My mother keeps falling

My 81 year old mother lives with me. I the past month, she has been falling alot. She has severe osteoporosis that I know contributes to her falls, She has a walker she walks behind and most of her falls has been when going to the ladies room, ect. She also waits till the last minute to go to the restroom and has an accident. I dont know what to do. She takes Hydrocodone every four hours for her pain, and she has fallen on her tailbone so often, it adds to the pain. What can i do? I do not want to place her in a nursing home because I feel she will become depressed and pass away quickly there. Any other suggestions?

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Oh dear, this is very hard for you both.
Her poor balance -- and overall probable weakness and impaired flexibility -- are causing her falls -- not the bone loss itself. (The bone loss would contribute to her fracture risk, of course).
The older type of walker with four legs is not suitable for frequent fallers and those with osteoprosis. Picking it up and putting it down is more than these folks can do safely. These older-type walkers also encourage shuffling along instead of picking up one's feet to take bigger and safer steps.
Instead the wheeled type of walker (4 wheels) allows them to stand straighter (very important) and pick up there feet more easliy.
Has she had a good check-up recently as to her balance? This could highlight just what aresa need to be addressed. Physical therapists generally carry out such testing as part of an assessment of strength and flexibility. Ther is much info online about falls and help with same.
Has her incontinence been addressed? -- this is a very common situation that leads to falls.
Another possibility might be low Vitamain D levels -- this should be an annula test of our older floks. A Vitamin D deficiency contributes to muscle weakness as well as being needed by the body for enhancing the absorption of calcium.
Check with the Section on Geriatrics of the American Physical Therapy Association's website for consumer education about falls. www.geriatricspt.org
Lucy Buckley PT

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Lucy had some great suggestions and I just have a few more. Depends or any brand of adult product are great for your Mom's situation; "there if she needs it". I'd suggest getting her a wheelchair just for safe mobility. I believe insurance/Medicare may cover some/all costs. Having your Mom safe saves a lot of "sorry". Best of luck -

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I would concur with all that has been said above. The incontinence issue should definitely be addressed. I'm not sure of Medicare reimbursement but there is much that can be done through physical therapy for pelvic floor weakness, pain and incontinence. Look up a reference for a physical therapist who specializes in womens health for this. Much can be accomplished.
If she is falling often, it can be only a question of time before she has a serious injury that will start the "downward slippery slope" of function.

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Wow... I also live with my 81 year-old mom, who is on the same pain meds as yours, and also has had many, many falls and breaks. I, like you, am at a loss as to how to educate my mom to be safer. She won't listen, walks around and does things without her cane. It's very frustrating when she refuses to cooperate. She recently broke her wrist and now we are headed to physical therapy and perhaps they can educate her on how to be safer. I have also been diagnosed with beginning stages of osteoporosis and am really concerned that my path will take me to where my mom is now. My prayers are with you and let's stay in touch....

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Yes, indeed, it is mighty hard to "get through" to these old gals -- our moms -- who have been so independent all their lives. They hate to appear to be dependent, even though they are progrssively becoming so -- and more of a danger to themselves. My own mom with over 12" of height loss by the time she was 80 -- she lived to 94 -- was proud of my education, but was of the old school that the doctor knew best -- this, 25-30 years ago when family practitioners and orthopedists knew "nada"about osteoporosis management and care. Never mind what physical therapy could -- and did do -- for her. BUT -- think back to your teen years -- did you and mom always see eye to eye? It is far better for a non-relative professional like a PT to work with her and get the message across, than her "bossy daughter".
Lucy Buckley PT

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I too am going through similar issues. My Mom, myself, and my brother live together. Mom about a year and a few months ago was diagnosed with small cell lung cancer. About 8 weeks ago we signed her up for hospice, got her a hospital bed @ home, a potty chair etc. She is on Morphine 4 pills per day which makes her disoriented, weak, mood swings etc. How to the issues:

1) about a week ago she began falling when going to the bathroom (it is at the foot of her bed). After the first two falls we got her a walker. She has fallen once since then. It's when she first stands up that she gets dizzy. Also when she gets to the potty she has to let go of the walker all together to lower her diaper and lift her nightgown. Those are the two areas she has fallen. She will not let us move the potty chair closer to her bed because others would see it, nor will she go for a bedpan etc. She has fallen a total of 3 times to far in the last week. Twice before the walker and once after.
2) She also due to the disorientation and mood swings at times refuses to take her medication; either because she doesn't want to or because she thinks shes already taken it. Mind you she's not losing her mind etc. it's just the medication. With some of it that's no big deal but with her pain med's and blood sugar reading it's essential. I know she has the right to refuse medication but fear she'll end up in a diabetic coma.

My problem is how do I cope with these issues. We want her to stay @ home and be taken care of there and so does she. It's just that the constant struggle to get her to take med's; dealing with her mood swings (one minute she hugs us the next she cusses us out); and the constant fear of her falling and hurting herself. I've been told and agree she be just as likely if not more so to fall in a nursing home and that she's better off @ home. My problem is have get very little sleep at night cause I'm constantly expecting to hear a crash and a scream of pain from something being broken etc. That and the whole situation is draining me mentally and making me physically ill. I've been hollered at at work for nodding off as well. I know it's unmanageable and out of my control but how do I convince myself of that and get peace?

