Mother (65) had her first fall. Any advice?

Falls are very frequent in the elderly population. Falls are very dangerous for these people. Hip fractures are the most common fractures among the elderly. Surgery to fix hip fractures is risky. There are many post-surgery complications and some patients never recover completely. Some falls can be lethal, particularly those in the bathtub where they can hit their heads. The reason for the falls is the "normal" loss of muscle strength and poor balance that occurs with advancing age. People with a tendency to fall should not live unsupervised.

In nutshell (per my own experience with my mom - definitely not the same with everybody & your experience may be different) speak to the social worker at the hospital regarding insurance. I believe she is eligible for Medicare (possibly Medicaid also).
When they deem her 'healed' enough, they will release her (usually 2 or 3 days providing there are no other health issues). The social worker can look into Skilled Nursing Facilities where she can receive physical therapy. Things vary on how long she will be there - insurance, progress with therapy, etc. PT can also continue once she goes home; again, it all depends on insurance.

If she does return home, I highly recommend getting her a medical alert necklace. Thankfully, my mom had hers on when she fell the last time while I was at work.
(This is a really quick, short description of what you may go through, but I figured I'd give you an idea of what to expect since you've never been through it before.)

Calico, welcome!

Does your mom have Medicare?

Why hasn't she been seeing a doctor?

Does she work?

Is she getting Social Security,?

You need to see the discharge planning office asap. Hospitals start discharge planning the minute you are admitted by law.

You need to let them know that mom has no caregiver at home and that she will need inpatient rehab and support afterwards. Because you have tovwork for a living.

#hip - ER - surgery - acute hospital - rehab. If she lives alone, often inpatient rehab, but could go home with PT visits if deemed safe by PT.

Talk honestly to her heath team. Don't over promise help you can't actually do.
Be realistic. If you can stay one week after discharge, tell them. If you can't at all, tell them. It will help the staff make the safest discharge plan.

Keep you common-sense hat on! Some Mothers will add big pressure to 'get me out of here'. Want promises you'll move in so they can avoid a rehab stay or PT 'strangers' in their home.

You don't need to fly into town on a white horse to save her.

It's her hip after all. The recovery & rehab is hers too.

Be as interested & supportive as suits your relationship.

She's young so hopefully should recover really well.

CalicOw, understand that Medicare Part A (hospitalization) is free to those who paid into the system. Part B costs $170 per month,

You want to ask the sw at the hospital to find out if mom qualifies for MEDICAID (medical insurance for folks who are low income) or if she qualifies for help with her Medicare part B premium.

My mom (who has since passed away) had 3 kids who loved her dearly. We all n worked and had mortgages, kids in college and retirements to fund. When she broke her hip at agev90, it did not enter our minds for ONE SECOND that our mom should be cared for by any of us. Mom went to NH and lived a good life for and lived another 4.5 years there with us as frequent visitors.

Do not let ANYONE tell you that you must do hands on care for your mom.

Is your sister going to travel to your mother's, too? This is the first stop of what may become quite a journey. Beware of taking the burden on yourself.

Your mother's insurance situation needs to be figured out pronto. What kind of relationship do you have with her?

Keep us updated!

Your mom is young and hospital will probably send her to rehab for weeks to regain her strength & mobility. When rehab releases her to go home you may want to hire caregivers for a short time until she is able to care for herself. Make sure she has home PT, OT & a home health nurse for check ins. Talk with the social worker at the hospital for some recommendations when you do discharge planning.

When this was needed for my parents & aunt we put a lock box on her door so caregivers, therapists and home health nurses could come & go.

Mom may be ready for some kind of a life alert necklace in case she falls again or has an emergency. There are also in home cameras to monitor her and you view from your cell phone. My aunt has "Nest" cameras since she is alone after bedtime. Mother has a life alert necklace but she lives in an independent apartment on a senior community. Another idea for your mom.

I pray she recovers well. Is any family in town or closer to her? Would she consider moving closer to you or sister?

Please ask more questions here. We have all been through similar issues and are very willing to help you.

Your mom is very young and you do not give any indication of other medical problems.
After her surgery she will go to rehab.
They should not discharge her if she can not safely care for herself.
If funds are an issue she should discuss with the Social Worker application for Medicaid.
You and or your sister can research on line what services she might qualify for. The Social Worker can or should be able to help with that.

