My mom is in NH in NY state. She is in a wheelchair, dementia and almost 100% blind due to shingles, and subject to falls from rolling out of bed. We have put these (authorized) precautions into place: Wider bed, fall mats on both sides, lowered bed to the floor, moved furniture away from bed that she may hit, padded the corners of A/C unit, 15 minute bed checks. When I am here and putting her down for a nap, I pack pillows around her and place her big call disc near her bum so she may roll onto it if she wakes up and is on the move, she may accidentally activate it. She is blind and can’t see it, and with the dementia doesn't use it in the normal way. These 2 last procedures are considered “restraints” in NY so are unauthorized, so the aids do this on the down-low and I can’t get them documented into her care plan. This is more than frustrating to me and the nurses. They’ve asked me to consider moving her room across from the nurses station where they think they will be able to spot or hear her and intervene. I hesitate to take this step as she’s been in the same room since moving here 2 years ago, it’s bright and pleasant and her roommate watches out for her and calls for the aids if Mom has a problem. Not her responsibility but she’s a lovely caring person who I try to help as much as possible too. The potential new room is depressing and roommate sleeps 99% of time and is noncommunicative. I want what's best for Mom, but I’m not sure what to do. I don’t want this to be about me, but I sure don’t want to be any more depressed when I’m here than I already am! Before I take this step does anyone have more ideas on bed fall prevention that we could try? They won’t move her unless I agree, and it’s the only thing left in their bag of tricks, although they are not familiar with dealing with blind residents, she's the only one here!

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How about a baby monitor for the nurses station? One that has the visual and sound. You need to set up a small camera across from her, pointing at her bed.
At least any nurse or aide at the station could see what mom's up to. They are also portable, so whoever has her as a patient could keep an eye on her.

This "restraint" thing has really gone too far, IMO.
What the heck, it's better to let them  fall, break all kinds of bones, tear ligaments, crack skulls, etc. ?

Oh well, guess I'm "old school".
Helpful Answer (20)

rocketjcat, I remember back when my own Mom was living in long-term-care, was a major fall risk, and was legally blind and very hard of hearing. The Staff did everything that has been done for your Mom. My Mom was like an escape artist, as her brain thought she could stand up and walk when in reality she no longer could do that. Thus lots of tumbles, falls, and scrapes.

Putting pillows around your Mom also worked with my Mom. Less falling out of bed. When Mom was in her geri-recliner, the Staff found putting a pillow under Mom's knees kept her in the recliner a longer time, until later when Mom was wrestling the pillow out from under her knees.

I would vote to keep Mom in her room with the roommate who is alert. Your Mom is quite lucky to have such a lovely roommate :)
Helpful Answer (17)

I agree with SueC. These restraint rules are ridiculous! Good intention, executed by people who don't understand nursing home needs. But we are not apt to be able to solve that for your Mom, rocketjcat.

I'm glad the NH is willing to use pillows. I pack pillows all around me in bed -- not because I fall, but because it is cozy and comforting.

Is Mom at risk for falling from her wheelchair, too? We asked for a tray on our mom's wheelchair so she could easily do crossword puzzles. It could be opened by the person in the chair, but Mom never figured that out, so it served as a nice restraint, too.

I feel sorry for the staff who really do want to do sensible things to help, but whose hands are tied.
Helpful Answer (10)

Thanks all for the ideas. We worked on the wheelchair falls and seem to have fixed it (until the next time). PT got her a smaller wheelchair and a pad that fits down the side to make it even narrower. She can still move her arms but is wedged in a little more than before and she hasnt fallen from that in a couple of months. NO tray tables guessed it...a restraint. Sigh. This restraint thing has gone too far in NYS.

Baby monitor in the room...perfect but verboten as well. Already tried that.

I did have a good meeting with the head nurse this afternoon and got the call disc placement by her bum approved and put on her care plan, after I demonstrated it. Small victory! And a commitment they won’t move her unless I’m in agreement. She recognizes the relationship we have with the roomie and also was concerned about how a move would affect her as I basically “take care” of her 4 hours a day too, as she doesn’t have family that visits much. They are grasping at straws now however, as am I, and the move is a last resort. Any other ideas are appreciated!
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Have the bed and chair alarms seen abolished in NYS? I noticed when i was in the hospital a couple of weeks ago I did not have one and I am a known big fall risk Last time had a bright yellow gown and wrist band to match to identify me
I actually like the bed rails up it gives me something to pull myself up on.
I would vote not to move Mom to a different room. it probably wouldn't help anyway patients have been known to fall even with three nurses in the room. if the nurses are doing there jobs they should not be sitting at the nurses station peering into patientss rooms in the dark. Unless Mom is also stone deaf it will be very noisy there too at night. Something with a light beam that sounds an alarm sounds like the best solution.
I asked for a trapeze for hubby and I was told he could not have one because they were only for orthopedic patients.
Would it be possible to push one side of the bed up against the wall? I don't know if that would be considered a restraint.
Are they allowed to put alarms under the floor pads?
This is getting really ridiculous. I think military hospitals are still allowed to use restraints. What about prisoners who are taken to hospital and restrained with hand cuffs while the have their babies? How about rubber rooms for the insane are they considered restraints.
Helpful Answer (7)

How about a Room Guard - placed discreetly opposite her bed, preferably near the door. Just not in the walk area. Switched on when she is supposed to be going to sleep.

Amazon have a Buzz Lightyear one at a reasonable cost.

They do other types but I remember this one from the grandchildren.
Just a thought. :)
Helpful Answer (6)

Why no baby monitor?
Surely THAT can't be a restraint. So, is it an "infringement" of privacy?

Who the h*ll made these dumb laws anyway? Maybe their loved ones never had dementia and died young.
Helpful Answer (5)

Tlkent I am afraid that an alarmed floor mat may be viewed as a restraint in NYS

Comuter girl have you ever been a patient in a nursing home?

Yes this lady is blind and can not see her surroundings but I don't believe she is deaf.

Her room mate is a plaesant and careing person and the patient's family visits with her too
I agree it is the staff job to look after patients but that does not include one on one care 24/7. I would have loved to have had room mates like that when I was in hospital and rehab

Imagine someone who never sleeps constantly poops the bed and waits hours to be cleaned up while you are trying to eat, or comes from a large family who talk loudly in their native language.

I would opt as I said in a previous post to not put Mom close to the nurses station and the constant noise and commotion that goes on there. Pleasant room keeps the room mate in good spirits and looking out for Mom gives her something positive to do with her life.

This familly's problem is stopping Mom falling and getting round the over zealous restrictions on restraints, this is a major problem with many elders blind or sighted.
Helpful Answer (5)

Veronica, yes bed and chair alarms have been banned in NH in NYS, some places are just faster to comply than others. Its not even consistent in the central N.Y area. Bed rails are only in hospitals, I don’t know if hospitals are part of this stupid edict.

Mom can hear a pin drop across a room, and can’t see if someone talking is actually speaking to her so her confusion increases. So I also was concerned that the commotion near the nurses station might make her restless sleep even worse, and cause even more “wake ups, get ups” and falls.
I will definitely ask about putting the bed closer to the wall and see what they say about that. Thanks!
Helpful Answer (4)

Thanks everyone for your thoughts! Just to follow up, I did start raising the foot of her bed up moderately while she took her naps the past 2 days, ( in addition to the bed already being lowered to the floor). When she woke up, I said Ok Mom let’s get up, and watched her flounder, unsuccessfully getting her legs and feet moved out of the well in the bed. The nurses were happy to get another tool to use, and it’s going on her care plan today.
I will research the fall alarm that rings at the nurses station.
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