FAIT ACCOMPLI

FALL IS NOT MY SEASON

Yes, I love the rich colors of the foliage. My birthday is even in Fall.  The first hint of chill in the air combining with the shortening of the days is always sure to trigger the blues for me.  I am one of the many who suffers from "seasonal affective disorder".  In a good year I begin to hibernate.  I take on projects to distract me. I listen to my favorite music, watch my favorite movies and cook my favorite foods. Sometimes these efforts even work.

2011 was the Fall of a lifetime.  There was no little trick to beat the blues.  This was the season in which the gods challenged my very being and nearly won.  

Late in September my mother was hospitalized again.  This was another bout with pneumonia and at 91 a bout with pneumonia can always be the last one. This was another of those episodes where the doctors warned us to expect the worst.  We have had so many of those that I began to accept them as part of the ritual.  Mom didn't seem so ill this time.  At least she was comfortable and responded quickly to medication. I was even able to relax a little because my mother's private aide spent nights in the hospital alongside mom.

Amazing Adelaide made it through and back home.  Mom's aide, Niki even convinced me to take a couple of nights away from home so I could relax.  This was in everyone's best interest.  At home I would just hover and Niki didn't need that.  The weather was beautiful and I spent my couple of "bonus days" on the New Jersey shore. This really was a great idea.  I regained some strength which I was certainly going to  be needing.

Mom was recovering very slowly this go 'round.  She had lost her appetite and was sleeping more than before.  I, of course, was worrying because that was what I did well.  

As if Fall isn't difficult enough for me, Mother Nature decided to let it all out and delivered the now famous Halloween blizzard of 2011!  Snow in October is not only unwanted but it is wrong.  Trees with leaves do not accept the weight of huge amounts of snow willingly and they did not.

As the snow began to pile up the trees began to fall.  This was as frightening an experience as I had experienced to that point.  Trees were falling on my house.  The snow was blowing in gale force winds.  Niki was beginning to panic.  My ancient dog Mickey wanted to go out an play but that wasn't going to happen. 

I was worried [I told you that was my job] that we would lose power if not the roof so earlier in the day I had checked the generator and made sure it was at the ready.  Niki and I had also loaded all the firewood I had on hand into the garage so we could have some extra heat and ambience.  Right on schedule, about four hours into the storm the power did indeed go out.

Luckily I had the generator up and running in minutes!  I was never a Boy Scout but I'm still good at being prepared.  Niki and I made sure to run cables to Mom's room to keep her electric bed functioning and heat going for her.  We had some lights for us and a nice fire roaring.  We were scared but comfy enough.  

That comfort lasted about three hours until the generator failed.  No matter how I tried I could not get it restarted.  Time for the back-up plan.  Lift mom off her electric bed and air mattress and put lots of padding under her.  Get the flashlights and lanterns.  Put quilts on mom and get the portable propane heater [indoor safe] which I had bought years earlier to "be prepared" for some other possible disaster.

Niki stayed with mom.  I slept in the fireplace room.  We made it through the night.  The snow had stopped. The trees stopped falling.  Neighbors came to my rescue and got the generator working.  It's a good thing they were able to help because we were without power for five days!

11  15  11  15  11

Adelaide never fully rebounded from her hospital stay.  This time it was different.  She was not the same.  She was not smiling.  She was not eating much.  Mid-November on a Thursday afternoon my sister was visiting and trying to feed mom lunch as she had so lovingly for so many years.  Mom just was not doing well.  My sister and I were both worrying.  Niki was obviously lying about her concern for mom's condition in order not to alarm us.  I knew better.  

The following day I could tell mom was not heading in the right direction.  I told Patricia that I thought mom was tired of fighting.  Neither of us wanted to believe it because we had played this scenario so many times before.  I could feel that mom was not the same.  Over the next couple of days I felt mom was slipping away. Niki continued her charade but we all knew.

On Monday mom was a little better.  She ate a little lunch for Patricia.  She even smiled a little.  Oddly enough when Patricia was leaving and kissed mom and said she would see her the following day, Adelaide managed to get out a quiet but unmistakable "goodbye" in return.  

That evening mom was doing worse.  I could not sit still.  I hovered and worried.  Mom's eyes appeared to be sunken in and she was awake but not with us.  

Tuesday was Niki's birthday.  She had gotten mom taken care of but had to leave the house for a new job that she had just gotten.  I heard her chatting away with mom as we all did. I could hear "it's my birthday.  Don't you want to smile for me?"  Niki said mom seemed a little better and then left.

