Falling when you are a senior citizen can be devastating.  If you mix dementia into the equation, it can really add to the complications of a fall. Often people with dementia are not able to feel pain or if they do have pain, may be unable to articulate its origin.

This turned out to be the case for my Mom over this past week. She had a fall last Sunday and a trip to the emergency room confirmed a break in the 4th and 5th metatarsals of her left foot. She felt little pain even though they were significant breaks and insisted she had no other aches as a result of the fall.

That evening, as she was hobbling down the hall with her left foot in the stabilizing boot, I noticed a bulge on her left hip. I had her sit on the bed and pushed on the considerable swelling and asked if it hurt. She said yes “When you poke at it like that!” I called her Nurse Practitioner the next day and her office had a mobile x-ray tech come to the house to x-ray Moms hip. Thank God, no break.

As the week progressed, Mom commented that her right knee was bothering her. But when I looked there was nothing of note and when I poked about on her knee she said nothing hurt. I assumed it was just a fatigued joint from all the compensating it had to do for the left leg that had a broken foot.

Then today, five days after the fall, she called me over to the couch to show me her knee. She pulled up her sweat pants and the right knee was very swollen.  When Mom tried to put weight on that leg she had significant pain. So with a broken left foot and an  unbearably painful right knee, we were once again off to the emergency room for an x-ray.

The ER Doctor came into the room and saw the note I had taped onto Moms boot that read “This Foot Broken”. He asked me if that was for him.  I laughed and said no that Mother had dementia and refused to believe her foot was broken because it did not hurt. She was always asking me to take off her “ugly shoe” and so I put the note on it to remind her why she should not remove the boot.

After the x-rays showed no break but considerable joint swelling, the Doctor felt sure it was in large part due to the fall and exacerbated by her favoring that leg because of the broken left foot. So, Mom and I sat waiting for the Doctor to return as he was going to inject her knee to relieve the pain and help reduce the swelling.

Mom was again focused on her foot with the boot but now she was making repeated attempts to read aloud the attached note. She kept pronouncing the words wrong or reading them incorrectly and was saying things like “T Fute ” or “This food “.  I managed to get her to read “This Foot” correctly but she could not read “Broken”.  She said all manner of words, most of them not actually part of the English language and all of them wrong.

Finally when she was really starting to get frustrated I said “Mom relax, try one more time, you almost have that last word. What does it say?” She looked at me and answered “It says maybe someone should get Marion her glasses so she can read it!” Oops….