Is it true that a fall can start "the beginning of the end?" Is my Mother heading toward that so quickly?

My Mom has severe osteoporosis and has had several falls over the years. The last time (May 2014) , she fell on her back, cracking a lot of her ribs on her upper left back. This resulted in a short hospital stay, then four weeks in a NH because she was on heavy pain meds and needed supervision. She's had home care aides for 2 1/2 years (since a minor fall in Aug 2013) and uses a walker, but we know she's just one fall away for going to a NH for good. Just had a brain scan, and nothing beyond normal aging, so I'm glad there doesn't seem to be a brain bleed or blockage like others mentioned. As others mentioned, a loved one can fall just as easily in an AL or NF facility as at home. At least at home, she has carpeting in her bedroom, so when she's slipped getting in/out of bed, she wasn't hurt. If she'd fallen at a NH, she would have landed on a hard linoleum floor. After viewing the previous posts, I think we've made a good decision to keep her at home, as long as her mild congitive impairment with short term memory loss doesn't progress to dementia.

I've seen this happen more times than not, and therefore I believe it to be true. Almost all the deaths of the sick or elderly in our family have been preceded by falls two days to a few weeks before death.

That is such a general question that there is on all encompassing answer. It relies on all the possible variables, most of which can't be identified until after the fall itself. Age, physical strength, severity of the fall, physical results of the fall, the victim's mental state, etc. Too many variables for definitive answer other than yes, it COULD be the beginning of the end but then again, it could spark a sense of needing to be more careful and a need to take better care physically. You have a different scenario for most everyone that's had a fall as to the direction of their being after the fall. All you can really do is guard against a fall the best you're able and hope for the best if/when it does happen.

Amy, I was also wondering if a blow to the head could worsen the symptoms of dementia. My mother's condition seems to have gotten wose since she had a fall in July. She was only in the hospital for 2 days and came home directly upon discharge, but has needed more meds and more attention from me. No way to know for sure, but it certainly seems like there could be a connection.

My best to you and your mom.

It can be. My mother lived for 13 years with cancer. She fell the first week of Oct 2013 and died 11/23/13. It was her first fall. She did not break anything, just bruised her leg, and she could no longer go up stairs. We put in a stair lift. My father insisted on having it removed after she died, and we lost about $10,000 on that. He sure could use it now since he can barely walk!

Well, I do not normally agree with visits after death. BUT, My dog died shortly after my partner.. I HEARD her back yesterday morning and again this morning. It is SO weird. Her ashes are in the dining room. As for my partner, I have not heard from him. I would love it. I miss his greatly. I have not been the same since his death. I feel myself going down and I am fighting it. I knew my doctor was concerned as he has really been paying attention to me lately. I hear many men and women die shortly after the love of their life dies. I refuse to go yet. I just need to get through this time. But, I love hearing my dogs bark. I

Her her BARK not back

Sounds similar to what happened with my mom. She had 2 falls back to back, on second day when I got home from work, she couldn't stand up and was kicking her legs and arms were flailing. Scary. Called 911, went to hospital and they did all the tests. They found a "mild" uti. She couldn't feed herself either. I thought it was the end, but after fluids, antibiotics and making sure we got her out of the bed, I was able to bring her home. She can walk, but wobbly, and she can feed herself, but noticed that she tends to want to use her fingers more than the fork or spoon. This disease is just awful (an understatement).

Amy Grace, never knew a hump would effect your balance. Mom has one and awful balance.

Amy, you realize that as long as she is falling, AL may not take her back. At 101 falling could be caused by anything. Have the doctors run scans?

From personal experience, I know that UTIs can cause falls. Has she been checked for one? The last UTI I had, I could not keep my balance and fell three (3!) times in one afternoon. Good luck, however it goes.

Falls,even the young die from them. I myself, at 56 years young, took a bad tumble in the shower, it was a close call.And it was just because I was in a hurry.I have tried to fall proof my house as much as possible but gravity can be a harsh mistress.My mother accomplished her 6th fall in 3 yrs, actually all things considered that isn't too bad,just a few days ago trying to "chase" after her 4lb. yorkie.5 have been at the house but her worst one was actually at the oncologist's office.She freaked out as she had just learned she had breast cancer and the md was explaining treatment options. I had a gown in my hand that I was going to help her change into but she suddenly, and I mean suddenly! grabbed it from my hand and took off. Next thing I knew she grabbed me by the shirt on her way down and took us both to the floor.I just try to do the best I can, but falls are going to happen.Just take a deep breath.

Mom is not going back to AL. She is no longer strong enough to walk on her own, even with a walker. She is at the point she needs 24/7 help and her memory is very bad. Sometimes she has hallucinations about things in the past. They had to reduce her tranquilizer dosage because she became too lethargic, although until she adjusted a little they had no choice because she was trying to get up every five minutes all night and most of the day.
They took x-rays and a CT scan of her head when she fell about 10 days ago. She seems to be improving over the past few days and eating a little. Its hard to know with her. They tell me she is very very stubborn. At 101, the doctor has advised she is not strong enough for any surgery and we have a DNR and DNI. Of course we have authorized she be given antibiotics, etc for illness but no extreme treatments. The woman in the room with her is also 101. She has been there for a year. She lies in bed and makes noises and jabbers all day, making no sense, not seeing any of us. We don't want Mom to end up like that.

