Falling

Thursday evening disaster struck. As the Alzheimer’s continues to eat away at Grandpa’s brain he is progressively losing his sense of balance. His increasing inability to walk is a great cause of his tendency to fall, but it is not the only cause. Thursday evening Grandpa spontaneously fell over backward.

He was standing in the living room, doing nothing and staring off into space, when I looked over from my computer and noticed that he was beginning to sway like a drunk. About five seconds later Grandpa realized he had become unsteady and started to turn to find something to stabilize himself with. That slight movement was all it took and he toppled right over backward as if someone had given him a hard push. He went down and struck his back at the point of the lowest rib against a chair.

By the time I reached him he was gasping, “Don’t move me! Don’t move me!” in a very pained sort of way. After confirming that he had not struck his spine, and so we weren’t dealing with a possible broken back, I managed to coax him to roll over and after allowing the pain to subside somewhat I helped him up.

At that point it was unclear how badly he had hurt himself. He could clearly stand, and though obviously in pain did not appear to be unbearable so. I asked him if he wanted some pain medicine and he said no, so I figured all he had suffered was a bruise, a pulled muscle, or a temporary spasm. Not fun, but given that he was an eighty-year-old man who had just toppled over backward he had escaped as best as one could hope.

But his injury was not quite so minor as at first it seemed. After his fall Grandpa sat quietly for awhile, but I could tell that he was still in significant pain. When I asked him again if he would take some aspirin he readily agreed. Still, since he wasn’t moaning or groaning I figured that two aspirin would take care of most of whatever discomfort he was feeling.

Later in the evening we completed Grandpa’s bedtime routine of snack, bathroom trip, and then to bed. Everything seemed okay until I helped him lay down and he exclaimed, “Oh! That’s where it hurts!” Grandpa always lays on his left side in bed, and that was the side he had injured. At this point I got the first glimmer that things might be difficult. Nonetheless, hoping for the best, I tried to get him comfortable, tucked him in, and sang him some hymns. At that point he seemed quited, but not asleep as he normally is by that point. I turned out the light and left, hoping that he would fall asleep and sleep well that night.

Such was not the case. When I next came into the bedroom to go to sleep myself I found Grandpa up and the room in a state of disarray which showed he had not been resting quietly. He was hurting too much to sleep. At this point I had the feeling that tonight was going to be a very bad night.

I tried to get him to lay back down again, but it quickly became apparent that his back was hurting him more and he absolutely couldn’t lie on his left side and he wouldn’t lie on his right side because then he would be facing the wall and that wasn’t acceptable. The solution was to move him over to my bed so he could lay on his right side and not face the wall. He was in less discomfort in that position, but it still wasn’t enough.

It ended up being a very long night indeed. A normal healthy adult with a back injury usually discovers that there is one position in which the injured muscle hurts the least. A normal functioning adult will then stay in that position. If Grandpa were still a normal functioning adult he probably could have passed the night in fitful sleep. But Grandpa is no longer a normal functioning person, and the more miserable he is the less coherently he functions.

Thus the night passed as an exercise of futility for me as I tried to get Grandpa comfortable and to sleep while Grandpa continually worked contrary to his own best interests. I would get him marginally comfortable and then he would have to go pee. I would get him comfortable again, and carefully stroke him until he drifted asleep . . . and fifteen minutes later he would cough and give himself a pain and wake up. Instead of lying still until he fell back to sleep he would shift and that would hurt more, and then he would decide to sit up.

It was impossible, and I finally gave up and left him to do what he would. For the second half of the night he moaned and groaned and muddled around with things. I realized that he would probably feel most comfortable sitting up on the couch, but I wasn’t sure I dared take him.

Eventually, as the night waned on toward dawn Grandpa crawled out of the bedroom and on down the hall. I think he left in search of (once again) the bathroom, but forget his reason or destination and simply expired halfway down the hall and lay there on the floor. At that point, halfway between bedroom and couch, I thought to try to get Grandpa the rest of the way to the couch. With much coaxing I managed to get him back to his feet, but I only managed to persuade him to take a few steps before his mind and body gave out and he just stood where he was and wouldn’t go any further.

I brought the wheelchair around and eased him down into it, then brought him around to the couch and transferred him from wheelchair to couch. At that point I wrapped him up in a blanket and went back to bed. It was 5:30 AM.

I don’t know if Grandpa slept, sat quietly, or did something else entirely. All I know is that I woke at 8:30 to him peeing in the hall outside the bathroom door. And so Friday began.

I had to go grocery shopping Friday. Grandpa spent the entire day sleeping, making up for his sleepless night. In the first day or so following the accident I wasn’t sure Grandpa was going to walk again, ever. He seemed to have lost all ability to hold himself upright, and he would make a quick descent to the floor any time he tried to get up.

But he did recover, at least mostly. Friday night I dragged my mattress out and threw it on the living room floor so I could sleep comfortably while Grandpa slept on the couch. The night passed more sanely than the previous, though sometime in the night Grandpa threw up. Every night afterward we were back in our normal beds and if Grandpa was not entirely comfortable he at least could sleep.

I suspect that Grandpa suffered more than a muscle injury. I’m pretty sure he cracked the last rib. The first most miserable night I was running over in my head whether I should take him to the hospital. For anyone else the answer would have been an immediate yes. But Grandpa’s mental condition is now such that to take him into such a strange place with so many strange people asking him to do so many incomprehensible things would be like immersing him into his own private hell. Under such circumstances the benefits for taking him must be very real and necessary. Besides proscribing pain medication there is little that can be done for a cracked rib and I decided that unless Grandpa’s symptoms became worse the gain from taking him in to the hospital was not worth what it would cost Grandpa.

He is much recovered now, though his side is still tender. I think I made the right choice in not forcing him to go to the hospital for an x-ray, etc but I wish he was in good enough condition to go to a doctor to be properly checked–just because.

Unfortunately, his problems with balance persist. Yesterday he nearly killed himself.

Grandpa has a tendency to want to play on the stairs. Obviously this is very dangerous, but unless you are going to physically restrain him, or gate off the stairs, there is nothing you can do besides trying to encourage him to occupy himself elsewhere.

Yesterday evening around supper time he was fooling around on the stairs and I asked him if he needed to go to the bathroom. He said yes, and started up. It is a split flight of stairs with a landing at the halfway point where the front door enters. He was about halfway up the second half of the flight of stairs and I turned away to go turn on the bathroom light. I heard a sound and turned back in time to see one of those things you never want to see.

Grandpa had apparently been hit by a sudden bout of vertigo and had promptly pitched over backward. I caught sight of him just has he began the inexorable plunge backward, the path of his fall sending him head first toward the steel front door. I only had time to shout.

If he had hit the door he would likely be dead today, but God was merciful. Grandpa was still hanging on to the rail and when he reached the end of his arm he pivoted, his head just missing he door, and came to land on his back. While greatly shaken, he escaped with only a minor injury to his hand.

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I hope none of the above was too incoherent, but it is getting late and I must quit without rereading or editing.