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He is of sound mind and the basement is his happy place. I don't want to witness his falling down the stairs. He can use a walker but spends most of the day in a wheelchair. He will not get a stair lift.
Without any assistance I would not let him use the stairs. I have mobility issues myself but am only 38 and 6 stairs is getting a lot harder for me now and I also have fibromyalgia, scoliosis etc.
Gotta face the facts, with any advanced age, 100 or even earlier. I’m nearly 70 and have used handrails with stairs to balance for about five years. I am also take Boniva bone treatments, and one side effect is fatigue.
I’m not sure there’s only one right answer here, but just want to share a couple of thoughts.
One, has he been evaluated by a PT to see just how safe he may actually be on the stairs, and what are some risk factors for him specifically? For example, syncope which is fainting from cardiac issues, balance issues which are also tied in with muscle weakness. Professional feedback might help either convince him or reassure you about the options.
Secondly, grab bars at the tops of stairs. My dad who is 87 just came back home in April after a scary cardiac arrest and seems to be doing reasonably well in their split level home. He also has a downstairs area he visits regularly. He has some mobility issues but works hard to stay active, long time runner, he still goes out and does his virtual (meaning you measure off the distances in your own neighborhood and send in your results) and in-person races for the local track club (slowly!). In addition to the railings we had grab bars installed by a local handyman service at the TOP of each flight. He says it makes a big difference not having to lean over to reach the diagonal railing right as he’s starting to head down, which I hadn’t considered beforehand. I was thinking they would help mostly once he reaches the top step, but he appreciates them most as he’s heading down.
If he already spends most of his time sitting, his muscles have declined and will continue to do so. Several sets of stairs a day is probably what has kept him moving at this point. So the question is, how well does he do climbing and descending the stairs? If it appears iffy, he needs a stair lift and would maintain mobility with OT and PT. Tell him even you worry about yourself falling on stairs since it has the great potential to put you in a bed for your own remaining g years. Time for hard conversation that involves IF he falls how would caretaking for the both of you look. Stair lift no longer optional if he wants to remain in this home AND be able to move between floors to hang out in basement. Then order one and get it installed ASAP. Call Dr and get in-home therapy started asap to keep him strong and mobile. I doubt he'd want to spend the rest of his days trying to recover from a broken hip or having to live in nursing home because of needing 24 hr care.
No. But I feel like the bigger question is, how are you going to stop him?
You can ensure there are safety rails, which I'm sure he's hanging on to. You could, if you can afford to, install a stair lift, or an elevator. Don't wait for him to do it. You could get him a wearable pendant to call for help if he needs help.
I don't think that his happy place is safe to get to anymore. Try to move everything up from the basement into an easier to get area - a garage, a spare bedroom, a shed...
Whose house is this ? If it’s your house you can install a stairlift if you want but your Dad may refuse to pay for it . But I don’t think you can force him to install it in his own house . Good Luck
I'm not sure why your Dad's happy place is the basement. If your Dad has a workshop in the basement, then you could possibly have a shed installed in the backyard, get it wired for electricity, and have a walkway to the shed. It would be costly, but your Dad would not have to walk downstairs. He could have his workshop outside. If his basement is a den, then possibly find a way for the den to be moved up into the living room. I agree with others who caution you that there are things that could happen that would be worse than sudden death. Find any way you can to stop your Dad from walking up and down stairs daily. I caution you about stairlift companies. We got an Acorn stairlift. The first installer really didn't have the proper training. He installed the stairlift not level or plum. We had to call the company for assistance to fix it. The second installer had to disassemble it and reassemble correctly. It was a big PITA. It was 10K for a curved staircase to second floor. A straight lift is less, but still expensive. May actually cost less to move the downstairs upstairs or to a shed.
@Isthis realyreal said: "We all have to die of something and going to your happy place and falling to your death wouldn't be a bad way to go."
@LakeErie said: If the stairs lead to a fall and that leads to death, at least he died happy doing what he likes to do.
@Terry0307 comments are the most realistic!
Unfortunately, a 100 year old man falling down the stairs does not guarantee a sudden death! Those who can only see death as the end result are living in a fairy tale. If it were guaranteed, I would agree and say let him live and die happy!
Depending on seriousness of the fall, he possibly would only have broken bones, punctured organs, internal bleeding etc. rather than sudden death! For my LO, I not only consider the risks, I also have to consider the consequences that we "both" may have to pay if he falls doing anything. There are a lot of stressors that come with a trip to ER, possible hospitalization, making decisions as far as testing and treatment, etc.
