital doctor did give my Mom something to calm her down.

I am not a big fan of Ambien... my sig other use to take it, and numerous times he fell while in a daze from the Ambien. Had to call 911 twice for him, because he fell half way down the stairs in the middle of the night. And here he is a healthy person who is in the work force.

When I need a good night sleep, I take an antihistamine [the drowsy type] and it works great for me. That would be something your Mom's doctor would need to order.

Fall history is key. Documenting dates/times. Start with 2017 and keep track. Hip surgery in June. Sorry to hear about that. Keeping her from falling again is a major priority. Getting proper sleep is another key to that. 7 hours is needed. If not getting it, and wakes after 4 hours, still needs 3-4 more hours. I say 4 more hours because after waking can take another 30mins or 1 hour to go back to sleep. Even with taking sleep medications and decent schedule, still may not always sleep great even when on schedule, so hard to manage. I am sure she is exhausted from having recent surgery. That is major surgery and even though these days out-patient after a week and back home, takes months to recover. Any sleep is better than none. Medications related to sleep based on what has worked and what has not and depends on recovery as well as existing health conditions. I hear 10mg here or other dosages. I don't think OTC medications are right choice at all. All dosages depend on other medications currently required, side effects, what worked the best in the past 5+ years versus age. Schedule is where it starts and really difficult for family members to send the message that better schedule be adopted, which is why sleep medications tend to help. Don't know what the time the prescription says to take. Typically it says, take at bedtime or something. Bed time at 85+ should be 9pm or after sunset. Need an hour for it to kick in or less, but once the sun comes up, get ready. By then medication likely worn off even if took at 11pm. And if waking in middle of night. Just have to ensure medication is taken exactly same at same time at night to get the body started, and the rest is just managing stress and life. You're on the right track. The lack of sleep issue is so monumental. It affects the next day's nutrition, ability to mange the next night, and it takes 5 days minimum to set it straight, but even with full care 24/7 with sleep meds, still going to have sleepless nights once in awhile. People especially the elderly just take sleep for granted and it impacts the caregivers' ability to manage it effectively. You can win the lack of sleep issue, enough to an acceptable level, but just keep in mind: we're human and there is no perfect, ideal solution that works consistently. I always say start with sunset/sunrise approach and manage the sleep while it is dark outside, and document the wakeups so can explain to primary. Primary needs to know how many times, how often patient is awake and then recommends change versus keeping things the same. Good luck!

You have a valid concern. No matter their cautiousness, falls will keep happening. 

To CindyAnn - Yes, Ambien 10 mg for my mother has helped her to not roll out of bed, absolutely. Tip: Medicare has a high co-pay for Ambien, so I buy it for cash via a www.goodrx.com pharmacy for 3 months for like $10. I save my mother $1740 a year by doing this RX myself. Also by purchasing it cash using GoodRX (which most of your local pharmacies DO honor this amazing price), it does not further the yearly RX allotment towards the "donut hole" because it is not processed through Medicare plans (Advantage in her case). Mother also does have the bed alarm and the alarm part is by the "central activities area" which is good. So yes, the Ambien works and is protecting her from further damage for the most part because as we all have seemed to learn, falling is part of the elderly's physical and mental and just ageing in general problems.

Thank you, everyone, for your responses. I've printed them so my siblings can read. It's amazing how many of us have been through the same ordeal. The hardest part right now is getting her to sleep! Since she went back to NH Tues evening, she has only slept 4 hrs straight Tues evening and a few 20 min of dozing off since then. Her confusion and delusional thinking is only getting worse. She was getting Trazadone which helped back in May but nothing is working now. She yells Help a lot & and thinks she's standing when she's laying in bed. Today my sister asked for her to be in wheelchair as much as possible. She has been pushing her around most of day & she's calmer but she doesn't realize what's going on & didn't know my sister part of the day. This is not how she was before the fall. What works to help them sleep? Any time in hospital when she went 2-3 days of no sleep, once she slept for 12+ hours, she came back & was more like herself. Last night a nurse suggested Ativan or Ambien. Any experience out there with either? Thank you so much for your input!

My mom fell and broke her pelvis at 88. Did rehab and did fine, even with dementia. She always said, "You gotta die of something!" She fell again at 90. Broke her pelvis again. This one did her in. But she lived a good life, and she was right! "You gotta die of something!" I managed to keep her in her own home up until the end. If I were to change anything, I might have figured out how to put a camera on her so I could monitor her when she was alone!