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Unless there are a good many underlying conditions or other reasons, 65 today is very young. I am 80, independent and walk about 2 miles a day.
You say your Mom is not on insurance. Is there a reason that your mother is not on Medicare?
You will be now in a hospital setting. It is time to discuss with Social Services. Call them immediately and let them know Mom will not have a support system.
Your Mom will likely go to rehab. It is important to let Social Services at rehab know that your Mom has no support system in the area. She may require placement for some period due to this.
If your Mom has made no POA designations and no medical advanced directives, now is the time to consider addressing this; Social services can help and guide. If you, nor anyone else in family wishes to do this then it may be necessary in future to allow the state to assume guardianship or conservatorship should Mom become incapacitated mentally in future. That is likely some time away; as I said, your Mother is not old by today's standards at all.
Speak with Social Services as soon as you are able. This being the weekend get nursing staff to get MD order for Social Service consult soon as possible, leaving your phone for contact.
Best of luck.

I am 66 and consider myself young and very active, however I have had a couple of falls too, but nothing was broken, just soft tissue damage. I would advise having a pendant alarm, which is what my mum has, so that she always has access to help. I would never want or expect you to give up your life or home for me and hope that your mum can get her independence back and enjoy a lot more years of good quality life. That's what I'm hoping for too. I may be 66 but in my head I am only 46. X

My mother took a class in Fall Prevention that was very useful if you do the practice. She stopped her practices and has started falling again. Luckily she is in semi Independent Living and has people at hand to help her up. One of the points that I feel is important is if you are physically capable of helping her up after she falls. One of my friends hurt her back trying to pick her mother up and now has chronic back problems.

Prepare to find undiagnosed problems if you haven't already. This may be as simple as lifestyle problems (obesity, drinking/smoking, poor nutrition, dehydration) but if so Mom has made bad decisions: at 65 she shouldn't be this fragile. It takes a bad fall and/or soft bones to need surgery.

In any case, she has demonstrated that she is no longer able to live alone safely. Her judgement is poor. She may go home now but you can count on this happening again with increasing frequency of medical/safety problems.

If you do let her "go home":
1. You need to know why and how she fell, and she won't tell you.
2. You need an in-home safety assessment.
3. Mom needs to be able to afford modifications to her living environment.
4. Mom needs to get regular medical care, take her medications, and be willing to follow directions.
5. You need to arrange regular visitation from a social worker and a visiting nurse.
5. You will need to arrange transportation, since Mom can't drive until medically cleared to do so. While you are at it, arrange for a driving evaluation to see if she is still safe to drive. And get her vision checked. If her depth perception is poor that can contribute to falls as well as be an issue for driving.
6. Make long term plans. Get the needed POAs to implement them. Do this now while Mom can (presumably) participate and make appropriate decisions.

I think most of us would strongly recommend that you look at long-term housing for Mom near you or your sister, to make inevitable needs more manageable.

Time for her to move to be with someone, or nearby. Or assisted living nearby.
You have time bc she will go to hospital to rehab. But after that...
If a person has a fall, they will have another. We were taught that in OT School.
So time for new arrangements, wills, poa, end of life decisions etc. Take care.

