What does the Physical Therapist say is impeding her ability to walk?
My mom, in rehab after a fall with "no breaks" was found to have a broken hip about a week later. She was "resisting" PT and thank goodness, the PT realized something was amiss and ordered a new xray.
Make absolutely certain there is not an injury that is causing her pain that she can't localize or express.
That she is at 50percent ability but she has a lot of fear and doesn’t feel strong and balanced. She gets so scared to walk by herself without someone hanging on to her from behind. I feel like it’s the beginning of the end.
Not sure about a psychiatrist there I will ask She has been there 2 weeks. She fell a few other times but for some reason this time it really shook her up. She is so scared. Never saw her like this apprehensive.
She doesn't need to be drugged by a psychiatrist just because she's afraid to fall and get hurt again. Any normal person would be afraid of a repeat performance, especially if they got hurt.
Let the physical therapists work with her some more, and if she doesn't make adequate progress, then consider going to a wheelchair. That's what we did with my mother when she had one very bad fall, hit her head, and ended up with 28 stitches. It was then clear that even with a walker, she wasn't stable enough to walk without someone holding on to her. We and her nursing home decided that rather than play Russian Roulette every time she stood up that we'd just put her in a wheelchair to move her from Point A to Point B. She could still stand up from the chair (with assistance) to get to the toilet and go to bed, but she had no more fear of falling, and that was huge for her peace of mind -- and mine, too.
A psych consult does not mean the doctor will “drug” her. What the consult can do is maybe figure out what she is afraid of and how to work past it. Which probably won’t require meds. There is no harm whatsoever for a simple consult.
She fell a few weeks ago, she's been in rehab for two weeks: so is it fair to guess that this latest fall resulted in actual injury of some sort? What injury?
She hit her head didn’t break any bones that goodness and hospital checked her head and didn’t see anything there. she said she feels really weak and is afraid of falling. I think it’s a combo of both some weakness but mostly fear of falling bc she can’t get up. I had to call my neighbors to lift her when she fell.
So what were they doing with her in hospital then? - if she only started rehab two weeks ago but she fell a few weeks ago, I mean. I'm not surprised she feels weak if they kept her lying around in bed, I hope they didn't do that. Had she said anything about losing strength in the lead-up to the fall?
Does she know what caused the fall? Does she remember what happened before, during, after? If not, it would make her even more apprehensive: if you don't know why you fell, you can't be sure of avoiding the same cause next time.
Rebuilding confidence is a typical reablement project, for which the standard prescription would be up to six weeks of support in the person's own home. A number of techniques and approaches would be used, including positive risk taking and SMART goals. I expect her PTs will be using these on top of exercises and practice to get her walking again.
Motivation helps too. Walking because you want to walk isn't a patch on walking to get a coffee with your daughter, or walking to the bookshelf, or walking to the bathroom. Is there anything worth looking at in the grounds or the communal areas in the rehab facility?
Encourage her to use her walker while you follow closely with a wheelchair or wheeled commode - if she makes it to her goal without needing a break, great; but all mobility is good mobility, and lay the praise on with a trowel.
Don't tell her not to be afraid. "I don't blame you. Let's give it a go anyway" is a much better response when she tells you she's nervous.
About positive risk taking: this involves encouraging someone to attempt a task or activity she's anxious about *to prove* to her that she can do it (or part of it, or at least make a start). When we use this approach we have to be very sure that the person will in fact be safe, and pretty sure that she'll succeed; so in context the risk is what the person perceives, rather than what's objectively assessed.
I fell and hit my head in April and I'm still afraid of falling again. I just now am able to take my usual walk without slowing way down to a snail's pace. I have a "mild" concussion. I am 74, have no other issues with mobility. The body remembers. If no other injuries are found, I would think perhaps your mom just needs time, that her confidence will return eventually, but do keep reporting to her doctor and working with the physical therapist.
She needs to be extra cautious, using a walker, cane etc as needed while rebuilding her strength. Help her stick to physical therapy and exercise follow-up. Her new mantra will be to always use handrails and supports where needed like on stairs. Have her pay attention to walking surfaces: choose flat and clean and not slippery, etc. When she is mobile, the more she walks and moves and gets around without falling, the greater her confidence will be. After recovering from a hip fracture, I remember curbs and lumpy yards and puddles were monumental obstacles for several months. If in doubt, use a cane, find something to hold onto, etc. Be the one who holds onto the back of the chair when needed in exercise class. Confidence will grow with accident-free time.
Can you sit in on some of the physical therapy sessions to try to gain more information about how it's going and what the therapist is doing? I had physical therapy for back and hip pain (no falls), the therapist spent a LOT of time watching me walk and making corrections. Like every session. I wonder if she is putting in the effort in physical therapy. It really does take some work to make progress, and progress is what builds the confidence.
Wow I will tell you it is a mental choice and there is nothing you can do. It is 100% in her mind if she wants to put in the work to walk again. I am sure you have been there with new year resolutions like loosing a few pounds that never fully took place. I will say based on my experience that it will be her own will that allows her to walk again. The only thing you can do is support and Encourage her on her fight.
This is exceptionally common in elders, and it is reasonable. That is to say, the fear of further falls is reasonable given our lack of balance and mobility as well as muscle and tendon strength as we age. The physical therapists will be very aware of this syndrome and will be happy to discuss it with you. They will decide if a walker is appropriate, and what type, or if a cane is sufficient and will encourage Mom to take larger steps and build strength. Hopefully she will be fully motivated as that can present another roadblock. Sure do wish you both the best.