As I said, @Terry0307 gives the most realistic picture of possible consequences whether a fall happens alone on stairs, outside, inside or anywhere even when we are holding their hand. We each have to decide for ourselves whether to do something preventative or not before we simply say "c'est la vie".
Back to the OP's original question... I say a simple NO. However, there are many very good posts with suggestions of practical suggestions to consider how to minimize the risk if OP disagrees.
For what it is worth, I have known a few 100 year old people like her father who were of sound minds till their death! Had my father lived to 100 years old, with a sound mind, I would have had trouble disrespecting my father. That can create harder issues I never had to face as a caregiver. If dementia is part of the picture, it would naturally be an easier decision but still hard to carry out.
KP to each his own. I still say trying to keep others safe is a farce. He 100, he knows the risk and chooses to take it. Falling at 100 would be a death sentence, he's already living on borrowed time.
You do what you can. I wouldn't, but what is the alternative? If you can set boundaries, do so. If he insists, perhaps he needs caregiver during the days.
My client was a feisty 104 year old when she died. You couldn't tell her what to do ...
If he has difficulty and insists, I would block the stairs with a gate that he cannot open.
You do what you can and then you have to let go... or these situations will cause you - and him - continued emotional and psychological turmoil.
If I had the legal authority, I would make some decisions, if my dad. And, let him be angry. Wanting to HOLD ON TO INDEPENDENCE is their often to the last ounce of hope, spirit, tenacity a person has. However, he will be horribly miserable if he falls and ends up in rehab and never coming home. Unfortunately, this may be his choice.
He might listen to a professional. Often family is 'too close' and dismissed. See if you can acquire a medical social worker or an OT to do an assessment ... and then talk to him.
You need to tell him that you are going to put in a chair lift then do it. let him get mad, but once he is over it he will thank you. He could live another 5 years. This is the only solution to letting him do what he wants but caring about him too.
Your 100-year-old father should be supervised at his age to get around, especially using stairs. Consult with his doctor. Does he have a walker at both levels of the stairs?
Going back to my maternal grandparents' days, my mother once told me that her mother used the basement stairs of her OH home unsupervised to do the laundry in the basement. At age 75, she fell down those stairs, ended up hospitalized with a stroke and never recovered. She died about one week later trying to do her laundry; called it "She died in her boots!". Grandpa fell several times at their house and was moved with several relatives' turns until he could no longer balance himself. He was moved to assisted living where he fell again and broke a hip. He never woke up from the anesthesia to fix his hip at age 96.
*No! Not at all. It'll take one bad fall & it could be a disaster. I went to a Dr's appointment with my 80 year old mom. She was reading something AND walking at the same time once we got inside of the building. I'd helped her in & out of the car & always have her hold on to me as we're walking outside or inside of a place. Well, I walked up to grab the elevator...& she sorta' bumped into the small waterfall in the center of the place & fell right down on the floor. She just went, "Plop"..just that fast. So, 100 years old..no, I wouldn't chance it. Maybe if affordable, arrange to install one of those stair lifts (it's just not his choice anymore & if he can be in a wheelchair he can allow a stairlift to help him,) or, convert the stairs into big, wide stairs that might be easy for him or, take him down there so often to relax & hang out & then go get him later & bring him upstairs for the rest of the night!
They're just, so fragile and elderly and yet, many times, they still think they are who they were when they were 40 and 50 years old so they do stuff that's not real safe for them and they end up getting hurt!
It doesn’t sound like any of you have ever come across a parent who has fallen down the basement stairs. People with undiagnosed dementia can be very wily and will lie to your face. They also are stubborn. Don’t believe them when they say they understand the risk. If they even do, it’s momentarily. They are basically children. Our parents protected us from running into traffic because we didn’t know better. As the adults in this scenario, we have the duty of care. My father would have said he would happily die working in his garden. The reality is he would have not realized he was becoming dehydrated. He would have become dizzy and fallen and possibly been unconscious but probably not. Then he would have lain there weakly trying to crawl or to call for help. It would have been a horrible way to die, rotting in the sun. Or fallen at the bottom of the stairs , neck broken but still alive. Lying there unable to move and either waiting to die or praying for someone to find him. And imagine being the person to find the crumpled body with the blood from the wound on the head. Neither of those scenes are letting our loved one live their best life to the end. Sell their home and use the proceeds to place them in assisted living. They will fight you every step of the way. And yes, mentally they will likely go down hill more quickly but they won’t be dying hurt, scared and alone. I’ve lived this story with my father and now I’m living it with my husband so don’t think I’ve got a wild imagination. I remember the look in my dad’s eyes - like a wild animal in a trap - when I found him on the basement floor. And I’ve seen the fear in my husband now that he has fallen and gotten a few good bumps on the head or bruises on his hips. He is on his second round of PT and another new drug to tweak his blood pressure. It’s still an indignity and has been enough to mentally bring on the next stage of dementia. I’m not looking for sympathy. Just keeping it real for you.
