How many physical falls are acceptable?

[Anonymous]

I often read here that someone's elderly parent fell "now three or four times" and how now something must change in the parent's living situation. It always makes me wonder how many physical falls is unacceptable? My father physically falls often. Sometimes it is multiple times each week and other times he will go a few weeks between falls. Fortunately, he only is bruised. No broken bones thus far.

He has severe mobility issues and it seems that his shaky legs are obviously weakening even more yet he REFUSES to move from his home. I do believe that the only time we can ever consider moving him to assisted living is if he were to fall and need hospital care.

So, are physical falls in this situation acceptable? I feel like my hands are tied for he has full cognition and states clearly and regularly that his plan is to remain in his home.

[Anonymous]

Zero. The chances of dying in the year after a fall is quite high for seniors.

[Anonymous]

What does acceptable mean to you? Some seniors might prefer to take the risk vs moving. Their choice.

[Anonymous]

Instead of pushing for assisted living where he will fall too, help make the house safer, get it cleaned up, grab bars, etc.

[Anonymous]

Anonymous wrote:Zero. The chances of dying in the year after a fall is quite high for seniors.

Hard disagree. The calculus does not have to be reduce risk of death.

[Anonymous]

Anonymous wrote:What does acceptable mean to you? Some seniors might prefer to take the risk vs moving. Their choice.

This, but it's very selfish on their part. The kids worry so much. What will happen is that he will take a nasty fall, and if he survives, then he will go to the hospital and when it's time for him to leave, you say that he has nowhere safe to go. I would have at least an idea of where you'd like him to go when (not if) this happens.

[Anonymous]

Anonymous wrote:

Anonymous wrote:What does acceptable mean to you? Some seniors might prefer to take the risk vs moving. Their choice.

This, but it's very selfish on their part. The kids worry so much. What will happen is that he will take a nasty fall, and if he survives, then he will go to the hospital and when it's time for him to leave, you say that he has nowhere safe to go. I would have at least an idea of where you'd like him to go when (not if) this happens.

+1
Or their falls are because of a heart condition?
That's very common and will make the kids worry "if only" they had been able to get help on that last fall.

[Anonymous]

Anonymous wrote:Instead of pushing for assisted living where he will fall too, help make the house safer, get it cleaned up, grab bars, etc.

OP here. We have done all of these things and so much more. My father only "walks" with his rollator 3x a day and that is to amble from bed to his chair for the day, to the dinner table for one meal and to return to bed at night. He wears diapers so there is not even the need for bathroom trips. He is still falling multiple times on a regular basis.

He reacts negatively whenever we gently bring up the need for assisted living. He is so scared.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Instead of pushing for assisted living where he will fall too, help make the house safer, get it cleaned up, grab bars, etc.

OP here. We have done all of these things and so much more. My father only "walks" with his rollator 3x a day and that is to amble from bed to his chair for the day, to the dinner table for one meal and to return to bed at night. He wears diapers so there is not even the need for bathroom trips. He is still falling multiple times on a regular basis.

He reacts negatively whenever we gently bring up the need for assisted living. He is so scared.

He's actually beyond assisted living IMO. Very sad.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Zero. The chances of dying in the year after a fall is quite high for seniors.

Hard disagree. The calculus does not have to be reduce risk of death.

I didn't say risk of death is the full "calculus."

Personally, I think any individual who is not suffering cognitive decline gets to decide where and how they want to live; they should have full agency. But an "acceptable" number of falls? That is going to be none; you need to do everything you possibly can to mitigate falls. There's no "acceptable" number of falls.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Zero. The chances of dying in the year after a fall is quite high for seniors.

Hard disagree. The calculus does not have to be reduce risk of death.

I didn't say risk of death is the full "calculus."

Personally, I think any individual who is not suffering cognitive decline gets to decide where and how they want to live; they should have full agency. But an "acceptable" number of falls? That is going to be none; you need to do everything you possibly can to mitigate falls. There's no "acceptable" number of falls.

OP here. So how do I do that? Mitigate falls? I believe that everything to be done to the house and his immediate environment to make things safer has been done. He does not want to remain in bed all day so a "walk" to his lift chair in the morning is needed and then a return to bed at night. He REFUSES to use a wheelchair or scooter (a wheelchair is readily available to him now). Yet, he continues to fall. His legs just give out. It is a physical thing. His heart is strong.