Please research Fear of Falling. It’s been a major obstacle with my DH regaining mobility. His obsessive fear has been difficult to come to grips with. Finally attended Counseling together. A breakthrough occurred with frank, objective observations of his hesitation to work to his potential because of nonstop exaggerated “what if”s taking over his mind and increasing his reluctance to try. (He wasn’t happy but it’s been immensely worthwhile) Please address the emotional toll sooner, rather that wait as this will derail PT benefits. Best of luck!
You Can do in Home PT - I did that with my Dad . That is a Option . Also talk to her Physical therapists on a regular basis in person for updates - if she isn't doing the work she will weaken .
Be mindful that in a rehab facility, the PT people will not linger if she shoos them away. They can’t push her to work if she refuses. For that reason, a rehab stay can have the opposite result you want. I saw this happen with my mother and she never walked again because of her fear and the lost time when she was in rehab doing NOTHING. It was during COVID so I couldn’t be there for her sessions. If I had it to do over, I would have taken her home and had home healthcare send PT and OT people to the house.
Hi She is really pushing herself to get stronger as she hates being there. I’m usually there to speak to therapist and keep her walking rest of day. Now will be difficult as I am starting work with gaining Pto days I keep pushing facility to give me a release date I think they just want the income of a bed bejng used but she def wants to come home and I want her too but with an aide and I want to put extra bars in house so she can hold on. She will be better mentally and physically at home. thanks for you Mr reply appreciate it😀
"Hit her head and the hospital checked and didn't see anything there." So possible concussion, because that doesn't show on imaging. Does she know where her feet are? How is her depth perception and peripheral vision? Is she walking around wearing bifocals? Does she need to? There are many factors that contribute to falls. Make sure she is properly evaluated before assuming her fear is unfounded. Not all of this will be addressed in rehab. Ask for a referral in your area to see any specialist not on staff there.
I am recovering from a bad fall that resulted in a broken hip. From my experience it’s going to take some time. I’m still afraid because you don’t want to go through it again. Helping her walk around and doing safe activities will help. Just give her time. Hope she heals quickly.
My mom, in rehab after a fall with "no breaks" was found to have a broken hip about a week later. She was "resisting" PT and thank goodness, the PT realized something was amiss and ordered a new xray.
Make absolutely certain there is not an injury that is causing her pain that she can't localize or express.
Rehab takes time. How long has she been there?
Is there a geriatric psychiatrist consult available?
mention she does and is using a walker
thx!
Once I bought my Dad one of those rolling walkers which has 4 wheels, hand brakes, and a seat, his confidence improved greatly.
Let the physical therapists work with her some more, and if she doesn't make adequate progress, then consider going to a wheelchair. That's what we did with my mother when she had one very bad fall, hit her head, and ended up with 28 stitches. It was then clear that even with a walker, she wasn't stable enough to walk without someone holding on to her. We and her nursing home decided that rather than play Russian Roulette every time she stood up that we'd just put her in a wheelchair to move her from Point A to Point B. She could still stand up from the chair (with assistance) to get to the toilet and go to bed, but she had no more fear of falling, and that was huge for her peace of mind -- and mine, too.
she said she feels really weak and is afraid of falling. I think it’s a combo of both some weakness but mostly fear of falling bc she can’t get up. I had to call my neighbors to lift her when she fell.
Does she know what caused the fall? Does she remember what happened before, during, after? If not, it would make her even more apprehensive: if you don't know why you fell, you can't be sure of avoiding the same cause next time.
Rebuilding confidence is a typical reablement project, for which the standard prescription would be up to six weeks of support in the person's own home. A number of techniques and approaches would be used, including positive risk taking and SMART goals. I expect her PTs will be using these on top of exercises and practice to get her walking again.
Motivation helps too. Walking because you want to walk isn't a patch on walking to get a coffee with your daughter, or walking to the bookshelf, or walking to the bathroom. Is there anything worth looking at in the grounds or the communal areas in the rehab facility?
Encourage her to use her walker while you follow closely with a wheelchair or wheeled commode - if she makes it to her goal without needing a break, great; but all mobility is good mobility, and lay the praise on with a trowel.
Don't tell her not to be afraid. "I don't blame you. Let's give it a go anyway" is a much better response when she tells you she's nervous.
About positive risk taking: this involves encouraging someone to attempt a task or activity she's anxious about *to prove* to her that she can do it (or part of it, or at least make a start). When we use this approach we have to be very sure that the person will in fact be safe, and pretty sure that she'll succeed; so in context the risk is what the person perceives, rather than what's objectively assessed.
Good luck with it, and don't rush her.
I will say based on my experience that it will be her own will that allows her to walk again. The only thing you can do is support and Encourage her on her fight.
She is really pushing herself to get stronger as she hates being there. I’m usually there to speak to therapist and keep her walking rest of day. Now will be difficult as I am starting work with gaining Pto days I keep pushing facility to give me a release date I think they just want the income of a bed bejng used but she def wants to come home and I want her too but with an aide and I want to
put extra bars in house so she can hold on. She will be better mentally and physically at home.
thanks for you Mr reply appreciate it😀