Mom did seem a little better.  She was certainly more alert.  She ate for me and that was a wonderful sign!  Way to go Adelaide!  

About an hour later I could hear mom coughing a little so I rushed to check on her.  She was obviously in distress.  I raised her oxygen level and put her on her side.  I stayed with her while I called 911 and then my sister.  I told my sister what was going on and she said she would meet me at the hospital.  I told her not to go to the hospital but to come home instead.  I knew Adelaide was not going to be going to the hospital.  

The paramedics arrived followed by my sister.  I was holding my mother while they were assessing her. Her breathing was very shallow. This was that moment that no one can ever be prepared for.  THE decision.  The DREADED decision.  They asked if I wanted them to intubate her. 

In that briefest of moments I kissed my mother who was still in my arms and said goodbye.  I told her I knew it was time and how brave she had always been and how much I loved her. I called my sister into the room and told her it was time.  Then I gave my answer to the paramedics and invoked the DNR.

 11:15 [am] November 15, 2011

It was over. Our beautiful mother was gone.  She slipped quietly to the other side while I held her and with Patricia at our side.  In an instant our lives would never be the same.  She was at peace.  It was beautiful.  We were devastated.

I am still so proud of myself for having seen to her caregiving all the way to the most fitting end. All those dress rehearsals.  All those emergency room trips.  All that worrying.  All that dread.  In the end she was as home where she belonged and where she would have wanted to be.  

I recall that the first thing I was able to say to my sister was that now we were orphans.  I am sure that sounds peculiar to those of you who are fortunate to still have one or both parents but I am equally as sure that anyone without parents will understand.  I lost my father when I was 10 and my mom when I was 52 but regardless of my age the sorrow is immeasurable.

No one ever told me that grief felt so like fear. 

c.s.lewis

Au revoir mon doux.

Ti terrò nel mio cuore per sempre.

Vestibulum ut res docuit.

A NEW BEGINNING

AT FIRST:  THANK YOU

In the last blog I wrote I promised to return to my good habits and diligent posts.  That was a promise which I swiftly broke.  As often happens to caregivers, the universe had a profound alternate plan.  

Thank you for your patience. Thank you for your loyalty.  Thank you for your empathy, sympathy and outpouring of well-wishes. I cannot find the words to express how deeply touched I have been by so many of my readers during this most difficult time in my life.

I'M BACK!

During these past few months since my mother's passing I have spent time thinking about the future of this blog. I wanted to return but I was unsure how to proceed. I am no longer a "stay at home caregiver" but I still have much to share.  

My friends and readers have urged me to dive back into my writing.  I am going to give it a try.  They are, of course, right. As I get back into writing again I plan to share my experiences at the end of our long battle with Alzheimer's. It would not be right to leave out the last chapters of Adelaide's Journey. I also want to share my current odyssey through grief and my struggle to rebuild my life which had been in limbo for so many years.  I hope you will come along with me.

"Mourning is not forgetting... It is an undoing. Every minute tie has to be untied and something permanent and valuable recovered and assimilated from the dust. The end is gain, of course. Blessed are they that mourn, for theyshall be made strong, in fact. But the process is like all other human births, painful and long and dangerous."

margery allingham 1956 

IN MEMORIAM

SUMMER OF MY DISCONTENT

Since I began writing this blog I have been fairly diligent about posting stories and recipes.  I have striven to keep sharing stories and events of my caregiving experiences until a few months ago.  Usually writing is a good, constructive outlet for my frustrations and I am always hopeful that sharing can be of some help to others.

My hiatus began when an unexpected tragedy struck my family.  In the past I would have taken a little time to get things back in perspective and use an event as a teaching or entertaining moment.  This summer has brought an onslaught of events, illnesses, accidents and mishaps which has kept me from my virtual "pen".  My favorite way to refer to a series of events like these is as a "Cluster Fuck".

[credit: Gary Larson, the far side]

Easter Week of this year my family was anxiously awaiting the birth of my [only] niece Kate's second daughter.  I was preparing for the usual family Easter dinner which would, as always, be at my home.  Decorations and holiday china were unpacked, menu was prepared and guests were invited.  I got the long awaited email that Kate had successfully delivered another beautiful, healthy girl. Mother and daughter  were both doing fine.

Two days passed and I was slightly concerned because I had no further updates on the new arrival and my phone calls and emails were going unanswered.  That evening I finally got a phone call from my brother to explain the lack of contact and to deliver the shocking news that his seemingly perfectly healthy 32 year old daughter had gotten out of her hospital bed the morning after delivering and collapsed to the floor with a massive heart attack precipitated by blood clot.  They had performed emergency surgery and now Kate was in a chemically induced coma to recover.  

