Husband fell in MC

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.

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...

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.

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

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

@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

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, 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.

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.

@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 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.