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My 91yo mother with dementia recently broke her ankle. She's always been anxious and afraid of things that could not possibly happen, but now with the dementia there is no reasoning with her. She doesn't want me to transfer her (for instance, from bed to chair) because she's afraid I'll drop her. I have no trouble doing it, but lately she has started clinging to whatever she's sitting on for dear life. The first time she did it, we both almost fell before I realized what she was doing, and I ended up wrenching my back. She whimpers and cries out in fear, and tries to stall endlessly. I've tried to be patient, but I'm nearing my wits' end.

Mom has also starts whimpering when I go to change her diaper. She says she is afraid I'm going to roll her off the bed, but there's almost no way that could happen. Nevertheless, she spreads out like a starfish and hangs onto the sides of the bed. I've tried to change her without rolling her, but she cries out constantly and it tears me up. She goes on and on asking why am I doing this to her and threatens that she's going to go into assisted living (if only she could:-).

I guess what I want to know is, should I try to calm her fears (I've tried to do this for more than an hour at a time but it doesn't seem to make her more at ease with the process) or should I just go ahead and do what needs to be done as gently and quickly as possible and ignore her protests? I know from experience that she will not stop protesting no matter what, so should I just try to save my sanity and get it over with?

It really bothers me that mom acts like I'm doing these things purely for my own sadistic enjoyment, and I'm really starting to build up some resentment about the things she says to me. I think it would be easier if she had just gotten this way since the dementia, but she's always been very childish, manipulative, and unempathetic, and afraid of stuff you'd expect a child to be afraid of. I sometimes wonder if her development got stuck at a very young age. She once told me, in all seriousness, that although she looked older, she is actually six years old.

Anyway, I could go on and on. Just having a really rough day. Any advice about ways to calm her fears would be appreciated.

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Hmmm. Well, she's afraid, isn't she? That's one of mom's fears as well...that she'll fall. For good reason it would seem, because she DID fall and break her hip. I was 10-feet away in the other room. She forgot she couldn't walk unassisted, and got up to go to the bathroom. A common fall, by the way. She's now belted in her wheelchair.

Before you start, try this: First explain to her, step-by-step EXACTLY what you're going to do. And then, "Mom, your mind is playing tricks on you. You think you're going to fall, and that's not going to happen. I've gotcha. You don't have to worry."

And now for a dose of humor: "But, mom?? If I do drop you?? (Which I won't!!!) You can slap me upside the head and peck me bald-headed. How about that?"

Humor works with my mom. It's fear, plain and simple.

I often use it to get her to walk to the bathroom (assisted by a walker and gait belt). She's afraid she'll fall, so she doesn't walk to make the trip. I've said that same thing to her: "Mom, if you don't have to pee when we go in there?? You can slap me silly."

Yesterday, in a moment of absolute clarity as she sat on the toilet after I said that to her, she said, "D*mn it. I peed." ROFL!
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Thanks, MaggieMarshall. I tried what you suggested and it seemed to help a bit. I think the problem might be mostly in the way I'm reacting to Mom. If I don't react to her tactics, but just explain what I'm doing, she's pretty much the same but I don't get upset. It's just really annoying and hard when she tells me she would rather spend the rest of her life on the toilet rather than let me shift her into her chair, and then hangs on no matter what with all her strength. I thought I had most of my personal issues with her worked out long ago, but it seems I have more work to do.
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Liz, you hit on one of the most critical issues of interaction between caregiver and her parent - the way the caregiver reacts. It's certainly something that's been a challenge for me, and based on the posts here, it also is for many other caregivers.

What I thought of though as I read your post is that like most of us, your mother didn't think bad things were going to happen to her. As teens and young adults, we often think we're invincible. As we age, and hit 70's and older, we realize we're not and start worrying about frailty and vulnerability.

Then suddenly we fall and one of the dreaded aspects of old age is now upon us. Perceptions of vulnerability are realized and sometimes assume larger than life possibilities. Our whole perception of our relation to space, to things, and our safety has now come into question. How do we deal with that?

I wish I had an answer. I don't, but did want to at least share those thoughts so that you realize this ISN'T a problem you alone are facing.

Maggie's suggestions are good. Sometimes slowly rationalizing and talking your way, step by step, is helpful and reassuring. And I do think that reassurance is critical, but it also puts the caregiver in the positon of trying to assure her charge that the feared action hopefully won't occur again.

I think at this point parents are like children looking to us to tell them that the world will still be all right, but now they're old and experienced enough to know it won't be.

My mother faced those fears, and given her personality of being shy and meek, she never did conquer them. She became so terrified of getting up that she would cry when pressed to do so. Only my father could move her, which he did by transferring her to a chair on casters which he rolled into the bathroom. (Their house old and the wheelchair was too cumbersome.) Then he eventually had to put a commode in the bedroom.

I've speculated before that there's a unique form of PTSD, especially the fear of falling after the first fall occurs, that plagues folks as they age. I think it assumes great than life proportions and doesn't respond to rational reasoning.

I haven't seen many discussions on how to deal with these intense fears but I think it's something a lot of us deal with.
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Two things. Ask for a psychiatric consult. And make sure there isn't a broken bone somewhere. My mom broke her hip in AL and couldn't tell us, but "refused" to walk. An alert PT noticed that she was not bearing weight on one leg. They did a re-xray. Voila!
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Is mom on an antidepressant? My mom's irrational fears and sense of constant doom were greatly improved by zoloft and remeron.
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My father fell two months ago, had surgery and seemed to be recovering well including walking. We had him at a rehab hospital during recovery. He became impacted with UTI and had to make an emergency trip to the hospital. Since then he is showing a huge fear of standing and walking. He is sure he will fall. We want to bring him home again, but he weighs 200 lbs and we need him to be somewhat mobile to bring him home safely.

Suggestions???
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Has he been evaluated by a physical therapist? Is he using a rolling walker?

If he has certain kinds of dementia, gait, ability to accuately percieve three dimensions and other visual motor abilities may be impacted.
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He is at Health South now. Getting PT throughout the day. He will not stand to use the walker or stand with assistance in any way due to his irrational fear of falling. As far as I know, he is capable of walking, he just won't do it.
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