My 91-year-old mother occasionally falls for no apparent reason. Her doctor says it may be because she has hydrocephalus, water on the brain, and we agree that treatment would be too taxing for her. She has a walker, but sometimes she just falls anyway. If I'm near her when this happens, is there a right or wrong way to catch her?
Expert Answer by Helen Lhim
Once the momentum of a fall starts, it's difficult to stop it. You're at risk of injuring her as well as yourself if you try to stop the fall. It's better to try to slow down the fall to prevent her from injuring herself and you.
To slow down a fall, position her so that she leans against you, easing her down to the floor with as minimal an impact as possible, especially protecting her head. For example, if you're walking with her and are on her right side and a little bit behind her, put your left hand around her left shoulder and your right hand around her right hip, and if her knees give out, hold her close to you, have her lean against you, and ease her down to the floor. If she starts leaning forward or to the side, you can, again, hold her close to you and guide her down to the floor. Using a gait belt while walking with her is also a good way to move her closer to you if she starts to fall.
If your mother is falling a lot, then try to think in terms of fall prevention. You can keep a record showing the time of day a fall happened, where it occurred, what you suspect may have caused the fall, what was going on prior to the fall, and what injuries occurred, if any. Identifying fall risk factors can minimize both their occurrence and possible injury.
Examples of the kinds of information to consider in a fall record include the following: Did her knees give way? Did she have any physical complaints before it happened? Does she start to lose her balance after a certain amount of time spent standing or walking? Might she need a change in medication? Is there a pattern in the way she's falling? Is there anything in the environment she traverses that needs changing?
If your mother does fall and she complains of pain or you suspect she has injured herself, she should get immediate medical attention. Report all falls to her primary physician. You can also ask for a home healthcare physical therapist to evaluate her for home safety and gait training and to train you in fall prevention.
Answer
Using a gait belt would provide you with the capacity to stop the fall or at least mitigate injury. However, I want to encourage you to change your approach from reacting to a fall and instead place your focus on preventing the fall.
The #1 cause of death for people over the age of 65 is due to falls. Yes, there is almost always an underlying diagnosis, but falling is one of the most dangerous events for the elderly.
I would recommend discussing this with your mother's doctor and determining if a four wheel walker with a seat would be appropriate. This would provide your mother with the opportunity to sit down if she felt dizzy etc...The doctor will assess whether your mother has the capacity to use the hand brakes for the walker.
It also might be time to transition from the walker to a companion chair. This means planning your mother's exercise so that she is never alone when she is walking. The companion chair is much lighter than a wheel chair and folds easily.
Beyond those measures, inspecting your home to remove some of the triggers that cause falls is also recommended. This includes removing loose rugs, mitigating or even eliminating stairs, removing clutter, and ensuring that lighting is effective.
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