How many physical falls are acceptable?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: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.

I don't think "acceptable" is a good framing here. I think what people are saying is, after 3-4 falls, it became clear they had mobility issues, so they worked with their parent to change their living situation. Well, you already know that your father has severe mobility issues.

The question is about tradeoffs. He has full cognition, so he gets to choose the amount of risk he's willing to take on to stay in his home, and it appears that he's willing to take on a LOT of risk to do so, with his eyes wide open. Those other people's parents may have had a very different risk/reward assessment.

Yes, it seems that the most likely path here is he eventually has a bad enough fall that he lands in the hospital, and he ends up dying in the hospital or is wheelchair bound. If he's cognitively sound, he knows this, and this is what he's choosing.

I think what it's hard for our generation to fully grasp is that - the end of this story is the same no matter what. This man isn't going to be alive, happy and healthy 10 years from now. He knows this. There is no preventing it. And it's not crazy to risk a painful fall and a shortened lifespan for the hope of two more years with the life you want.

The one thing I would ask is that he wears one of the medic alert bracelets or necklaces so he can alert someone if he falls. That's an easy safety feature that basically costs him nothing. Beyond that, you've got to let it go.

Most people over 80 aren’t cognitively sound. They may be grounded in reality but often have lost the ability to make reasoned decisions. Op is smart to research options because their dad isn’t going to do it, and will likely be forced into wherever there is an open bed after a hospitalization if no action is taken, thereby making his worse fears come true.

Citation?

https://pmc.ncbi.nlm.nih.gov/articles/PMC9118064/

[Anonymous]

My parents are in their early 90s and refuse to agree to live anywhere but their home. They also refuse to use a walker (despite my dad falling after getting out of a cab and breaking his jaw). My mom is dead set that they can handle things alone. Any time on of us kids intervene, it is met with angry outbursts
Unless they have been declared incompetent, you have no say really.
I talk about this with my siblings all the time - we will just have to wait for something catastrophic to happen before things change.

[Anonymous]

How do you make a complaint about falls at a facility, and also how to do you look up prior complaints when looking into a facility?

[Anonymous]

Anonymous wrote: Honestly, OP-I think what will likely happen is that he will eventually have a fall where he is injured, admitted to the hospital and then likely discharged to a rehab facility.

At least, that is how it worked for my dad. I'm sorry you are going through this-it's scary, I know. I'd be at work and get those calls from Mom 'dad's on the floor, emts' coming'. The EMT's are angels! My dad typically did not get injured (he had advanced Parkinsons and usually just did a slow roll to the floor) but I called 911 twice, both for head injuries (or what I thought could be).

Once he's admitted, go to the hospital and talk to them. Although my elderly mom was the legal POA, they were always good about talking to 'the daughter' (it's like an unofficial title LOL). Rehab might help your dad get better on his feet.

I had the POA, so that might be different. But It was clear people (staff, doctors, insurance even) wanted to talk to me.

One of the things I did was get information on all the rehab facilities while my dad was in the hospital, and we knew he would have to go to rehab. I was able to pick one (had to do it quickly) so we got him in the best, and the easiest for us to access. Otherwise, notification is sent out by the hospital to all rehabs in the general area, and whoever responds to the call gets the patient.

I chose the facility, and then they handled everything with the hospital (and verified the insurance) immediately so that they got my dad instead of someone else.

If they are of sound mind, all you can do is know your options once an emergency does happen.

[Anonymous]

Anonymous wrote:My parents are in their early 90s and refuse to agree to live anywhere but their home. They also refuse to use a walker (despite my dad falling after getting out of a cab and breaking his jaw). My mom is dead set that they can handle things alone. Any time on of us kids intervene, it is met with angry outbursts
Unless they have been declared incompetent, you have no say really.
I talk about this with my siblings all the time - we will just have to wait for something catastrophic to happen before things change.

This is the bottom line. They are choosing freedom over safety. He gets to have his boundaries unless his choices are putting someone else's life in danger. It doesn't sound like you are dropping everything and flying to him when he falls, so that's a good boundary for you. Aging is sad and there's no perfect path to the end. Western medicine is very focused on "safety" mostly so they don't get sued. But the reality is that a shorter, freer life might be a great choice for your dad as long as he's doing no harm. You have done what you can, so worrying is senseless. When there's a catastrophy, you will handle it.

[Anonymous]

Anonymous wrote:Call me heartless but I’d try not to worry too much. One day things will come to a halt and then you’ll figure something out. Most likely he’ll be taken to a hospital and pass there or at the post hospital rehab.
Take this from sometime whose mother refused to leave her hoarded house and died in that hoard. I wish I didn’t have the fights with her that lead nowhere, for her sake and mine. Sometimes they just want to leave on their own terms.

