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One thing that seems so very elementary but was pointed out to me when I was caring for an elderly relative years ago was to pay attention to the shoes your loved one is wearing. Running shoes are not appropriate for the elderly who have mobility issues. The rubber upturned toe can cause them to trip easily and fall. Now, this seems like a "no brainer", however, after all the time I've spent in nursing homes and hospitals, I've learned that it's not uncommon to find our elderly loved ones hospitalized, or worse due to wearing these kind of shoes. Also, the old fashioned type walkers are another fall hazard. They are being replaced by newer technologies in walking assistance. If your loved one is still using the old standard kind of walker or cane, it may be an impediment instead of an aid.
Baric crap, but things we dont always think about. God bless you all and best of luck to you and those you love.
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Llamalover47 Apr 2019
ClickChick: YOU are absolutely correct about the turned up toe of an ELDER'S tennis shoe! You're a genius! And thank you so much for pointing that out! I am an elder (yes) at 72 years old & I've almost tripped in my shoes like this! Thank you! Thank you! Thank you!
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Maybe Now it is Time for a Nursing Facility called "Skilled Nursing."
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Have you considered that dad may now require the care that a Nursing Home can provide? Maybe his Assisted Living days are over. I don't know, but you may want to think on that. God bless you. Good luck!
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Most AL facilities will have staff that can be hired as needed for an additional cost that is substantially less than hiring outside care. They should also have PT available to work with him. If it isn't a physical weakness, please take him to a good eye doctor who knows more than a little about measuring depth perception and spatial awareness. Too many elderly patients can't see where steps and obstacles are, and their bifocal or progressive lens glasses are the cause! This is an easy fix. So is therapy to improve balance and coordination. Try noravisionrehab.org or covd.org to find an appropriate person to diagnose and treat these types of problems.
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Judysai422 Apr 2019
Not all facilities offer this. When my parents were in Brookdale, they did. Now the facility they are in does not. Just not something you can count on.
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We just encountered that problem with my MIL. Yesterday we sat with the house nurse and discussed our concerns. They are now moving her to the next level of care. We'll see how it goes.
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Recognize that the assisted living facility where your parents currently live don't want to lose a good-paying tenant. They don't want to stop the gravy train and let your father off. It's so much easier for them to place the burden on you. Move him to memory care or a nursing home. Perhaps your parents will have to move together to a new facility where your mother can reside in AL and your dad gets the care he needs.
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Judysai422 Apr 2019
My mother in law fell in a nursing home. Memory care is staffed more than AL, but neither will guarantee no more falls.
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Dad would probably go to NH. There, he could be watched more closely with other residents while perched in front of the tv
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My dad was in memory care AL for 4 years. As his dementia increased he started having falls. His bed was moved against one wall and had a pad alarm under his shoulders at night. He went from walking to wheelchair he would fall as he didn’t know/remember how to set the breaks and the wheelchair would scoot out from under him. After the falls his was checked anywhere from every 15-30 minutes.
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It is so very tough to find the "right fit" for our parent(s). First of all...no one knows them like you do. When you are looking for a memory care or assisted living PLEASE spend time where the other residents hang out during the day and make sure there are no wanderers at night. Your loved one will be living with these people and it is important to evaluate the residents as well as the caregivers. A good place will monitor movement from bed or in their bedrooms.
I found a darn near perfect larger residential home where there were 6 ladies and 2 men. After I moved Mom in, I took a photo album highlighting her stages of life and different family members with a short description under each photo, (1 per page). I took it out while I visited and included the caregiver (s) every time possible. It was a great way to show and tell....so caregivers could get to know mom.
Before I found that good fit, I also had to move my mom from what was a memory care until new owner purchased and didn't want to bother with those that needed that extra help...which entailed talking to my mom for a few minutes every so often. After all, these elderly with memory loss are in a place where they know no one, nothing is familiar and yes, they may get a little scared, confused and agitated. So moving mom was actually a blessing in disguise.
I'm sorry you are going through this. Being a great advocate for your loved one is necessary and eventually those care givers will get to know he or she.
Good luck to you!
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Invisible Apr 2019
I, too, was going to have to move my father from his memory care to another because he was having trouble transferring with assistance and they didn't have a lift. That was the question I should have asked before signing the lease. He fell, went into hospital with suspected UTI and the facility couldn't/wouldn't allow him back until he was able to at least stand and help with transfers. Had to go into nursing home (for rehab) and died there. I fault each organization (memory care, hospital, NH) and myself for not anticipating his needs well enough. The admitting doctor said he could have come home from the hospital the same day he went in. You don't want to go there. The memory care said he wouldn't have had to go in the first place - they can treat UTI - except they weren't staffed for/with a lift.
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Simply tell them
I would if I could but I cant so I won't. The money isn't there.
Same situation with my Dad.
He refuses to or forgets to use walker. Weve come to conclusion it is what it is. It's going to happen. Sorry to say. Now we're deciding if its time for nursing home.
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NeedHelpWithMom Apr 2019
Cloud,

