Husband fell in MC

GiGi1963

Last Sunday my husband either fell forward out of his chair or fell in the hallway picking something up. It was 6:28 am when I got the call he was going to ER. He was there several hours and returned to facility. My son who was with him said he slept most of the time. Since the fall he is totally different man. Not talkative, asleep in a chair, cannot feed himself anymore. He has become a shell of himself in a week. Was it the fall? They are checking for uti but no results. Blood work wasn't great either. Advice please.

Quilting brings calm

My step-father started his final decline after/with a fall. However, I don’t think the fall was the cause -I think it was a symptom of the decline itself. Falling is one of the symptoms of the later stages of dementia because the brain just can’t control balance anymore. In my step-father’s case, I believe that his cancer had spread and his fall was due to weakness etc. we called hospice in about a week after the fall.

GiGi1963

I am afraid that is true but so hard for me to accept. Beyond sad.

M1

My partner has had several falls. None of them have required ER eval yet, but its a matter of time. I agree that the falls are symptomatic of the decline, but the trauma isn't trivial either. Im so sorry. Is it time for hospice? I guess you'll know soon. Please keep us updated...

GiGi1963

Thank you for your insight. I can't accept it is time for hospice. He was the most active and talkative resident until last Sunday. I will do the best for him though my heart is broken. Will post updates.

housefinch

I’m very sorry you’re seeing that change. My family member with dementia was falling because of progression & then urosepsis. At hospital admission he could walk, lift his walker up and over furniture, etc (couldn’t remember to use it and was obviously not meant to swing it around practically over his head etc). He was found to have a medical issue requiring major surgery (something disfiguring that he would not have understood). He declined significantly in the 10 day hospital stay, refused to sit up, and became bedridden. Our family chose not to do surgery and he was discharged to a nursing facility on hospice.

mpang123

After my dad fell and fractured his spine, he went to the hospital and had surgery. He was given a strong pain med and after being on anesthesia, he developed hospital delirium and his mild dementia became mid stage. He is using a wheelchair now and hospice is coming Tuesday for assessment. Hope he qualifies.

mpang123

Correction…my dad broke his back from lifting something heavy. He has severe osteoporosis. Then after 3 months of recovery from his back surgery, he fell and fractured his pelvis. He went back to SNF for rehab. His mental status declined after all that

Belle

My DH's relative that had dementia was doing very well in AL then one day suddenly lost most of their ability to walk. We brought in PT and it didn't help. They passed within 4 months of that day they stopped walking. It was a very, very sudden downturn and the doctors suspected a seizure or stroke could have happened but at that point there was nothing we could or would have done for treatment. I would opt for a hospice evaluation.

harshedbuzz

I'm so sorry.

This can sometimes be a chicken or the egg scenario. Is the progression you're seeing the result of the fall? Or was there some progression or complication that caused the fall?

HB

clarinetist

Very sorry to hear this, GiGi. My mother with vascular dementia has been falling out of her chair and out of bed recently. She had a stroke in November, and I think doesn’t remember that her right side is very weak. She has a full time aide at home, but it’s impossible to watch her every minute.

If you’re not ready for hospice, you might consider palliative care. My mother is in that program, and it offers many helpful services. For example a nurse comes to the house every week to check on her.

GiGi1963

Harshedbuzz I am trying to understand if the fall caused the overnight change. He was his usual self when I saw him before Sunday fall. Talking, eating independent of help, walking. The head and cervical came back good, ekg normal. Blood work not very good with rbc and others in that category. His HS Troponin 1 was 19.7 when tested. They retested later andit was 16.5. He was in ER several hours and slept most of time. Yesterday he was asleep in chair for his haircut and barely awake while I fed him lunch.

GiGi1963

Thanks to all of you for your advice. It is hard to accept this is a downturn after being so alert. I will seek hospice if I don't see an improvement this week.

harshedbuzz

@GiGi1963 said: Harshedbuzz I am trying to understand if the fall caused the overnight change. He was his usual self when I saw him before Sunday fall. Talking, eating independent of help, walking. The head and cervical came back good, ekg normal. Blood work not very good with rbc and others in that category. His HS Troponin 1 was 19.7 when tested. They retested later andit was 16.5. He was in ER several hours and slept most of time. Yesterday he was asleep in chair for his haircut and barely awake while I fed him lunch.

And what I'm saying is this might not be answerable. It might not even be the right question.

Given the 6:28am call to meet the ambulance and the fact that the mechanics of the fall are unknown— stopping or from a chair— I am assuming this was not witnessed by you or anyone else so it's not clear if this was a mechanical fall or one cause by something else.

It could be that he was fine when you last saw him (was that Saturday?) but had some sort of event— perhaps a mild infarction of some kind— that caused him to fall. Perhaps his BP dropped, or he was dizzy or out-of-breath. I've seen this in my own mom; a mildly elevated Troponin I that drops into an acceptable range within hours in the ER. Prior to taking her in, she reported fatigue, breathlessness and some chest pain. The ER doesn't have a clear answer and keeps her for observation. Follow-up with cardiology doesn't show anything significant aside from a subtle progression in her CHF. Her cardiologist does recognize that "something" happened. Initially, she's been very fatigued (she doesn't have a dementia diagnosis and can accurately report on how she experiences this) after these events but does get back to her baseline after a few days. Perhaps that will be the case for your DH.

