Why Sometimes It's Better to Fall 'With' Someone With Dementia Instead of Fighting It

When I was in graduate school, I attended an in-depth training so I could volunteer with a hospice. The volunteer coordinator who organized the training, Kathy, was tremendous. She did a great job of making the experience meaningful, interesting, and practical. Somehow she also made it fun. (I have since learned that people who work for hospices tend to have great senses of humor.)

A lot of things that Kathy said impacted me, and I think of this training often even though it was more than 15 years ago. How time flies.

One thing that Kathy said that has really stuck with me was a point she made in reference to fall prevention. She said that if someone started to fall, sometimes it’s better to fall with them than try to keep them upright.

“There’s only place you can’t fall from, and that’s the floor,” she said. “Once you get them to floor, they’re safe from falling.”

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I had spent time with nursing home residents before this, and I thought my role if someone might fall was to use every bit of my physical strength to keep them upright. This was a new perspective.

Kathy explained that if you fall with someone and get them safely to the floor, you might need to help getting them back up–but it wasn’t an urgent situation. In fact, she told us matter-of-factly that if one of our hospice patients was on the floor and we couldn’t help them back up, we should call hospice for assistance and just hang out with them on the floor while we waited for back-up.

This seemed like a reasonable strategy compared to trying to fight with every bit of muscle to keep someone upright–especially since I was about 125 pounds at the time (those were the days…holy metabolism) and some of my hospice patients would be much larger.

Kathy explained that often falls are more dangerous when we are physically trying to prevent the fall rather than accepting that person’s body is not able to stay upright. When we accept that a fall is imminent and help someone smoothly transition to the floor without injury, it’s a win.

And that was a revelation for me.

At the time, I found this useful information and applied it when I volunteered in hospice. However, in the years since the training I’ve found that maybe it has broader implications.

We often fight changes in other people when we might be more successful if we accepted that change was coming and became a part of that change. In other words, sometimes we have to fall with someone rather than fight the fall.

A friend of mine, John, whose wife died from Alzheimer’s a few years back, reminded me of this when he explained that the strategies he had used to make himself a college athlete and then a successful businessman were massive failures when he tried to implement them after his wife’s diagnosis.

John was a problem-solver. When there was an issue, he read everything he could get his hands on to fix the problem. And he was a hard worker. It didn’t matter what he had to do. He would go to the end of the earth to be successful. Things always went his way because he made sure they went his way.

With Alzheimer’s, that meant he made appointments at Mayo Clinic – and appointments at other memory centers when Mayo couldn’t “fix” Alzheimer’s. He even checked into a memory clinic in Switzerland before deciding there was little they could offer her. He read online articles about supplements and behavioral interventions that could “cure” the disease. He even sent money (I didn’t ask how much) to a guy online who offered to provide him with a diet plan that would reverse his wife’s symptoms. He convinced himself that if only he did enough research and diligently pursued all possible options, he could “fix” his wife.

In social settings, he worked hard to “cover” for his wife’s symptoms. When she was asked questions, he answered for her. When she did something that didn’t make sense to others, he explained that she was tired or stressed.

Sometimes she would say she was too tired to go to an event. He wouldn’t take no for an answer. He’d insist she attend anyway, even if he had to help her get dressed and blow dry her hair.

He didn’t want to see his wife fall.

He would do whatever it took to keep her upright.

After a couple years, it was his wife who convinced him to change his strategy. She was sick of how fighting Alzheimer’s consumed all their time and energy, and she worried that the fight was exhausting her more than Alzheimer’s itself.

She acknowledged that her disease was progressing, and she wanted John to come with her instead of battling the disease. She knew he was trying to fight the disease, but sometimes it felt like he was fighting her.

John adopted a new strategy. He accepted that her symptoms were getting more noticeable. He realized that she was still the same person she had always been, but he acknowledged the changes in their lives as a result of Alzheimer’s.

When I’m struggling and I confide in someone, you might think I’m asking them to hold me up. But often I’m asking them to fall with me. To break my fall. To hang out with me on the floor until I’m upright again.

There’s a time to fight like hell. But there’s also a time to accept that a fall is inevitable and not fight that fall.

And falling with someone is better than falling alone.