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Mom has mild to moderate dementia and is very unsteady on her feet. Can't seem to get her to use her walker in the house. She is convinced she won't fall. For now I am following her around on the ready. Any tips for getting her to use it?

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Make it pretty and lovely so she's proud to be seen with it. I wrote sometime ago about a woman I met online who was an artist and painted lovely flowers on walker legs. These assistive device works of art were apparently quite a hit at local nursing homes.

I've always planned to decorate my father's walker but never got around to it. You could just decorate it, w/o telling her what your motives are. Or just casually mention that as long as she doesn't need it, you thought you'd decorate it and make it a pretty addition to the room.

Add some silk autumn leaves in areas such as the crossbar, where they won't interfere with walking. In December, change to holly and ivy and some small poinsettias. Hearts are for February, Irish decorations for March, pastels for Spring, red, white and blue ribbons or flags for Memorial Day, etc.

You can also try to find a decorative bag to attach to the crossbar. Some are nice, others are typically "assistive device unattractive".

But unfortunately, the attitude that "I won't fall" isn't unusual. I think some of it is positive self reinforcement, so I've backed off and try not to be negative and just say "okay". "I hope you don't fall because that means another trip to the ER, hospital stay, rehab stay, long waits for toileting assistance..." That's usually enough to discourage bypassing the walker.

That's why I suggest making it a work of art, so she's drawn to the lovely flowers or leaves, and people compliment her on it when she goes out.

I think as along as someone tries to get someone else to use a walker, they'll often resist. But sometimes they legitimately forget; older brains (including mine) often do that.

You can also ask one of her doctors to script for home PT to strengthen her legs. Or buy one of those little bike pedals that can use used on the floor or table to strengthen legs and arms. Search for "bike pedal exerciser". Some are just the pedals and can be found in catalogues for about $15 (last time I checked). Others are more heavy duty and more expensive, and harder for an older person to drag out to use.
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Mouse my mom is the same way,, those things are for Old people and she wont fall, as she wobbles all around.. and uses me and my Aunt as her personal devises, I have even pointed out that my younger friend uses a cane. I have a bad back,, she knows this.. but no matter. Good luck !
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This is so common with old folks. I have the same issue with my mom. It drives me nuts. She knows she has no balance, must always have one hand something to steady herself but is falling more and more.

She doesn't have dementia but the reasoning is just not there anymore. She'll use her walker when she remembers but will try to make the short trip ( like 6 ft) to the bathroom with out the walker and have a terrible fall. I WAS JUST GOING TO THE BATHROOM!

Sadly, I think falls are just a fact of life for the elderly. We can only do so much prevention. I do like GAs suggestions however. I might try and tart up my moms walker and see if that makes it more noticeable and appealing.
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There goes my heart rate soaring, just reading your post. Oh my word this is one of the huuuuuuuuge frustrations!

Don't do what I did for far too long and try to reason, explain, cajole, plead or turn purple in the face. The remembering and thought process that goes into rising from chair, taking hold of walker and using it correctly is no long happening in your mother's head. So no matter what you say or how you communicate the walker's importance, she is not going to do this for herself.

I found placing the thing so that to leave her chair mother had to either move it or use it sometimes worked. But quite often she would just move it out of the way, then totter off perilously grabbing at chair backs and table tops to steady herself.

Have you already installed a pressure pad so that at least you get some warning when she's off on her travels?

By the way, when it goes...

You - Mother, please remember your walker! It's so important that you don't fall.
Mother - I'm fine, I always hold on to things, I don't need it etc.

... her excuses and reasoning aren't actually relevant. She doesn't use it not because she believes she doesn't need it, but because she can't - literally can't - initiate and carry out the action.
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I had the walker in her walkway. My grandma when she first started using it, refused to use it all the time finding it too cumbersome. She refused one time and was yelling at me as she fell with her back against the cabinets causing a compression fracture in her back. That kind of made it so that she was afraid to fall so much so she started using the walker more. Which kind of walker are you trying to have her use? The grey one with no wheels just had grandma lifting it and she found it hard to use. The grey one with two wheels was confusing to her as well and she would forget to lift it and almost lose her balance but the one with a seat was perfect. It took lots of practice. I kept reminding her following behind her with the walker. A few times when she was waiting I'd encourage her to sit in it and she began to realize the convenience of having a walker to sit on. I even had the grand children put pictures on it saying that they loved her. That way when I brought it to her, she would see their faces and see the pictures they drew for her. We added a cup holder for her drink so she could push it while having a drink with her. We added a tray underneath the seat so she could put her book and pencil in as well as a jacket or anything else she was carrying to make it more inviting.

I also at night time and during the day, have the walker right in her way. She either has to walk around it awkwardly or push it. She seems to have no problem pushing it now and won't walk without it as it's in her long term memory or somewhere that she thinks she needs it. 

