Fourteen years ago, my grandmother came to live with us. Over time, dementia set in, and about five years ago, its effects became more pronounced. Through a specialized program, we managed to provide her with in-home care. She settled into a routine of peaceful eating, center activities, outings and sleeping, punctuated by occasional moments of moaning, or swearing.
We installed cameras and a communication device to monitor her well-being remotely. I checked on her multiple times daily, often finding her peacefully asleep in her recliner. We did her grocery shopping and visited often. Although she occasionally expressed a desire to move around, her disabilities made this rare, so we ensured she was safely tucked in.
A few weeks ago, tragedy struck. During a period between visits, she became restless, kicked off her shoes, threw her legs over the chair arm, began kicking and eventually fell from her chair. We don’t know how she managed this as she had become more fragile and loss muscle mass after she stopped walking last year. Despite her advanced age, her sudden passing has left our family devastated. I can't help but blame myself, questioning if I could have done more. My mother had suggested adding an extra pillow, but it seemed unnecessary since she always favored sleeping on her other side.
Of all her children, only my mom and I took on the responsibility of caring for her. I thought I was a vigilant caregiver, especially as she was in good overall health, and I was very involved in her daily care and overall health plan. However, the guilt weighs heavily on me for not checking on her that morning in between visits and instead, being occupied elsewhere.
Her aide found her 20-30 minutes after she had fallen. It's a loss that has shaken our family deeply, leaving me grappling with feelings of regret and sorrow.
Did I fail my loved one?
Unfortunately, falls are very common and leads to death of elderly .
My grandmother had Alzheimer’s and lived with my Aunt . My aunt reminded grandma not to get up while my aunt went in the kitchen to make lunch .
My grandmother of course forgot . She would get up to “ change the TV channel “ , because she forgot the TV had a remote . Grandma thought it was the 1950’s when you had to get up and turn the dial on the TV.
Grandma got up and fell hitting her head on the corner of the TV stand which lead to a subdural hematoma and death .
Please don’t blame yourself , even if you had been in the home with her , it could have happened . I doubt an extra pillow would have made a difference with her kicking . The pillow would have landed on the floor
Elderly in facilities often fall as well .
You are feeling grief and it’s common to jump to what if’s , only if’s . Your grandmother was lucky to have someone who cared .
I know cameras are frequently encouraged . Personally I skipped cameras at home and placed my mother in a facility , where she fell a few times , including the day before she died while napping in her chair .
Anger is easier than grief and tears, and they help us prolong that time when we don't have to walk through the "valley of the shadow".
How old was your grandmother?
Did she have dementia?
You say she was kicking to get out of the chair, and did so. Now she is gone. Did falling kill her?
Deaths that happen in the home unexpectedly are often coroner's cases; in most states that is
the law. What did the coroner's report say about cause of death.
Again, there is information here, but not the crucial information for us to make any judgements as to whether or not grandmother was safe in her home.
So we need age and mental status and overall mobility to make that call.
The truth may be that your grandmother should have been in in facility care.
I will tell you that is no guarantee of not falling. Falls are an inevitability past a certain age, not only because of our bones and muscles, but more because our brains have such lower brain balance deficits. Falls are often "the beginning of the end". It was a fall that took my mother, eventually, in her mid 90s. She had after the fall one thing after another, pneumoia, UTIs, and eventual move to care where she lasted on Hospice only two weeks.
We age. We die. And honestly we die of SOMETHING or other. I suspect with that many years of care your grandmother had a long life. Now she is at peace. I think if you look at it realistically, what happened could have happened anywhere and anytime, and was likely inevitable.
I wish you the best.
Our encounters with care homes were unfortunately marked by poor standards, including instances where facilities misrepresented her hygiene and overall care. I've observed that unless families advocate tirelessly for these patients, they are often neglected.
Installing cameras allowed us to intervene when aides forgot tasks, verify attendance, ensure adequate hygiene, and communicate promptly if issues arose. They were indispensable and made it possible for me to sustain long-term care for her.
We passed on surgery but she was in rehab trying to learn to pivot on that bad leg. But she kept trying to get out of bed at the rehab. Her sister and nieces visited her every day and stayed for hours, making sure she was eating, drinking and had her hygiene addressed. Mercifully, she passed in her sleep right before having an assessment for placement.
Did we fail her? No, just like you didn't fail your Grandmother. What would you consider "not a failure"? That someone never suffers (despite heroic efforts) and then passes peacefully in their sleep "when we're ready"? I'm not trying to be snarky or disrespectful, just wishing to point out that no one gets to stay here forever, and no one ever has control over how and when they exit. I work on this in my mind almost every day to some extent. My own Mom is 95, my MIL is 89 and we're managing care for them and my 105-yr old Aunt. My Mom now Sundowns and has paranoia but lives semi-independently in the house next to mine. My MIL is on Medicaid in LTC and now has skin cancer on her shin, which we will not treat. I've come to peace with knowing we're doing the best we can for all of them, given the resources and circumstances. That's as much as anyone can do. You did yeoman's work on your Grandmother's behalf. Kudos to you and I'm sorry for your loss.
Just want to say, I can feel the profound devotion and commitment you had towards your grandmother, may she rest in peace 🙏
You and your mother did an amazing job making grandmother comfortable and safe AS POSSIBLE in her home… there is only so much you can do because you are unable to make someone age in reverse…
Perhaps, grandma passing in that way was divinely guided so you were not there to witness. And now, she is no longer in pain.
Finally, as a care giver for my own Grandpa, I can truly relate. I want to say your grandmother will always be with you. She is so proud of you, so you should be too :)
Take care of yourself and be well! Many blessings to you and your family
"A few weeks ago, tragedy struck".
Think about the word you used: tradegy. Hopefully soon you can find a new kinder word or phrase to use.
A long life, a short passing. At home. I'd call this natural. A blessing even.
Stop thinking about the extra pillow. That cannot prevent blood clots, heart failure & a myriad of other ways the body winds down.
Celebrate your Grandmother's long life. Maybe place a few lovely photos & flowers in the room to mark her absense. Go well.
Grandma lived to be 96. You and Mom provided great care for her.
This deserves repeating:
"A long life, a short passing. At home. I'd call this natural. A blessing even."
Falls happen, please don't beat yourself up over this.
Every time your mind goes there , tell yours every day I did the best I could do. Over and over. Because you did!!
Really...just stop. What you're now feeling is grief, not guilt, so quit mixing up the 2 words when they mean 2 totally different things.
Your grandmother would NOT want you feeling bad at all, but would want you to know how very much she appreciated all your help over the years and how very much she loved you.
You did the very best you could and that is all any of us can do.
Often it is a fall that will take a person out in the end, and I do believe in time you too will actually see this as a blessing as your grandmother no longer has to suffer with the horrible disease of dementia.
So honor your grandmother now, by moving forward with your head held high knowing that you did a really good job with her care.
God bless you.