And PP stated it clearly. My father is 100% cognitively sharp. He constantly makes his wishes known that he will not leave the house. Yet, he falls often and needs EMS to get him back up off the floor as his wife is unable to lift him herself.

I live a plane distance away and am so frustrated.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Zero. The chances of dying in the year after a fall is quite high for seniors.

Hard disagree. The calculus does not have to be reduce risk of death.

I didn't say risk of death is the full "calculus."

Personally, I think any individual who is not suffering cognitive decline gets to decide where and how they want to live; they should have full agency. But an "acceptable" number of falls? That is going to be none; you need to do everything you possibly can to mitigate falls. There's no "acceptable" number of falls.

OP here. So how do I do that? Mitigate falls? I believe that everything to be done to the house and his immediate environment to make things safer has been done. He does not want to remain in bed all day so a "walk" to his lift chair in the morning is needed and then a return to bed at night. He REFUSES to use a wheelchair or scooter (a wheelchair is readily available to him now). Yet, he continues to fall. His legs just give out. It is a physical thing. His heart is strong.

And PP stated it clearly. My father is 100% cognitively sharp. He constantly makes his wishes known that he will not leave the house. Yet, he falls often and needs EMS to get him back up off the floor as his wife is unable to lift him herself.

I live a plane distance away and am so frustrated.

You tell him he can choose between a full time caregiver living in the home or a move to skilled nursing facility. He may be lucid but that doesn't not mean he is capable of making reasonable choices on his own.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Zero. The chances of dying in the year after a fall is quite high for seniors.

Hard disagree. The calculus does not have to be reduce risk of death.

I didn't say risk of death is the full "calculus."

Personally, I think any individual who is not suffering cognitive decline gets to decide where and how they want to live; they should have full agency. But an "acceptable" number of falls? That is going to be none; you need to do everything you possibly can to mitigate falls. There's no "acceptable" number of falls.

OP here. So how do I do that? Mitigate falls? I believe that everything to be done to the house and his immediate environment to make things safer has been done. He does not want to remain in bed all day so a "walk" to his lift chair in the morning is needed and then a return to bed at night. He REFUSES to use a wheelchair or scooter (a wheelchair is readily available to him now). Yet, he continues to fall. His legs just give out. It is a physical thing. His heart is strong.

And PP stated it clearly. My father is 100% cognitively sharp. He constantly makes his wishes known that he will not leave the house. Yet, he falls often and needs EMS to get him back up off the floor as his wife is unable to lift him herself.

I live a plane distance away and am so frustrated.

The falls will continue unless he gets serious about working with PT and OT to build muscle, increase balance, and use his adaptive equipment. Otherwise he will eventually injure himself to the point of needing rehab/snf, and he’ll be stuck going where there is room. He sounds depressed so addressing that might help make him more receptive. I don’t envy you, OP, it’s very hard to make change like this happen and it’s ultimately his decision. All you can do is present him with options and facts. If you’re out of state look into a care manager and the Area Council on Aging.

[Anonymous]

Would he accept a home health aid to do transfers morning and evening? They would have him use a walker and probably hold on to him with a belt to stabilize. He could also have OT come to help make transfers safer. That is all cheaper than a care facility of some sort! It also sounds like he is in that in between stage where it is really hard to find an appropriate placement. His needs are too much for assisted living, but he doesn’t have skilled nursing needs…that is a hard spot.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Instead of pushing for assisted living where he will fall too, help make the house safer, get it cleaned up, grab bars, etc.

OP here. We have done all of these things and so much more. My father only "walks" with his rollator 3x a day and that is to amble from bed to his chair for the day, to the dinner table for one meal and to return to bed at night. He wears diapers so there is not even the need for bathroom trips. He is still falling multiple times on a regular basis.

He reacts negatively whenever we gently bring up the need for assisted living. He is so scared.

Does he have care workers in his house? Who changes the diapers? Who makes the meals? If he can afford care workers, then have them 24/7 if you don't already. My mom had 24/7 care, her kids with her regularly, and she still fell regularly. She could be a foot away. The only way to prevent this is to make the elderly wear one of those harnesses and whenever they are standing the care worker holds on to it.