Don't give up! It's a work in progress.
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Kitty reminded me that my father is actually more comfortable, and safer, with a rollator, than with a walker. The only shortcoming would be if someone doesn't know how to use the brakes.

But it's better for short walks b/c of the seat; 4 wheels instead of 2 provide a more even stride.

Windy, um...."tart up"? Thanks for the chuckle! Just don't make Mom wear sexy clothes or you'll have another problem on your hands. The wolf whistles might encourage her to walk all around the neighborhood!
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I have little different take on this. Walkers can be extremely helpful if they are used correctly. Used incorrectly they can actually increase the risk of falling.

People with dementia have a hard time learning to use these devices safely. (As well, of course, of remembering to use them at all.) I'm of the opinion that when they are in their own homes, if paths have been cleared and obstacles removed, they may be better off "furniture walking." Watch how they do this and perhaps move some items a little closer together so there is always something to hang on to.

Outside of the house a wheel chair may be the safest bet. Many public places have them available. A transport chair is not hard to carry in most cars and can be used getting into and about in a building, whether is is a clinic or a children's museum.

There are something like 47,000 elderly Americans treated in emergency rooms each year from falls WHILE USING walkers and canes.

I think walkers can give us a false sense of security. For seniors with no cognitive problems, it is important to make sure they are trained in using the devices and they use them correctly consistently. For seniors with dementia, I'm not sure it is worth the anguish caregivers go through trying to enforce the use of these devices.
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My mom fell using the rollator. After rehab, etc., she started using the gray one with no wheels. She used two tennis balls to slide it along. It worked well for her but she was given lessons while in rehab because she would look off to the side while continuing to go forward. That's how she fell, looking at one thing to the side while continuing to go forward. She used it for about five years.

My aunt uses a cane. I asked her therapist if she should stop using the cane and start using the walker. He said no, that it would be more dangerous for her to use the walker. She seldom moves without the cane. She has worn through the rubber tip on the bottom once. That was a lot of steps. She got used to using it when she was going through a period of being dizzy. It helped her maintain her balance. She fell once before she started using it and has fallen once recently. She normally takes it slow and easy and even though she uses the cane, she will still hold onto furniture or people if available. I encouraged her to use a cane in the beginning because I felt it made her be more visible and helped others see that she might fall if bumped into. It made her feel more secure.

I've noticed that my aunt can't talk and use her cane at the same time. If someone asks her a question, she will stop walking in order to answer. 

My mother had OT for years. My aunt alternates between PT and OT. It really helps them not only be able to safely use the walker or cane but also they have more strength in their arms and legs and should they fall they will recover sooner. It also helps with balance. The therapy also helps cognitively. 

The cane is easier to carry in the car etc.
My mom used the walker only in the house. She used a wheel chair if she was out of doors or going to the doctor. She could walk without the walker, she just felt safer using it. 

Another thing that I think helps elders not fall is for them to wear pads and/or disposable underwear to keep from thinking they have to rush to the bathroom. 

So, I would say, get your mom a cane and ask her doctor to order her PT. Just tell them she is dizzy and needs help with her balance. They will come out and evaluate her and see what she needs, PT or OT. Then the therapist can walk her around her home with the walker and/or cane and show her how it can help her. If you get OT they can give you some advice on hand holds etc. that will make her more comfortable and safer in the home.
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I have to say OT and PT where I used to live was amazing. Every few months the doctor wrote up a script for OT to come and help us maintain the house for grandma's safety. They would evaluate what has changed in here and give us pointers in where we could help keep her safe. PT down there was also amazing. He would pick a body part or just do it for balance (although the balance grandma hated due to the fact they would make her stand and do weird things on foam pieces which made her feel like she was going to fall during it. I think it helped her tons though!!). Now I have to confess, right after PT coming to the house for a few weeks, she was feeling more confident and it would be a struggle for her to ask for help. She's feel overconfident and secure and as though she could take on the world since she'd be feeling younger so I'd have to keep an extra close eye on her. She'd have a tendency for a few weeks after to just get up and walk without asking for assistance and try to use the bathroom without assistance (she needs help walking and tends to get UTIs and sores if she doesn't have assistance wiping the right way) but I wouldn't have traded PT coming to the house for anything. Here in Maine they suck and do nothing but come and try to use it as a chatting session offering you nothing.
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We liked a 2 wheel walker in the house better than a rollator, unless you have a large open concept house rollators can be hard to manoeuvre between furniture, down narrow halls and in the bathroom, my mom also sometimes forgot to use it even though I placed it so she had to push it out of the way.

