Brief Answer: It may be a sign of dissatisfaction! Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about these numerous falls that your mother has been having. I hope we get to address the and prevent the huges consequences that can result fro them like fractures. From the information you have provided, falling to the ground without any real cause and showing no efforts in either preventing the falls or waking up raises of the suspicion of munchausen syndrome. These are persons who want close attention by often pretending to be sick. Also, the fact that she has been diagnosed with a somatoform disorder makes this more likely. These diagnoses are common in younger individuals than the old. I will like to suggest that you step back and take a critical appraisal at how much attention you pay to her when she has not fallen. At times, it is their own way to call your attention to them so that she can feel cared for and loved. By this doing, get they get the necessary attention that they may not otherwise get. Try showing her more love and concern if you are not already doing so. If you are, try to intensify how much time and love you show her. If there are any reasons that you may think she is not happy with, try and address them. These may be simply ways of expressing her discontent and frustration just like children throw tantrums when displeased. Finally, have a XXXXXXX and honest discussion with her on the consequences of falls. This may call her attention to be more cautious and try to do more than just let herself fall to the ground. Until you can guarantee that she will no longer fall easily, please keep her away from heights, XXXXXXX milieu with sharp/hot/toxic substances as she ay fall and sustain concerning injuries. also, never let her walk unguarded and if possible with the aid of a walking stick, wheel chair or using rails. I hope this addresses your query and provides guidance on how to approach this problem. Thank you so much for using our services and do feel free to ask for more information if need be. I wish you well and hope she takes greater responsibility of herself. Dr. Ditah, MD

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Brief Answer: She needs to be reviewed thoroughly. Detailed Answer: Hi and thank you so much for following up with me. I believe you when you say your deepest thought is that her actions are not deliberate. However, I would want you to get her re-evaluated fully. You mentioned she has somatoform disorder which is exactly reporting symptoms that are simply not backed by examination findings. It is in this same light that munchausen comes in as a likely possibility. I will suggest that you get her complete evaluated again and make sure there is nothing that can explain this. But if the somatoform disorders are still confirmed, then I will stick with my initial answer. If it is not confirmed any longer, then re-evaluating will be a very good option to consider. Dementia, of which Alzheimer is the most common cause, has to do with memory loss. These are persons who are unable to relate to their past or forget so much about their day to day living and environment. For example, missing the way to the market, forgetting the number of kids they have, their names, etc. it has nothing to do with frequent falls. The core of diagnosis is about memory loss but unfortunately, you have not reported any such symptoms. I will suggest that you get her evaluated by at least 2 specialists. Please, strongly consider to see a neurologist and a psychiatrist in this order. if the neurologist fails to identify any possible case, then the psychiatrist would try to put the symptoms together and make sense out of them. It never hurts showing a little more concern. Just try it and see if there is any improvement in her falls. If not, then she may not just realise what is happening to her. For the mean time, try and prevent falls as much as possible o avoid huge consequences. I wish you well and hope she gets to find some help pretty soon. Feel free to ask for more information if need be. Dr. Ditah, MD

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