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My 84 year old father is on hospice and lives with me. I have done everything to modify my home to address his needs. He is very weak and on oxygen. Due to his weakness and previous falls, he has been told to ask for assistance to help with getting out of bed. He refuses and insists on doing it on his own. He refuses to have a portable commode in his room. What can I do? Stressed over worry he will fall again.

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Since his body is wasting away, expect him to fall again. Advice Hospice and see what they suggest and tell them that he refuses the safety measures.
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I was coping with almost the exact situation: Fiancé with pancreatic cancer, had lost a tremendous amount of weight, didn't want to use a walker, didn't want a commode, etc. etc. He, too, had taken a number of falls previously, but he said, "I'll never do THAT again!"
Well, he did fall while begrudgingly using his cane and this time he broke his left hip very badly. It was the most painful experience of his life, including his former Whipple surgery, quadruple by-pass, and others! He had a week in the hospital, three weeks in rehab, came home and has basically been in bed ever since. Instead of being able to use his few remaining months of life to do the things he would have wanted to do, he has been confined to his bed. After experiencing the broken hip he was happy to use the walker if he had the strength, but mostly he had to use a wheelchair. For a while, the commode was a lifesaver, but now he doesn't even have strength to get to it, so I have to clean him up in the bed.
Masculinity is apparently a very fragile thing. Many men equate having to use a cane or walker with a loss of masculinity, but they stand to lose far more by not using them.
Please share my experience with him, and ask him if this is really what he wants. But remember, sometimes part of the patient's illness is that he doesn't necessarily make good decisions. If that's the case here, then try to convince him, but that's about the best you can do.
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Thanks to all who offered their insight. As caregivers I believe we all at some point face the challenge of trying to do what we feel is the right thing to do for our love ones. Unfortunately, there are no crash courses in caregiving - just people helping people. I have shared my concerns with the hospice team and they have offered up suggestions. Thanks again😊.
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He will most likely fall again, no matter what precautions you take or whether he has assistance each time he gets up. Sorry to sound pessimistic, but that’s the reality of where he is in life. My dad is there also. We’ve done all the precautions. He also insists on walking, a slow, shuffling step. Most of his falls are upon getting out of bed, and sometimes the help is right there and it happens anyway. Acceptance is good for both our parents and us
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We used to worry about people falling all the time and blamed the nurse of facility when folks fell because of their stubborn desire to be independent. Now, we realize that you can't "stop" or "change" that personality trait. The best option is to see the risks and take precautions for when falls happen.

Get thick mats to put next to the bed. When he tries to get out of bed and falls - which will happen - he will not injure himself. Also try to get his bed as low to the ground as possible. Make sure he can not fall and hit his head on a side table. There are devices that can be attached to the bed or person to let you know when they try to get up.
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Could you get a wheelchair. If he doesn't want to sit in it and wheel himself to wherever, he could do what I do (I can't walk)....I walk behind it, lean on it and use it for support and balance and getting from A to Z points - works great. Or, you may have to place him into a facility where he will be safe and supervised.
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Get the alarm mentioned in other posts so you know when he starts stirring. It's possible he doesn't really remember or understand that his ability to walk has diminished. If he wants to try and walk, get a gait belt and walk with him. His body may be wearing out while his mind wants to push on.
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Budpit4 Apr 2020
Thank you. My dad did say he forgets about the danger of falling or calling for help.
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Hi, My suggestion to you is get a bed/chair alarm, it will go off when your Dad gets up without assistance. Hip protectors are also a good idea. Put a urinal in a bucket beside his bed, he may use it, also a night light might let him see what he is doing if he tries to use the urinal. If he is incontinent look into getting him a night pad/ incontinence pants. Be prepared with a first aid kit.... Good luck
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LexiPexi Apr 2020
I was going to type the same answer. My husband is in stage 4+ Parkinson's, has dementia and is clinically blind. He thinks he can get up on his own and he cannot. He falls as he has no balance or strength left. The alarms for the bed and chair have been a life saver, as well as the other items mentioned. Amazon sells two pads and one alarm (that can be moved back and forth) for less than $100.
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My sister is not 84, but she is 72 and experiences falls and the rescue squad is continually called. She refuses to have a portable commode as well. Those of us who love her encourages her to make changes so the quality of her life will be better. As a family member we all have to accept the situation and be willing to assist within our ability.