65 years is pretty young. Push for acute rehab when she discharges from the hospital. (Rather than subacute rehab in a skilled nursing facility.) You don't mention any other longstanding acute medical problems. And I am assuming she was previously walking and taking care of her own needs. Patients who were previously highly functioning, who are very motivated to return to independence are usually considered for acute rehab. She must be willing and able to do at least 3 hours of rehab per day. She will have PT/OT evaluation while in the hospital and the therapist will make a recommendation for what type of rehab and if she can do the 3 hours. So, tell her to do her best with PT/OT after the operation and always request Acute Rehab so she can return home and be independent. You and sister can ask about acute rehab too when you meet the case manager or discharge planner or social worker who will work on mother's discharge planning. After total hip replacements, most patient's will be full weight bearing as tolerated so they will usually want her up and walking (with adequate pain control) the day of or day after surgery. Ask the ortho surgeon to explain what to expect to her Before so that she understands and hears the post op plan from the surgeon. Don't let the surgeon just communicate with you and sis. Mother should be able to understand what to expect after the surgery unless she has some severe other issues you haven't mentioned. She will get more aggressive rehab in an acute facility vs skilled/ SAR (subacute rehab). The acute rehab facilities have multimodal therapies - PT, OT and most can do some type of cognitive evaluation while there. Then, when discharged from acute rehab (usually 2 weeks max for a total hip without complications), she should request/ case manager at rehab offer, continued home health care PT for another 3-4 weeks. Also, nurse visits for 2-3 weeks to help her get comfortable managing her medications. When she is cleared to drive, she could also go to outpatient rehab. If it were me in your shoes, with mother only 65 yrs, I would push for her to return to independence and able to live at home, maybe with some home health aides coming a 2-3 times per week to assist with meal prep, housekeeping, and socialization. (Long term, this will likely be self pay unless she has some actual skilled medical need - like IV antibiotics, complex wound care, etc). If she really is in bad shape and the possibility to return to independence and living at home will be fraught with problems and not lasting very long then consider longer term facility support as I am sure others will mention. Good luck. On the plus side, she is young, and as far as you mention, she doesn't have a ton of other medical issues and was previously independent. Get her rehab'd back up to baseline, and then see where you are. I would make plans for you or sister or both to be there a few days before d/c from rehab and then be with her at home for at least a week or two when she first discharges. So she doesn't back slide at home, to get the home services set up and to set the new home routines in place. If she doesn't already have grab bars installed in bathroom and shower in her home, do it while she is away. Does she want to return home and be independent? Does she own her home? Does she have other connections to where she lives now? If no to all of those, then I would consider moving her closer to you or sister, just to make it easier on both of you and for her to have you available to stop by but not do full time caregiving.

fight as hard as you can to keep
her mobile. It gets worse than you can imagine if she has to go to a facility

Omg, no medical insurance? The BEST thing you can do for her is get her onto a good plan. When I first began falling, yes, at 65 years old, I had Kaiser HMO, and they sent me to a rehab place where they taught me how to not fall, how to walk with a walker (I ended up paying a bit more for one with brakes and a seat so I can sit down when I feel like falling, and physical therapy. I am still independent at 75 years old but it is getting much harder because now I have osteoarthritis. I USE ONE OF THOSE FALL buttons where you push it to get help. I like the necklace one better than the bracelet, personally. The cheaper ones only work in the home or apartment, and the ones which work outdoors are more expensive. I now also use a mobility scooter. Be careful because sometimes you can have an accident on them, the same as on a bicycle or motorcycle So, lately I bought a bicycle helmet. Now, I feel safer. Another thing you can do is look into your mom's city's Office on Aging for some referrals and help for her. When she gets onto a good health plan, they also have social workers who can advise you. Is she still driving? Most cities have special buses which pick up the person at their door and take them to where they need to go. They have ramps to accommodate physically impaired. I drive my scooter right up into the bus on the ramp. Lastly, do an inspection of her home to identify hazards such as throw rugs which can slip, etc and where special bars can be installed for holding onto. I have those in my bathroom. I also added a shower seat because standing, now for more than a minute is dangerous to me. You still may need to go visit her a minimum of once a month to do things in her home that are hard for her. For shopping, there is Instacart or other delivery services. If she can afford it there are laundry services. I use my own washer and dryer but have had to recently hire someone to come and help me twice a week. She also takes out my trash and garbage. By the way, your Office on Aging might be able to set her up with one meal a day delivery (mine is free). For socializing, look into her neighborhood Senior Citizen recreational places. They are called Senior Centers here in Riverside, CA.

Mom now can get Medicare unless she never worked in the US. Why isn't she on Medicaid?

Check with the Hospital business office and see if there is someway to have Mom's bills paid.

One thing I would get answered is, did she fall and break her hip or did her hip break, causing her to fall?

This will make a difference in her overall outcome and future care needs.

Because, if she has osteoporosis so bad that her hip spontaneously broke, she will likely end up immobilized pretty quickly without medical intervention and that isn't going to happen without medical insurance in place.

To bad she is learning the hard way, everything is fine until it isn't.

Find a Medicare broker, they will help you find the best coverage for her needs and that is what's really important now.