It was one of those rare times when I was mute.  All I could manage was to offer my love and support and services in any way I could be of use.  I could hear the forced bravado in my brother's voice and I suspected there might be even more to his daughter's condition than he was able to share in that phone call.  I called our sister to catch her up on the situation.  

More time elapsed without further contact or new updates and my sister and I feared the worst.  We struggled with our overwhelming instinct to run to our brother and sister-in-law's side but we also respected that they were inundated with worrying about their only child while helping to care for the 2 year old and now the newborn grandchildren.  Finally, on that Saturday, I got the call we feared letting me know that Kate had passed away.

That evening we went to Kate's home to be with the family and to offer any possible love and support that we could.  In this twenty-first century women are not supposed to die from childbirth.  As I sat holding one child on my knee and the other in my arms all I could think was that parents aren't supposed to outlive their children.  Men aren't supposed to become widowers at 32.  A two year old and a newborn are not supposed to be motherless.  Nothing was right.  The world was off its axis. 

After some time had passed and I was settled back into the normal routine of caregiving for my mom I was feeling the urge to resume my blog.  Summer was just beginning, I was planning a short vacation and also planning my annual summer shindig that my friends and I all look forward to.  I had a birthday party to go in Central New Jersey and I needed some "down time" with dear friends.

It was a beautiful day for the birthday party and everything was shaping up great.  I didn't even have to drive myself to NJ as I was being "chauffeured" by a friend and her husband. We arrived at the party and I was having a great time seeing old friends, laughing and relaxing.  That lasted for about 2 hours before I got a phone call from my mother's aide telling me that my mother was having difficulty breathing and I needed to come home.  I told her to call 911 and get her to the hospital that that I would be home as soon as possible but that was 2 hours away.

I informed my "chauffeur", we said hurried "goodbyes" and headed to the hospital.  All the while I was in contact with the aide for updates which were not good.  My mother was turning blue.  My mother was struggling to breathe.  "Where was the 'DNR'?"  [Oh my God]  I was in a panic.  After all these years of caring for my mother on a daily basis I didn't want her to die without me by her side.  I understand her advanced age and declined health but one is never ready to lose a loved-one.  Now this is a caregiver's big fear.

Meanwhile I called my sister who was also out of town on vacation and about the same distance from my mother as I.  I make an executive decision not to call my brother until we know what's going on because he had enough time in the hospital with his daughter and this was too soon.

I arrived at the hospital and when I saw my mother in the ER she was in bad shape.  I knew she was close to the end.  The doctors said it was pneumonia and we all know how serious that is for anyone let alone a 90 pound 90 year old.  She was struggling to breathe and looks so frightened.  I tried to comfort her to the best of my ability.  They had her on antibiotics, fluids and oxygen but her numbers were very bad.

The doctor caught me up on her condition and suggested we give morphine to try and relax her breathing.  That concerned be but I agreed.  He also informed me that she wouldn't make it through the night.  I know this is a prophecy we have been given all too many times in the past but this time I believed the doctor.  

We stayed with my mom until she calmed down and was more comfortable and at least her oxygen level approached normal.  She was resting and had had the morphine so there was really no more we could do.  I asked her aide to stay with her and to stay in contact with me through the night, which she did.  She's great with my mother and my mother loves her so I knew my mother was in good hands. As is my tradition in these situations, I kissed my mother goodbye, told her I loved her and also told her that I was making sure she had whatever help she needed to survive but the choice was hers'.  I told her I would understand if she was tired of fighting but it was between her and God.

Once again my amazing Adelaide defied all the odds!  That woman has the most amazing strength, grace and will to live.  It was a struggle, to be sure, but my mother was back home with me in plenty of time to celebrate her turning 91!  You may recall that it was a year ago that we went through a similar trauma and she celebrated her 90th in the hospital.  

We survived another "incident" and Adelaide is doing fine!  Aside from getting even more gray hair, I also managed to get a nasty upper respiratory and inner ear infection while spending so much time in the hospital.  That lasted nearly two weeks with heavy, nausea-inducing antibiotics.  I also had to postpone my planned [very much needed] vacation.

