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Carol Bradley Bursack, Published December 29 2012

Minding our Elders: An elder’s fall can cause lasting trauma

DEAR CAROL: Reading your column has helped me care for my 83-year-old mom who has Alzheimer’s disease. Now, I’m writing with my own question. Mom fell while in the memory unit of a very good assisted living center. She had a urinary tract infection and the doctor thinks that’s what caused her fall. The UTI is now cleared up. When she fell, she cut her head badly, needing several staples to close the wound. She also suffered a back injury though no broken bones. The facility couldn’t care for her after she was released from the hospital, so she’s in a skilled nursing home. It’s been three weeks, yet she’s still confused and agitated, far worse than before the fall. Mostly she just sleeps, or sits and stares at nothing. Her physical injuries are healing but she seems to be getting worse overall. What is going on? – Mary Ann

DEAR MARY ANN: Your mom’s been through significant physical, mental and emotional trauma that would be tough on someone much younger and not fighting dementia. I think you need to expect that her current condition is natural considering her age, her dementia diagnosis and all that she’s been through.

Studies are now showing that confusion of hospitalization in itself can push some people with dementia deeper into the disease. When you consider that, as well as her physical injuries, it’s not unusual that she’s lost ground.

The trauma she’s suffered since the fall may leave permanent damage. You want her to get back to the way she was before the fall and that’s natural. However, think about how much she’s been through. While I’m not a medical person, I’ve seen many elders traumatized by falls. Please talk with your mom’s doctor and ask what you can realistically expect. You may also want to talk with the social worker at the nursing home. Social workers see many cases like your mother’s and can give you an experienced opinion.

Spend as much time with your mom as you can with the realization that after all she’s experienced there is a possibility that she may never return to her previous condition. Naturally, the medical team will do what they can, and if your mom has the physical resources there’s hope that she’ll regain more function. However, you should likely prepare yourself for little or no improvement, or even a possible decline in her condition.

Stay hopeful but realistic. By communicating often with the doctor and the medical people in the nursing home, you be able to keep informed about your mom’s prognosis. Your mom has Alzheimer’s, so she’s likely having a hard time making sense out of her physical pain, as well as being moved from assisted living to the hospital and now to the nursing home. Hold her hand, sit with her and let her know you are there. All any of us really have is the present, so make the most of that while you try to help her with the future.

This column was written exclusively for The Forum.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carol@mindingourelders.com.