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She isn't supposed to go up the stairs alone, and insists she can do it. She's fallen twice already (fractured C1, C2, dens and femur).

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Is there a bathroom on the first floor, so that she really has no need to go upstairs?

If so, you might consider one of those baby gates, with a padlock on the other side. I wouldn't really like to have anything this arbitrary in a house, but it sounds as though she needs it for her own protection.

It doesn't surprise me though that she feels she can stil climb stairs. Lack of insight into one's limitations seems to be a characteristic of the denial of aging.

If she does need something upstairs, perhaps either of you could either get it for her, or if you feel she can handle it with your assistance, put a gait belt on her and help her up, resting when you get there before she comes down.

But do ensure that there's nothing upstairs she needs so she has no excuse to go up.

I'm wondering also if she's alone during the day or if someone is with her to ensure she doesn't use the stairs.
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I would recommend something sturdier than a baby gate. A waist high wooden gate on secure hinges with a door alarm added should work. see "Gatekeepers" for an example.
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Getting someone with dementia to follow "rules" is not generally possible. This is only going to become more difficult as she starts to wander outside.
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gatekeepersafe looks like a good suggestion, rather than the commercial Gatekeepers site

Gatekeepers{safe} | Baby Gates | Pet Gates | Safety Gates | Stair Gates | Child Gates - Gatekeepers, DeForest, WI
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If she has dementia, she can't follow rules, but even if she doesn't have dementia she's likely to resent being told there are "rules" in her own house.

The idea of a gate is a good one. She won't like it, but if there is nothing she really needs upstairs, she may not try to unlock it. Make the lock strong. If dementia is the issue, you may have to re-evaluate where she should be alone. Some houses are much easier for "aging in place" than others.

Please keep us posted on how you and she are doing.
Carol
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Rules were made to be broken ; "she" chooses not to loose her independence.
This is the way of LIFE....You have been given some really good advice here in the responses. Take what you need & leave the rest. Blessings....
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A baby gate is likely to be dangerous. People have been known to fall over them and hit every step on their way to the bottom. It has to be above waist high, and should have a confusing locking system that is beyond the ability of a demented patient to figure out.

A full sized door is preferable. Costly, but much cheaper than hospital care for broken bones.
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Boy can I relate! My mom with early Alzheimer's, is still living in her own home alone. Fortunately, a one story home, but she has a 91% fracture at L-4-L-5 and since being released from using a walker a year ago, has insisted on having no help in the home. I've done all I can to keep her safe...alarm system with necklace, video camera etc, so I can see from computer if she's OK from where I live 5 hours away...and constant contact from me. BUT, I can still see her climbing on a chair to get in a cupboard, even though she has a small ladder in her kitchen; climbing on countertops to wash her BR mirror, but OH she doesn't need any help with cleaning; still going out doors in 100 degree weather to use the hose to clean off her car and carport and patio because all must be OH SO clean. She is 4' 10" and 99 pounds, with CHF, COPD and pulmonary hypertension, so she has no business exerting herself like that, but she will NOT listen. She will not wear the necklace at night or when in the house alone...she just 'carries' it around with her when she remembers. She sits and has her couple drinks of bourbon every night...and either is 'feeling' her drinks or sun downing at night, because she gets very argumentative and loud on the phone. I have POA and pay all my parents bills and hande medical stuff, but she insists she needs no help. Has always been very independent, yet manipulative of others to do her bidding. I want to keep her in her home as long as her dementia and physical abilities are OK, but feel constantly like we are right on the edge. And other than calling for my own welfare check with APS, I don't know where to go with her. I know at some point I will have to insist on the in home care. I try constantly to discuss with her that accepting help before she falls and breaks another hip, or finishes off the back fracture so that she is paralyzed, should be more preferable to her than waiting for one of those things to happen, because then she will likely be immobile the rest of her life. But her ONLY and CONSTANT idea is that 'family' should be there with her. There IS no family except me. Granddaughters both live out of town too. I have a husband with Parkinson's and at age 70 am still trying to keep a home business going too, plus overseeing Dad's care in his facility and handling all their bills and other needs. I cannot go down there just to live with her to 'do things' for her .....always her way, when I there, no matter how dumb her way is.... when she is basically OK if she would just act safely. So I am coming to see that the day is coming, as it did with Dad, where she will be given choices....either help in the home with you, or sell the house and move into assisted living where you have the support you need. I don't have any other ideas, and if anyone does, just jump in there. I like all the ideas suggested for this Mom who wants to climb stairs. But boy, these elderly folks can be so stubborn about their independence! I just do not remember my parents having these kinds of issues with their own parents though.
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Joannes, My mother is the exact same way, doing everything shes not supposed to. She wouldn't wear her alarm necklace either, but one night she layed on the floor for 12 hours until someone came the next day. Luckily she wasn't hurt, and since then she wears the necklace all the time. When she had a UTI she kept falling, and pressed the alarm one morning. When she fell again in the evening she didn't press the alarm. We asked her why she didn't use it, she said she used it once already that day, and didn't want to bother the man that answers the call again. She smoked for 65years, and after returning from rehab after a UTI, we refused to buy her cigarettes anymore. She is very angry about that, and I don't blame her, but its not that we worry about the damage to her health, its that we worry she'll fall asleep with a lit cigarette. No matter what you do your not going to win, they're just too stubborn. Her mother was just like that, and I keep reminding her of that, but she pretends shes not listening. My sons keep telling me that I should remember all of this so I won't be like that when I get to her age.
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