THE CLUSTER FUCK CONTINUES

Mom and I were both back to health and I booked a second attempt at a little vacation.  I was desperate for some swimming, sun and fun.  New Jersey Shore: here I come!  I had a week before the second attempt at vacation so I decided to begin work on my afore-mentioned annual summer party.  I tend to go just a little overboard and build some simple theatrical sets so there is a backdrop for whatever theme I have conjured.  Yes, my neighbors think I'm nuts but they know my history as a man of the theatre and arts.  Last year one of my neighbors wanted to know if I was "getting ready to put on dinner theater" in my backyard!

The set-building was going great.  This party was to have a simple Italian-American backyard BBQ theme to invoke my childhood.  Think of it as "Jersey Shore" meets "The Godfather" with a lovely trellised, grape covered bar, chianti, red and white check table cloths and make-your-own panini buffet.  The trellis / arbor bar structure was done and looked great.  After 4 or 5 hours in the blazing sun I decided it was time to hang the grapes and vines.  I stepped back to admire/assess my wonderful creation.  Unfortunately when I stepped forward again I was still admiring and not looking at the ground.

I managed to stumble over the combination saw that was on the ground and I fell smack down onto my face. I remember thinking "I think my teeth went through my upper lip" before I passed out for a couple of seconds.  When I came to I put my hands to my face and was ecstatic to find my teeth and lips intact.  It wasn't until I managed to get to my feet that I noticed that in the stumble over tools I managed to tear a chunk of fat and muscle out of my right leg.  

After some screaming and swearing, my friend helped me to the front porch.  I told him where to find my emergency kit along with some wound-care supplies [always on hand] and I cleaned the wound and got a nice tight bandage around the leg.  I then had him fetch my wallet, iPhone and some clean clothes for our trip to the ER. He yelled at me for wanting to change my clothes before heading to the ER.  I guess he doesn't know me as well as I had assumed. After so many years of caregiving I should have my own parking space out front although I am rarely there for myself.

While we were waiting for me to get stitched up my friend said " well, I guess you're not going to the shore on Tuesday".  "Like hell" I protested.  Frankly, it hadn't crossed my mind with all the commotion.  "If I have to go in an ambulance, I'm not missing this trip again!"

Did I mention that although I'm a terrific and brave caregiver, I'm a horrible and cowardly patient?  I'm fine with blood.  ....other people's blood.  My blood, not so good.  I hate needles.  I've only had stitches one other time.  I'm thinking it might be a good time to pass out until it's over.  I didn't pass out even though the lovely doctor kept telling me how "ugly" the wound was and that "it wasn't going to be one of those nice scars" and then added "I'm going to have to stitch it open because I can't pull it together".  I still didn't faint, but I wanted to.  Instead, I explained that I'm a coward and asked the kind doctor to get me an nice little anti-anxiety pill.  She obliged and while I was being x-rayed and examined, the pill had time to take me to a better place.  

I got stitched up [without fainting], asked the doctor about swimming in the ocean on my vacation [told "NO"] and even managed to have my mom's aide drive us out for dinner that evening.  Perhaps the dinner wasn't such a good idea.  In the middle of dinner Niki the aide looked at my leg and noticed that I was hemorrhaging through the bandage.  On the way home we made a side trip back to the ER.  Yes, twice in one day...and now it was mid-evening and the place was mobbed.  Anyway, I got patched up and sent home to spend lots of time with my leg elevated and not much else.

Vacation day finally arrived.  I decided I was OK to drive and I was going to go even if it meant bringing medical supplies and of course, eliminating the "swimming" portion of the trip.  Yay!  The shore at last!  I walked a lot.  I played tons of mini golf.  Everything was swell.  No, really, swell.  Or perhaps I should say "swollen".  My leg swelled from my toes to my knee.  I called a doctor friend and was assured I'd be OK if I kept it elevated as much as possible and that did work.

My trip was short but great.  I didn't / couldn't swim but that was OK.  There was a lot of summer left and I'd get more chances to swim when the stitches came out after 10 days. To ease back into being at home a friend invited me to a workshop of a new play.  Perfect!  It was a beautiful sunny Sunday.  

We sat in the theatre thoroughly enjoying the show.  A short time into the show I was thinking to myself "I know it's hot out but I wonder who it is that stinks".  This was odd because we were surrounded by some pretty well know celebrities and theater people.  It wasn't until intermission that my dear friend said to me: "look, I know you hate doctors but you have to promise me you'll go to the doctor tomorrow.  I think your wound is infected because it smells".  She was, of course right.  I had been smelling my own leg wound!  I hope no one from the CLOSER reads this!

