My husband fell 18 times in Nov. How do I convince him to use his canes or wheelchair?

I suspect my Dad will go down this path with Dementia as he lives alone, very stubborn, mean, anxious and angry, he is probably not as late stage as this. He gets exploited by a homeless woman occasionally and I report both of them for self neglect and mutual abuse, and get vulnerable adult protection orders. He won't listen to his 52 year old daughter who works in eldercare hospice and formerly in banking finance nor his 54 year old military dentist daughter who has given up and has not talked to him for 5 years. I am at the stage where once a month the phone rings, usually it is authorities or neighbors, and I have to report things like falls, wandering, driving while lost, not remembering where his car is, etc, to authorities like APS, DSHS, Superior Court Judges. I do this because he won't let me, his only trusted, responsible next of kin to help him and is just really really stubborn and angry. I am waiting for the ultimatum call, the one where the state I live in asks if I will be the guardian as I am the only one they could call. At that point I will then decide the who and what, as finally I can act on his behalf, like do I put him in adult family home spend down or medicaid community to put him on medicaid, as it will have to get to this, he will never listen to me nor get better, only worse. I will NEVER be able to prevent his self harming and self neglect. My mother died 24 years ago of cancer and I actually envy her that she does not have to deal with this hell. I have boundaries and I offered to commit to being my dad's power of attorney many times have asked him to spell out his advanced directives like what he wishes when he no longer can bathe, toilet, walk, transfer or spell his name, etc, but he has always refused and gotten defensive and mean. I would get your husband put on hospice as he sounds late stage, with this much decline, the hospice social worker/nurse would help you navigate the system, and at least find placement or different options. The other thing to do is do not let him come home from the hospital until he gets placed in a medicaid facility stating that caring for him at a private residence beyond what anyone can do. I have already written my advanced directives so my children know exactly my wishes if I ever get to this point as I wish my future generation live their life with the peace of knowing I committed to my own wishes, and committed my kids to carrying those wishes out, while of sound mind, so that they don't have to wonder every time the phone rings what their loved one wished for at end of life. I really resent my Dad for not making those commitments to himself nor to his kids, yet he committed to bringing me into his life, even though I offered many times while he was still decisional and of earlier condition, still of sound mind to have it spelled out, but he never brought himself to commit to those directives, which I view as cowardly. He is just a very, very stubborn, lonely old man now with very bad dementia. However he is my Dad and when I do get the call from the authorities asking if I will act as guardian I will decide then whether I will commit to that, and I just don't know. I don't think it is very fair to the next generation to be so irresponsible about one's wishes at end of life.

“We are not going to any kind of nursing home. That is not viable.”

Yes it is, and you should. You are living in a fool’s paradise thinking you can convince your husband of anything. It’s just as foolish to think you can handle him and yourself. You are already in way over your head and this is hard to accept.

Why are you so against doing what needs to be done? Because this stubborn attitude is going to kill him or you long before a care facility ever could.

There are also ways to prevent a lot of falls - like installing bath/shower rails, and eliminating throw rugs. But you are probably doing those things already.

Does he have any male friends who also need to use a chair or a cane? He might listen to them, even if he's in denial with everybody else. INCLUDING healthcare professionals. A priest or minister might also be able to get through to him - if he is inclined that way

My father was the same way - about using a cane and a walker for his own personal safety. He would listen very nicely, and then smile at us and say, "I'm ninety one. And you're not."

Gaye1967: Due to dementia, your DH (Dear Husband) has lost the capacity for rational thought processes.

Our neighbour refused to use glasses or walk with a stick- being proud
her son was at despair stage
she kept falling - last episode resulted in her face left black and blue ( fall must have hit her nose?)
anyway as an outsider I approached her
talking about how I fell - and how I am getting a walking stick and his I see everyone using walking sticks now- they’re height of fashion!
anyway - next time I saw her she had a quoted glasses and was using a stick to walk
sometimes an outsider is listened to or maybe another member of the family
maybe invent a story saying someone in work died after falling and leave it to sink in
make sure there is a stock left near them
my dad refused a stick first of all
then I said humour me dad just use it once
after that I’d leave it near him and he started to use it
then I upgraded to a better three leg stick helping balance more and he hasn’t looked back
A lot of People if a certain age got a pride thing going on .. got to make it look like it’s the norm now
or maybe a fold up one he can hide at times as he breaks in and accepts he needs to use them.

Get a walker with wheels. If he's or you are a veteran the VA will provide you with one. Also get better canes. Maybe the caves that are taller and help you stand up straighter or at least bout the big

My Dad had Parkinson’s with Lewy Body Dementia. I stopped counting after he fell for the 90th time. He was one of those incredibly stubborn men who insisted on living at home when he absolutely should have been in a facility. We finally forced him into one when he was too weak to get out of bed on his own.

Lewy’s Body Dementia is one of the worst types of dementia. You will not be able to handle him if/when he gets aggressive.

I’m sorry but you need to see a Certified Elder Care Attorney to help you qualify for Medicaid for him. They can help you.