I'm not sure if they tested for a UTI lately. She had one about 3 months ago and fainted. She was treated and cured then. She is partially incontinent. Now that she is in a nursing home, they are able to keep her a lot cleaner than she was keeping herself in AL (she refused to shower or bathe and wouldn't accept help and they couldn't force her) Good idea though. I will ask if they will test her, just in case.
I asked about hospice because I was wondering if she was put on that, whether her Tricare health insurance would pick up some of the cost of the nursing home. Its awfully expensive.

I feel sad for all on this page, as we are all going through this horrid disease with our loved one. My mother fell and broke her hip on August 24, and had surgery, then rehab in a facility for eight weeks, where her progress plateaued, and therefore Medicare would no longer pay. We got her into a very nice Extended Assisted Living, which is supposed to also become a memory care unit ASAP.
She has in the last two weeks been refusing to let them shower her, sometimes she won't even allow them to change her when she is wet. They tell me they cannot force her, which I understand. Over the last ten days, she gets delusional, mostly at night, and starts calling me and my sister to come get her from college, that she doesn't want to sign up for another semester. All sorts of crazy stuff like that. It is so hard to explain to her that I cannot come and pick her up. My stepdad stays upset, worrying about her. He is living with us and has been ill, so he hasn't been able to visit in a week. Her physician wants to up her Xanax, and has mentioned mood altering medications ???? (which I know nothing about).
At what point can you involve Hospice?

Just a note, my Dad has had many falls, and I mean many, over the past 7 years and he just recently had his 94th birthday. So not all falls mean the beginning of the end. Dad just doesn't have his balance any more and like most stubborn elders, would try to walk around without his cane or his walker :0

janamark, sounds like the typical progress of dementia, and anything that helps to calm her without making her worse in some other way is worth a try. It is all about quality of life from here on out - absolutely anything that comforts her or distracts her from her very real distress and confusion could be a blessing.

agreed about medication - responsibly used it can be very helpful. My mother's QOL has greatly improved due to an antipsychotic and now, hopefully an antidepressant will help her as well.

Thank you vstefans and Golden23. I appreciate this more than you know.
Gotta laugh once in a while too. Tonight she called 911. A friend of mine on the police force went by to see her. She told him she wanted a ride home from college. Hoping she doesn't make that call a habit.

Everyone is giving great advise that I totally agree with. Any & all professionals should be involved with what seems bizarre behavior. What we all have to realize (been there as a professional caregiver) that ANY kind of dementia is caused by something happening in/to the brain. Outside "trauma" to the body also effects the brain. The very definition of dementia equates part of the brain has stopped working & whatever behavior that has changed comes directly or indirectly from that. I had a client who had fallen & hit his head. Fortunately we had a savvy dr. at ER who ended with treatment for traumatic closed brain injury. When we seriously thought about it, TBI hit the nail on the head (sorry bout the pun). The damage had already happened & he did not return to pre injury behavior, but it gave us answers we had not thought of before. Food for thought folks. Good luck to all.

((((janamark))))) - good to see the humor in it. Don't be afraid of meds prescribed by a Dr. you trust and even then keep an eye on your mother and give them feedback if needed. Most of us feel rather like babes in the woods walking through this.

paradise - absolutely - our LO with dementia of any kind have brain diseases from which they will not recover and they will decline. These diseases are terminal. Of course that does not mean you do not look out for things like UTIs and other ailments that affect behaviours. Mother has vascular dementia and is loosing mobility. Some are saying - she is not using it so she is loosing it, and I say no. She has walked a lot all her adult life and she would be now if she could. She is loosing it due to the effects of the vascular dementia on her brain.

They are putting mother on Zyprexa, which when I google it, it clearly states that it's not approved for use with dementia patients.
Confused about this. I emailed the doctor but no response yet.

My sister and I are thinking that Mother might be better off in a nursing facility, rather than extended assisted living. She refuses baths, and even though dripping wet, refuses to be changed. They try but they say they can't force her. Every night now she is doing and saying strange things. Sundowners? I just know that the confusion is worse at night.
Any suggestions are greatly appreciated. Praying for all of you who are also going through this horrid situation.

I used to feel so sad when I saw my partner lying on the floor helpless. I fell asleep one night on the couch next to his hospital bed. He had slid out the bottom and tried to go to the bathroom. Well, he only got one step and WOW down he went. The carpet was blood everywhere I felt so very bad for him. I had to call 911 as I could not lift 200 lbs of solid weight. I think he gave up that night. Taking care of someone you love can be so hard. So very hard. I will miss him greatly for the rest of my life. But, I am thankful he passed in peace know my Lord Jesus Christ.