At 65 she qualifies for Medicare & she can also get social security, but would get more if she waits until 67. You need to get her Medicare activated right away. There are good plans available that will cost her very little. I opted for the AARP supplement plan G when I first became eligible because they cannot turn you down or require you to be underwritten if you choose this plan when you first become eligible, it's automatic acceptance. It costs me more every month, but I have no co-pays at all for anything other than the one time $274.00 for the Medicare co-pay at the first of every year. PLEASE get ahold of a good insurance agent who knows about the ins and outs of the Medicare plans and get her signed up before her window of opportunity passes by.
AND...do not automatically assume she is an incompetent invalid like some alarmists seem to think. You can talk with her and make a better determination. I'm 68 years old and far from needing to go to assisted living but would gladly do so if I needed it.

You can have physical therapy come right to her house. When my daughter had a total hip replacement they arranged for her therapy to be at home.

There is absolutely no reason she can not remain independent in her own home. If it turns out she needs additional care in the future and needs assistance. You can look into a program like IRIS which will help you pay for care and whatever else she may need in her home so that she can be independent. They will help to pay for the in home care and SHE would choose who she wants to be the caregiver and how often. She can choose family or friends as well.

She can also apply for early SS right on line if she needs additional income.

Calic0w: Your mother should qualify for Medicare.

Ask the hospital to connect you with a social worker who can coordinate care for her. Have the doctor and social worker recommend assisted living. Insist that you cannot stay with her and go home. You can manage this from where you live. It isn’t easy but it’s what’s best for mom.

Please work with social work or case management to get her to a rehab facility. She will get more exercise in, more time and evaluations buy physical therapists, and more time and evaluations by other healthcare staff. When she is in rehab,, ask if you can teleconference with the ream when they have discussions about her progress. They can let you know if and when she will be ready to go home or need another residential option.

That's right, 65 is not elderly. No reason to think of this as her "first" fall, as if she has more ahead of her. She needs a good home evaluation by PT experts to help her avoid falling and other home accidents. Some simple home modifications can prevent mishaps.
She may need a couple or 3 weeks in a rehab facility but, from more than one sad personal experience, I say AVOID rehab facilities that are located in nursing homes! They often treat everyone as "old", senile and basically uncooperative...tend to convince patients and family that nursing home is next likely stop.

An actual rehabilitation hospital is much more likely to encourage patients as capable adults with a future. Unless she has several on-going medical or mental problems she should soon be up to independent living at home. Someone to provide housekeeping help might be a good idea, for awhile. No need for you to stay except maybe to get her settled safely back in her home.

65 is quite young in this day and age. I would expect Mom to be able to move back to her own life. How soon is another question.
You say Mom has no insurance? Is Mom on Medicare? If not, why not?
I think your Mom will need to go to rehab after her hospitalization and the quickest way to get all that started is to talk to Social Worker TODAY in the hospital, explaining that you and your Sis won't be there, that Mom is on her own.
After this you will likely be contacted as things move along, at to how rehab is going for Mom and what assist she will need when she is home, what medicare and medicaid help there might be for her, and etc.
As I said, by today's standards Mom is not old. I am 80, and just went backwards in the yard yesterday. At some point, active as I am, something WILL bust. I expect to get back on my feet quickly as I can after that, but one never knows.
Mom will, of course, get her checkup now in hospital.
A good time for you and your Sis to discuss which of you, if any, would like POA, and to talk to Mom about planning for the future with getting a DPOA in place while you are now there. Many attorneys will visit in hospital. Many hospitals have volunteer notaries. Another thing to discuss with Social Worker.

Breaking a bone as an adult is one of the most painful things that can happen to anyone. Any PCP will agree that it's in the top ten of traumatic injuries. The PT for this is painful and will require a great deal on your mother's part to recover her ability to walk. She will need to follow the PT's Advice and do the exercises that they will give her. Also there are mobility classes for the elderly to regain gait, and walking function. Your mother should be in these ASAP after the PT and Doctor's clear her to take them. Also while she is healing, after the surgery be aware that if they put titanium implants they can cause a lot of pain. She will need to take the painkillers they give her. Most people that get titanium have to have antibiotics before dental procedures. Sometimes this is 1-2 years after the break. Sometimes it's a lifetime. You will have to work with the Dr's on this. Some dentists will not even exam you till they have a letter about your titanium implants.

Today, 65 is young, she may need to have her bone density checked and treated for that.

I wouldn't be too overly concerned, my mother had her hip replaced at age 88, she is 97 now, doing just fine, hip wise.

If you are concerned get her a life alert type device that she can use.