DW fell

ghphotog · April 4

She is in MC for almost two months now. She has been unstable for a long time but could walk on her own howbeit very slow. When she lived at home I always had a hold of her wherever she went. The MC doesn't have the staff to hold her by the hand day and night as I did.

The other day the MC called to say she fell and the head nurse examined her for injuries. She was very sore but didn't see any signs of serious injury so we didn't send her to the ER. I might still try to take her although she wouldn't do well in the waiting room at all so I'm reluctant unless it's obvious she had serious injuries. She hurts very much when she moves certain ways. When a staff member and I tried to help her get situated in her bed she screamed in pain. She has always been very sensitive to discomfort so it's hard to tell with her.

My biggest fear is her falling again very soon and next time she might really be hurt. They can do X-rays onsite but our PC wants to schedule a visit first or send her to the ER. She is far more unstable standing now after the fall.

When I called the nurse to see how she was the nurse said she was better, just had breakfast and starting the morning exercises and was in good spirits. Last night when I walked in at dinner time she was slumped over in the chair not eating. I fear this will speed her decline especially if she falls again.

They have a wheel chair for and a walker but much of the time they let her walk unaided. Another serious fall is imminent unless I bring her home but I can't but I might have to consider that.

harshedbuzz · April 4

@ghphotog

I am so sorry. This is such a scary part of the disease.

It's likely that her falls are a symptom of her decline rather than them causing her to decline faster. An exception to that might be if she were to fracture her hip or pelvis with a resulting hospitalization and surgery which could leave her more impaired.

Falls are hard. TBH, dad fell quite a bit. If anything, he seemed to fall a bit less in the MCF because the space was designed for those with dementia and because some of his falls happened when we were taking him to his various doctor's appointments. Realistically, you might not be better at preventing falls than the MC is because you are one person and DW is likely not in the same place functionally as she was when you were last her 24/7 caregiver.

It's difficult to keep a PWD who wants to walk in a wheelchair without restraints where are illegal. When my aunt broken her hip and was supposed to call for help but couldn't remember, family had to bring in 24/7 care which was prohibitively expensive.

To that end, does this facility have a PCP with whom they are affiliated? We switched dad to their PCP who was a geriatrician and would order basic testing if the DON felt it was needed. Mom was reluctant at first, but it did work better for us.

HB

Quilting brings calm · April 4

She could have fallen even if you were with her and holding onto her. Which could have caused you to fall also. So please don’t beat yourself up about the fact that she fell in the MC.
We handled Mom’s two falls in the AL in different ways - once a visit to the ER, and once just watch with a visit to urgent care a few days later to get an X-ray.

terei · April 4

Almost every PWD starts falling at a certain stage, whatever you do to try to prevent it. The only solution is to have them in a wheelchair all the time.

Beachfan · April 4

I am sorry for this new worry, but I remember those days well….”fear of falling”. Quilting makes a good point; the last fall that DH had at home, we were toe to toe. All I could do was try to lower him to the ground gently and I ended up falling on top of him because he had me in such a death grip. (Like you, I always had DH by my side or holding his hand, 24/7 at home.) His MCF was physically set up to minimize or prevent falls; a small, circular cottage with residents always in sight, and short distances to maneuver from point A to point B. Still, there were several instances over DH’s 17 month stay when I would arrive to find a bruised patient, the result of a fall.
It is a worry for sure, but I agree with HB that falls are part of the overall decline among our LO’s with Alz. One of my biggest concerns was ER visits or hospitalization for DH; I knew he could not process what was going on and would not cooperate. Thankfully, we were able to avoid all that. I wish you well; it was so hard for you to place your DW. Please don’t feel guilty that you can’t protect her at all times; it’s not sustainable and both of you would suffer.

Elshack · April 5

I too am echoing Beachfan's comments. My DH was in memory care for 15 months before he passed away in Nov. He was 93. He fell many many times and most times they examined him and knew he didn't have broken bones. A couple of times they took him to the ER which was right across the street. Often he would have bruises on his arms and head from many falls but he didn't suffer horrible painful consequences from those falls. Please don't consider bringing her home. As Beachfan said, MC is better equipped to handle falls . My heart goes out to you. It was a good sign that she was able to eat breakfast and was in good spirits. The decline is part of the disease as you know. Some days my DH would be all smiles and other days as you said slumped over in his chair. Sending you virtual (((hugs ))) and be assured you are doing the best thing for her and you.

Joe C. · April 5

The hospital is a very scary place for my DW. After her last fall and visit to to ER resulting in an overnight stay I informed the MC staff that going forward transport to the ER would be an action of last resort, it was just to traumatizing for her. I would definitely do an in-house X-ray prior to going to the ER.

