<p>Being in the orthopedic biz let me tell you there are two kinds of falls. Tripping and what the elderly do. Most elderly fall because there is an underlying condition, their bones have gotten so frail, their balance so off and some cognitive issues that cause them to fall. Elderly don’t generally just trip and break a hip, their hip is already about ready to go. It’s generally when you see broken hips. If it is an honest to goodness trip, they recover and move on. If it’s underlying causes, they’ll generally pass within a year.</p>
<p>I am somewhat amazed that based on some posts, you are now where you are DW. Proud of you! I also think many others understand how difficult this process has been.</p>
<p>I also think there have been ‘tough love’ comments. Not meant at all to hurt anyone’s feelings.</p>
<p>You are on the ‘home stretch’. Hugs and encouragement to have this truly be a very productive Sept.</p>
<p>I have not read the whole thread, but I very much sympathize.</p>
<p>Just for reference - my friend’s mother was able to have her father committed involuntarily to an Alzheimer’s ward (lock and key) with no medical backup. At that point, it was the second time in a week she put him in a home - and the second time she ended up taking him out again the next day.</p>
<p>The money involved was outrageous, and they basically had to threaten to call the networks if they didn’t get their money back ($25,000 deposit in the second case).</p>
<p>The things that the wife complained about weren’t good enough? How about not having any soap or washcloth on the day he moved in? How about too small (the wife had gone there before and decided it was big enough for him)?</p>
<p>My friend’s mother is bipolar and her husband’s problems mostly relate to opiate addiction. The best thing my friend can do is not think about the situation.</p>
<p>And as for “she doesn’t fall” I have to agree with most here. It only takes one fall 
My dad is very very fit at 86, takes care of himself including many regular doctor check-ups, and he has a Life Alert thing so he can call for help if he falls or has another health situation.</p>
<p>It’s true, the fact that a senior has never fallen before doesn’t mean they can’t fall now, and falls are devastating for this population. My mom has only fallen once. Luckily, she broke her leg, not her hip, but even so, she has never been the same. She will have to use a walker for the rest of her life, meaning less mobility. As a result, she exercises very little, which has led to weight gain, which has led to knee problems and a general physical deterioration. Her world is vastly smaller since she broke her leg. I also trace the beginning of her mental decline to that broken leg.</p>
<p>As with babies and toddlers, this phase of life is filled with rapid physical changes. It’s wise not to make assumptions that the past is an indicator of the present or future.</p>
<p>rhandco, welcome.</p>
<p>I’ve read that often it’s not that a frail elder falls and breaks her hip. Rather, she breaks her hip and falls: her bones are so weak that they simply fail.</p>
<p>Yes CF, that’s usually what happens, your break happens before the fall. </p>
<p>^Yikes, I never knew that!</p>
<p>It depends. The one thing in elder medicine you can count on is that looking at their past vitality doesn’t help with predictions. We have to look forward and admit the declines will continue. So, I like travelnut’s advice about level of care. It can be different when our relative is in his/her 70’s.<br>
<a href=“http://www.cdc.gov/homeandrecreationalsafety/falls/adulthipfx.html”>http://www.cdc.gov/homeandrecreationalsafety/falls/adulthipfx.html</a></p>
<p>You’re all right about the fall business. I realize I have a false sense of security that my mother “doesn’t fall.” That’s exactly what it was: a false sense of security. Thanks for the wake up call.</p>
<p>SOS Concern: THANK YOU for the words of encouragement that I needed exactly now. I saw the MD this morning and got my RX. Haven’t eaten a thing all day. It’s 3:40. Haven’t fed my kids a morsel - they are just feeding themselves. Haven’t even seen my 11 year old since last night. I have been sitting in the hot upstairs bedroom in front of the computer (DD2 has the other one in the cool basement.) I have probably emailed back and forth with the rep at Maplewood three times and talked to her once; talked to three different people at Clancy Movers (local place) and left a voicemail for the person I need to speak to; wrote twice to the payroll rep. She sent me the info I wanted wrongly. I wanted a breakdown of the taxes my mother is paying each payroll. Instead she for some reason (what good would it do me?) she lumped together the taxes the employee and the employer are paying. Because I care, I did a web search of the best way to find a job for an eldercaregiver because we will be losing ours and in the past she had poor guidance/search skills…she is a foreigner…etc. And we may be losing her soon. In minutes I found caregiverlist.com, spoke to a person there who says they place women only in homes that adhere to the law exactly. I printed out six color pages to get her started when the time comes (luckily she has her own laptop). I have called my mother’s bank for her latest balances so I can do her accounts accurately - show her her assets and anticipated debts tomorrow to drive home the point that she must move soon.</p>