They do medication reminders. Why can’t they remind him to use walker? Maybe NH is the next step. So hard to decipher these things at times.
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After dad kept falling and then had a pelvic fracture with a rehab stay, then back to AL and fell with a femur fracture and rehab stay, AL would not take him back. He didn’t need memory care so he went to LTC. Expensive..oh my yes!! But having to hire a daily sitter would have been even more. And as someone else said they’re on their phones most of the time. Time for LTC for your dad to have more eyes on him and immediate help close by.
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This happened to my mom when she was in memory care. That sort of move will not resolve the issue with the need for a private caregiver due to falling, heck private one on one care will not resolve the issue of falling.

My mom had falls in memory care but her primary issue was agitation and aggression. That extra pair of eyes was necessary on and off over the two years mom was in a facility. Yes, it got expensive. Mom was eventually kicked out because of her behaviors. She was on hospice at the time. Hospice recommended an excellent care home where the caregiver resident ratio was better. Private caregivers were still necessary, occasionally. But, the care home was cheaper than memory care so, that helped.
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I agree with GAinPA - finding the right/better fit could make the difference. My Mom is about at the same level as hers and was in an Assisted Living facility for only 3 weeks. She fell and broke her arm (along with multiple other injuries) and she was on the floor for a few hours before she was found. AL facilities are not required to check on residents as often as other types of facilities. After this happened, AL said she was not appropriate for their facility. It was a blessing in disguise as we had to find a Memory Care placement for her when she left rehab. She has been there for two weeks now and the difference has been remarkable. They check on her every couple of hours (more often if we had a higher level of care), encourage her to get out of her room and participate in activities and have seated her at meals with a group of ladies who are about at the same level of cognition. Mom no longer feels awkward because she "doesn't fit in" and most of the time is genuinely happy because she has met people she can relate to. There are many others there who need a lot more assistance so I can see where she will be able to age in place and probably won't need to move again. And it is considerably less expensive than paying caregivers and an ALF or a Skilled Nursing Facility (nursing home).
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Lymie61 Apr 2019
Sounds like an ideal situation, good for you! It struck me that moving a LO to a place like this (if you can find one) sooner rather than later offers the benefit of helping them accept more help as that becomes necessary too. If they see it all around them, it's "normal" in their world the fear of standing out or being "different" the internal "shame" of not being able to walk un assisted for instance is removed seems like it might make it much easier on everyone.
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It is truly not sustainable!! Who sets the prices of these senior group homes anyway?
You may feel to move your loved one to a SENIOR group home. When someone falls between assisted living and a nursing facility, for me, a licensed group home fills the gap.
Better care (usually 6 residents or so), more attention, slower pace, home-cooked meals and, the BIG one, less expensive.
They just don't have all the bells and whistles of a facility in terms of activities and events, yet CARE is priority in my humble opinion.
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Invisible Apr 2019
The group homes I looked at were actually more expensive than the memory care places. They were also harder to get into. I worked for a woman with CP who lived in a couple of different group homes. Staff turnover was high and it is hard to get away if you have one bothersome resident. Also, since she was very dependent upon assistance for all daily living activities, she was somewhat at the mercy of everyone else's schedule. Issues might be very different with dementia residents.
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Until I started taking care or looking out for mom I did not realize we all had the same mother:)
That said I had the same issue with mine and she eventually fell and had a brain bleed although small and healed. She could not re turn to ASL because of Level 2 back sore from setting to much. She refused to consider Nursing home before. What happens to many times is their refusal leads to what they do not want. So She ended up in rehab and next step is Continued Care we call it instead of nursing home. ASL do not offer continue monitoring, so it is private setters and the ASL has to approve them, or family. Private care cost more then Nursing homes I have found and you really do not know what you are getting. Good luck there is no magic help.
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Part of the issue is that "assisted living" is not the same as a "nursing home." (You may be confusing the two.)

A person in assisted living is supposed to be somewhat independent. You father may need a higher level of care at this point (e.g., nursing home), if he is having frequent falls.
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I would not keep my family member in a home that doesn't know how to reduce falls. Nowadays there are training programs that educate nurses and CNAs in how to do this. They may be understaffed?

