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My mother is a severe fall risk and is supposed to use a walker to get around. I have asked her a dozen times at least to NOT go outside if no one is home. Well, she was left alone about 2 months ago for a few hours after the nurse left and decided to go outside (no one was home) and fell on the concrete steps. She busted her knees and scrapped her feet really bad and was out there for about 30 minutes because she couldn’t get up.
We again had the talk that she can’t do that and to NOT go out on the porch if home by herself. Well... last night she was alone for 1.5 hours and decided to go out on the porch and she fell ... this time on her face and it was like 40° and she had to army crawl back inside since she can’t stand herself up.
i am at the end of my rope !! I don’t know what else to say or do to get her to understand that she absolutely cannot attempt to go on the porch by herself!!! I can’t afford to have someone with her all the time when I’m not there. I was trying to give her a little bit of freedom so she felt a little independence by leaving her alone for 2-3 hrs here and there.
I thought that after the 1st time falling and busting her knees up and her feet that she would have learned... but she didn’t. And this is all to have a cigarette!!!! She isn’t to be smoking! She’s a heart patient and had had 3 heart attacks and has severe blockage in her arteries.... not to be smoking!
Any advice???

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Is the nurse advised that she is a fall risk if left alone?
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Your mother should NOT be left alone for any length of time.
You either need to have a caregiver there with her when you can not be there.
You can ask friends if they can come sit with her.
Adult Day Care would be a good option if she can.
Leaving her will result in a tragic accident either she will die as a result of a fall or she will break a hip and it will be a long rehab if she tolerates the surgical repair and recovery. At that point she will probably be past using a walker and using a wheelchair.
Please for her safety do not leave her alone.
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No Dementia? Any cognitive decline related to her heart?

Not sure if I agree with Grandma. This woman is 71 years old and if there is no cognitive decline, she is just being stubborn. Yes, you would think that falling and not being found for 30 min would have some impact. Last thing I would want to be is in the hospital or rehab.

Sometimes people like this (I have them in my family) need a reality check. I would tell her if she ever breaks something and needs rehab, that she will be in that facility permanently. That you refuse to care for someone who doesn't do what they are told.

Now if Dementia is involved, different story. You cannot reason with them. Then like Grandma says, Mom can't be left alone.
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You don't 'get a parent' to listen to you...........it doesn't work that way. You can stand on your head on the roof and STILL she is going to go outside to smoke. She has an addiction and will do anything, even risk her life and limb, to satisfy it. I know. I smoked for many years and would go outside in a blizzard if necessary to have a cigarette. It is what it is. No amount of wagging your finger at her is going to stop her from smoking, either. She's already proven that by having 3 heart attacks and severe blockages in her arteries.........and she's still smoking.

There you have it: The Ugly Truth.

Here's some more ugly truth: Your mother should not be left alone at all, for any length of time, period. She is in need of Assisted Living which is less expensive than having an aide come into the home 24/7, that's for sure.

My father flat out refused to use a cane. So my husband took him to the grocery store to pick out a cane; no choice, pick one out or I will pick one out FOR you. He then started using a cane. When he needed the walker, he again refused to use it. So he fell one night and broke his hip. Rehab refused to release him back to independent living with my mother, so I had to move both of them into Assisted Living.

Sometimes, when an elder refuses to make a good choice, another choice is made FOR them. This is the road your mother may have to be on herself.

Best of luck to both of you. It's a tough road to be on, I know. My mother will be 93 next month, lives in Memory Care now, and is STILL giving me all kinds of hell. Last night, after I worked a 12 hour shift, she called to tell me 'just throw me out in the street, why dontcha?' Then she hung up on me.

Isn't it FUN dealing with all of this?
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ML4444 Dec 2019
I really appreciate your viewpoint on this forum. I’m dealing with a few of the very same things as you, and your advice/wisdom has helped me immensely... Just wanted to say thank you.
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Here’s a suggestion that might (??) help. Lock her in. Put a key to the exit in a glass fronted case next to the exit door, with a hammer that would break the glass. She can get out in an emergency, but has to break something to do it. If you simply can’t manage 24/7 supervision, that might work. And remove her cigarettes - it's that or an Assisted Living facility!
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Isthisrealyreal Dec 2019
Can not legally do that. The original poster would end up in jail for locking her mother in the house.
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Sighing deeply for you, I would say "save your breath to cool your porridge."