+1

You have to let adults make their own decisions. Whether they are the choices you want them to make or not. You can provide support, as it seems OP has done with making sure the home is physically as safe as possible. But that’s it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Call me heartless but I’d try not to worry too much. One day things will come to a halt and then you’ll figure something out. Most likely he’ll be taken to a hospital and pass there or at the post hospital rehab.
Take this from sometime whose mother refused to leave her hoarded house and died in that hoard. I wish I didn’t have the fights with her that lead nowhere, for her sake and mine. Sometimes they just want to leave on their own terms.

+1

You have to let adults make their own decisions. Whether they are the choices you want them to make or not. You can provide support, as it seems OP has done with making sure the home is physically as safe as possible. But that’s it.

o

This really isn’t true. If they are truly old, more than 80, they have inevitably lost some of their capacity to make reasoned decisions and are stressed about their stage of life. You can listen to their fears, and do the legwork on what their best options are. Often, when things really fall apart, or they can no longer cook for themselves or drive, they are willing to consider changes they were refusing a year or two earlier. It can be a process, with a lot of two steps forward, one step back, but I don’t think the onku option is to leave them to their own devices in an elderly unfriendly house.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Call me heartless but I’d try not to worry too much. One day things will come to a halt and then you’ll figure something out. Most likely he’ll be taken to a hospital and pass there or at the post hospital rehab.
Take this from sometime whose mother refused to leave her hoarded house and died in that hoard. I wish I didn’t have the fights with her that lead nowhere, for her sake and mine. Sometimes they just want to leave on their own terms.

+1

You have to let adults make their own decisions. Whether they are the choices you want them to make or not. You can provide support, as it seems OP has done with making sure the home is physically as safe as possible. But that’s it.

o

This really isn’t true. If they are truly old, more than 80, they have inevitably lost some of their capacity to make reasoned decisions and are stressed about their stage of life. You can listen to their fears, and do the legwork on what their best options are. Often, when things really fall apart, or they can no longer cook for themselves or drive, they are willing to consider changes they were refusing a year or two earlier. It can be a process, with a lot of two steps forward, one step back, but I don’t think the onku option is to leave them to their own devices in an elderly unfriendly house.

Well it’s ok to revisit the conversation but it makes no sense to fight or even try to persuade them. But if they are willing to listen I am there to help them.
I am the PP with the hoarder mother. When she died, my sibling and I knew what to do about our father and he was very amenable to that and it went smoothly. We were prepared to just abort the whole operation though if he suddenly didn’t want to proceed.
We moved him thousands of miles away and he is doing well!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Call me heartless but I’d try not to worry too much. One day things will come to a halt and then you’ll figure something out. Most likely he’ll be taken to a hospital and pass there or at the post hospital rehab.
Take this from sometime whose mother refused to leave her hoarded house and died in that hoard. I wish I didn’t have the fights with her that lead nowhere, for her sake and mine. Sometimes they just want to leave on their own terms.

+1

You have to let adults make their own decisions. Whether they are the choices you want them to make or not. You can provide support, as it seems OP has done with making sure the home is physically as safe as possible. But that’s it.

o

This really isn’t true. If they are truly old, more than 80, they have inevitably lost some of their capacity to make reasoned decisions and are stressed about their stage of life. You can listen to their fears, and do the legwork on what their best options are. Often, when things really fall apart, or they can no longer cook for themselves or drive, they are willing to consider changes they were refusing a year or two earlier. It can be a process, with a lot of two steps forward, one step back, but I don’t think the onku option is to leave them to their own devices in an elderly unfriendly house.

Have you been thought this? If you have, did you force a parent to move? If you haven't, then you don't know what it's like. If you have, then you are justifying what you did.

I don't think anyone here is saying leaving anyone to their own devices. Frankly, it's a lot more work for the kids to allow parents to age at home. But by law you really can't force someone to move if they are deemed competent.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Call me heartless but I’d try not to worry too much. One day things will come to a halt and then you’ll figure something out. Most likely he’ll be taken to a hospital and pass there or at the post hospital rehab.
Take this from sometime whose mother refused to leave her hoarded house and died in that hoard. I wish I didn’t have the fights with her that lead nowhere, for her sake and mine. Sometimes they just want to leave on their own terms.

+1

You have to let adults make their own decisions. Whether they are the choices you want them to make or not. You can provide support, as it seems OP has done with making sure the home is physically as safe as possible. But that’s it.

o

This really isn’t true. If they are truly old, more than 80, they have inevitably lost some of their capacity to make reasoned decisions and are stressed about their stage of life. You can listen to their fears, and do the legwork on what their best options are. Often, when things really fall apart, or they can no longer cook for themselves or drive, they are willing to consider changes they were refusing a year or two earlier. It can be a process, with a lot of two steps forward, one step back, but I don’t think the onku option is to leave them to their own devices in an elderly unfriendly house.

