Falls and Fall Prevention in Older Adults - StatPearls - NCBI Bookshelf.
Risk factors for falls in order of evidence strength include a history of falls, impairment in balance, reduced muscle strength, visual problems, polypharmacy (defined as taking over four medications) or psychoactive drugs, gait difficulty, depression, orthostasis or dizziness, functional limits, age over 80 years, female sex, incontinence, cognitive difficulties, arthritis, diabetes, and pain.
An update, I drove to the in-laws home yesterday as my husband was pretty overwhelmed.
There was no room in rehab, my mil was 2nd in line at one rehab as was the one other place she would go.
She decided she was well enough to go home if she couldnāt get into the more intensive rehab, the hospital agreed and sheās home. Of course the hospital agreed because it saved them tons of paperwork!
So mil is home. Of course it was on Friday at 4pm. An assessment for a home health aid is scheduled for Monday. Meals on wheels or any other assistance, that meeting was Friday at 1:30, they no showed.
There is a local woman who is coming today, twice.
My husband and I drove to our house last night after we went to Costco and loaded up on necessities and prepared meals. My husband plans on going back tonight but he had to take care of a few loose ends here.
Local sibling is less than helpful, left this morning for a week of vacation and left the dog with my in-laws for the week. My husband has realized that he will receive no help from local sibling.
The dog imo is a big problem to persuading in-laws to move to IL and I think sibling who creates his own reality will discourage them from moving as it would mean he would have to figure out his own solution for the dog. The less I say about local sibling the better.
It not only saved paperwork now she canāt get into rehab unless in the hospital for another three days again.
I know
My husband was at the hospital in the morning. Thought she wouldnāt be discharged until Monday at the soonest. Waiting for a placement to rehab
My husband went to their house for the meeting with the office of aging, Iām not sure but I wonder if there was some sort of misunderstanding about the meeting. No one showed.
My husband and I came back at 2:30, she was being released. PT thought she was well enough to come home and thatās what she wanted.
Some things are out of our control.
Actually, I found this on Medicare website while looking up something regarding my MILās coverage:
*For example, you wonāt have to pay a deductible for inpatient rehabilitation care if:
-Youāre transferred to an inpatient rehabilitation facility directly from an acute care hospital.
-Youāre admitted to an inpatient rehabilitation facility within 60 days of being discharged from a hospital*
So your MIL would likely be covered if they do get her a placement (and if itās deemed medically necessary). I could be interpreting wrong, though ā¦ hereās the link Iām referencing: Inpatient Rehabilitation Care Coverage. And thereās this if she doesnāt qualify for the more intensive rehab (although it sounds like she probably would qualify for regular rehab): SNF Care Coverage.
Itās frustratingāof course most patients want to go home, even if they would benefit so much more from getting rehab but prefer the old & familiar. She can get in-home rehab therapy since she was discharged to her home. The hospital should help with that to get her stronger.
Iāve told this story before on CC, but when I worked in skilled care and rehab as a RN (sunset career, worked until I turned 65), I did rehab admission assessments exclusively for the last 2 years. One lady insisted on going home instead of rehab, and was so weak she fell out of the car at home - so they brought her right to our rehab where all was in place for her to come.
Some parents put enormous pressure on their adult kids to follow their instructions even when it is AMA (against medical advice) or even common sense/walking around common sense. One lady was checked in, was in bed, and all the assessments were to begin the next day. She badgered her son, and the son sent the sister who was going to be burdened with responsibility of looking out for mom. The son called and said he was sending his sister to pick her up, and he said āI have to do what mom wants, and I donāt want her to be unhappyā. I encouraged the sister that perhaps her mother will put more effort into ārehabā at home - but it was a shame to miss the baseline assessment and treatment plan.
I saw the range of parental manipulation, as well as patients and their adult children being in denial about the patientās condition. There was one gentleman who was quite elderly, and on the evening shift it was clear he was medical conditions and agedly tired. His son was encouraging him to do more activity - his son IMHO just didnāt see how medically challenged his dad was. That night the man had a cardiac event and died in his sleep - natural causes.
Iām going to agree that there is a ton of denial. No one wants to see their parents decline, deep down I know they want the best for their parents.
The intent is to hire someone to come in 3 times a day. Twice is the cleaning person/dog sitter to straighten up, make simple meals and feed the dog. Once for bedtime and personal hygiene responsibilities. There will also be in home PT also and hopefully mobile meals. The dog sitter can transport to appointments and do any shopping they need.
I do think my mil will be ok in their home. Sheās getting around better than I thought she would. Sheās in reasonably good shape for 89.
I also think an intensive therapy regime would be best. Iām not in charge of any of it.
I hope this works out, at least for the short run. I hope local sibling is paying for the dog person too!
Iām tossing this in here because it is about denial, not about a parent or a spouse. Well, it is about someone elseās spouse.