You have some great suggestions - try one and if that doesn't work try another. Rest in your mind and heart knowing you are doing your best - that is all we should epect from ourselves
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Get help. Someone needs to sit with him. He can't be trusted . He needs 24/7 supervision. Is he havibg diminished memory issues? He may lack capacity to make a rational decision. So you have to mak the decisions.

In the time of coronavirus, you don't want to have to send him to hospital after he breaks whatever bone he breaks.
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I believe the best answer is that there really isn't a "best answer". Having said that, I like what dogparkmomma suggested that Budpit4 should ask his/her father what he wants and expects. It may be that he thinks asking for help results in inconvenience for others, not realizing that when others worry about his falling, the latter is more of an inconvenience than giving him help. Somewhere in between is the sweet spot, but it probably changes from day to day.

We haven't received any followup comments from Razzleberry offering clarification, but maybe this comment wasn't intended as a criticism of the preceding comments (both of which were fine) but rather an expression of frustration or depression about the difficulty of finding a solution to an unfortunate situation. As I'm sure many others would agree, on this forum we deal with a lot of difficult issues, and we pool our thoughts, knowledge and experience hoping the OP can find at least some of the suggestions helpful.
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disgustedtoo Apr 2020
Nice try at diplomacy, but that post was not helpful and was for all intent and purposes a swipe at the site/comments. If I want to be generous and say oh no, not really.. then I have to ask of what use was that comment? It didn't offer any suggestion, which is what OP was seeking, just a rather off-handed statement that was NOT helpful. It would have been better left unposted.
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AHHH men, they think they are so strong but as "we" know they are the weaker sex.
By asking for help, by using a walker, by using..(god forbid) a commode he probably feels like a weak, dying old man. And that is not what he wants to feel like. None of us want to feel weak and old. (And I bet he has always been a bit stubborn as well right?)
You have explained to him, Hospice has explained to him what he needs to do to make sure he is safe. Hate to say it but that is all you can do.
You can tell him how hurt you will be if something happens to him, how heart broken you will be but this is his choice. (sorta like when he told you not to do something when you were 16 and you did it anyway..sometimes going against him turned out alright, sometimes you got hurt, either physically or emotionally..that's life)
Your dad is dying..we all are he just knows that his time is much shorter.
Your dad has gone through a lot.
Your dad knows what will happen if he falls.
These are choices he is making.
You don't have to like them, approve of them or support them but you should support him.
Just tell him you love him. Let him know that you are there to help and support him.
By the way..if you are near him when he starts to fall do NOT try to stop the fall, guide him to the floor.
Do NOT try to pick him up yourself call 911 and ask for a "Lift assist". As long as there is no transport to the hospital there usually is no charge.
Best of luck...
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When I read responses like the two before me, that's when I remember why I don't come to this site that often. Of course you don't want to lose your dad and as I see it you are doing everything you can to allow him to be with you longer.
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dogparkmomma Apr 2020
Not sure what you mean by that. I thought they were perfectly reasonable answers. And your dig at the site was unnecessary and not helpful. Of course OP is upset and afraid he will fall. But if he won’t stay in bed and won’t listen, what ielse can she do. He is going to fall and possible make his short term situation worse.
i have 2 suggestions. One) read Being Mortal by Atul Gawande. It will not give you the magic to make him stay in bed but it may help you understand his actions. In fact, if you google him, there is an article that I read that contains his 5 questions. Two) if this is possible, sit down and talk to your father and ask him what is important to him and what he wants. Clearly having his daughter empty the commode bucket is not what he wants. Instead of telling him what is best for him and being aggravated and upset, it might help if he is allowed to talk about what he wants. It can’t hurt to try since you cannot do anything else.

after I read this book, I talked to my FIL about moving. He lived with MIL in same house for almost 70 years. They needed to do something. Get help in house or move. We had been telling him and he resisted. But when I asked him questions, it made a huge difference in his thinking. He did agree to move.
Good luck. Lean on hospice people for support for yourself too. It is very nice that you took him in but it is very stressful for you.
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If it's so upsetting to your father to do those things, you should talk to your hospice providers and ask if you can just let him do what he wants, and what to do when he does fall. I'm on cwillie's side here- he's dying, you can't stop that, and he wants things the way he wants them. I see dignity in getting up to use the toilet. I think that's important.
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I think you need to accept the fact that he is going to die soon and it is his choice to be the master of his own fate until he does, even if a fall makes that happen a little sooner. Do call for assistance if/when it happens, don't try to deal with it on your own. ((hugs)).
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