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My mom falls all the time. She has always been very independent, but now her judgement is poor so she thinks she can get up on her own. She won't wait for help at the NH. She fell yesterday and the day before. We're in the ER now because she broke her hip last night when she fell. She also has a mass on her lung and a stomach virus, so they're of course admitting her and she will need hip replacement.


I've been worried they would kick her out of the NH for not listening to them about getting up. Now I'm worried they'll say she can't come back. I don't know what I'll do if that happens. We are applying to medicaid next month once we finish her spend down. We got really lucky to find a medicaid bed at a nice facility and I don't want her to have to leave. There are not many other nice ones in our area that take Medicaid that don't have a huge waiting list.

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Generally this is the type of patient that nursing homes in general do deal with. I cannot imagine that they would "kick her out" because of illness and falls, as I would imagine they have few who are not dealing with these situations in their care. That doesn't mean they will hold a bed for a month she will likely be in rehab.

If you signed a contract you may want to read your entire packet. They often state the reasons someone may be asked to leave.

The important thing for you is NOT to start upsetting apple carts at this time. Your Mom is going to need at least a month of time for rehab I would think. They are unlikely to "hold a bed" but they are likely to take her back if they have a bed, and I would assume that is the case.
Do not contact them until they contact you.
And once Mom is better it is important that you not accept her into your own care and home, even "temporarily" (because it won't be): not even with promises of "we can get you help " (they can't) and "we can make this work" (they won't).
Make certain that you let them know at discharge planning time that you are in no wise able to take your Mom into your care EVER even temporarily--not physically able, not mentally able, not emotionally able.
They will then have to find placement at her current facility (preferred) or a new one.
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STLonlychild Mar 2023
Thank you so much. I know they have seemed to hold beds for other residents who were out for a while so hopefully they will for her. Another resident recently broke her hip too. I have come to terms that I can in no way, shape, or form take her into my home. She is beyond my scope mentally and physically. I want her to have the best care, but I can't be that person.
They do rehab at her facility, which is how she ended up there back in December after having COVID. I don't know if that is "enough" rehab, but I'm hoping if they send her back there for rehab it will help her keep her bed. It's scary because we're kind of in a gray area right now since we're applying for Medicaid next month.
I will be sure to say absolutely not to her coming to my home. Thank you for reminding me of that.
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Good that you are thinking about it now. Mine waited until the day my Daddy was released from the rehab to tell me they would not take him back! grrr! Keep in talking with the administrator so that you know where you stand. I had to put my Daddy in a group home and let me tell you that was better than the memory care facility that he left. I was treated like family with them and the communication was soooooo much better!
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STLonlychild Mar 2023
Thank you for your reply. I've been happy with her care at this place so I hope she can stay but I'll just have to take it one day at a time. I'm glad you were happy won't the care your dad got in the group home.
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There are ways to slow a person from getting up out of a chair or a wheelchair.
If a wheelchair you recline it a bit, tilting the back a little. This makes it a bit more difficult to get out of the chair.
If she is in a regular chair reclining it a bit will also help and adjusting it so it is not as easy to get it upright. (my daughter used to direct my Husband into a rocker recliner chair that they had he could not get out of that chair until someone helped)
Placing a chair alarm helps but it can be disruptive.
Placing a chair right up against a table will slow someone down. Trying to get out of the chair you have to push it back and a movement like that should be noticed by staff.

There is also the great possibility that the broken hip will definitely slow her down and depending on how she does in rehab she may be past the trying to get up on her own.
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STLonlychild Mar 2023
I don't know if they allow Geri chairs at her SNF. It may fall under restraints but I could be wrong. I brought her lift recliner for her a couple weeks ago because she would slide out of bed and a lot of people there sleep in their recliners. I never expected it to enable her to get up and I feel responsible for this, although she was getting up out of bed and her wheelchair too. Her wheelchair is one of those higher back ones for people with poor trunk control. I think it may recline but not sure that will help.
I don't believe she will be getting up on her own now though. And maybe never. It's sad.
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My Mom had a Geri chair. It looked like one of those flat slat vinyl beach chair with wheels. The seat could be slanted backwards so makes it hard to get out of. Also reclined so Mom could nap in it. There were cushions on each side of her head to keep her head from slouching over when she slept. She scooted all over in it.
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STLonlychild Mar 2023
I'm not sure if they allow them. My mom can barely scoot in her wheelchair, but the other other day, she fell and they found her trying to use the remote to recline the chair so she could get up instead of calling for help. The administrator took the remote and didn't tell my mom and someone found her lifting the chair by herself looking for it. 😳
The thing is, she is still very strong, but her brain can't motor plan which is why she is weak and can't get off the floor. She has the muscle strength to do it but her brain can't tell her body. And she THINKS she can still do stuff.
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It is heartbreaking to think of an older adult in serious need of care being thrown out. I can’t imagine this happening to anyone. Where would they go? Family members aren’t equipped to handle their loved ones who have these challenging conditions.

Speak to the DON at the nursing home and express your gratitude to them for caring for your mother and say that you don’t know how you could possibly manage caring for her at home. Do ask them what suggestions they have for preventing these falls from occurring again.

I think that you will be able to put your mind at ease knowing that they will hold a spot for your mom at the nursing home.

Wishing you and your mom all the best.
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STLonlychild Mar 2023
I had just spoken with the administrator the day of the fall, because she had also fallen the day before. She called to tell me about taking my mom's remote. We have discussed multiple times how to prevent these falls and just like I did when she was at home, they've tried everything they can think of. The problem is my mom. She was always a faller. Her whole life. Very very very clumsy, inattentive, and accident prone. She had more car accidents than I could count. This is all long before her brain injury. It's just who she is, and she has hardly ever been hurt so she didn't/doesn't take it seriously. The brain injury just magnified who she is. She has this knack for overcoming any kind of precaution you put in place and there is just no solution I've been able to find. So now she actually has a serious injury. Maybe this will help her learn, if she even makes it. I have a very bad feeling about it all. The mortality rate after a fractured hip in the elderly is very high. The one thing she has going is she's only 70. 71 in April.
The NH has given me no indication they'll kick her out. I just have a bad feeling and I know they must be tired of all her falls and not being able to stop them.
She is just not gonna listen when they tell her not to get up on her own.
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When you say NH are you actually talking about a Nursing Home AKA a Skilled Nursing facility or are you talking about Independent Living facility or an Assisted Living facility?
Generally Independent Living will not have staff come and help residents. So if mom is falling or depending on staff to help her then she really is not "Independent' and should probably be in Assisted Living.
If she is in AL and is not waiting for the help to arrive they may determine that she is a danger to herself and needs a higher level of care. They may not "kick her out" but they may suggest either Skilled Nursing or Memory Care. (is there a diagnosis of cognitive decline or dementia that might make her living in independent or Assisted more of a risk?)
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STLonlychild Mar 2023
She is actually in a Skilled Nursing Facility. We tried for both Independent and AL but they would not take her bedside she needed a higher level of care due to her frequent falls and weakness. She was in rehab at this SNF the moved to a long term Medicaid bed, where she has been since January.
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