By clicking Talk to a Specialist
for information about our privacy practices.
My father was not interested and couldn't be persuaded to leave home, so we tried to accommodate, making a lot of changes, working with neighbors who checked up on him and called me if they were concerned. I took him everywhere until some friends became involved, so I had a chance to assess his balance and coping skills, as did his friends and MOW people.
It's hard to make the kind of assessment you face. Perhaps you could establish criteria for remaining at home (living alone is always a challenge and you need to go back to work), but you can create at least a framework and nominal changes as posters have already suggested. And monitor as well his progress, improvement and, hopefully, not deteriorations.
One concern I've had about elders living alone is stimulation; they often need contact, so consider that. Dad looked forward to his MOW delivery people, and they provided insight and feedback to the coordinator who had a lot of experience (and a fireman husband) to assess an elder's skills.
When I came out, we went for walks to the local beaches, and at stores. Dad shopped as long as he could when it was safe.
What kind of resources would your father have? Neighbors? Friends? Church people? All of these can provide feedback, monitoring as well as companionship.
How did the accident occur? Was it at home or elsewhere? That also could make a difference in his future planning.
Pblise offers good suggestions for remediation actions. There are others that can be taken. Since your father's at home, I assume he received home PT including from OT as well as nursing? In my experience, they offer excellent insight into factors contributing to falls, even if some of them aren't practical due to home configurations.
We also asked his ortho doctor to script for additional PT, so that helped as well. Good weather is obviously the best to avoid dealing with snow and ice at a PT facility. Dad got a lot more help there than with the nominal home help, but it still was very valuable.
Flooring: is it carpeted? If so, the older kind of thick, fluffy carpeting, shag I believe it was called? Or is it flat and smooth? Floors w/o carpeting can be slick, and falls can be more dangerous. Throw rugs can also be hazardous.
Grab bars: are they installed, and if not, please consider them, but only if they're installed by carpenters. Although I've read here that others have used glue-on grab bars, I would never consider them. You want bars anchored only in the studs to provide sturdy support, especially in the bathroom.
Furniture: are there clear paths throughout the home? Obstacles can cause tripping.
Modifications: walkers. After Dad's second fall, we discussed options for protection, and decided to pad his walker, since he had once fallen on the legs of his walker. Dad decided on pipe insulation, so we bought some, cut it to size and taped in on his walker legs. When he fell in the future, it cushioned his legs not only from pavement or floor, but from the metal legs of the walker.
We also got a Life Alert pendant which Dad eventually took with him everywhere. If you consider this, research, then contact the providers. Some didn't even meet standards. What I wanted was a provider with 24/7 service, levels of contact, and a good reputation.
You'll see ads in AARP and on tv; check out these organizations like you would anything else. I found in my research that not all of them met my standards, especially the ones that (a) only wanted to send literature or (b) took 2 - 3 days to return my inquiry call.
Emergency contact: In addition to the pendant, Dad installed a lock box in the studs, outside, next to the front door. If I wasn't available to get to Dad's home immediately, and the life alert service needed to call EMS, I gave them the combination to get in the house.
Medical: is your father taking any medicine (such as Toprol XL) that can cause orthostatic hypotension, which affects someone's ability to safely rise from a seated position, and result in a fall?
Body strengthening: Is your father still doing exercises? If not, this is something my father found helpful, and I'd recommend it. These arm and foot pedals can be used while seated at a table (arms) or while sitting (legs). My father bought his from one of the mail order catalogues. Less costly, but functional.
Rehab facilities have the more sturdy and expensive versions, just as good but harder for an older person to lift and move. My father had one like the model second from the left in the first row. You might even be able to get one from a DME store if a physician scripts for it.
Lighting: helps so much to illuminate interior areas and diminish tripping.
Shoes: good tread for gripping.
This doesn't on its own mean he can't live alone, but it does mean he'll be at serious risk of falling. What does he want to do?
Where is he now? In his home? Are you in your home down the street or living with him? How is he on his ADLs? Does he need things a housekeeper could help with? Did he have home health when he came out of rehab? Did he continue his therapy at home? It’s difficult to give you an opinion without knowing more about his condition. Is your job in PA or NJ?
On the surface it would seem he needs to be in an ALF but it really all depends on why he still needs help 90 days after the fall that would prevent you from working. If you need to work and he needs help, then he has to change his residence or hire help. Try not to make it more complicated than that for him or you.