OK, trip number three in 10 days to the ER.  Hell yes, infected.  So much for having the stitches out and resuming my summer activities.  Antibiotics and 5 weekly visits from my mother's wound care doctor the last stitch came out 2 weeks ago.  I'm as good as new but the original doc was right about not being "pretty".  No leg modeling in my future.

So far it's been a great summer.  Anyone else who shares my seasonal depression will understand just how important my summers are to me.  I forged ahead with my summer party plans.  I streamlined a little but I was determined the "show would go on".

DOG DAYS OF SUMMER

About 10 days before my big party my wonderful old pal Mickey, who had a rather large tumor, began to bleed where the tumor had ruptured.  I tried to tend to him but I couldn't get things under control.  This guy is over 13 years old which is very old for a golden retriever.  I felt so sorry for him but knew I had to muster the strength to do the right thing. I kissed him goodbye and I sent him off to the animal hospital to be put to sleep. I sobbed like a child along with a dear friend who was helping me through this.  This is the same friend who told me my leg was rotting.

The day you get a puppy is the same day you begin to dread the eventual day that you are going to have to say goodbye to him.  We picked up his bowls and gathered his toys from around the house because I didn't want to stare at them.  My friend left.  I moped.  The phone rang.  It was the Vet calling to tell me that Mickey was in good enough shape, even for his age, that they could remove the tumor safely and that we didn't need to euthanize him.  Oh, it was, of course, going to be expensive.

When you're grief stricken and get a reprieve how can you think about cost?  I think they know that, the doctors.  Now if I say "go ahead with the original plan" I feel like a murderer.  It's one thing to put your friend to "sleep" when it's the right thing to do but quite different if he can be helped.  Of course I gave the "OK" for the surgery.  Money be damned.

Mickey did very well with the surgery even though it took twice as long, he had to stay in the hospital twice as long and the cost was three times as much as the estimate!  After some recuperation, my dear old pooch is doing just great.  I keep telling him I want to change his name from Mickey to Jaguar because I could have had a new car with what he cost me!    Still, that is the most happy news of the summer.  Instead I tend to call him Lazarus because he came back from the dead.

My summer soiree came off without a hitch.  The weather was wonderful.  My friends and I had a really great time.  Some of my high school mates that were at the party hadn't seen one another in 30+ years!  

Since the party I have seen the babies a few times, my mom has been doing well, my leg is healed and I'm OK'd to swim, dog is amazingly well and summer party was a huge success!  We have also had a 5.8 earthquake, a direct hit by a hurricane, some locusts, plague and a meteor hit but we survived.

This summer is not one that will ever be forgotten.  Our lives were forever altered.  We will always see Kate in her two beautiful and precious gifts to us.  

I am looking forward to a wonderful autumn!

OK blog readers, I'm back! 

I hope you get back in the habit of visiting here.

FOODIE FRIDAY RECIPE - BAKED RICE PUDDING

Oven-baked rice pudding is one of my favorite desserts.  I like it with a lot of custard, cold and with a dollop of whipped cream.  You can have it either way but I prefer mine without raisins.  Sometimes I like diced dried apricot and/or slivered almonds but usually I'm a "purist".

This is a simple, flexible recipe sure to satisfy.

Whenever I make rice in my handy electronic rice cooker I make extra.  I like to have it on hand to throw in soup or make into Spanish Rice or use it for rice pudding.  

Ingredients:

1.25 cups cooked white rice [not instant variety]

2.5 cups milk

.5 cup sugar

4 large eggs, lightly beaten

1 vanilla bean + .25 tsp. pure vanilla extract

.5 tsp. ground cinnamon

.25 tsp. fresh grated nutmeg

pinch of ground cardamom [optional]

.75 cup raisins [optional]

butter for coating baking dish

Method:

Begin by soaking vanilla bean in the milk for 20 minutes.  Preheat oven to 325* and grease an 8" X 8" baking pan with soft butter, place the pan inside a 9" X 13" baking pan and put aside.  

Combine eggs, sugar and spices and slightly beat.

Remove the vanilla bean from the milk and reserve.  Add milk to eggs and lightly beat with a whisk.

With a sharp knife, split the vanilla bean and remove the seeds by scraping with the dull side of the knife.  Add the seeds to the liquid mixture.

Add the cooked rice and stir.  Add the raisins [if you're one of those people] and pour the mixture into the prepared smaller pan.

Move the double pan set-up to the oven and fill the outer pan with about 4 cups very hot water to make the water bath.