I like that he's still active but I understand your concern. Can you limit his trips to just a couple with supervision? Go down in front of him and behind him on the way up? If he's coming up for meals,take them to him. What's the reason for him coming up? Maybe make it possible for him to stay down there? Twin bed or couch for sleeping,bring meals. Move him downstairs and keep him happy! I don't know the age of the house so I don't know if it's possible. If you're worried about not being able to hear him call for you, he can use hand bell like they use to call servants. It sounds like he's living with you or you with him, I hope he's not on his own.
Julia, I want to discourage you or anyone from using your own body to stop the fall of another adult. We can't, unless it's a toddler we are blocking and even then we can be swept off our feet. The end result would be that both of them fall and that does no one any good.
My mother did the same thing, she'd go into the basement when no one else was in her house. I worried about it but finally gave it up to the gods. I was not her dungeon master and eventually became very fatalistic about it all. She was an adult and was firing on all pistons mentally. If she fell, she fell.
But she had a fall alert medallion and she did have a chairlift to the basement level. If cannot convince your father to get a chairlift, there's nothing you can do about it. Just leave him alone and hope for the best.
He is 100. Let him do his projects in the basement.
Studies show that those who can stand and use their legs are less of a fall risk than those who are 100% in a wheel chair. i.e. Having leg strength to get up and down the steps will continue to help him with toileting and getting out of bed.
Using the steps (moving his limbs) will help protect against bed sores. Once someone is 100% in a wheel chair it is tough to prevent bedsores.
I'd check the railings of the steps and make sure they are very secure. I'd have a second walker and wheel chair in the basement.
I'd also look into installing the rubber matting on the floor around the bottom of the steps. https://www.greatmats.com/horse-stall-mats/stall-mats-4x6x34-4ft-border-black.php?identifiers=pla-2328628189372425&Campaign=Smart%20Shopping&CampaignId=590156798&AdGroup=Ad%20group%20%231&AdGroupId=1229255060161076&AdId=76828574104793&Network=o&msclkid=4c2c1fe7f6651e99df3377899f2b44b0&utm_source=bing&utm_medium=cpc&utm_campaign=Smart%20Shopping&utm_term=2328628189372425&utm_content=Ad%20group%20%231
Tractor Supply sells this. It is used in gyms and in horse stalls and in areas of day cares. It is about 1" thick. Lowes and Home Depot may have it.
I live in Florida. Seniors do better who have a purpose in life and who are moving and supporting their body.
I had a friend who died a few years ago at 99. He used a walker. He was an artist and his studio was on the third floor of his family's NYC brownstone.
Until about a month before he died, he went up to his studio to paint every day. He was fully cognizant of the risks and was very careful . He did not fall.
I am picturing these celler steps like my MILs and an Aunts. Steep for one thing and just boards, opened otherwise, with hopefully a railing. Very dangerous.
I think that given the mobility problems this is a disaster waiting to happen. I would keep this room with staircase under lock and key and assist him down whether he likes it or not. A fall is often the beginning of them end for an elder, and as he sits on the cusp of the end in ANY case, and no matter what he does or does not do, it is simply another temptation to fate.
He's 100. He's going to die of something sooner or later, and more likely sooner. If the stairs lead to a fall and that leads to death, at least he died happy doing what he likes to do.
Is someone usually with him? If so, make sure his caregivers are appropriately trained to assist him on stairs, and know when and how to help him up if he falls. Falling downstairs when you are home alone is NOT a good way to die. It is as likely to end in pain and incapacitation with regret for everyone as it is sudden death, if not more so. If there isn't someone with Dad, why not? Finally, if Dad really is still functionally independent, get a PT to work with him and teach him how to go down and up stairs safely.
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Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
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Logically, of course not, and neither should my 90 year old frail mother.
We are all doing the best that we can, and thats all we can do.
Sometimes you have to say to yourself, let go let God.