Thanks Marianne, I will look in to an Iridologist. My Mother and I came up with a plan. I am with her all the time, except when my son and his wife are here for me to go to Church or Dr. appointments. Mother will be 100 years old in October and I am 74. My Mother and I are now in Independent Living together. This Facility that Mother is now in, is heavenly. We are fortunate that the facility worked it out that with my Doctors suggestion that we should do so because I am on oxygen at night time and could not bring my oxygen tank here without their agreement. For 2 years prior to being in this Facility Mother and I were in a rogue Independent Living Facility. Due to their negligence and the facility and brother, cousin wanting me out because of thinking they could do better than Mother's PCP, Mother's wishes and my decisions as POA of Health Care.  (they do not speak to or spend time with her, maybe total of 4 to 5  brief telephone calls a year from brother who lives in Florida and cousin a few short lunch times together per year.)  We have a Dr.'s statement that there was no reason to place Mother in Health Care, then transfer her from there to Persona Care. They forced Mother into Personal Care. They kept me out of there as much as they could. Mother was falling all the time. It left her confused, an invalid, she could not even sit on a chair without falling over and they took no responsibility for their actions, i.e., bringing her back from breakfast and sticking her in front of the TV without taking her to the bathroom and to bed.  The first Sunday, I got there after Church and found her on the floor saying, "thank God you're  here."  I complained about that, put signs in her apartment how to keep her safer and complained. When they cut my hours to 5 days a week, 4 hours a day, my son helped me get Mother out of there to this new facility. ( Two good friends of mine blamed their parents deaths on the rogue facilities negligence. One friend's Mother with Alzheimers was using the facilities Nurses Aids every day at $25.00 per 12 hours a day  to stay with their Mother in Independent Living where she lived with her invalid husband. The NA was called away to tend to another resident, unknown to my friend's family.  The facility was billing two resident's for the same NA's time. His Mother wandered out of the apartment and fell down a whole flight of concrete back hallway steps when they were responsible for her. She was returned to her bed without being sent to emergency. The facility said it was a little fall, no damage. The family later found out she had broken her shoulder. It was the beginning of the end for her with multiple falls afterwards even though they placed her in a memory unit at another facility. She was never the same after the untreated broken shoulder. The rouge facility knew I knew about the incident being told by my friend and also by an employee with that secrete bothering her.)  I am not convinced that the elderly are safe as they can presently be  without a family member being with them constantly no matter how good the facility seems to be. The rogue facility tried to keep their negligence covered up making spies of some residents in IL giving them extra privileges for information of complainers. and they tried to control the victims and their families through threats and intimidation. Other than those outside stressors, having this time with my Mother is a comfort to her that she is blessed by God to have me here and I am blessed to have this time on earth caring for Mother especially where when we are now in a great, loving community. We have a bed posey to wake me up at night when Mother gets out of bed. Newer technology would be nice. There could be big improvements in all facilities in fall prevention. It is not a natural end to life.

I can't do a darn thing. I cannot watch her 24/7. Got her a device to wear around her neck "just in case" many years ago I might add, and she absolutely refuses to wear it. It does't go with her outfits and probably the reminder of being old is the other reason. You can only do so much. I must let go of certain things because if I worry about everything, I will end up certifiable. If she is in a facility, she can still fall. Bedrails, tying down if she is an escapee, only way to avoid it.

Both my parents have had falls. My dad fell more frequently went he was taking Xanax- probably not the best choice for a senior with dementia who is frail. My mother also has had her share of falls. Both are in assisted living now with pendants and nursing 24/7. I feel so much more secure as opposed to when I stayed with them and every thump caused me to roam the house seeing who fell.

My dad was falling and hurting himself a lot. His was due to all the medications he was on. When I became his full time caregiver, I took him to an Iridologist.
He is 93 and has been under the care of an Iridologist for over a year. He has gone from 13 meds to 2. He is more coherent and says he hasn't felt this good in 30 years. Sometimes too many meds or a lack of proper minerals in the body can throw everything off balance. I hope this helps.

My mom has end-stage Alzheimer's and she used to fall weekly..sometimes several times a week. I started her -- with her walker-- walking. Every single day-seven days a week. Some time, same place, daily. I slowly progressed (it took a year) but she can walk a little over a 1/4 a mile a day -- and now she very rarely falls. Safety protocols include lighting at night, keep rooms uncluttered. Most falls happen near the bed. I bought a fall mat and that really helps her a lot. It seems to help her get a footing on the floor. But walking her 7 days a week really improved her and she's not as bad behavior wise either.  Exercise is the key to decrease falls. No substitute.  I keep her awake during the day, so she sleeps all night.  I give her coffee in the morning and early afternoon, or a diet Mountain Dew. She loves Mountain Dew. But only about a half cup a day and no later than 1 pm..you don't want caffeine in her system later. That really helps her from sundowning. At least this routine works for me.  Everybody is different.  You have to establish your own safety protocols and follow them.  Go online prevent falls.   NO PSYCHOTROPHIC DRUGS. NO SEDATIVES. NO HYPNOTICS (sleeping pills)  Those will predispose to falls.  If she goes kind of crazy during the day I'll take her walking again and that fixes that problem. I'm telling you the truth she sleeps all night because I keep her awake during the day.

