Mom has fallen 3 times. Twice in a 24-hour period. Doesn't remember either time. I'm afraid we've entered a mobility decline. Thoughts?

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Mom has fallen 3 times. Twice in a 24-hour period. Doesn't remember either time. I'm afraid we've entered a mobility decline. Thoughts?

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I spent Christmas Eve (Tuesday) with Mom in the emergency room because of a second fall. She fell prior to Tuesday on Monday morning; I got the call Monday afternoon that she had a medium-size skin tear on her arm and her buttocks were bruised pretty bad. Thankfully, the ER trip revealed no broken bones. She fell on her right knee. Of course she cannot tell me or the AL staff what happened because she doesn't remember falling. The second time she fell, they found her sitting on the floor in her room.

Yesterday, Friday, I visited her and she said her side was sore. When I lifted her shirt, I gasped at what I saw! Her right side was a blackish-purple and it was wide-spread. Dang! Another fall? I wasn't sure and thought that it may be from the second fall, since it was only a few days ago.

At 10:00pm the AL called me and said that they were going to x-ray her side because she was complaining of it hurting and they were also going to take blood. X-ray revealed nothing broken. Mom takes Xarelto. The ER doctor was concerned about this and said if she falls and hits her head she could have a brain bleed, which would be bad. But, if she is taken off of Xarelto, she could have a heart attack, stroke, or develop a blood clot. Not good, too. ER doc advised that I talk with her doctor, which I am going to do next week.

I am noticing that Mom (84 with Vascular and Alzheimer's stage 6) is more unsteady when walking. She uses a cane and has for a number of years. A walker is useless to her as she doesn't understand how to maneuver it and she will not stay in a wheel chair.

I'm afraid more serious falls are inevitable. I don't know what to do about the Xarelto, either.

Sorry so lengthy. Please share your experiences with similar situations. I don't know what to do.

Many thanks.

Alzheimer's & Dementia Falls Mobility

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Ah, the joys of Xarelto. My mother will be 93 this month; she was on Xarelto for years due to a DVT in 2011. She fell 36 times in the ALF due to balance issues and neuropathy in her legs/feet and wound up being moved to the Memory Care annex of the same ALF. The Xarelto made the bruising an ugly thing to witness, naturally. Well, she started getting horrific nosebleeds. And when I say horrific, the ER doctor was PHOTOGRAPHING the clot when I arrived there the last time she had a nosebleed. In his 15 years, he'd never seen a clot THAT big, and was going to post the photo on the bulletin board for all the staff to see up close and personal. Sigh. After 3 such nosebleeds, the doctor said TAKE HER OFF XARELTO. So I did.

She proceeded to have a stroke. Not a major stroke, but one that did cause another decline in cognizance and balance issues.

But the nosebleeds stopped.

My opinion is this: at some point, we have to STOP taking heroic life-saving measures with the elderly, especially when dementia is involved. Action A creates Consequence B, as indicated with the above story, so you're damned if you do and damned if you don't.

My mother is at a place now where she can't be prescribed many meds at ALL because they will create ANOTHER medical issue that cannot be treated. The PA thought she had another DVT last month..........the remedy is Xarelto. We can't give her that Rx for obvious reasons......see where I'm going with this? She did not have a DVT, by the way, as it turned out.

So it's Palliative Care options at this point. Keep her as comfy as possible with as FEW medications as possible. Keep the falls to a minimum, she's up to 40 now, and let God handle the rest. I personally feel that when her number is up, it's up. When it's her time to pass, she will, with meds, without meds, whether she falls or whether she doesn't. I'm about out of options at this point, and her dementia is ruining what's left of her life ANYWAY.

Wishing you the best of luck dealing with all of this...........I know how hard it all truly IS. Sending you a big hug, too

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I feel so bad that your mom and family went though that with that drug. That sounds absolutely horrible. People do have reactions to drugs. I’m glad you explain this reaction with your mom to help others see possible side effects. Geeeez, if I were your mom I would never want to take that drug again.