One, has he been evaluated by a PT to see just how safe he may actually be on the stairs, and what are some risk factors for him specifically? For example, syncope which is fainting from cardiac issues, balance issues which are also tied in with muscle weakness. Professional feedback might help either convince him or reassure you about the options.
Secondly, grab bars at the tops of stairs. My dad who is 87 just came back home in April after a scary cardiac arrest and seems to be doing reasonably well in their split level home. He also has a downstairs area he visits regularly. He has some mobility issues but works hard to stay active, long time runner, he still goes out and does his virtual (meaning you measure off the distances in your own neighborhood and send in your results) and in-person races for the local track club (slowly!). In addition to the railings we had grab bars installed by a local handyman service at the TOP of each flight. He says it makes a big difference not having to lean over to reach the diagonal railing right as he’s starting to head down, which I hadn’t considered beforehand. I was thinking they would help mostly once he reaches the top step, but he appreciates them most as he’s heading down.
Food for thought. Good luck!
Tell him even you worry about yourself falling on stairs since it has the great potential to put you in a bed for your own remaining g years. Time for hard conversation that involves IF he falls how would caretaking for the both of you look.
Stair lift no longer optional if he wants to remain in this home AND be able to move between floors to hang out in basement. Then order one and get it installed ASAP. Call Dr and get in-home therapy started asap to keep him strong and mobile. I doubt he'd want to spend the rest of his days trying to recover from a broken hip or having to live in nursing home because of needing 24 hr care.
But I feel like the bigger question is, how are you going to stop him?
You can ensure there are safety rails, which I'm sure he's hanging on to. You could, if you can afford to, install a stair lift, or an elevator. Don't wait for him to do it.
You could get him a wearable pendant to call for help if he needs help.
But I don’t think you can force him to install it in his own house .
Good Luck
I agree with others who caution you that there are things that could happen that would be worse than sudden death. Find any way you can to stop your Dad from walking up and down stairs daily.
I caution you about stairlift companies. We got an Acorn stairlift. The first installer really didn't have the proper training. He installed the stairlift not level or plum. We had to call the company for assistance to fix it. The second installer had to disassemble it and reassemble correctly. It was a big PITA. It was 10K for a curved staircase to second floor. A straight lift is less, but still expensive. May actually cost less to move the downstairs upstairs or to a shed.
@LakeErie said: If the stairs lead to a fall and that leads to death, at least he died happy doing what he likes to do.
@Terry0307 comments are the most realistic!
Unfortunately, a 100 year old man falling down the stairs does not guarantee a sudden death! Those who can only see death as the end result are living in a fairy tale. If it were guaranteed, I would agree and say let him live and die happy!
Depending on seriousness of the fall, he possibly would only have broken bones, punctured organs, internal bleeding etc. rather than sudden death! For my LO, I not only consider the risks, I also have to consider the consequences that we "both" may have to pay if he falls doing anything. There are a lot of stressors that come with a trip to ER, possible hospitalization, making decisions as far as testing and treatment, etc.
As I said, @Terry0307 gives the most realistic picture of possible consequences whether a fall happens alone on stairs, outside, inside or anywhere even when we are holding their hand. We each have to decide for ourselves whether to do something preventative or not before we simply say "c'est la vie".
Back to the OP's original question... I say a simple NO. However, there are many very good posts with suggestions of practical suggestions to consider how to minimize the risk if OP disagrees.
For what it is worth, I have known a few 100 year old people like her father who were of sound minds till their death! Had my father lived to 100 years old, with a sound mind, I would have had trouble disrespecting my father. That can create harder issues I never had to face as a caregiver. If dementia is part of the picture, it would naturally be an easier decision but still hard to carry out.
Yep, happy place trumps everything.
I wouldn't, but what is the alternative? If you can set boundaries, do so.
If he insists, perhaps he needs caregiver during the days.
My client was a feisty 104 year old when she died.
You couldn't tell her what to do ...
If he has difficulty and insists, I would block the stairs with a gate that he cannot open.
You do what you can and then you have to let go... or these situations will cause you - and him - continued emotional and psychological turmoil.
If I had the legal authority, I would make some decisions, if my dad.
And, let him be angry. Wanting to HOLD ON TO INDEPENDENCE is their often to the last ounce of hope, spirit, tenacity a person has. However, he will be horribly miserable if he falls and ends up in rehab and never coming home. Unfortunately, this may be his choice.
He might listen to a professional. Often family is 'too close' and dismissed. See if you can acquire a medical social worker or an OT to do an assessment ... and then talk to him.