Uncertain about your comment "NH is not viable". He has fallen more than half the days in a single month. You struggle with balance. Obviously, he is not going to use canes or wheelchair to move around - either he doesn't remember he needs these helps or he is just refusing. And it doesn't appear you reminding him to do so is working at all.

By viable, do you mean it is not helpful (in your opinion) or not financially possible due to low income or because you don't want to use personal funds to pay for NH? If financial, you should speak to an elder attorney because you may be surprised to find out low income would get him into a NH. Even income over the Medicaid limit for a NH bed can be qualified with trust. If you can't afford an elder attorney, call or send someone to the local Medicaid for Elderly/Disabled to discuss income/bank account balances to see if it's worth it to complete an application.

At any rate, being at home and falling that many times in a month is not viable either. Eventually, he's going to kill himself or create injuries that permanently put him in a bed. At that point, what is the plan to care for him.

Please refuse your husband's discharge. Your husband could break a hip or hit his head. I am sorry, but your husband needs to stay in a personal care home. He should be sitting a wheelchair, if his balance is getting worse.

Seems like he needs a walker or the wheelchair. Also, seems like you need "a helper or two" to come in throughout the week.

Oh my.
Gaye, you can not "convince" your husband with dementia of anything.

WHY? did he come home at 3:30 in the morning (the middle of the night!) from the hospital?

The next time he goes to the hospital - and it won't be long - DO NOT BRING HIM HOME! Talk to a hospital social worker - let them know YOU CAN NOT TAKE CARE OF HIM SAFELY AT HOME!

I know you hate seeing him bleeding on the floor. I'm so sorry you are going through this!
He will continue to fall. You can not make him use a wheelchair or cane, or any other mobility device. He will fall again.

He should be in a care home. I don't know why you say that is not viable.
YOU do not need to go to the care home with him.

You can opt, if you can afford it, to move with your husband to an assisted living apartment. You still can not prevent him from falling.

I'm sorry to say it, this is the beginning of the end. He is not going to get better.
He is not going to change for the better and start practicing safer habits.

Either this will continue; He will continue to fall at home, you will call 911, he will be taken to emergency, and come home again, if you allow it.
Or, you will find a suitable care home placement for him.

I know you will miss him. I kill myself every day trying to take care of my husband at home. We are only 63. This has been going on for 10 years.
We were both strong and healthy before his massive stroke, which changed both our lives.
My body has aged badly! I went from strong and fit to barely able to walk in a matter of a few years. In our case, I will continue to try. I will die trying. Because that is my level of commitment, and I am paid to be his caregiver. If I am not doing this, I will have to find a job at age 63, after 10 years out of the job market.
This is the job I choose. And as long as I am able to do it, I will. But at some point, I will no longer be able. That's when it is time for a skilled nursing facility.

At 87, your husband has lived a long life. None of us will live forever. It is time for him to live out his remaining time with the help he needs, with professional and compassionate care. You can not do this.

If you won’t go to a nursing home, you’re dooming both of you to dying at home, probably alone. Or at least that’s what it looks like.

Why would you not want your husband to have the professional help that he so clearly needs? Why would you deny yourself help with him and help for yourself?

I don’t understand. We see it a lot on here, and the thought of what happens to these people is horrendous. I’m very sorry it’s happening to you.

Sounds cruel to me to expect a blind, mostly deaf man with dementia to use a cane or walker, much less be reminded into remembering to do so. I hope it’s unintentional and out of good intentions, but it’s still misguided in my thoughts. The falls will be near continuous and that’s just awful. I watched too many falls with my dad and he had far less going on. In your shoes, my husband would have a wheelchair and professional help

Welcome Gaye1967. I'm sorry you are going through this.

I do have a question. In your post you say "We are not going to any kind of nursing home. That is not viable". I'm just curious - why is it not viable? Because neither of you want it? For financial reasons? Separation?

If it is because of financial reasons - it may be far more viable than you realize, with options other than private pay.

If it is because neither of you want to go to a nursing home - you are in good company. I don't think anyone WANTS to go to a SNF. But sometimes, your options become so limited that what you want and what you need are in conflict.

As others have mentioned - LBD is one of the forms of dementia that really has a heavy fall risk. If you factor in the inability to remember to use safety tools to assist with mobility, as you have already seen - the next fall is just queueing up and its just a matter of time.

I think we all know there is literally no way to prevent someone from falling - not even if you spend every moment of every day with them - you may lower the risk or number but you can't prevent it entirely.

It is so hard to watch someone you love go through this. But you also have to be as practical as possible when doing so. He is blind, almost deaf - this alone would impact balance and safe mobility. But you have to factor in the LBD and the lack of actual memory that any of that applies.

To give you an example - my grandmother who has dementia began to yell the other day that she was blind. My mom turned to look at her and said "Mother, are you blind? Or is it because your eyes are closed? Are you able to open your eyes?" She had momentarily forgotten how to make her eyes open. Mom had to literally walk her through opening her eyes.