Did her nosebleeds stop shortly after going off the drug?

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Just a comment about brain bleeds. In the couple of years I have observed two seniors experience brain bleeds following a fall. Bleeding in the brain often results in strokes, as indeed it did in both cases in my extended family. After a few days in the hospital and those major strokes, both my family members (94 and 92) went on comfort care and died shortly after. We miss them, neither of them had any cognitive issues at all and both deaths were "sudden". They were living in their homes one day with some limited mobility issues and less than two weeks later they were dead. Please read the first words in that last sentence again... "They were living in their homes..." Based on what I saw with these relatives, I don't fear brain bleeds all that much anymore. To be living a mostly independent life until you take one bad fall and then be gone after only a brief illness is (in my opinion) not a bad fate.

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I had a really spunky aunt (by marriage) who died in her own home a week ago today at age 85. I had just seen her at Christmas dinner a few days earlier. She was her usual spunky self and ate a ton of food, drove herself home in her nice car to her own home that she still took care of. A few days later she had a stroke and died. It seemed a much better fate than my dad who died in November after 3 years in a memory care facility at age 81.

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I've come across several people who are absolutely hopeless with walkers/Zimmer frames but take to trolleys with no trouble at all. It's a trolley, you push it: I guess that makes more sense to them than getting to grips with an unfamiliar item?

A trolley also has the advantage that you can trundle your personal possessions around on it.

Might be worth a try, but. I'm sorry this is happening.

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Thank you for sharing. I'll check out a trolley.

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Your mother may have moved beyond Assisted Living. When my mom began falling frequently, her room was moved to one across from the nurse’s station so they could keep a close eye on her. Speak with her doctor and the staff at the AL to see what they think.

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Will do, thanks.

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AbbyRose, my Mom advanced to a stage where her brain forgot that she couldn't stand up due to permanent injury from a serious fall, thus Mom would be constantly falling. Thus, the wheelchair was her only way of getting around, but she kept trying to stand up... [sigh]. The nurses tried a seatbelt but Mom was a master of unclicking a seatbelt, as we would hear for years when she was sitting in a car.

Next step was a Geri-recliner where Mom could sit and the recliner wasn't easy to get out. A nurse would place a pillow under her knees to make it even more difficult to stand up. Mom would be placed by the nursing station.

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I so hope we don't get that far as to buckle her into a chair. I pray for God to intervene should that become the case for Mom. Thank you for sharing your story. Hugs.

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My dad was in Memory Care beginning March 2017. In 2019, his mobility began to decline rapidly and I started receiving frequent calls that he had fallen, with no injuries other than skin tears and scrapes. The whole time he was there I visited at least once per week and we had walked outside on the walking path or just around and around inside the building. By early summer 2019 he had become so wobbly I stopped taking him outdoors because I would not have been able to catch him had he gone down. I became very concerned, because the ability to walk was his only quality of life left :(

A walker was prescribed and he received training from an occupational therapist, but it was beyond his ability to learn it and know that it was his. Staff had him evaluated by Hospice and he went under their care August 2019. I watched and worried as he was then often in a wheelchair and I was afraid he was becoming close to being bedridden, as had happened to his mother.

I took him out for a car ride in early November. He was kinda out of it that day but did seem to enjoy the ride. When I returned to his Memory Care home, he could not stand to exit the car and I had to call a nurse to bring a wheelchair to get him inside. I gave him a hug and he was wheelchaired inside. That was Sunday afternoon. The following Tuesday morning at 6 AM I received a call that he had just died in his bed.

His mother had lingered for years bedridden and eventually blind in a mediocre nursing home 3,000 miles away from me. I know he never wanted to end up in that state (we had many late night discussions about it). I was relieved that he passed before reaching that stage.

That's my experience. Once his mobility began to wane, the last aspect of his life that brought any quality was disappearing. I think he gave up and was ready to go. I didn't really have time to grieve as I immediately had to turn my attention to my mother, who is a whole other horrid story. I have an appointment to start seeing a therapist this upcoming week, which is long overdue.

