Mom takes unnecessary risks and is making me crazy. Any advice?

Does your mom have dementia? Has she been evaluated for dementia? That would be a pretty good answer for why she doesn't remember that she's not supposed to get up without assistance nearby.

What does she say when you ask her why she got up?

I think I'd get her into a geriatrics doctor soon.

I'm going to try to offer a different and third perspective here.

Your ideal is "sit and read, watch TV, look at magazines"... "scrapbooking, and so on." Do you realize how boring that can be? With the exception of scrapbooking, it's all passive, not active, activity.

I understand and agree with your concern about her mobility as well as concern for her safety. But I think she's probably bored and needs something to provide some exercise, both physical and mental.

For example:

1. Bring a chair over to the bookcase, let her sit and dust the books.

2. Do the dishes, put them on the table, let her sort them and hand to you to put away.

3. Ask her to help with the laundry by folding clothes. Don't refold them if she doesn't fold them according to your standards.

4. Think creatively - what household chores need to be done that she can do sitting down? How else can she participate and be a viable member of the household?

5. Give her the opportunity to get out of the house and be with other people. Consider taking her to a senior center for activities, to a free concert for music, to a library for a book club meeting. Check with the local libraries' online list of events and ask her if she's interested in any. Then take her.

6. You can buy little home use exercise bikes; they're really just pedals on a base, similar to those used in rehab facilities except cheaper and less complicated. Set one on a table, use screw or spring clamps to anchor it and let her exercise her arms. Set it on the floor and she can exercise her legs.

7. Find things for her to do that stimulate, not suppress, her intelligence. Magazines can help, but they're still passive activities. Or have a discussion after she reads one, again, to stimulate her mind.

8. If she likes board games, play them with her. Or puzzles. Both of them stimulate mental activity, the puzzles address spatial conceptions.

9. In the meantime, ask one of her physicians about PT for balance and strengthening, either through home care or at a PT facility, where she'll get a wider range of exercise and also have a chance to socialize.

Perhaps she's defying you because the world you've prescribed for her is too limited. Perhaps she's bored. I would be.

My first post was 1/2 of a two-pronged approach. This is the other half, making the house safer. I've posted a list of several steps that can be taken to either prevent or minimize the risk of falling.

https://www.agingcare.com/questions/greatest-fear-right-now-is-husband-will-fall-again-187632.htm

Yes, all good stuff, but does she have dementia? If so this has to be taken into account at all times and the necessary precautions and supervision must be provided.

Babalou and Windy, you're right. Since no mention was made of it in the original post or Tinkster's profile, I assumed this wasn't a factor. If it was, it would certainly change everything.

Well, its a lot more complicated than my simple post would indicate. Mom has had MS for over 50 years. She has great difficulty getting around. She is functionally blind in one eye and God only knows what her vision is in the other. She doesnt want to socialize at all or go mingle with others. She has always been this way.

My mom has some cognitive issues related to her MS, but apparently no dementia.

So, I think GA has some really suggestions. But I think you also need to get a handle on her cognitive issues. As in, does she fully understand the consequences of her falling so frequently? That you won't be able to care for her at home?

Tinkster, I'm not trying to minimize the fall risk, but can a compromise be reached? Like using a walker?

Also, I like all of the suggestions here, but what if it is just being stubborn? I ask because my Dad did this after he got home from the hospital. He wasn't supposed to walk by himself and promised to wait or call, but never did. He would do as Tinkster's mother does, and wait until we went to get the mail, then get up a try to walk to the bathroom by himself. I think he truly didn't want to face the fact that he could not be an independent, self-propelled individual anymore.

If dementia isn't a factor, are there any suggestions for helping a person get to a place where they can acknowledge and cope with the fact that they shouldn't be walking around by themselves? How does one cope with a loss of independence?

Wish I'd known she has MS when I responded. That makes a huge difference. Does she use a wheelchair? Has your house been "adapted" with grab bars, and other devices?

I'm just wondering if you had considered contacting a MS support group to get some advice on your mother's situation? In addition to the cognitive issues raised here, I'm sure there are others that affect people with MS, such as the knowledge that they're dealing with a degenerative disease which will never get any better but will get worse over time.