<p>Also had to deal with a crazy scare: my husband forwarded me a scary email that said our daughter’s college tuition was unpaid. The students acct dept was only voice mail. I said in my voice mail we had the CANCELLED check but it was still a worry. I thought maybe something went wrong with her federal loans so with a trial I found the right number to call re student loans and found out her loans HAD been paid to the college. Called the financial aid office to tell them to do something the person in federalloans.gov told me to tell them to do. I told her about the email I got from the students accounts dept. The woman laughed and said You’ll never hear back from them today! The email went out by mistake to hundreds of families! She DID say we owed $300 and I have NO idea what that is–I was SURE we had a zero balance. </p>
<p>Falls are one of the important prognosticators for an elder’s future, as is their ability to ambulate. If your elder is starting to be less stable, makes sense to anticipate the likelihood that they will need additional support. </p>
<p>My now 91 m-i-l has defied the odds big time, but wishes she hadn’t. She has multiple things contributing to her being completely unreliable on her feet- weakness, severe bone deterioration and arthritis, spinal stenosis, series of very small strokes, injuries from these falls keep her off her feet for a long time (last was a fractured sacrum) and her muscles (like most elders) waste very quickly, leaving her weaker and weaker after each incident. She is now in a NH, stating that she had hoped it wouldn’t take so long. I really feel for this once mega-high energy, intellectual powerhouse who now is facing the loss of living with her most supportive of husbands, as she can not navigate the simplest task without direct, professional assistance. It is heart-breaking. </p>
<p>Travelnut, I have read your note carefully and I will follow your advice. Tomorow I will sit down and think and wirite down the key questions and call both places and get answers. </p>
<p>But tell me, am I right to assume at the upcoming nursing care assessments (what level of care/how much money to tack on) I will be able to assess how each facility examines her and ask pertinent questions then, yes?</p>
<p>jym, thanks for the link - I will read it later. Am I right, are you saying one or both places might turn her down as a candidate too frail for AL? I got no impression of that kind from the two women who gave us the two tours, not at all. (At the place we have eliminated, we had the nursing assessment the same day as tour/lunch and she was assessed at the lowest level of needing care.</p>
<p>We live with one house between us on a street with sidewalks. With her caregiver she often walks all the way down to the nursery at the end of the block, with her walker of course. No, I did not say she falls but from the earlier discussion I am now much more aware of the danger.</p>
<p>Yes I would say she was “frail.” But I wouldn’t say “frail and feeble.” Somehow to me there is a subtle but important difference between the two.</p>
<p>Travelnut, I’m sure you know - it goes without saying - we are only looking at the best five-star facilities. One day when I got exasperated with her I searched Assisted Living in - and typed in my County. There are many I would never, ever approach. </p>
<p>@travelnut - that is so sad about your mil. I fear my mom is facing the same issue, physically deteriorating, but mentally still just fine and sharp. She will need a NH within the next couple of years and I know it will be awful to be surrounded by people in way worse shape. I also was shocked when we saw AL places how much worse my mom was than the people who lived there! The problem with many AL places is how independent they want you to be and how far away things can be from your unit. It makes those with walking issues unable to move there. </p>