Gena / Touch Matters
Going back to my maternal grandparents' days, my mother once told me that her mother used the basement stairs of her OH home unsupervised to do the laundry in the basement. At age 75, she fell down those stairs, ended up hospitalized with a stroke and never recovered. She died about one week later trying to do her laundry; called it "She died in her boots!". Grandpa fell several times at their house and was moved with several relatives' turns until he could no longer balance himself. He was moved to assisted living where he fell again and broke a hip. He never woke up from the anesthesia to fix his hip at age 96.
So, 100 years old..no, I wouldn't chance it.
Maybe if affordable, arrange to install one of those
stair lifts (it's just not his choice anymore & if he can be in a wheelchair he can allow a stairlift to help him,) or, convert the stairs into big, wide stairs that might be easy for him or, take him down there so often to relax & hang out & then go get him later & bring him upstairs for the rest of the night!
They're just, so fragile and elderly and yet, many times, they still think they are who they were when they were 40 and 50 years old so they do stuff that's not real safe for them and they end up getting hurt!
Our parents protected us from running into traffic because we didn’t know better. As the adults in this scenario, we have the duty of care. My father would have said he would happily die working in his garden. The reality is he would have not realized he was becoming dehydrated. He would have become dizzy and fallen and possibly been unconscious but probably not. Then he would have lain there weakly trying to crawl or to call for help. It would have been a horrible way to die, rotting in the sun. Or fallen at the bottom of the stairs , neck broken but still alive. Lying there unable to move and either waiting to die or praying for someone to find him. And imagine being the person to find the crumpled body with the blood from the wound on the head.
Neither of those scenes are letting our loved one live their best life to the end.
Sell their home and use the proceeds to place them in assisted living. They will fight you every step of the way. And yes, mentally they will likely go down hill more quickly but they won’t be dying hurt, scared and alone.
I’ve lived this story with my father and now I’m living it with my husband so don’t think I’ve got a wild imagination. I remember the look in my dad’s eyes - like a wild animal in a trap - when I found him on the basement floor. And I’ve seen the fear in my husband now that he has fallen and gotten a few good bumps on the head or bruises on his hips. He is on his second round of PT and another new drug to tweak his blood pressure. It’s still an indignity and has been enough to mentally bring on the next stage of dementia. I’m not looking for sympathy. Just keeping it real for you.
But she had a fall alert medallion and she did have a chairlift to the basement level. If cannot convince your father to get a chairlift, there's nothing you can do about it. Just leave him alone and hope for the best.
Like already said below , make sure railings are secure. Have railings on both sides of the steps . another walker and wheelchair in the basement.
Studies show that those who can stand and use their legs are less of a fall risk than those who are 100% in a wheel chair. i.e. Having leg strength to get up and down the steps will continue to help him with toileting and getting out of bed.
Using the steps (moving his limbs) will help protect against bed sores. Once someone is 100% in a wheel chair it is tough to prevent bedsores.
I'd check the railings of the steps and make sure they are very secure.
I'd have a second walker and wheel chair in the basement.
I'd also look into installing the rubber matting on the floor around the bottom of the steps. https://www.greatmats.com/horse-stall-mats/stall-mats-4x6x34-4ft-border-black.php?identifiers=pla-2328628189372425&Campaign=Smart%20Shopping&CampaignId=590156798&AdGroup=Ad%20group%20%231&AdGroupId=1229255060161076&AdId=76828574104793&Network=o&msclkid=4c2c1fe7f6651e99df3377899f2b44b0&utm_source=bing&utm_medium=cpc&utm_campaign=Smart%20Shopping&utm_term=2328628189372425&utm_content=Ad%20group%20%231
Tractor Supply sells this. It is used in gyms and in horse stalls and in areas of day cares. It is about 1" thick. Lowes and Home Depot may have it.
I live in Florida. Seniors do better who have a purpose in life and who are moving and supporting their body.
Freedom of Choice VS Duty of Care.
Does Dad understand the risk? You know your Dad best.
I have found a Risk Matrix useful from time to time.
In this case, Liklihood of a fall would be? Unlikely, possible, likely, near certain?
Consequences would be? Minor, medium, major, catestropic?
But then again, if Dad & you both understand the risk, you can choose based on other values.
Such as, at this great age of 100 - what is it that really matters?
Until about a month before he died, he went up to his studio to paint every day. He was fully cognizant of the risks and was very careful .
He did not fall.