M1 · April 5

Obviously many of us have this in common. We've not had ER visits needed yet but i think it's inevitable. At least they have staff to help get her up, i would be hard pressed to do it by myself at home, Eve though she's relatively petite. I do hold onto her when we walk.

Pinkscarf · April 5

My DH has been in a MCF since 2020. He started in assisted living and is now in full-fledged lockdown MC. I worry about falls; he can still walk. Yesterday, he could not get out of his recliner and I was trying to help. I thought both of us were going to go down.

He fell in the middle of the night in January and broke a tooth. They sent him to the ER and everything else was OK, but by the time he had been in the ER for several hours, he was catatonic. It was a horrible experience for him.

Good luck. We are also just doing the best we can.

ghphotog · April 6

The sentiments I hear about the ER are my own as well. A last restort. She would not cope well being there. She wouldn't know where she was or why she was there. The long waits in the ER would just be too traumatic for her. . . and me. So unless it's life threating or she broke a hip or something of that nature the ER is my last resort. I'm filling out the paper work so the contract doctors and staff can treat her right there. I thought I had filled those forms out but apparently I haven't.

Jgirl57 · April 6

sorry to hear about DW fall. I guess I thought that the MC contract doctors immediately take over. Thanks for the info. Hope she feels better soon

916Donna · April 12

Hi, My husband died last year after falling out of bed 6 days after going to hospice/assisted living care. He had dementia but we communicated like like he didn't have it. It was around others he had problems finding the words he needed.

He went to the emergency hospital thinking he was having a heart attach but he wasn't. Doctors wanted to keep him over night for observation. When I went to see him next day, they told me he had covid and is in quarantine for 9 days. When he was moved to new room, I was told he had sepsis and a uti. He couldn't walk either. After 22 days they discharged him and 3 guys put him in the car. Well he couldn't walk we took him back and doc said consider hospice.

He had no underlying medical conditions at the time.

I left his red arm band on showing he was at risk for a fall. When he fell out of bed, he cracked his head open and broke his hip. When they returned him to his new place, the owner said i don't know why he didn't have a railing. He died 5 days later never speaking or eating. His death certificate said he had a stroke. No one told us so I asked hospice how come no one told us and she said what difference would it have made???

I will never be ok. I lay on the bed crying every single day and night. I want to be with him .

But what I find odd is most all your answers imply it's ok for falls to happen. It's not. They are not doing their job if falls are happening. It's not acceptable.

My heart breaks for everyone on this board. Much love to all.

ghphotog · April 12

916Donna, I'm sorry to hear about your husband. When she lived at home she was starting to fall out of bed more and more and although she didn't get seriously hurt then, it was still scary to wake up to a loud "thud".
My understanding and I could be wrong is that bed rails are not allowed as they can become tangled up in them and become trapped or hurt even worse. I don't really know that an MC can prevent falls unless they are with her and holding her by the hand every single minute from sunup to sundown as I used to do. I don't blame them for her fall but I'm glad they are there if she does fall. The head nurse will examine her and determine if she needs and ambulance but at least they try to pick her up if they feel she isn't hurt that seriously. At my mom's MC they aren't allowed to pick them up but are instructed to call an ambulance if they can't pick themselves up.
Again, I'm so sorry to hear about your DH. I also miss my DW being with me all of the time.

916Donna · April 13

https://alzconnected.org/discussion/comment/205473#Comment_205473

Thank you for your kind words.

I related to almost everything you said from falling out of bed to a loud thud, and especially "holding her by the hand every single minute from sunup to sundown as I used to do".

When he was diagnosed 6 years ago I knew this was going to be the most important job I will ever do and I was lucky to have good health to care for him with nothing but love and kindness to get him through this.

We laughed right up till the end and I was never more in love with him but the sadness of what he was going through was the hardest for me. I would never cry in front of him but at night looking at him sleeping I was a mess. He was so sweet and loving always ready for whatever we had to do.

The only times he changed was when he was in the hospital. They had to restrain him 3 times in the last few months before he died. The doctor said it was common for dementia patients to get 'combative' as he put it 'in a hospital environment'. Once home he was fine. We would tell him about it but didn't remember all the details. He wanted us to apologize for him.

The last time he was in the hospital and had to be restrained, his room mate told me the next day that my husband had a wild party with a bunch of young girls and they were making so much noise he couldn't sleep. It was hysterical.

One more thing, a bed railing was required in his discharge paper work from the hospital. After he came back from the ER the owner said "I don't know why he didn't have a railing but I'll order one now." I left for a few hours and came back to a bed that looked like a cage that you see lions and tigers in at the circus.

I beat myself up wondering why I didn't realize there was no railing. I was always on top of everything. I just remember thinking this is so nice because I could get closer to him and hold his hand and hug him. Every single day I go over it in my head. We were married for 40 years what I wouldn't give to have more time with him.

I hope your wife is doing well.

Again, thank you.

Donna

DW fell

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