littlemisskitty Posted December 2016

Right to Fall.


I'm struggling with this whole statement of dementia patients having, "The right to fall". My grandma is in a rehab facility having falling from her chair by leaning over for her blankets and breaking her ankle. She had to be sent to rehab as she was a nonweight bearing patient and we were told rehab facilities are perfect for this as they are prepared to deal with patients like this.

So I went along with it but find all I hear is "she has the right to fall" when a request for anything is put in. I asked for bed rails as she is expected to roll herself over from side to side to be changed in her bed. When she goes to roll herself she has nothing to hold on to so cannot do it so they get annoyed and roll her themselves ignoring her loud screams of, "Help me. I'm going to fall. Help me!". One night she even yelled, "who stole my railing. I want my railing!" I asked about bed rails so she can feel safe and be able to help with the rolling properly and was told it was not allowed as it was a restraint. My grandma can get out of those bedrails easy enough and in fact when uninjured she used them to safely get out of her bed and to help me position her properly on the mattress. I'm frustrated not being able to get something to even help her with rolling.

So that brings me to my next statement. AT my house I use a camera. I understand they cannot. Before the baby monitor I used a bed alarm. Eventually I taught her to yell for help. So now she sits quietly in her chair or lays on her bed then yells, "Help me" when she as to go to the bathroom. Since I use a camera (the screen turns itself off until I hit the button) it allows me to hear her yell so I can get up to help her. She isn't going to get up by herself but will ask for help so I can help her safely get up. (We have been working on this for years so even with severe dementia she remembers luckily). At the rehab they have a button to be pushed. I never have used a button with her so she still yells. She is close to the nursing station thanks to my fussing but while in other people's rooms, they cannot hear her yell so no one comes to her aide. Then her next step is to sit up and yell louder. They don't hear her but if a bed alarm was allowed, they would hear the beep the same as they could hear the bell of a call bell. But they said the patient has the right to fall so no bed alarms can be used.

I'm so frustrated. I feel like it's an excuse for them to ignore the patients' needs and wants and just not do their job. Anyone else struggling with this idea of the "right to fall" and have any suggestions as to how to deal with it?

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Veronica91 Dec 2016
My experience as a patient in three different hospitals is that most beds are equipped with two sets of half rails The top set only goes a small way down the bed and can assist the patient to move get up etc. When ap patient is sedated for a proceedure the second set at the end of the bed is also raised but full sets are illegal to use at any time. As far as bed and chair alarms are concerned they seem to be freely used which of course can be very annoying. One hospital even made patients they considered fall risks wear yellow gowns and an orange wrist band

Sunnygirl1 Dec 2016
I'd ask the facility to provide what they are saying about falling in writing.

I'd insist on the bed alarm.

I'd discuss it with her doctor. I've heard that under some situations a person can get a doctor's prescription for a hospital bed, if their safety is in danger. I'd inquire anyway.

cwillie Dec 2016
Different jurisdictions have different rules, but when I had my mom in a respite facility all I needed to do to get her bed rails was to sign a waiver as her healthcare POA. There are also bed stand assist rails that are not classified as restraints yet still give them something to grab to stand or turn and also help them to feel more secure.
The call button problem is one that must be fairly common. I think many with dementia would not have the mental ability to remember to use one, and unfortunately many (like my mom) will call out for no reason so staff soon learn to tune it all out.

I've never heard of the "right to fall." Perhaps it's a corollary to the "right to be stupid" for whoever created this lame excuse.

Bed rails are restraints, and the facility is subject to state regs or statutes on their use. So that unfortunately isn't a good option.

The subject of falling and fall prevention is discussed on this thread: I think it would be helpful for you to read the suggestions there.

Gershun Dec 2016
"The right to Fall?" What a ridiculous statement. It's like saying they have the right to soil themselves and sit in their own feces for hours on end or they have the right to choke on their food, etc., etc. Is this place titled Care Facility or The Right to Suffer facility? Maybe go back there and hand them a dictionary with all words that describe helping those who can't help themselves circled.

Hm. [said grimly]

How long is she set to be in this rehab facility, any idea? I'm not sure it's worth the candle arguing with them if it isn't going to be for long, is the thing.

I gnash my teeth for you over the frustration of it. Right to fall my Aunt Fanny! - this sound-bite type phrase is their trainers' way of getting people to understand that frail elders can't be restrained even if the good intention is to stop them falling. But it isn't a right to fall, any more than it's a right to help herself to a broken hip. Stupid buggers!

Moreover, where you do have a line of attack, is that the aim of rehabilitation is to re-enable the person as far as possible. To that end, she must be assisted to help herself. She should be provided with hand rails, grab bars; her environment should be adapted as far as it reasonably can be to what she is able to use. And quite clearly they're not interested in doing any of that.

And their line about the bed alarm is purest baloney - alerts of that sort in no way intrude on the person's privacy or impede their freedom of action. [I should know. I'd have given my right arm to be allowed to impede my mother's freedom of action] "Can't be arsed to get one and train the staff" is more like it.

It's mot unsatisfactory. The question is, is it worth the battle? What's the plan for her next steps?

MsMadge Dec 2016
I have never heard of the right to fall but bed rails are considered a restraint
When my mom was in rehab with a broken there were minimal bed rails at the top of the bed for her to grab and which had the control buttons to move the bed up and down

I can tell you that falls happen frequently at my mom's memory care even if beds and wheelchairs are alarmed - resident gets up and the alarm goes off but no staff is around to prevent a fall

My mom fell 10 days ago and sprained her ankle/foot - she couldn't bear weight for the first 47 hours and it took two of us to transfer her to bed and toilet - her foot is still swollen and wrapped and she's not walking yet - a year ago she fell and broke her ankle in two places but luckily don't don't need surgery - that first week was h*ll - I didn't sleep for nights as she screamed in pain and couldn't get in the bedside commode

If you haven't done so yet, ask for a care planning meeting with physical therapist and head of nursing for their suggestions

stew7428 Dec 2016
I think I would be asking the facility if she has the right to safety. I would even talk to a lawyer that specializes in elder care about this and have him write a letter to the facility asking about the dangers of no bedrails and any thing else you are concerned about. Are they willing to stay in her room to make sure she is safe? Find out how many nurses per patient are there on each shift, also how many cna's are there on each shift per patient. Observe, without asking too many questions so you can see for yourself if this is a good place for her to be. On one of your visits have her use the call bell for something that she needs and see how long it takes them to respond. Do that on several visits. Do not always visit at the same time, break that up also. This is pretty rediculous on the part of the facility. In stores that carry medical supplies you can actually purchase a half bed rail that is mounted to a board. The board slides under the mattress to make the half rail sturdy. It is not designed to keep someone in the bed, but more as an aide for positioning and getting out and in the bed. My husband purchased me one a few years back when I was having back surgeries so very often. It has helped us out many times. He was especially glad to have it when he had a kidney removed due to cancer. If they won't provide a bed with a rail, this may be good to look into. They are not very expensive. The last time I was in that type of store the price for one was about $50. I wish you loads of luck pressuring the facility for the safety of your loved one. Sandra

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