I think you need to stop and think about what is it you are really fearing. Once you identify that work on letting that control go. Most worry is based on lack of control.

My mother broke her hip, had surgery, While in rehab had UTI which ultimately was her downfall. I lived in rehab for two and a half months, hiring someone to spend the night three times a week so I could go home. It was pretty rough once she got the UTI, but I would not change what I did at all. 

Having said that you need to really look at your situation and come up with a plan that works for the five of you. For one thing, I believe you indicated that at this time she has pain and her movement is compromised - that should slow her down for the time being. In the rehab I lived in the nurses came quickly when they heard a bed or chair alarm go off. For escape artists they lowered the bed as low as it would go, nearly to the floor. This made it harder for residents to get up, allowing the nurses more time to get to the room when an alarm sounded. Additionally, a firm padding was put next to the bed so if they did fall an injury was less likely to occur. Given your mother's situation, these tactics might be enough to make her safe at night. Tell the nurses that you need them to respond to the alarm rather than you, so you can see if she will be safe without you there at night. Otherwise they may assume you (or your sibling) will be handling the alarm situation and not come.  Stay with her two or three nights so you feel comfortable that these tactics are working, then relax and spend nights at home. 

Does one of you have POA? Does your mother have financial resources that would allow you to hire sitters to free you up some? If so, pick a good agency, insist on a caregiver with a significant history of working with dementia patients. A minimum of two years as a HIRED caregiver was my goal. Do not accept a young woman who took care of Grandma or the like. You want someone who has two years as a professional caregiver of dementia patients - not someone who pitched in on occasion over the course of two years.  Require that they assign you one person. Mom may come to recognize them over time and be more comfortable. Additionally, they develop an understanding of her and how to best work with her and communicate in the way that is best for her. Rotating caregivers can not develop that familiarity. Identify a set schedule so the caregiver is committed to your mother on certain days. 

These steps will give you some relief and some breathing room. It will give you some time to calmly devise a plan for your mother's, your siblings and your future. There is a limit to what you can do. You can no more keep Mom safe every moment, than she could keep you safe every moment when you were a child. I am sure she felt very much as you do now, when you were little. The difference is that you were beginning your life, and hers is coming towards it's end. That regrettably cannot be stopped. So share your love, play dominos, make her laugh - watch METV with The Andy Griffith Show, Gunsmoke etc., listen to Big Band music or whatever music was her favorite in her youth. When you are with her, make it count.

Cindyann, your situation is SO similar to what we are going thru (even our first names are the same!), my sister called me early this morning to tell me to read your post. Our Mom was in a very large SNF after a fall at my home where she'd lived for almost 4 years. Nothing broken that time, but too weak (heart, a-fib) to go back home. Rehab tried, but she was still too weak to get herself around without a wheelchair or a walker with an aide holding onto the seat of her pants. So one day in April after an afternoon nap, to make a long story short, she tried to get out of bed, fell and fractured her hip. Back to surgery, rehab again, and this time we moved her to a smaller, highly rated SNF. But, even there, with great care, she has fallen, or nearly fallen, several times. She thinks she can walk, no matter how many loving lectures and warnings she hears from us, PT staff,aides, nurses,etc. (She does NOT have dementia, but gets confused.We have had the Dr.adjust some of her meds. We shall see!) And it's true even in the best nursing home, they can't be watched every minute. My sister and I have been doing alternating daily shifts for over 4 months, and it is taking its toll on us. So we know we have to cut back, and we are planning how to do it, because we don't want Mom, now 92, to outlive us! We are with you, Cindy, and all the others here who are going thru the same things!

First of all, I completely sympathise. I lost count of how long I spent holding my breath and inwardly whimpering with anxiety, but I certainly wouldn't want to go back to it.

So I can understand you and your siblings' decision to do these shifts, and I don't think it's over the top, and there is the valid point that the only way to make absolutely sure your loved one doesn't fall is never to let go of her at all - so that's what you're doing.

But. How long can you keep it up? It just can't be possible to go on contributing the equivalent of a 42 hour working week each to your mother's care. The four of you are going to have to put your heads together, ideally with your mother's doctor or senior rehab nurse in the room, and set yourselves a realistic timetable.

Tightly crossed fingers that your mother will make good progress and solve at least some of the problem that way.

My mom fell or rather slid off her bed many times and my house and AL. last year when she was moved to the SNF floor she would had a few falls in the bathroom because she wouldn't use the call light. Her room got changed because my mom worried about her roommate so much that my mom wouldn't leave for activities. Since the room change she's been behaving herself.