Janamark, what other meds have they trialed? If nothing else works, you try the non approved drugs, imo.

Oregon girl, bittersweet memory, I'm sure.
Falls are terrible. So many friends tell me that a fall took the independence from a loved one. I'm very careful myself.

janamark: My mom wouldn't bathe either, or let AL help her. She would stick her dirty depends in drawers. Unfortunately AL is bound by laws and they can't force a resident to do what they don't want to do. We understood, but it was embarrassing that Mom was so irrationally difficult. I don't know much about drugs but if there is something out that that might help, it would be worth a try. Mom was on an antidepressant which helped her agitation, but didn't help memory or make her more cooperative.
AL is less than half the price of a nursing home, so if drugs will keep her there longer, I'd try but it does sound like your mother needs some oversight. AL will tell you when they think your mother needs more care than they can give. With my mom, she refused to use the walker and fell a couple of times. At that point, they realized she needed someone with her all the time and shouldn't be liable if she fell and really hurt herself all because she refused a walker or help. Mom would still be there if it weren't for the last fall she took which weakened her. Also, she wasn't eating so she was weak from that. In the NH she is watched constantly to keep her from getting up and falling and given nutrient drinks, etc all day (which an AL doesn't do - it is for people who need some assistance, not 24/7 oversight) But, a NH is really expensive!

AmyGrace, I found out after the fact that my Mom and my Dad were saving their used Depends and had them on the clothes drying rack. Apparently they were reusing them, don't know if it was a cost measure or the fact they were children of the Great Depression.

Yikes nursing homes are expensive. I thought the cost of $306 room rate per day was reasonable, but then there are the general costs not provided in that room rate... such as $900 per month to have an air mattress.... $540 for incontinence supplies.... $120 for Geri-recliner rental.... $5 per Boost... etc.

What is sad is that my parents were always very frugal with their money, saved big time. So the money saved is now going into the nursing home. If my parents had shopped until they dropped and never saved, Medicaid would be paying and Mom would be having the same identical care. Too bad Medicaid isn't available for all elders... but I know that would bankrupt the States.

All these stories sound like the experience with my Mom & Dad. Dad has passed. Nobody can leave parents without some guilt. Fortunately, my Dad left enough funds for awhile to hire sitters for my Mom. She had hernia surgery, then 2 leg breaks later in AL now & wants to leave. I say delusional not dementia or alzheimers (maybe at 1st-drug induced). Now she is better after 1 on 1 PT for 2 months thru home health & round clock sitters. But she is still a fall risk & wont admit it. Irrational-now doesnt want to take meds so I'm at a loss. Still in wheelchair for the most part. As long as the PT guy is there, walking with him with walker is great but she is still not strong enough to even manage with sitters. They dont get paid enough to be that responsible to be sure Mom doesnt fall for fear they will be liable. It takes 6 people & me to manage her. She wears a pendant if emergency-buzz it someone from AL facility comes 1st to check her before calling 911. There is a nurse i signed up for & be aware that laws have recently changed & another comp pkgs meds & another company that comes in that administers meds twice a day. This is Louisiana requiremt so I've been told by AL facility. So monthly apart rent, pharmacy co pay & difference that medicare & private ins. doesn't cover, & fee to have nurse come into administer the meds. So even tho it is less than NH-Assited Living fees do add up. But when she got sick, I called Nurse Practioner (which is billed to medicare), they come out & can get meds &/or shot quickly & she got immediate relief. But she still trys the guilt trip with me, the sitters as well as my brother & sister. Her line is you just dont understand what I have to go thru...she is 88 yrs. I am POA & executor of my Dads estate & that ain't fun either. He passed end of April this yr & he would maybe still be here if I could have taken care of both of them but I was so overwhelmed, he had 95% needs so I located him to Memory care in good NH & he did well until at his earlier request to be moved to a war Veterans home Memory care--MISTAKE-that was a BIG MISTAKE! With so many obstacles, his chances would have been better in a smaller NH Memory care where I had him at 1st. Me..made the best decisions I thought at the time but you as a child, grown adult have to keep on top at all times. My lady sitters keep a notebook for them & as well for me so if I need to get something done for my Mom I have documentation. Nursing homes, VA facility didn't in my observance even come close to having enough people on all levels to care for each & every resident. Most shifts are there to get a pay check to cover their bills just like most people. So my moto became "Trust No One". Drop in as often as possible at any & all times of day & night. you still wont be able to manage or catch everything but that is what I've found. Workers at facilities don't know how much we pay or Medicare/Medicad pay, they only know what their job is & how to get home. I actually had one young girl tell me she went to college..& when I worked there was the phrase & anyother...didn't matter if I went to college or had a degree or certification to do the particular job given...JS..ya'll have a Happy New Year!

Talk with the doctor about hospice. Requirements may vary state to state, but I was told by our doc that a doc must certify in writing that the patient has 6 months or less to live in order to qualify for hospice. Also make sure you check all Medicare & health insurance requirements as far in advance as possible.