That might be part of your mother's resistance to caution - she may be trying to defy the limitations of the disease.

GardenArtist, she has several styles of walkers, a scooter. Like i said, my mom has had MS for a long time, so grab bars, etc are a way of life. But she falls when she uses the walkers, too. That is why we insist the she let us know if she want or needs to go from one place to another -- so we can stand by to assist. She understands the consequences of falling. She apparently is able to convince herself that she wont fall.

Tinkster, my own Father had a simular yet different disease process called PSP, and I believe as Gardestated, he was always pushing the boundaries and limitations of his disease progression in an attempt to defy it, part of his masculine pride. It is a very sad and frustrating position for you and your Mom. Unfortunately my Dad is no longer with us.

My mom's MS has been this bad for years, so it's already done its "get worse over time" thing. I've talked to the local MS support group. I've talked to her primary doctor. I guess the point I'm making is that if her mobility issues were a new or developing thing, I could see her grappling with it and being in denial etc. But this is not a new thing. And I know for a fact that this behavior is not a new thing, either. But it has to stop. If it doesn't, we will not be able to care for her at home.

Tinkster, have you told her that? Not in the heat of the moment, after a fall, but when all is quiet? Is this a self destructive urge?

How long has she been pushing the envelop by taking risks after she tells you she won't? The reason I ask is that my cousin started out that way too. She seemed fine, except for her disability of arthritis, but she began to refuse to use her cane. Even on hilly and uneven ground or long distances she would insist she was okay. I would question her about how dangerous it was and how her falling wasn't just a problem for her, but for me who had to take off work to care for her, but she was oblivious to my please. She knew better, but would defy safety precautions and go it alone and with no cane. She kept falling and eventually had multiple fractures. Eventually, it became apparent that she did have dementia. She could read, write and balance the checkbook, but she could not realize she needed her cane, that she needed to bathe or that she shouldn't eat spoiled food.

I would carefully consider any subtle changes to see if this is the culprit.

And regardless of the reason she is acting this way, whether she is suffering dementia or she is in defiance, what can you do about it? I think the only answer is to never leave her unattended. That's the only way to ensure she doesn't walk improperly or take unnecessary risks. Obviously, your pleas don't matter. I wouldn't think she is going to change.

Yes, Babalou. Its been an ongoing conversation every time one of us (her children) has spent caretaking time with her over the decades. Until June, her partner was her fulltime caregiver. Many hours distant from her family, and no transparency relative to her health or situation. I know she put her partner through this for 30 plus years.

It sounds as though your mom needs to be somewhere with several shifts of caregivers, an alarm on her seat and something in front of her (weighted table, desk, with an activity on it, of course) that might delay/deter her rising. When was the last time a psych saw her for a cog assessment ?

She was in the hospital in July and they (psych) did an "assessment", but I have no idea what it consisted of. She is very good at behaving "normally" in front of professionals.

You might think about requesting a neuro psychological assessmet, which would assess her reasoning abilities. It would tell you, to put it bluntly, if you are reasoning with an adult or a 5 year old. Those are two very different approaches.

I know it was Neurology that did the assessment. I guess that doesn't mean it was the right sort though.

Do you have HIPAA rights, or medical poa? I would have a conversation with the folks who did the assessment if you do. You need to know "functionally" what you are dealing with. As in, at what age equivalent functional level is she operating?" " can she understand the consequences of her own actions? "

I absolutely understand your frustration and concern. My mom a lot! But we all need a reason to get out of bed. Your mom likely needs to feel useful.

I firmly believe that we,. as caregivers, can take away an awful lot with our need to protect. I found that out with my dad, too. There were some risks in giving him more physical freedom but there were greater (in my mind) risks in forcing him into doing nothing so he didn't get hurt.

Gardenartist listed some excellent possibilities as far as physically supporting your mom while she does things. You might want to check with a physical therapist, as well. Your doctor or a social worker can help you find someone who might have more suggestions.Consider your mom's losses and the reasons why she doesn't want to just sit. Then try to find methods that satisfy both of you.