Sadly, by this age and with those "challenges" ... another fall will occur. My mother is almost 96 and in MemoryCare now (after she was no longer able to function in her condo even though I moved and bought a unit next door to her to help her for many years). In addition to severe dementia now, she is also wheelchair bound and blind (due to a stroke - optic nerve, not her actual eyeball health- which was good before the optic nerve was affected). In CA "restraints" are illegal, in a wheelchair ...in a bed. It becomes a "Sophie's Choice" as far as their quality of life. My mother's Memorycare is highly staffed with multiple loving caremanagers, but as you said, they cannot be everywhere all the time. Her falls (or roll outs from sofa or bed) have not broken bones because my mother thankfully took HRT and exercised daily into her elderly years, so she gets "skin tears" and so far minor konks on the head. (Major fall et al sends her to the ER. I am in almost daily contact .. they contact me or I contact them .. with regard to any issues that arise.) The more "in contact" you are with the Residence, the better the communication (at least in the case where you are paying out of your own funds for the residence; I cannot speak yet to the care from State owned facilities.) As the years go by and my mother lives a very long life (I imagine to 100 years old), you can basically only find solace in the fact that everything is being done, but some things just cannot be controlled, and while we want our loved ones to live a wonderful life forever, no one lives forever and it is these challenges - whether physical or mental - that actually are the reasons that most people die. Very few people live to 100 with great health and mobility and then expire in their sleep just due to old age. Those are the lucky ones, but ever so few. So yes, I have felt the "fear or falling" but have learned to accept it. PS - my husband and I looked at a 6 bed Board and Care in a very fancy house and neighborhood (though it was less pricey amazingly). I looked at the single bed in the beautifully furnished room and said to the owner, "So what happens if she rolls out of bed? Who will find her?". And the answer was very Unsatisfactory; unless it is a 24-hr "night service" home (which of course is more expensive), then that is also not a solution even though many people feel the ratio of two caremanagers to 6 people is superior. My experience has been that this does not solve the problem either.

I can't help with the worry but my mom broke her her pelvis in 2 places and her back. The u.t.I. hallucinations and straight. Cath.'s , rehab and all the rest the same story. She even had a side journey to a geriatric psych. Unit hospital. She has been at home 10 days now at her house. She is up walking and has new meds. Basically I am just waiting for the next fall. After reading many posts on here and answers from the good folks above that just posted, this is common. This road trip has been going for 5 1/2 years. They had every kind of alarm on my mom everywhere she went and nothing stopped her. Alzheimer's made her forget she couldn't walk and even when people were with her she would pop up out of the wheelchair and immediately fall. I have learned you simply cannot watch them every second. You will go crazy trying. Also they told me my mom has severe osteoporosis so maybe something broke first and that caused the fall like someone said above. Most interesting to me is that my mom had pacemaker implanted in March 1 month before she fell. This sounds familiar!

I agree with freqflyer too. The women in my family are genetically clumsy. 80). This certainly continuednwhen my mom went to a facility. They handled it by changing her room to one right across from the nurses station. They were able to get to her much more quickly when she got out of bed. Also, if your mom is not in memory care, maybe she needs to be. These units are usually smaller and have a few more aides to keep an eye on the residents.

You can't be there every minute nor should you. We just can't provide protection 24/7. As others said, once they fall, they keep falling. Their muscles are weak, they have no core strength to keep balance. Often a fall is the beginning of the end and it's really something I've come to accept as part of his aging. I do feel ultimately it will be the cause of my father's death, that or if he has a massive stroke. I have come to terms that he will die and I can't prevent it. Besides that, he has told me repeatedly he is ready to go. So my advice is to accept it and not worry so much as it will not change a darn thing.

I agree with Frequent Flyer. Once my Mom started falling, she just kept falling. I accompanied her to a doctor's appt. once just to prevent this. I was walking right behind her watching her carefully and boom she fell backward and landed flat on her back. I was watching her and it still happened.

I admire your solicitousness to your Mom but you do need to take care of yourselves too. Keep us posted.

Cindyann, when it comes to elders once they start falling they will continue to fall. There isn't anything one can do unless you are glued to their hip every minutes of the day. In fact, you can have a room filled with nurses and aides, and an elder will somehow figure out how to fall in a blink of an eye.

My Mom was very stubborn and refused to use a rolling walker, she tried to use my Dad's but didn't like it. Sure enough Mom had several very serious falls at home where my Dad had to call 911. The last fall Mom was in the hospital, then to rehab, then to long-term-care. Yes, she kept falling. The nurses/aides tried many different things to limit the falls, but Mom was an escape artist getting out of her bed [she could no longer stand but her mind thought she could] and climbing out of her Geri-recliner. They ever tried a seat belt with the Geri-recliner, but within seconds they heard C L I C K... the belt was off... [sigh].

I realize you and your siblings are with Mom because she just returned recently from the hospital. That is understandable. If time marches on, then staying with Mom will have health consequences for you and your siblings.

As for falling and breaking a hip... sometimes the hip breaks, thus causing the fall.