Have you been thought this? If you have, did you force a parent to move? If you haven't, then you don't know what it's like. If you have, then you are justifying what you did.

I don't think anyone here is saying leaving anyone to their own devices. Frankly, it's a lot more work for the kids to allow parents to age at home. But by law you really can't force someone to move if they are deemed competent.

Yes, and nobody was forced to do anything. It took a lot of time (two to three years) and frustration but ultimately became something they asked to do.

Are people taking their parents to competency hearings at age 85 or 90? That seems extreme and no one has mentioned doing so.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Call me heartless but I’d try not to worry too much. One day things will come to a halt and then you’ll figure something out. Most likely he’ll be taken to a hospital and pass there or at the post hospital rehab.
Take this from sometime whose mother refused to leave her hoarded house and died in that hoard. I wish I didn’t have the fights with her that lead nowhere, for her sake and mine. Sometimes they just want to leave on their own terms.

+1

You have to let adults make their own decisions. Whether they are the choices you want them to make or not. You can provide support, as it seems OP has done with making sure the home is physically as safe as possible. But that’s it.

o

This really isn’t true. If they are truly old, more than 80, they have inevitably lost some of their capacity to make reasoned decisions and are stressed about their stage of life. You can listen to their fears, and do the legwork on what their best options are. Often, when things really fall apart, or they can no longer cook for themselves or drive, they are willing to consider changes they were refusing a year or two earlier. It can be a process, with a lot of two steps forward, one step back, but I don’t think the onku option is to leave them to their own devices in an elderly unfriendly house.

Well it’s ok to revisit the conversation but it makes no sense to fight or even try to persuade them. But if they are willing to listen I am there to help them.
I am the PP with the hoarder mother. When she died, my sibling and I knew what to do about our father and he was very amenable to that and it went smoothly. We were prepared to just abort the whole operation though if he suddenly didn’t want to proceed.
We moved him thousands of miles away and he is doing well!

Glad it worked out so well for you and your dad.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Call me heartless but I’d try not to worry too much. One day things will come to a halt and then you’ll figure something out. Most likely he’ll be taken to a hospital and pass there or at the post hospital rehab.
Take this from sometime whose mother refused to leave her hoarded house and died in that hoard. I wish I didn’t have the fights with her that lead nowhere, for her sake and mine. Sometimes they just want to leave on their own terms.

+1

You have to let adults make their own decisions. Whether they are the choices you want them to make or not. You can provide support, as it seems OP has done with making sure the home is physically as safe as possible. But that’s it.

o

This really isn’t true. If they are truly old, more than 80, they have inevitably lost some of their capacity to make reasoned decisions and are stressed about their stage of life. You can listen to their fears, and do the legwork on what their best options are. Often, when things really fall apart, or they can no longer cook for themselves or drive, they are willing to consider changes they were refusing a year or two earlier. It can be a process, with a lot of two steps forward, one step back, but I don’t think the onku option is to leave them to their own devices in an elderly unfriendly house.

Most (but not all) of my family have lived well into their 90s, sharp as tacks, and with amazing health. They weren’t stressed about their stage of life at all. As to the rest of the statement, most people are presenting options and advocating for changes. But understanding that you can’t force a competent adult to do something they don’t want to do is important for caring children/grandchildren who are extremely stressed and feel guilty when their LO refuses help.

[Anonymous]

OP here. Coming back to update that my father has now fallen 3x in a week's time. Falls in which he thankfully did not break anything but had to have assistance to get back up (called EMTs 2x and a neighbor the 3rd time). It is so upsetting to get the after-the-fact calls from him, but I have re-read all of the posts here and they make me feel better. He is INSISTING on remaining at home and will not even discuss additional help in any form. Hangs up on me when I bring alternatives up to him. Lovely, huh?

Anyway, I just wanted to thank everyone who took the time to respond to my OP as your posts continue to help me.

[Anonymous]

Anonymous wrote:OP here. Coming back to update that my father has now fallen 3x in a week's time. Falls in which he thankfully did not break anything but had to have assistance to get back up (called EMTs 2x and a neighbor the 3rd time). It is so upsetting to get the after-the-fact calls from him, but I have re-read all of the posts here and they make me feel better. He is INSISTING on remaining at home and will not even discuss additional help in any form. Hangs up on me when I bring alternatives up to him. Lovely, huh?

Anyway, I just wanted to thank everyone who took the time to respond to my OP as your posts continue to help me.

Can you suggest home PT and OT? Medicare covers it if he's homebound. They can help him get stronger and get some strategies.

[Anonymous]

There is a difference between accepting his decision to stay at home and thinking three falls a week is ok. It isn't the role of EMS to help your dad get back up multiple times a week. Have you looked into getting him help at home? Do you know where you would want to send him when he inevitably gets hurt and needs a rehab bed?