You'd better try to create a safe, accessible space where she can smoke if she really wants to that much. For one thing the damage is done and there is comparatively little to be gained by forcing her to quit. For another, it's not working: you're not stopping her smoking but she is now at risk of injury through falls *as well*.

The understanding part... It isn't that she doesn't understand, especially not when you're eyeball to eyeball with her explaining for the fortieth time. It's that she doesn't *agree.* And when the cat's away, the mice will play.

Make her as safe as you practically can, and then after that learn to accept the risks of her own creation and focus instead on what makes her happy and you least frantic about her.
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Not sure of your situation but my mom fell several times prior to living with me. She on a blood thinner and one fall cut her eyebrow open and couldn't get up for awhile when she finally did she couldnt find her phone as usual. She made it outside and it was the 3rd door she knocked on b4 she finally found someone home. I live 130 miles away, my sister lived down the street and really is no help. I couldnt quit my job then so it was aweful to figure out what to do.
I then had a security camera put in her house with one camera in the living room. She always slept in her recliner and this way I could continuously check on her where I could call for help.
This worked for a couple years and I also gained alot of info on what was going on with her leading to her bipolar diagnosis. I started seeing her very manic acting and getting no sleep and not acting tired. Then sitting all the time in depression. It was a real eye opener. This may be a temporary fix for you like it was for me.
You can get cameras where you can talk to each other too. This works through an app on my phone.
Good luck, care taking is very hard, I had no idea until bringing mom to live with me the last 6 months.
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NeedHelpWithMom Dec 2019
Great suggestions.
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She isn’t going to change her behavior. She isn’t a logical thinker. She has proven that she will do as she pleases.

Does she live alone or in a facility? She can’t be alone anymore if she is living at home.

Hope you can find a solution to this situation. If not other accidents will happen.

My brother even smoked with the nicotine patch on. Some people are super addicted to nicotine.
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LoopyLoo Dec 2019
Smoking WITH the patch?! Good Lord!😁

I know a guy that’s been known to smoke in the shower.
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If she's not having issues with dementia, then she's refusing to do as you ask, even though she agrees to it.  If she's got dementia, she's unable to retain much of what you say. 

She's obviously not going to quit smoking .. right now anyway.  Maybe try some nicotine gum to help her not smoke or not smoke much.  Get the gum that's plain .. not mint, etc. .. unless she likes menthol cigarettes.

Is there any way to make the porch or another area inside safe for her to smoke?  With her a fall risk, it's worrisome that she may be smoking, walking, fall, and set the home ablaze so if you make a place inside, be sure it's fire safe.  You can get smokeless ashtrays and air purifiers to help with odors so she could smoke inside.  I'm not trying to help her smoke, but if she's going to smoke anyway, better that she's safe and comfortable.  She could doze off with a cigarette in hand, too, so better that someone is there with her when she smokes.

Sounds like someone needs to be with her more if possible.  And, whoever's there with her needs to know she smokes, to please take her to smoke wherever that safe place is, and wait with her *patiently* while she smokes.  Mother may be embarrassed to say she wants to smoke since she's not supposed to and there's so much stigma, so she may not ask those who help her (including you) to help her to the porch.
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Lori, I know it's overwhelming to deal with something that seems so frustrating. Before, I started dealing with my LO, and her many falls and fractures, I didn't get it. I don't have any magic answer, but, I will relate what I discovered. Once, a person starts having multiple falls, it's very difficult to get them to stop. You can try to figure out what is causing it, but, normally, it's poor balance. You can see if she qualifies for physical therapy to help with her balance. My dad had that and it did help some. But, I don't think that's common.

When my LO started her falls, she was refusing to use her cane and insisting on walking on rocky surfaces. She knew it was dangerous and yet she refused to stop it and continued to walk on hilly ground with no cane. No matter how painful and inconvenient it was to suffer from fractures, she would not change. It made me angry, until we realized that she had dementia and was not thinking clearly and not using proper judgment. So, she had to be supervised 24/7 to keep her safe. But, even with that, she continued to fall and have fractures, because, no one, even those in MC can be held onto 24/7.