<p>DW- The purpose of my posting about level of care and exactly what is offered/available at each place, including a higher level of care post AL, is that understanding that (within the context of financial circumstances) is the most critical variable in the entire decision. You are trying to get her situated once and for all and day to day, give her and you the peace of mind that almost whatever comes up, the place can handle it appropriately with her. Yes, you will likely chose to be on the hook for some things as nearest relative and concerned daughter. But that is different than being needed to refill every prescription, note changes in them, buy Depends, supervise showers, spend the day when she has a cold or worse, etc. At my parent’s AL, nurses would routinely check vitals, monitor colds and order a chest x-ray on-site if pneumonia was suspected for example. They would set up a vaporizer, arrange for meds, etc. Huge help. All included at one monthly rate, with the possibility to pay for laundry service and a washer dryer on-site. Anticipate increasing needs and be pleasantly surprised if this takes awhile. </p>
<p>There is no cookbook for how each place handles nursing assessments. If it were me and I was seriously interested in a place, I would ask how those are done and schedule a separate meeting for myself to get questions answered from a relative’s perspective. You really need to be able to picture your mother’s day there and see if there are gaps currently filled by her aide at home. There are multiple sites that list questions to ask AL and nursing homes. I looked at a lot of them while searching. See what is relevant for you and know that her being able to move seamlessly to the next level of care is critical. </p>
<p>Eyeamom- sorry about your mom. When my mother moved to AL, she had those mobility issues. What made it work for her was a power wheelchair, custom made to address all of her issues. NH residents are usually not eligible for funding these chairs, but Medicare will pay for someone with a certified need in AL last I knew. She went to a hospital and with a physical therapist and a wheelchair company rep, all the needed features were determined and measurements were taken. It took a few months but the magic chair was crafted. She was past using a walker to get to the dining hall and activities. Because her hands and mind worked, she could do this. I advocate getting this as soon as it makes sense, so the elder gets maximum use out of it. It is not easily transportable in any regular vehicle, but was great inside and out of the AL grounds. Of course, no one wants an ambulatory elder to use a power wheelchair when walking is safe and possible. But as a quality of life issue, for some, it is a real asset. Best with your mom, I am so sympathetic to this dilemma. </p>
<p>DW- Just saw your post and recognize your careful effort to find quality places. Within those quality places, there is a wide range of what to expect day to day. Opt for the most help being available for your mother. It will change both of your lives. You are almost there. </p>
<p>Just do a point by point comparison on each place re: meds, cost, services on site (Drs, PTs, podiatrists, dermatologists, hairdressers, etc). Know what happens when someone gets sick. That kind of stuff varies depending on how a facility is structured. If my father was sick in AL, the head nurse would call me, describe symptoms, send him to an in-house Dr or nurse practitioner, monitor things,order new meds, etc. My friend’s mother was in a lovely place, but if mother was sick, she got a different call. “We don’t know what is wrong your mother. We think she needs to go to her (outside) doctor. Call us when you have an appointment. Pick up scripts from the pharmacy, have Dr write us a note. set up her pill box with new meds” Different worlds, comparable quality places. Friend wound up moving her mother to my father’s AL after seeing how tiring that lifestyle became for her and her mother. </p>
<p>Good news! The realtor called this morning and my mother got an offer on the house. The realtor said it was low because they always start low. The house is listed for $250,000 and the offer is $220,000. The realtor told me she would counter at $245,000 and go from there.</p>
<p>Also, someone is seeing the house today and someone on Saturday.</p>
<p>The assessments AL needs to do is based on a combination of things. You may very well have to pay for ‘add ons’ with service - you just have to see how the evaluations come out and which place would be best for your mom.</p>
<p>Do not ‘borrow’ worry, DW.</p>
<p>I worked for a short time with an AL facility that was part of a chain. The place I worked for had ‘operations’ people, and ‘sales’ people. I worked on the sales side even though I was a RN. In our area, many bought in to the multi-stage facilities even though those were more costly for AL. Our mid-sized town had a lot more quality competition than where our other facilities in other states had. </p>
<p>A place that is pretty much always at 100% capacity is good for the owners, and hopefully also good for the residents and families - providing good services and full dedicated staffing.</p>