It's been a tough ride. Take care of yourself.

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Upstream, thank you for sharing. If and when my mom loses her mobility and can no longer walk, this will be the end for her too, I'm afraid. As I've traveled this journey with her, I am slowing accepting that death will be a blessing if the good Lord will take her before she reaches the horrible end stage of this devilish disease. Hugs to you as you continue on your journey.

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Seems like she needs more care than AL can provide. At her age and condition, seems like she needs more monitoring. Not that any level of care will prevent her falls. As long as she's getting out of bed, falls will probably continue, at least to some extent.

Ask doctor/staff about falls vs xaralto. Which is the greater risk at this point? Hard to know and there isn't always a "right" answer. I would be inclined to go with less medication, all other things being equal.

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Less meds is what I'm thinking, too. I don't know but I'm wondering if I should surrender and let my mother's life play out on God's time. By taking her off her meds I know that her demise may come quicker. I want to make the best decisions for her. I just don't know what that is. Thanks for sharing.

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This is just about your mother’s bruise. As I am sure you know, the bruise color comes from blood in the tissue, and it takes normal blood flow to move the dried blood away and bring things right again. (I am not a medico, so correct me if this is not the way to put it) As we get older, the blood flow is not as good, and the bruises linger on.. and on..and on. I fell on rocks in the paddock on December 12th. My head is now OK, my hip still aches, but the bruise just below my knee and down my shin is still very purple/ yellow - there is so little blood flow there. The bruises can look worse than they feel.

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Very true. Thanks for sharing.

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Sounds like she should transfer from AL to Memory Care. More people to watch her and make sure she is using a walker or remaining in a wheelchair.
This is not to say she will not fall again she will. It will be a matter of when, how bad and how often.
There are wheelchairs that can be configured so they are more difficult to get out of. My Husband had one that the seat tilted back a bit and the back reclined so if he wanted to get out of the chair it would have taken a LOT of effort.

Continuing the medication or discontinuing it. You will hear pros and cons on both. There are pros and cons to either option.
There is no Correct decision and there is no Wrong decision.
What I always said when making decisions for my Husband I am was being ruled by 2 organs in my body.
My Head
My Heart.
I always hoped my Head would "win" any argument (and for the most part it did)

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It is tough trying to decide what to do. And, you're right, I hope my head makes the right decision whatever that decision is. Thanks for sharing.

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AbbyRose, your anxiety, uncertainty, being consumed with your mother's care, and overwhelming sense of loss struck a chord with me. In my dad's last 6 months (Alzheimer's stage 6/7) he began falling more frequently and his memory care facility suggested hospice assistance as a way for them to continue providing his care. As soon as I did that, the hospice nurse instructed the facility to keep him in a wheelchair rather than to keep helping him use his walker. But knowing that he would decline even faster without walking, I helped him walk with his walker during my daily visits. While the staff wasn't allowed to do this, almost all of them agreed with what I was doing for him, even though I was less than 100% certain it was best for him. And now, almost 10 months after his death, I'm still not sure, but I'm also not sure if I had allowed him to be immobile, decline faster and die sooner, or if he had died from injuries suffered in a fall, if either of those outcomes would have been worse than what he went through. I do highly recommend the book "Being Mortal," for providing insights on making these hard decisions. Best wishes for you, your mother and your husband during this difficult time.

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Thanks for sharing. I am now wondering if it is Hospice time for Mom. If she continues to fall, I know it will be time to make the call. I also know that the longer my mother continues on this journey, the faster she is going to decline, both cognitively and physically. It's just so hard to watch, knowing that I am helpless to make her quality of life better. I will check out your book recommendation. Thanks for that, too. Hugs.

Mom has fallen 3 times. Twice in a 24-hour period. Doesn't remember either time. I'm afraid we've entered a mobility decline. Thoughts?

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