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My mom is 94, has lived alone in the house since my dad passed away 4 1/2 years ago. My brother and I went there every evening and called her every afternoon to make sure she was ok and to make dinner. Last Summer she fell two separate times requiring separate hospital stays of a few weeks each time. She broke a bone in her foot one time and the other time hit her head, along with other bruises. She insisted on going home and continuing the same routine. I wanted to place her in a nursing home, where she would be watched 24/7, but my brother was against it. She's gone downhill, forgetting pots on the stove, staying up all night watching TV, unable to deal with bills, only taking sponge baths, etc. A few weeks ago she fell again, on the carpet by her bed. My brother found her and phoned me to help lift her into bed. She's only about 90lbs but I have osteoporosis and arthritis so it was pretty awkward getting her off the floor. I think we should've phoned 911, but she said she wasn't in pain and my brother said he'd stay with her to make sure she was ok. She was shaken up but by the end of  the week she was alot better. About 10 days later she was just starting to use her walker again, when he left the room for a minute to get her something, and he heard a thud. She had fallen from standing by the foot of her bed to the floor. This time someone working in the backyard helped my brother lift her back to bed. Right now (this happened 8 days ago) she's got a badly bruised, swollen upper arm, shoulder, bruised knee. Last night she told me the back of her head also hurts. But maybe that's because she's been lying flat on her back for a week and refuses to get up even to use the commode, we have to use the bedpan. She mostly just goes in her Depends. She said she's afraid to even sit because she may fall again. It's worse everyday, even eating soup flat on her back, her head just on one pillow. I think she should be in hospital. This 2nd fall was 8 days ago and she absolutely refuses to try to get up, she sits up on the bed occasionally, with my brother right beside her. He's been staying there 24/7 since this happened and now I'm worried about him because of the stress and lack of sleep. She won't accept outside help, only wants us to be there. I'm only there every 2nd day now, because of my own health problems. Even though she's 94, she's very stubborn and will not get up. She's got some degree of dementia, takes donnepezil, which I suggested my brother ask the Dr for, about 3 years ago, also she has a pacemaker, takes diuretics, and thyroid meds. I wanted to put her in a nursing home when she came out of hospital last Summer, but my brother felt she'd be happier at home, and she was, until a few weeks ago. I'd really like any advice on what to do now, since we, mainly my brother, do everything for her, and she refuses to get up out of bed. Should we call an ambulance? What should we say is wrong with her, because last time the hospital discharged her last Summer, they said it was because she had recovered and no longer had an a acute condition. Is this refusal to get up and 2 falls in 17 days acute?? I think she should be in hospital.

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Your brother should call her doctor first thing in the morning, give your mother's history, and get advice.

Your bother should also call a nursing and/or home care agency second thing and sign up as a client. A reputable agency will do some sort of needs assessment, and he can take advice on what services would be helpful. The key thing is that this support is not so much for your mother, who is refusing it, but more for *him*. Because as you correctly perceive, he cannot possibly sustain this level of care for somebody as frail as your mother on his own. So he doesn't need her permission - he needs help, and he should buy it in immediately.

If your mother wants to die at home she has the right to make that choice and it is do-able. However, I would be surprised if her doctor did not insist that the injuries sustained after her latest fall are evaluated in hospital: the swelling in particular could well mean that something is broken or dislocated, and for heaven's sake that's *treatable*. If she's determined to come home again then so be it, just agree: the last thing you want is for her to refuse medical assistance for fear that she will be locked up, which is what seems to be happening.

With or without your mother's consent, your brother MUST seek professional advice. If he doesn't, with those obvious and visible injuries, he's going to be in the frame for neglect.
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Call 911. Say your mother fell, you were trying to treat her at home, she can no longer get up from the bed. They will want to know when it happened, what you have done to help her so far, what has seemed to help and what has not helped.
They will take her to an ER and evaluate her condition. If she has a dr I would also call her dr. If she doesn't want to go to the ER, ask her dr for hospice to come evaluate her condition at home. Going to the ER will give brother a little while to recover. At 94 they will most likely put her in the hospital for a few days to check her out. Give them a list of all her problems to go over at time of check in. Dizziness. Falling. Etcetera. Then ask for rehab so she can regain her strength. Then make a decision on home with help or NH.
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I would call 911 and ask them to evaluate. Sometimes falling from a standing position means that a hip has broken and caused a fall, not the other way around.