Take care,
Carol

Assessments by neurologists and neuropsychologists are quite different. My husband—with PSP—has had both. His neurologists have tested things like nerve conductivity, eye movement, strength, balance, and memory. The neuropsychologist interviewed both of us for an hour so she would know which tests to give, then took him away for two hours hours of testing. Most psychological tests I know of—and I have a graduate degree in the subject—involve paper and pencil or questions and answers. Words, drawing, spatial relations, reasoning, and the like.

I agree that if dementia is a factor, that has to be considered. However, even with dementia, people need to feel useful. Supervision is often necessary but allowing them to do some "work" can be good for their emotional health.

I have a slightly different take here and maybe this might be a solution. While I am probably young enough to be your moms daughter, her history sounds exactly like mine. I fall almost weekly. And, yes, I tend to do my "riskier maneuvers" when I am aline. For me, I think it has to do with coming to accept the loss of my mobility, and having a well intentioned, but not very practical way to protest the loss of my independance.its very difficult to develop a new way of being in the world, and having to adjust to so much loss...especially for a person who used to run not only a house, but a job. I used to do direct service work with all kinds of people, before my own body fell apart. Quite humbling to have a former client be the one to teach me the advantages of using equipment. For me, the best thing I did was go see a physical medicine and rehabilitation doctor and get myself a power wheelchair evaluation for use in my home. Since I got that chair, I have only fallen once, and that was getting out of the pool. I dont consider myself confined to it. Its a tool. When I am able to, I wheel over to the bookshelf, and stand up to dust. I carry my laundry safely. I can cook without being afraid im going to drop something on the floor. My apartment was built in 1986, so its grandfathered in on the more recent changes on wheelchair accessibility, however, for my purposes it works just fine. I put some double hinged door hinges on the doors so they open flat against the wall, a threshold ramp that I got online for less than a hundred bucks, and a few simple things like hanging my clothes on a second hangar so they hang lower in the closet, taking doors of cabinets in the bathroom and kitchen, and voila. Its also nice to be able to roll down the street and get a few things at the store without having to worry about what would happen if I fell . My chair also comes apart (sort of) & I can get out and go to the fair or church ir the movies. I dont like the stigma, and had to get over the idea that I was sicker or somehow less than others because I needed this tool. It hs made my life so much better. And, my house is cleaner, too. Just a thought. If you decide to try it, be aware that medicare has definate timelines...and doctors are not always aware of these. So its a lot of callingto check. They also may reauire you to use a contracted provider...mine is hover round here in california. Hoverround is not allowed to call me, because they can get dinged badly for soliciting business so I called them almost daily to make sure my paperwork didnt get lost. The doc is required to refer to OT and PT both, for a wheelchair evaluation, specifically, and those appointments MUST be done in the same month. Keep a copy of those reports and your do tors notes and prescription, as wheelchair companies are notoriuous for losing things. Hover round kept losing mine, til they finally told me what my account number was and I wrote it on every page. Medicare provides them for use in the home, and I am lucky that my supplement covers the 20%, that medicare does not pay. Its a 13 month rent to own...saved me from many broken bones. I still exercise and do as much as I can to stay active. It definitely improved my quality of life. Now I use my "defiance" to do things I used to love. Like trim the roses.

Yo want to try to remember that people don't like losing their independence with age. Instead of making plans with your loved one, try doing things on the spur of the moment as they come up and see how that works.

ruthieruth, that's a great idea referring to items as equipment to help you. I will use that approach with my elder Dad as he keep tumbling over and forgets to use his Rolling Walker... I will tell him this walker is a "tool", no different than a drill or a saw to use to get something done... that walker will be a tool, too.

Ruth, your post is not only helpful in adapting and finding ways to remain mobile, but it's a testament to inspiration, coping and the ability to gracefully accept yet turn around a situation which has occurred in your life.

As does FF, I think considering devices which help as "tools" is an excellent way of thinking positively and creatively.

Thank you so much for sharing your insights. I'm copying your post and keeping it in my caregiving inspirational file.

Put an alarm or bell on her person. She gets up and moves and it will go off.