I was in Alaska last week and one of the excursions had an element of danger. We were in canoes in 34-degree rushing water in front of a glacier.
A well dressed (reasonably appropriately) woman, perhaps 70, seemed to be unable to follow the guideās directions. She did not enter the canoe properly, did not row in sequence, held her paddle parallel to the surface of the water ā and STOOD up in the canoe.
We were far from life-saving support and had been told that weād only have about 4 minutes to survive.
The guide did his best. The husband seemed to be in quiet denial. He barely encouraged correct behavior from her.
I can guess that she might be declining more rapidly than anticipated when they booked the cruise or they might not have been fully aware of the canoeing part of the trip.
Iām still angry that they risked our lives.
Thatās crazy. To put everyone on that excursion at risk is very irresponsible
Iām on my way this morning to my in-laws to help out. Thereās something going on at our house that my husband has to be here for
I know we have golf scheduled on Thursday so it wonāt be for long.
Iām not quite sure what Iām helping with, from what my husband has said, I donāt think theyāve arranged private nursing services yet. Thereās a couple of meetings today and then that should be scheduled
One of the meetings should have happened on Friday, one I said the agency no showed. Actually they called the house to confirm and my fil told them not to come. His son was taking care of him, his wife was in the hospital, they needed to talk to her.
Yes, my mil told my husband that she thinks his dad doesnāt have dementia. SMH
I hope your trip goes as well as it can! I have to say, my MIL would not welcome my āinputā at all. Never has.
I hope the home care situation gets resolved. Soon.
Iām going to keep saying that this is because I love my husband and he has something he canāt reschedule
Iāve never had great large motor skills (Iām great at small motor skills, though, ha). I am getting worse as I age, even though I go to the gym regularly and try my best. The last time I went scuba diving, I was so klutzy I was slowing down everyone else in the group. So Iāve decided thatās one activity I will give up and let my husband go by himself. Itās too bad, because I love diving (itās MUCH easier than snorkeling, because youāre down below the sea chop). Maybe we could schedule a private excursion at some point.
Unfortunately, the employee didnāt realize what he was dealing with. When she didnāt enter the canoe properly and was not able to row like the others - but it is an out of the box thing for the employee to stop the canoe and turn around w/o fulfilling the excursion. IDK if they ever had any training in stopping an excursion with certain signs. In hindsight the employee and all onboard were glad it didnāt turn bad with someone in the water. Yes, life threatening because a woman was not within her capabilities and the husband in big-time denial. Yes, danger for everyone else in the canoe.
I was with a whitewater rafting excursion in Alaska (large circular raft) with my family and everyone was younger than DH and me - at the time we were in our early 50ās. We all needed to hold onto the raft loops with both hands at our sides as we sat on the raft - it was exciting, but we all recognized that we needed to follow the instructions to stay safe.
I certainly hope you gave feedback to the excursion firm (or if it was in conjunction with a cruise, gave feedback there).
It gives us all warning that if there seems to be a dangerous situation developing, to direct others to do the safest thing in the moment.
Family almost always needs to be very vigilant with their elderly loved oneās finances. Here is a very sad case of bilking this woman out of very significant funds. Glad they were caught and the primary two prosecuted with more to come. Mountain Brook is a wealthy āsuburbā of Birmingham. There are suburban cities around Birmingham, which makes up the metro area population.
My mom is being discharged back to her AL home on Friday, with a plan in place for her to be checked on much more often. I was worrying about her walker ā between general stubbornness and memory loss, we arenāt confident sheāll use it and will fall ā but her PT therapist says she is actually walking really well without it, but we arenāt to tell her that quite yet!
She has 5 different appointments in the coming weeks, which I spent most of today arranging and troubleshooting, but Local, Preferred and I have worked out who is doing which ones. So far, so good. Iād feel much better if her platelet count came down; I was very direct with her oncologist/hematologist today but canāt seem to get them to attend. She has an appointment with them at the end of next week so weāll see what we see. Phew.
My MIL was returned to her AL Monday (rehab allotment ended). The new hospice is engaged, and they had the nurse in to see her that day; PT will start right away. She will be in a wheelchair, so the AL staff has to step up - they promised to do so, and time will tell. We have to get the second hand account from Hās BIL, who makes it sound like everything is sunshine and roses. MIL is on pain meds that are controlling her pain, so thatās a good thing. We arenāt going to go back for a few weeks, because we want assess things after some time has passed (in case care begins to wane).
I donāt think the attorney who handled Momās probate did his job. The financial advisor said she checked the county court website and there is a request for an extension in submitting the inventory for Mom (October 2021!), but nothing else afterwards, and the case is still open.
So he charged a ton and then seems to have dropped the ball. Ugh. I placed a call with him, but I do not think he will return it. 
Oh no! How did you find this attorney? At this point, I would probably try to find some reviews of him/her and see if other people have had issues.