It's not " you need to be in the hospital". It's a matter of " we need medical professionals to evaluate".
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Is she in pain ?
My mom's horrible fall at home was straight back in the kitchen - she hit so hard the hardware on the drawers were bent - she spent 6 weeks in rehab - came home with caregivers while I worked and began running away from them and fell twice more breaking her ankle and injuring her knee
It was a difficult decision but after another hospitalization I moved her to a memory care facility last year - she's nearly 94 and after several falls there she no longer walks

Depending on mom's finances you may try assisted living - better quality of life than a nursing home but I'd be concerned she may have a fracture based on the bruises you describe - you and brother need to take action

My mom only wants me to help but I can't be her sole caregiver so I do the best I can by her and try to remember that she is god's child and trust I'm making the right decisions for her
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Your mother needs to evaluated. My mom hit her head and had a subdural bleed. My mom complained about her head hurting after her fall. I called 911. She had been on blood thinners which made it worse. She ended up with brain surgery 2 weeks later after having seizures and being in and out of the hospital and rehab. Please get her checked out. Not uncommon in elderly and dangerous too. My mom was 92, lived 2 more years and passed last fall. It was downhill after the fall.
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I didn't even need to read your entire story, before posting my VERY STRONG recommendation: Your mother needs to be in the hospital for a complete examination of all potential injuries. From there, she needs to be moved directly into a rehab facility or nursing facility. Call 911. Request an ambulance. Admit her via the Emergency Room. Be there with her and be her strong health advocate. Describe EVERYTHING.

My friend, I say this with all due compassion and respect to you: This situation is officially above your head. It's more than you can handle, anymore. Have mercy on your mother, and get her professional care. Hopefully, a comprehensive hospital stay will render her healthy enough to be transferred to rehab. I'm sure she has a UTI, due to poor hygiene, which will be treated in the hospital. She may have broken or sprained something. She may have head trauma.

Do this for her health and for yours and your brother's! Don't delay. Call that number now. Also, it is completely within your jurisdiction to have her admitted to the hospital.

Best of luck to you. Be stalwart.
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I'm sorry about your Mom. They deteriorate quickly, before you know what happened. She sounds like she needs to be somewhere they can help her. You and your brother need to put her someplace where she will be safe. My Mom was in Heart Home, nice place. Good luck
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Notenough;

I wish you all well and hope that you come up with a solution to this problem!

Saying to my mother "I can't do this anymore, Mom" was THE hardest thing I've ever had to do. But I had to harden my heart, because I KNEW that moving her out of her house was the best, safest thing for her. She no longer had the capacity to make safe decisions. Yes, she was legally "competent"; but she had the reasoning skills of a 5 year old and it was no longer safe for her to live alone.
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We finally got my mom to ER and had her looked at. She's got a broken shoulder, and was finally admitted after waiting an unbelievably long time. So glad she's there and being cared for by professionals. She's still afraid to try to get up, the physiotherapist was in and tried to get her to stand, but she's very afraid of falling. I don't know how they're going to convince her to try, but I'm sure they know way more than my brother and I. Just wanted to update the situation, I'm so tired tonight. Thanks for the latest post from Raised on Elton, I was feeling bad because I sort of lost it a couple days ago and told her how selfish and unreasonable she was being, (it didn't phase her anyway, just made her tell me to get out of her bedroom) but I feel a little less guilty now, for losing it. But still a bit bad because I wouldn't have said quite the same things if I'd known her shoulder was broken. I really don't think she understands most things, but when she's asked questions in the hospital she can appear pretty normal, most of the time. I don't know how she can do that. I'll write more in a couple of days. Thanks for all the great help
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Which province are you in? - then I might be able to help as I have contacts in NB, SK, ON, QB, AB, BC who know the ropes to help you - some in medical field & some as front line helpers like you & me

So glad your mom is where she needs to be now - she will start to heal after her 'retreat into her shell' which that broken shoulder initiated which a normal response to a trauma like she had -

I know this was hard on you & bro but now you are in the system you will so much more help now - you were right that there was something untoward with your mom - our instinks are the subliminal alerting of a deeper awareness & you listened to yours .... GOOD ON YOU for going with your gut instink that something was wrong & out of kilter with her & got her the help she so badly needed - remember "d' nile" isn't just a river in Egypt

Just remember, they will bombard you with info - you & bro need to really look at this as it can be overwhelming - do either of you have a 'strength' in anything? ... like is either of you in financial or medical profession - divide this up between you going to where strengths are shown or just pick a part each so that you can wade through this

NEVER SIGN ANYTHING IN A HURRY - you have to look at everything well because you don't know where the loopholes are - if you are ONTARIO I have some experience as both mom & dad are in nursing homes here, so I will try to help where I can - if another province maybe my family contacts will know -

Keep letting us know how she is doing - you & bro are doing a good job taking care of her but at sometime you both may need to step up again keep her safe - hugs M
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