I would look for another home. Quaker-based places are usually much more advanaced in their approach to care of the elderly. You should not have to hire your own staff PLUS pay the AL home (probably) an astronomical amount. PS If your dad was walking safely when he entered that place but they kept him seated for most of the day instead of walking him, this isn't good. For their own convenience they don't let the residents walk, then they become weak and are more prone to falls.
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Invisible Apr 2019
I think that is an unfair assessment. They no longer allow restraints in memory and long term care, thank heavens. I don't know how else you could prevent falls when someone who has just been checked on 5 minutes earlier decides they need to get up and walk to the bathroom. People with dementia can't plan ahead; they are impulse driven. They don't think to push a button to summon help and they won't wait. Cameras everywhere are invasion of privacy and alarms on beds/chairs aren't the answer. Additional staff is expensive. You just have to pay for it.
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I understand the complexity of finding the right fit for the specific needs . My mother is somewhere between personal care and memory care as far as her needs are concerned. She can walk with a rollater. She can dress herself and do her morning: clean dentures, wash face, comb hair, but all with prompting. Go to the bathroom herself, but she needs daily assistance wiping up after a BM. That being said, she has no idea where she is nor does she remember what she had for breakfast 10 minutes after she eats. She is not as far advanced into dementia as the other 13 people on her unit and feels uncomfortable eating in the dining room and participating in some of the simple activities that the others enjoy. My point is that memory care was a better fit for her needs and her finances as compared to SKN which she, at this time, does not need. That being said, I find that the staff attends to the other residents who need more assistance due to their cognitive decline and mobility issues and my mom doesn't get the basic prompting and toilet help she needs. She is in a good place that is almost a good fit.
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Sorry to hear. Do you live near a college or university? Perhaps you could find a nursing student wanting to earn some extra cash and it would be less expensive than an agency. Or if know an active healthy retired person who would like to earn extra income.
I am disabled, and when my grandma was in a nursing home several years ago, I just couldn't be there every moment. So, I hired some girlfriends who wanted to pick up some extra money, to stay with her and tend to her needs when I couldn't. I felt guilty about it at first. After the first couple weeks, she started asking when I would prepare to leave, which of her girlfriends was coming to replace me! She was looking forward to their visits! She considered them friends and they lifted her spirits. They formed great friendships with my grandmother. And it helped them out financially, while costing about half of what an agency would have... everyone was happy.
Just a thought. I hope it can help you in some way to find a solution.
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I feel for you. I had the same issue when my Dad was in MCAL. The hourly rate is insane. And moving him to MC won't help with this expense anyway. If from now on he will always be a fall risk then 'grooming' him for a wheelchair might help. My Dad used a wheelchair now and I moved him to a NH. He fought the wheelchair but actually likes it now. Otherwise a 'high functioning' NH will be your best bet. Good luck. :-)
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Long-term care, sounds like = meet his needs
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Thanks. Memory Care would be less expensive, but he's mentally not there yet. We've discussed the possibility with staff they also felt it would be a bad fit. Skilled nursing might be our next step. So depressing :(
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Does the AL facility have a Memory Care unit? If so that might be where they are both better off. They will get more attention, usually a smaller group of people with staff more trained for dementia problems. And the Memory Care units are usually more confined so it is easier to keep an eye on the residents.
If your parents are together now it would be a simple move to move them together so little of their personal routine is disrupted and they will still be together.
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Move Dad to NH. He needs it just like everyone here is saying.
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He needs more care than AL. Time to move him to the level he needs.

I am sorry, it is hard, but it is the best way to go to ensure his safety.
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I second pamz. It sounds like dad needs a nigher level of care.
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This happened with my MIL.. they hired a lovely young lady with poor English who did not speak to my MIL, and spent most of her time sitting all the way across the common areas where MIL was parked daily.. and she played on her phone all the time,, no eyes on MIL and too far away to catch her when she got up. Nope.. not on my dime! Moving her to MC was cheaper( than paying for AL and the extra help ) and more eyes on her. Perhaps it is time for a move?
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Renesmith Apr 2019
You are in a bind. My mom is in a NH. Her roommate has dementia. She has fallen out of her bed trying to get up numerous times during last month. My mom has had to buzz the nurse station each time. They have promised her daughter to put a fall mat beside her bed, but it has yet to appear. In other words,the NH probably will not be...or help with ...a solution. After seeing a woman fall out of her wheelchair face down onto the concrete floor right at the nurse's station with nurse's around (She had to be sent to hospital), I asked why she had not been restrained in the chair since they said it had happened before. I was told that a) she had probably done it on purpose and b) the "Safety Committee " says restraints are not allowed under gov't rules.
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