PALS first fall - how to avoid more?

[Compass Rose]

Ny brother fell on the pavement outside a pool at a resort in the Dominican Republic today while on a family vacation. He went down hard, hitting his head, scraping up a leg, injuring a finger (broken? sprained?) and making a problematic shoulder even worse. His feet had been getting weak from too much walking (the resort's grounds, though gorgeous, are spread out and require a lot of walking). My bro/PALS called before our arrival date and arranged to have a wheelchair that he could use, but when we arrived we were told one wouldn't be available for several days (the resort has a medical clinic but no wheelchairs WTF .. ?) he was able to get rides on those golf cart-style vehicles resorts use to cart guests around, but the resort is very spread out so he ended walking a lot anyway. His feet got tired, the toes of one curled under and down he went, taking a hard knock on the head. We took him to the medical clinic at the resort to be assessed, and are monitoring him carefully for concussion symptoms. He's scheduled to fly home tomorrow, so I really hope he's okay. He's very sore but doesn't seem to be showing signs of a concussion yet.

This is his first serious fall, and it could have been a whole lot worse (broken bones, etc.). I think he's going to have to be more proactive in trying to prevent falls from happening. Is that primarily a matter off using a wheelchair or walker more often, or are there other measures to take as well?

I would appreciate any tips or insights people might have for being proactive, and also the potential risks involved in these those of falls, which I have heard can speed progress of the disease (is that correct?)
Needless to say, we are not happy with the resort for telling us there would be a wheelchair for him to use and then when we checked in, saying there wouldn't be one for several days. I can't say for sure if the lack if a wheelchair, and consequently how fatigued his feet got, contributed to the fall, but that very well could have been a factor. And what if he wasn't able to walk at all? Then what would we have done? Curiously, a wheelchair magically appeared today AFTER the fall - one without foot rests that appeared to be made in the early 20th century, but it was better than nothing. It was an eye opener about what could possibly happen when travel in a developing country with someone who has mobility issues.

If anyone has thoughts on how to encourage PALS to take safety measures to prevent this type of thing from happening while they are in that devastating phase of still being fairly mobile and not ready to use a wheelchair full time, I would love your input.
Thank you,
Deborah

 

[lgelb]

For the next stage, around the house/yard, I would recommend a rolling walker that also has a usable seat -- we had the Active Walker. For longer treks, some people go to a scooter (self-funded) before a wheelchair, depending on where they go out, their progression and other circumstances. Others, like us, go into a wheelchair, usually a manual while you weigh options/timing for the power chair. I don't think a lot of messaging will be needed after this fall, as much as support/validation for moving to the next stage of mobility aids.

 

[affected]

This can be a tough one.

My husband had a couple of serious falls and indeed they not only assisted the disease progressing but they have caused him ongoing issues.

His right arm was his 'good' arm. He fell onto the shoulder rupturing the main tendon. That arm became useless and of course the tendon never will heal.

That was the lesser of his serious falls...

The only thing that stopped him was when he could no longer take a step forward without assistance.

Now he can stand with assistance and can walk very short distances with a walker and someone right behind him constantly 'catching' him as he totters along. This is very short distances and only ever inside our own house.

So how to avoid more? I did things like call family meetings and have him tell his children that he intended to keep taking risks and he had to listen to their responses.

My husband however has ftd, so this makes a difference. He can't empathise with anyone and he views any attempts by me to instigate the use of equipment as punishment to him for his body progressing with the disease ...

 

[skipper66]

I would make sure he uses a walker and all times and you should also get him a gait belt. My dad fell down a entire flight of stair before his diagnosis. Luckily, he didn't land on his head and the floor was carpeted. Don't take any chances. Make sure there aren't rugs or anything around that he could trip on as well. Hope he heals quickly and am so glad he wasn't more seriously hurt then he was. That is beyond terrible of the resort not having a wheelchair as promised. I would make a complaint to the head manager there and explain the situation. You need to stand up so it doesn't happen to somebody else in the future as well. Kim

 

[rosec]

This is how my PALS managed his mobility related issues as the disease progressed:
First he used a cane, then a walker / rollator. While he used the walker, after sometime, even though he could still walk, he did not have enough strength / trust in his hands to use the break if he needed, so one of us, the children or I, would hold the walker in the front, and walk backwards as he walked. Then, after a while when he could take just a few steps inside the house, one person would hold the walker while another would hold his manual wheelchair behind him while he walked. After a while he would just shuffle for a few feet like that, and we referred to it as his 'walk' for the day. He doesn't walk anymore.

 

[Compass Rose]

Thank you all for the input. It sounds like a rolling walker with a seat might be a good next option. Kim, I've never heard of a gait belt but will look into that.

It turns out my brother has a mild concussion, but fortunately no damage. He's taking a few days off work and is at home resting.

Again, many thanks for your suggestions.

 

[BrianD]

Look into AFO for him. They are lightweight braces that helps with foot drop like you described. Stands for Ankle Foot Orthodics. They are usually custom made to the individual. Ask your PT about them.

 

[tinyandme]

For next vacation: we took a cruise recently. Very accessable, very helpful staff and in ports where my CAL wasnt up to extra walking we just stayed on the boat and enjoyed the empty pool deck. Staff clearly were unsure what was exactly "wrong" with my hubby but were happy to help wherever they could. And lots of free wheelchairs!