This is what dementia does. All of those natural things that we just do - become a task that has to be remembered and executed as they are now.

It's not that he needs to be convinced to use the cane or walker. It's that he doesn't remember that he needs them. He doesn't remember that his body doesn't work the way it used to work. He does what comes naturally to him, forgetting that it doesn't come naturally anymore.

This is why it may become important to see additional caregiving assistance because as he progresses, it may become too much for you to handle on your own.

I wish you the best of luck.

You can’t convince him of anything . He can’t understand or remember what you tell him . He also can’t see what is around him , or hear you well .

So long as he’s walking around , He will continue to fall and likely end up in a nursing home anyway with a fracture , or head injury .

I’m sorry for your situation

Depending on the state you live in, Hospice is all about setting up comforts in the home and treating the individual and family. It sounds like late stage lewy body dementia with enough decline to qualify, and anyone can self refer to different hospice agencies, although depending on your location there can be a ton of choices (like California has 900 choices or NYC has like 8 choices). The private ones not affiliated with hospitals tend to be the most liberal in what they take on. For example, instead of going to the ER after a fall, hospice nurse will visit and assess as it becomes about treating the person, and this sounds pretty bad, they will probably review the meds too. They might also recommend things for the family like he has to be in a certain kind of wheelchair or equipment if he is too much of a fall risk. It is a daily benefit under medicare or most insurances to provide supports at the end stage of most chronic diseases and lewy body end stage is one of the most severe, this many falls usually means late stage. I don't mean to be depressing or alarming but some people are on hospice for years if there is enough decline, and if they get better they get discharged, but very rarely do people get better once they get to late stage dementia. Just saying try it out if you don't like it revoke it or discharge and go back to what you are doing now... Also the hospice social worker would be able to help you navigate this and hospice all about comforts at the end stage, and that can be a bit much to have people come in and give their opine, but at least it's professional and well meant and designed to bring comforts at the end stage. Best of wishes, I don't envy anyone dealing with this and hope you both get some peace.

He obviously is not remembering to use his cane or walker, or (being blind) can't find the cane or walker when he needs it. You won't be able to remind him since he is totally deaf.

What kind of miraculous solution to this problem do you think exists? Unless you follow him around all day, there is unfortunately no solution that you seem to be open to, so I guess he'll just have to keep falling at home until he hits his head and goes to the hospital and then is bedridden -- or worse.

You are now the only one who has the ability to change or adjust.

If he is assessed as a candidate for LTC, this can be covered by Medicaid, if he qualifies financially (Medicaid pays for his medical and his ss pays for the custodial care).

I wish you wisdom and peace in your heart as you make decisions to protect him and yourself.

Have you tried giving your husband the ultimatum that he either uses his wheelchair or you'll have to get him placed in the appropriate facility?
But in all reality as much as neither of you want to go into any kind of nursing facilities it may very well be where you both end up, as I don't believe that you'll be able to continue on the way you're going.
You now have to do what is best for the 2 of you, and allowing your husband to continue to fall and risk hurting himself or worse yet dying from a brain bleed because he hit his head sounds way more cruel to me than having him placed in the appropriate facility.
Life often doesn't give us what we want, but we must do what is best under the circumstances, and I think you know what needs to be done in yours and your husbands circumstances.
I wish you well in making the right and best decisions for you and your husband.

Lewy's is infamous for removing balance. This is a brain thing, not a leg thing. If he doesn't use a good walker, then he will continue to fall. And falls are often the beginning of the end. There is little you can do short of attaching yourself to his hip about this. He cannot remember to do this. I am so very sorry.
And I honestly think, given your own limitations, that it is time soon to be in ALF for more care. And perhaps in Memory care for hubby. I am really very sorry. My brother had Lewy's and the hallucinations AND the awful balance. I know what is happening to you and I am sorry. But this is no longer safe.

Gaye, welcome to the site. Could you provide a bit more information? Your profile is almost blank. It would help to know your ages, and the forecast for your DH’s dementia.

Is there any way you could confine him to his wheelchair? Perhaps strap him in, with the catch for the strap out of reach and sight at the back of the wheelchair? Perhaps acceptable at home, although not in a facility.

It would also help for more information about WHY “going to any kind of nursing home ...is not viable”. The reasons might include distance from where you yourself will continue to live, DH not being in need of nursing, financial limitations, or a strong opposition to facility care. There might be helpful comments on any of these, if you can provide a bit more detail.
Best wishes, Margaret

No cane, walker or person is going to prevent him from falling, unfortunately.

How are canes going to help DH if he's blind? He needs 24/7 supervision in a wheelchair full time now. If or when he falls and hurts himself badly enough, the option of a Skilled Nursing facility will be taken off the table and he will be placed against his will, for obvious safety reasons. That's what you tell him to convince him to stay in the wheelchair. How are you both able to function w/o help? Please look into at least hiring some help to assist with cooking, cleaning and showers.

Best of luck to you.