Also I'm resenting my brother I think because I'm the one who gets up @ night. He has to get up @ 5:30am so goes to bed @ 9pm. Since I don't go to work till 1pm I do the night duty. He takes care of her from 6pm - 9pm at night. I do from 8am - 1pm then from 9pm - 11pm and at night if she hollers so my brother can sleep

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Hi just read your response about your mom and my mom having the same problem, and are both 81. My mother is stubborn like yours too. I guess its hard for women to let go of her liberty. She still wants to do what she used to. My mom goes around cursing some when she cant do certain things. Like, dam, dam, dam.. lol. But I just stay behind her and watch her the best I can.

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Is there a way you can get intouch with someone from your moms health insurance and having a doctor write an order for physical therapy/ nursing care to come into your home twice weekly to monitor your mom? I did that for mine. I am also having my mom approved for state help. We cant afford to pay someone out of pocket to come and assist her in the home, but the state can if they approve her. I know its a burden sometimes on your own life, but I look at it that my mother sacrified alot for us, dealt with all our burdens growing up and now its time to repay her love and caring.

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I agree with the last part; I was homeless sleeping in my car hooked on drugs and alcohol till my Mom and brother in May of '98 invited me to her home to turn my life around. So you could say I owe her my life literally. As far as the people coming in once a week she is in Hospice and the visiting nurses to come twice a week and the bath lady twice. As far as state help my Mom makes $1400/month with pension and SSI, my brother makes s good mount working for the state and I have a good paying job. We all live together so...

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If your mom is already on hospice, these people should be helping you handle all this.
Medicare covers hospice and cases such as this are why hospice was created.
To keep folks in a supportive and safe environment and to assist the family caregivers.
Make more noise -- ask more questions of hospice.
A johnnie or short nightie would be easier than a typical "old-lady nightgown that does get in the way of pottying.
Be matter-of-fact --- just do what is needed and don't "ask"Mom about it. (Just like we do not "ask" a 2-year-old if she wants a nap now). Your mom is not functioning all all cylinders mentally -- with her meds and ailments and age to hamper her reason.
Good Luck!
Lucy Buckley PT aka Mother Goose

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Mothergoose,

I have a question. Not only do I take care of my mother, my older sister has stage four colon cancer with mets to the liver and lungs. She is 51. I talked to her dr yesterday and she said my sister could stop the chemo if she would like and go on hospice. My sister pretty much lives alone and prefers it that way, also deals with a mental illness. Would it be better for me to let her go about her usual daily ways, as long as she is able than to tell her what the dr said? Seems that my sister is going to meet her destiny no matter what.

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Suzsezok:
Boy, do you have your hands full!
Try to get some more guidance out of the doctor. He/she is essentially telling you that your sister is not going to be around much longer. Do I gather that the doctor has not shared the prognosis with your sister? If so, this makes it doubly tough for you. You can sit on your hands and just let time do its thing -- or -- share the hospice direction with yur sister. To be fair to your sister -- might she not want to have what time she has left spent in getting her affairs in order? Does she have a family? A health agent? A living will? I am sure she would like to stop the chemo since it is doing her no good -- and probably making her feel lousy, to boot. Do you have anyone to share this with? Social services? Such help and direction is available almost everywhere nowadays.
To take care of yourself (important) you must try to reduce the stress (a risk factor for health problems including osteoporosis).
Good Luck!
Lucy Buckley PT
aka Mother Goose

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My sister is divorced, has a 22 year old son that is pursuing a career in another state. Her ex husb, sons father, lives with her, but he is terminal also with end stage liver disease. Anyway, with my sisters mental illness, bipolar disorder, (she refuses help for that, in denial) she is hoping that she will get better and be able to go on with her life. Her doctor told her that if she is near the end, she will be the first to tell her. Her doctor continues dragging her through chemo treatments, ect. which makes her moods even worse. Nothing has been done as far as arrangements although she mentioned cremation. She doesnt want to think about it . I guess when the time gets here I will let someone else tell her that she is going because when I mention it, she goes off.

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Is the 22 yo son aware of the severity of his mother's illness? And of his dad's illness, as well? He should know what is going on.
I can well understand that your sister does not want to hear anything negative -- especially from a sister -- but didn't you say that the doctor has said she could stop the chemo? Social service needs to be involved here -- for sure! Does she have hospital connections? Community services? Church organizations?
You ALL need help!
Lucy Buckley PT aka Mother Goose

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My sister keeps things away from her son to protect him, even though he is, or should be a grown man now. I think I am just going to sit back and let life takes its course as it will anyway.

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Wow. I certainly sympathize with this. In 2006, my mother-in-law had falling and incontinence problems. I ended up having to live with her for more than 6 months. The problem with the falling and the incontinence, however, turned out to be an electrolyte imbalance. Her sodium level was extremely low. Although we dealt with cracked vertebrae and tailbone, extreme pain, nursing home and hospital visits and thought she would never live by herself again, in December of 2006 she danced at her granddaughter's wedding! (I should explain here that all the Fosomax and Actonel she had been taking and having trouble with did nothing to prevent the fractures.) We finally figured out that she had been progressively having little fainting spells that she didn't even recall. Now Gatorade is a daily part of her life.

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