I'd discuss it with her doctor, but, I'd focus on preventing the falls, so as to keep her comfortable with direct supervision. Plenty of residents at AL smoke. It's one of the last pleasures they have.
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I’m not sure that the ‘visible key in a box by the door’ suggestion is as unrealistic as the responses suggested. Most people lock all the occupants of the house in every night, but know where the key is. What’s the difference? I can’t imagine an ‘against the law’ prosecution being mounted or succeeding with a visible key – there should be better things to do with their time. It’s fairly easy to avoid the ‘blood everywhere’ scenario, with a little thought. Make the glass shatter-proof, but held in with gunge that will break when the glass gets hammered, so the glass drops in one piece. For many carers, ‘you have to provide 24/7 care’ can sound even more unrealistic.

It’s interesting to read Lealonnie’s sympathy for smokers. After living through all those years of ‘I can’t work if I can’t smoke in the office’ and ‘my restaurant won’t survive if people can’t smoke inside’, the sympathy of non-smokers and ex-smokers has dropped down a lot, and it’s good to be reminded. Perhaps ‘one more time and you have to go to AL, so please start checking which local ALs allow smoking’ might be a useful strategy.
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worriedinCali Jan 2020
No said it was stupid? They pointed out that’s illegal and bad advice. At least here in the US it it. And because here, we most certainly don’t lock people IN the house at night. We don’t need to a key to get Ourselves out of the house. We lock others OUT but we ourselves aren’t locked IN. We are free to come and go as we please. Fun fact, some of us have front doors that remain locked 24/7 however if you are in the house, you can open the door without unlocking it. If you are outside, you must unlock it with a key. What you suggested is locking someone IN and taking away their ability to come and go. It is not at all comparable to locking the front door at night. Doors are locked preventing people on the outside from coming in but not preventing those inside from leaving. Big big difference and it is very much illegal to lock someone inside and prevent them from leaving, we’ve had this discussion before. We cannot Just confine someone to a room even if our intentions are good.
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When someone behaves this way it is hard to understand how they wouldn't have some form of dementia or cognitive illness. I just learned recently that there is a name for it when people cannot see or understand their own limitations or illness and it is called anosognosia. It is related to damage to the parietal lobe and it is common with Alzheimer's patients. You cannot reason with them or get them to listen. I am dealing with this with my own mother.

I agree with others that if she does have dementia then you cannot ever leave her alone. To do so, knowing she has dementia, could be considered negligence on your part. If she does not have dementia and continues to make bad choice like this, then it is her choice. We have the right to make our own bad decisions (as long as we are competent.) So it seems to me at this point you need to pursue a diagnosis for her if you haven't already. Next steps would be based on that. Sorry if my answer was based on assumptions that don't apply to your case.
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This is a crap answer but it has worked for me in the roughly 2-3x I've done it; me 'losing it' in front of my parent/s has changed specific behaviors. Discovered this accidentally and involuntarily. For example, my mom was post surgery a few years back - helping her with that was a no brainer of course, surgery is hard! - but she is a RELENTLESS and terrible patient omg...I got 2 hours of sleep over night and my Dad made a comment about there was no reason for me to be there. I burst into tears and yelled something to the effect of ," I've been up all night and you have no idea what I've been doing this whole time!!! " Holy lord they were angels after that.

Keep in mind normally I come across very calm ( not internally! ) and am not one for histrionics!! I hate drama so these rare outbursts are the real deal. I think it's the emotionality that gets through. I've lost it in front of mom twice since then - over a period of 5 yrs - and each time she hove to like magic. Obviously this is a lousy and accidental way of changing a behavior. I think it's worked in addition to the emotions getting through because mom probably thinks, " Oh my...daughter's lost it...I better help HER..." In this way my mom thinks she has the power and control.

So I'm not suggesting you wait until you are so stressed you're bursting into tears or whatnot, but perhaps fake some emotional moment? Emote how her going outside alone is totally stressing you out?! If that gets through to her then maybe she'd grab a walker at least and thus she might feel SHE'S helping YOU....

Again this is a lousy answer but you get the idea. For an big safety issue trying something out of the box might be better than nothing?

Blessings to you!
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lealonnie1 Jan 2020
I don't think this is a 'crap' answer at all. In fact, showing our true emotions is a necessity! Sometimes the parents don't realize how much their illness or care giving is affecting US, and an emotional outburst gets that message across. If we're calm, cool & collected at all times, how do they know how upset we truly ARE?
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