I think making sure the pathways are clear, the furniture they grab is sturdy, and adding some railings down hallways and grab bars in other strategic places is sometimes more worthwhile than fighting the dementia. And if someone is weak and unsteady they need some PT, a walker or rollator is no substitute for their own muscles.
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Yes to the rollator type of walker, only if Mom is able to use to hand-brakes. My Mom tried Dad's new rollator and she just didn't have the coordination to use the hand-brakes which didn't surprise me. I remember my Mom many many decades ago trying to ride a bicycle which had hand-brakes... nope, nada, never again.

But Dad really liked his rollator walker, which cames in different bright colors, liked the seat which was quite comfortable, and the basket so he could carry stuff around the house and outside.

As others had mentioned, so many of our elders won't use these so very helpful devices. For my Mom, it was mainly vanity, she didn't want anyone to know she was aging.... hello, you're in your 90's...  if the neighbors saw her use one they'd probably would be thinking "it's about time". Mom didn't even want my Dad to use his walker outside, but Dad held his ground on that argument :)

Even a very serous fall wouldn't change my Mom's mind about using a walker. She didn't like the tire marks on the rugs.... [sign]. Yet, not using one finally become her down fall [pun intended] as that next serious fall she never recovered :(
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My mom with Alzheimer's wasn't "happy" till she fell once too often, would absolutely not let me help her up, and that last time, she was hurting bad enough finally that I had to call an ambulance. Little as she was, I could not lift her especially with her fighting me all the way. It is an incredible relief to have her in the nursing home now where she has plenty of supervision.
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murphyclm, a walker is no substitute for a nursing home, if that is what they really need.
Glad you got your mother there, but sorry for how it came about.
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97yroldmom: "I've noticed that my aunt can't talk and use her cane at the same time. If someone asks her a question, she will stop walking in order to answer. Yes! This is my 91-year-old mother! It just drags out the time further, and is one reason why doing anything with her and going anywhere takes so long.

My mother was told by the PT to use the rollator outside and a cane inside. She likes to "forget" the cane inside and prefers to lurch around. When my mother's friend takes her to Mass, she only uses the cane and holds on to her friend. I have warned her that this could be dangerous. She dismisses my concern. At least if she falls, it won't be on my watch! (And that will probably be the end of "independent" living for her -- she will probably need to be in a facility after that.)
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My dad fell and broke his pelvis getting up from the toilet. why?....because he forgot to set the brakes on the rollator and out it went and he lost balance and fell. Off to hospital, rehab for 5 weeks and then was barely back in his AL apartment when he’s walking down the hall to breakfast with a 2 wheel walker and he lost balance fell and broke the femur around his him replacement. This was 6 days ago. He ended up with a major surgery to repair it (at 96!) and we just got him back in rehab and skilled nursing yesterday. He can’t put weight on it for 4 weeks. This may be the end of him. Goes to show that walkers while valuable are not the total answer.
All I can say is all of us need to be keeping our own core muscles toned as well as our leg muscles. I do weights and go to yoga now and I can tell which ones who do not work on their legs and core. They nearly fall over in yoga. And mind you this is a gentle yoga. So please bear in mind as you yourself age. Sitting is our worst enemy.
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Good point, Harpcat - I wish they would come up with a rollator that works on the same principle as airport baggage trolleys, so you have to squeeze the handle to go rather than to brake, and then the worst that can happen is you don't go anywhere instead of its running away with you and landing you flat on your face.

I saw a wheelchair with exactly that mechanism last week - hoping it's just a matter of time, then.
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At least she still has the cognition to use a walker. Eventually they won't. As for "safety" in nursing homes..don't kid yourself. they still fall in nursing homes--all the time. Most are just not reported unless there is injury or death. One CNA has like 20 patients to care for you think they are watched all the time? Really?  Nursing homes are places where you check in and never check out--a kind of polite elder disposal area.  Now nursing homes when it comes to advanced care will remove the bed-frame and just have a mattress on the floor so they can't fall because they are already on the ground and can't get up.  When they are up what makes you think they don't fall? They do!  They say you can avoid falls but in reality you can't. Unless you are with them 24-7 around the clock at arm's distance and practically attached to them. 
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Harpcat,
Sorry about your Dad! My mom just furniture walks. When she stands up her b.p. drops so she starts to sway and she starts to fall more with the walker. She simply does not understand how to use it and can't remember because of the dementia. I also now own a beautiful fancy cane that I guess I'm saving for me because she was even worse with that. She does better with furniture walking!
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My mom is now in a wheelchair all the time. I remember she was resistant to the walker. Putting in front of her so she had to use it helped. I do recall she would park it on the other side of the room & wobble back to her bed or her chair. Drove us nuts, but we do laugh about it now.
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I bought my mom a new "regal rose" walker. It's only 7 lbs. and is easy to fold up and put it in my car. I plan on just taking it out and telling her she needs to use it before she falls. She is constantly grabbing onto me, the car - anything she can find. I'm hoping the "prettier" walker will entice her!
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I agree with those who report how they could not get a person with dementia to use their walker. I had the same experience with my LO. At first she had a cane, but, she refused to use it. Reasoning just didn't work. She then had some falls and went to a walker. THEN she started forgetting. She just could not remember to use it in the AL. THEN repeated falls and fractures put her into a wheelchair. The falls were then less frequent.