HB

ghphotog

That's hard to see. My mom fell and broke her neck along with a brain bleed. She was put on hospice and died several weeks after.
My DW is in MC, has osteoporosis and has fallen twice. Once standing, once from bed. She was bruised and sore but no serious damage but it's only a matter of time. She is very unstable on her feet. She walks with micro baby steps. She is very very sensitive to discomfort and pain and a broken bone from falling would be catastrophic for her. I'm waiting for that call as I know it will come.
I'm sorry you are dealing with this. It's very hard to watch.

GiGi1963

HB, yes I do agree he could have had an event which caused him to lose balance as he is frail and 130 lbs. Will see in the coming days if he improves.

My son and daughter visited this morning and said he was tired but talking and asked a question or two. Not where he was but better than discharge from hospital. I have pneumonia so have only visited Tuesday and yesterday. Will go tomorrow since I'm still weak and tired and being cautious about coughing even with mask.

ghphotog

https://alzconnected.org/discussion/comment/211415#Comment_211415

Hope you feel better soon and get over the pneumonia.

jfkoc

Gigi…your concerns are understood and it certainly seems rational to wait a moment and see how things play out.

That said, I would take the time now to interview several hospices. I would pull them into the team as soon as possible. When they are good they are very, very good and will be helpful to you as well as your husband.

ButterflyWings

@Gigi1963 Regarding the fall, did they rule out a UTI? Also, my DH has fainted more than once, collapsing with me breaking his fall each time. It would be a full blown “fall” if unattended. This is caused by a sudden drop in blood pressure caused by a Vaso syncope. He is back to baseline within the hour.

And he previously fell once years ago, after taking Ativan (Lorazepam). So many things could prompt a fall and then the downward spiral can surely start there as these posts illustrate. I am holding my breath these days as he is quite thin and I worry that he might not fare well if falling in the future.

GiGi1963

Thank you all so much for your advice, support and comfort. They seem to be slow checking uti and will follow up on Monday. Hoping for the best but know in my heart he would never want to linger. He has told me often.

ButterflyWings

My heart goes out to you. And I guess I jinxed us- DH fell about an hour ago. I got him up to change him so his briefs would not overflow after sleeping for several hours.

He is wobbly when walking but just won’t stand still so I had him stand by the table to hold on. I needed to get another pad & pull-up since he pee’d on the dry ones (and the floor) while I was trying to pull them up.

I took 6 or 7 steps, grabbed the new supplies and heard a crash. DH on the floor and me feeling like an irresponsible idiot. It appears he was bending down and reaching for something and lost his iffy balance. Thankfully he didn’t hurt himself this time. Heaven help them, and us all.

ImMaggieMae

ButterflyWings, don’t ever think of yourself as irresponsible. It’s amazing how fast they can move when they want to! You are an inspiration to all of us.

GiGi1963

BW I agree you are so helpful always sharing experience and advice. Visited my hubby today. He was awake and standing talking to his lady friend who does not like me. He was negative for UTI. He is very low spoken but did try to ask me a question but lost the words. He stared at times and stared off. He always tells me how great I look and loves me. The staff and director assured me he is in a normal progression. Sometimes he can feed himself but forgets how at times. His incontinence is worse and can happen anywhere. He starts or agitates other men by cussing and threatening them and has been punched. So I think I feel a little better but will be proactive and research hospice in my area. For now he is not there yet.

M1

we’re in the ER right now after another fall and a whopping shiner again, this time on the right eye. Bloody scalp injury, waiting on imaging. Completely at a loss what to do. She can’t remember to use a walker and would have to be sedated not to get up.

ButterflyWings

@M1 Is it a full moon or something? DH fell in the wee hours this morning too though we were really, really lucky this time. Just a little redness on his arm where he scraped it, but it could have been so much worse.

I'm so sorry for what you all are going through with these falls and injuries. At a loss is an understatement, I know - what can you do when every option seems like a long shot or has down sides anyway. Horrid disease. We SO need a cure in our lifetime.

GiGi1963

M1 so sorry to hear your loved one has fallen and in ER. I am sure she is scared and confused. No good answer on how to make them remember their walkers. Would she stay in a wheelchair or is she still too mobile? Take care.

M1

too mobile to stay in a wheelchair without sedation. Real rock and a hard place. It may take one on one.

Quilting brings calm

@M1, @ButterflyWings neither of you are irresponsible. You could be holding onto them and they could still fall. Which is exactly why I won’t go anywhere with mom without her walker. And yes, I’ve caught her taking steps without it( very unsteady and holding onto furniture) Three falls since December 4. All in her AL apartment. I am resigned to the fact that a fall is going to break a hip eventually. Although her oxygen level may get her first since she forgets to wear the cannula.

M1

the end result is fractured cheekbone and large superficial skin tear that they glued back together. In the ER until 3 am. Sigh. Gonna be a very long day.
Gigi I hope your husband is coming around….

ButterflyWings

@M1 and @GiGi1963 Sending you both big hugs. Feeling so sorry for both your LOs and you two.

Everyone here is either where we all are in this free fall, has been there before, or will be. Wanting so much to help them and spare them any harm, but dementia is relentless. I sit here next to DH today just waiting for who knows what loss next. This is so hard.

Sorry for the sober post. Where’s our friend Lady Texan today I wonder? I miss her ability to draw on gratitude even in the worst of situations.

GiGi1963

M1 so sorry to hear your loved one really took a bad fall. My husband has improved and tried to talk but lost words. Staff and Director think he is trending down but still mobile. He wants a wheel chair. I think he equates to a car! Will keep you in my thoughts as you deal with the new burden just when she was enjoying her new room. Big hug.