Bake for 30 minutes, stir and then bake for an additional 20 minutes.  Carefully remove from oven and allow to cool before serving.  I like to refrigerate mine before eating.

Enjoy!

SHAMELESS SELF-PROMOTION

Online Radio Interview

On Tuesday April 5th at 8:30 PM Eastern time I will be intereviewed on the HealthyPlace Mental Health Radio Show, an online radio show that airs over the HealthyPlace.com website.  The show is focusing on Adult Children of Parents with Alzheimers.  

They will also place a small blurb about me on their website.

I hope you will listen to the show.  

CLICK HERE TO GO TO THE RADIO SHOW AND SITE

PRUDENTIALISM

"Prudentialism is a moral principle based on precautionary principles that are acting to avoid a particular negative effect."

wikipedia

Recently I noticed a woman walking aimlessly near my home.  As I watched her amble in the cold and fading daylight I realized that it was an elderly neighbor from a couple of blocks away.  I knew her.  She was a college friend of my mother's and like my mother has Alzheimer's disease.  This is not someone who should be wandering alone so I gingerly approached her, introduced myself to her and asked if I could help her. She graciously refused my assistance explaining that she was out for a walk. "I'm fine" she proclaimed in a thin voice, "I'm not ready to go home".

I didn't want to scare or upset the wandering neighbor.  This is not the first time I have seen her out and about.  I know her husband is also up in years but I also know that they have a caregiver.  I called their home and explained to the husband that I had seen and talked with his wife but she refused my help.  He thanked me and said that they were looking for her and would take care of bringing her home.

Shortly thereafter I got a call from a police officer asking me where I had seen the neighbor as he was helping to locate her.  Later I got a call from the husband to let me know the wanderer was home and to thank me once again.  

This time there was a happy ending.  I'm still worried about their situation because what will happen the next time if they don't make any changes to their environment.  

"Roaming" is a particularly frightening problem with dementia patients but it is only one of many serious yet preventable dangers not only for dementia patients but for the elderly at large.  There are many tricks, aids and gadgets to solve the common threats.  The time to become familiar with them is before you need them.  The time to implement them is also before they are needed.  

Roaming:

The issue of roaming can be easily addressed both for prevention and recovery.  For prevention, there are inexpensive  electronic alarms that can be placed on exit doors.  You can even place them on internal doors for nighttime monitoring within the home.  These simple, battery powered alarms sound if a door is opened to alert you.  They can be purchased over the internet, from your local Radio Shack and even from "As Seen on TV" at your local mall.

Recovery devices are more expensive but there are GPS services available.  The patient wears a bracelet with a GPS device that you can track from home.  

Safety in the home:

The average home is filled with hazards. Danger lurks around every corner.  The first danger to address is the one place we should all feel safest: the bed.  I have heard so many stories from fellow caregivers about parents falling out of bed.  Some have found a parent on the floor hours or even days after the fall.  If your love-one isn't ready for a full hospital bed you can easily and inexpensively outfit a normal bed with side-rails.  They can be found at stores that sell infant and children's furnishings, major chain toy stores, on the internet and through surgical supply stores. They are simple to install and to use and worth any cost to prevent injuries.

If the patient is still self-ambulatory it is imperative that you install rails at key locations around the home.  Showers, toilets, stair landings and near entry doors.  These may require pro installation but they are a must.

Stairs pose a particularly worrisome challenge.  There is a remedy.  It is costly but effective and safe.  It will extend the time your loved-one can safely move about the house, prolonging "normalcy".  It is the stairlift.  They can be either purchased or rented and there are many styles to suit your needs and your home.  We have had ours for over 10 years and it was well worth the investment.  These are available from specialty sources which can be found on the internet or in your phone directory yellow pages.

The next item may seem daunting but it for the benefit of both patient and caregiver.  The Hoyer Lift.  This is a pneumatic winch and sling system used to lift and transport a bed-bound patient. The patient can be lifted in either a seated or prone position. One person can easily lift the patient for bed changes or to aid in transport from bed to chair, etc.  This has been a back-saver for me and I think my mother actually enjoys the ride.  Medicare will pay for this rental if it is medically prescribed.

Of course there are also small precautions to be taken such as removing obstacles and scatter rugs.  Another precaution is to check the temperature of your hot water.  Make sure it is not hot enough to scald if the patient dials it up to high.

Please evaluate your home or your loved-ones' home and make any improvements you think are necessary.  This will save you hours in the ER as well as fending off feelings of guilt.  

"An ounce of prevention" really is "worth a pound of cure".