I know you have heard or seen a lot about the risk of a fall. It seems like the smallest of worries when you are dealing with concerns over personal and financial safety. However, it looms as one thing that changes EVERYTHING for many of the clients with which I work. It was also the pivotal event that preceded my mom’s death.
For my mom, ending up the Emergency Room after a fall in her Memory Care community resulted in another small stroke (or maybe two). While the doctor suggested surgery, I struggled with the idea that if she emerged from surgery, she would actually be cognitively worse and have to manage through the pain and recovery. She didn’t recognize me at the hospital and she was no longer swallowing her food. While the medical solution was surgery, I was advised to tell them she would prefer to “let nature take its course.” The initial tests confirmed that she was too frail to survive the surgery and she moved into hospice care. Unfortunately, my experience is more common than most realize.
According to The Washington Post, “researchers found that frail older women who broke hips were unlikely to fully recover their prefracture qualify of life, even after as many as 10 years.” Another study from the Journal of General Internal Medicine found that only 31 percent of the cohort they followed after breaking a hip recovered to their prefracture ability. They did find that many of the adults were already frail and had trouble walking, dressing, or bathing before the fall.
There are several things that can be done to minimize the fall risk and include:
- Get exercise. A variety of types of exercise can help from strength training to aerobic activities. Getting someone who has never exercised to exercise can be a fools errand. My mother never exercised but was very active and loved to walk, so we worked to get regular walks. When she needed to move into a Memory Care community, we found one that allowed her to freely (and safely) walk the grounds.
- Take Fall Prevention Measures. Remove trip hazards like area rugs and keep the floor tidy. This is a ‘no brainer’ that can be harder to manage if your loved one is resistant to give up the rugs they have always had in the hallway, or if they don’t value a tidy room.
- Eat Well. From addressing any vitamin deficiencies like osteoporosis or neuropathy to maintaining a healthy weight — all are contributing factors to better well-being and fitness.
- Stop Smoking. Apparently they have found that smoking delayed the heal of a fracture!
I figured being over-prepared is the best defense. The smallest of falls can be the one event that blows up all of your well-made plans. Maybe it’s time to consider how to incorporate ways to combat fall risks into your plans. Recommended.
I remember the internal debate I struggled with as my parent’s cognitive decline progressed. When they first moved into Assisted Living, they were scheduled for visits with the dentist. I knew it had been at least two years since their last exam and with a dentist visiting the facility, it was simple enough to have the staff take them down when it was time for their appointment. However, my parent’s both refused to see the dentist. We tried three different times and each time one or both of them dug in their heels and declared that they no longer needed to get their teeth cleaned. Six months later, my Dad was diagnosed with a tumor on his tongue. Would that dental visit have eased his pain or changed the outcome?
My client just shared this with me today. She’s 92, and the last few months have been difficult. She’s been having hallucinations, phantom pains, and doesn’t quite remember much about her past. While it’s sudden delivery surprises me, I also recognize that I would love for us all to be able to reach this point and gracefully exit.
The weeks after my Dad died were one of the worst transitional periods in navigating as a Caregiver for my Mom with Vascular Dementia. I was shocked and devastated at his quick decline and death, and my Mom, who no longer had any short-term memory, kept asking for me to take her to visit him.
I know how often I second-guessed the choice of where my Mom lived. My siblings and I often discussed how we could better use the money being spent on their care community that never seemed to be the right fit for them once their dementia really changed their thinking and behavior.
For those of us who are caring or who have cared, we know how many choices we are faced with and many are things never discussed.