I would say that the only real way to ensure proper use, is to constantly supervise her every time she gets up to walk. Instruct her to use it, And get an alarm for her bed, so it alerts you when she gets up in the night and you can get to her and supervise her use of the walker to the bathroom. I've never seen any other measures that work, such as reminders, as they either don't have the initiative to read the note or they are not able to process what it means.
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Dad has a walker, rollator and two wheelchairs in his apartment in various rooms for convenience. He likes to scoot himself around on the transport chair, which is fairly compact and he feels more stable. When I am there, I insist we use the rollator (bought an upright one called Nitro by Drive, which is stable, very easy to use, light and compactable for car trunk) to ensure he doesn't lose his ability to stand and walk. But sometimes he can only hold one thought in his head at a time and when he is distracted, he might stand up and wobble over toward the object of distraction. We just keep placing the walker or rollator in front of him and reminding him to put on brakes when getting up/sitting down.
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We had this issue with my grandmother. She rally needed to use the walker to prevent falls but never felt she needed it at home. She had many falls and often the recovery wasn't fun because she was on Cumadin, she often looked like she was being beaten! Anyway the fancy one with a seat was what made the difference for her as well. This was years ago so probably different equipment now but having the seat with her all the time was so convenient she started to like having it with her. Hers was blue I think and I bet she would have loved having it decorated too. But a big element of not using it at home I think is habit, especially when you are dealing with any sort of dementia, even without memory issues the longer one has lived in a particular home the more being a creature of habit is going to be a factor I imagine.
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I've played this game with my Mom for far too long. She is in assisted living and the aides all see to it that she uses her walker. But, while she is in her own apartment, she doesn't feel she needs it and that is where most of her falls occur. When I visit I always remind her that her walker is not next to her, which frustrates her because she honestly feels that she can walk a foot and not fall. Which, of course is not true. When she does fall, she always has and excuse .... well I was just turning to get ...whatever. Unfortunately, I am at a point where I believe that you can lead a horse to water, but can't make him drink. At 94, my Mom is her own worst enemy. We do what we can, but they (older folk) will do what they believe they can do and to hell with the rest of us. Hang in there. You will have many visits to the emergency room to take care of Mom. But you are not alone. See you there?
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Just want to say thank you for all the great advice. Helps just knowing that others struggle with same stuff.
I think I will be placing it in front of her seems to work so far.
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I'm having a similar problem with trying to get my husband to use a cane. He has moderate-to-severe Alzheimer's and shuffles in our small apartment but always has something to lean on. He's getting PT now. Two PTs and an RN told him he should use one. When discussing it with him, I find that it's a matter of pride. He doesn't want others to see him using it. Even if he gains strength in his legs and core, there's the matter of him having episodes of dizziness, partly due to his meds. Next week he's due to see the doctor and I'm thinking of asking the doctor to tell him he needs a cane and he's not to leave the apartment without it. Hoping the doctor will cooperate and that my husband will listen to the doctor's "order". That stops me from being the "bad guy" as so often I turn out to be. I always need to be able to say, "the doctor ordered this."
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My mother won't use hers most of the time and often won't bother with a cane. I think with the cane she just forgets about it and starts moving - holding onto whatever is handy. Unfortunately a lot of what is handy is unstable. She hasn't fallen yet, but she could at any time.

With the walker I do think it is a pride thing. Only old people use walkers. I guess she figures age 85 isn't old.
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Well walkers may be for old people but my experience has been that people are far more helpful when I am using a walker rather than a cane. I started falling many many years ago long before i became old. I have a pretty red colored walker which gets compliments and have rifgged up a basket so i can carry things around - like food. my home is constantly an obstacle course thanks to hubby so the walker makes it safer. i have the front wheels on mine which makes it easier to move. I also have a rollater which i use when taking a walk. I love the seat which means i can sit and rest when i get breathless. I use an electric cart in the grocery store and a wheelchair for hospital visits. The walker is easier for me to put in the care than the rollater which is heavier. If i go to a store and need to use a regular cart I may walk the short distance with a cane when i have hopefully found a handicapped parking space, which seem to be totally inadequate in number.
I don't think i would be persuaded to use any assistive devices if I did not want to but for me they make life a lot easier. "Go Gma go"
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Please try to obtain a written doctor's order saying that a walker is needed and place it  or even enlarge the document so that it can be placed where it's visible to her.
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