The staff can't watch her 24/7...I wonder if there is something the family or staff can do? Or is there a way to remind her to take it? She's really going to get hurt :(
Regarding tying something to the walker. I like the idea to make it more noticeable and attractive to Gran, but be sure that you don't obstruct her vision in the process or cause her to be distracted. For example a balloon sounds cute, but would flail around and be a distraction and possibly get in her range of vision. Not saying that's what you'd do - just an example. Some people have made sort of aprons to tie onto the front of a walker to carry things - if the apron keeps the patient from seeing where their feet are, then it's a hazard. Just some things to keep in mind. I can picture some patterned Duct Tape wrapped around the rails like a peppermint. Have you seen all the patterns available these days? And bright colors of tape that's like electrical tape, narrower than Duct Tape. Walmart has an impressive assortment. I'm sure you can come up with other ideas, that's just one.
Due to the fact that so many elderly have been injured or killed trying to climb out of bed and becoming entangled in the bedrails, this has become the rule:
When less restrictive means of insuring a resident's safety have failed, then a nursing home can legally use bed rails or other means of restraint if they can document that the benefits outweigh the risks. The patient's physician must order that rails be used, and the nursing home must closely monitor the patient and regularly re-evaluate the need for bed rails. If the patient's need for the rails changes, then use of rails must be discontinued.
It is important to remember that even when family members request that bed rails be used, the nursing home cannot use such a request as medical justification for using them. Regulatory agencies will hold the nursing home accountable for giving every resident the most independence possible. Use of "restraints" that are not medically necessary, including bed rails, is not permitted.
my note:There are things that NHs can do before resorting to rails. They lower the bed to within inches of the floor and place mats over the hard surface of the floor. It is more difficult to rise from that level and if they fall out, there is the mat and not so far to fall. There are also mattresses that have raised edges to help keep the patient from rolling off. And other tricks of the trade.
That's for your suggestions all. For my gran it's not a pride thing... She just often forgets. I think the idea of tying something to the walker potentially would help... We will try.
I was told with my father that the nursing home couldn't use rails on the bed, it was considered a violation, but yet, when he was in the hospital they could use them. I never could figure that out.
And who can blame them for watning to retain their independence? It whats they cling to and probaly the last thing that people like this will ever give up. As for meds and not being put to bed.... This is simply not acceptable...so Put in writing to the care home and send a copy to your doctor and to the ombudsman that you are formally requesting a review of her support following several falls and that you wish to have a plan written down that will ensure the risk is minimised in the future. You cannot eliminate falls - its impossible but you can certainly minimise them and the associated risks.
According to Centers for Medicare & Medicaid Services (CMS) a fall is defined as failure to maintain an appropriate lying, sitting, or standing position, resulting in an individual’s abrupt, undesired relocation to a lower level.(that's a shock I never knew that!!!!!!!)
Preventing falls constitutes a significant challenge in nursing home settings and requires a substantial interdisciplinary team effort. Every facility should have a fall prevention program that, at the minimum, addresses the following three elements:3 1. Assessing residents for risk of falling 2. Identifying and implementing interventions to minimize risk of falling 3. Identifying and implementing interventions to minimize risk of sustaining an injury as a result of a fall
ASSESSING FALL RISK Regulatory guidelines require that a comprehensive patient assessment, the Minimum Data Set (MDS), be completed within 14 days of admission to a nursing home.
Certain items on the MDS will indicate that a resident is at risk of falling
When the MDS is completed, a resident who has one or more of these items (also known as triggers) will trigger a falls Resident Assessment Protocol (RAP).
Assessment instruments such as the RAP may provide clues to possible causes of falls.
So that is what the care facility should be doiong hun good luck xxxx
My mom was 94 early last in January 1994 and living in an assisted living private room. She had her rollator walker next to her bed but still fell while going from her bed to her bathroom. Fortunately, no serious injuries. Mom's mental state was declining; she suffered some mini strokes and she would just forget what a walker was for. Her strong independence was also a factor.
thank you for your adviceI have contacted the obudsmanshe is having a difficult time getting to the facility because sshe's having with her arm she has been there once to meet with me and the administraor rmom was up an hour and a half in a wheelchair trying to get up and down the halls 3 weeks ago because they gave her an Ambien and did not put her to bed and they don't think that there's anything wrong with that ihave been down every night since to make sure she is in bed and safe I'm sure that's why my mother was having all these falls I'm sure they were doing that all along and that poor woman was trying to get herself to bedI have contact an attorneyall I want is for my mom to be safe and for me not to be attacked when I asked a question about how she's doingI have to be here every day or she won't even get to the bathroom or nothing to drink anyone else ever have this problem and my moms on Medicaid and there are very few beds in this area that are available I have tried everywhere.
My mother is in a nursing home and she has fallen 3 times since December I have now come to realize they are giving her her sleeping med land not putting her into bed I'm having an awful time getting them to do this I have to go down every night to make sure she is in bed before they give her the pill I have talked to the administrator the director of nursing the nursing staff and they still don't get it now I realize why my mom have those falls. she was trying to put herself into bed so you might want to ask what they're giving your mother and dogood luckthis a very stressful time for all of us a very stess of us.
When my MIL was in rehab she would try to do the same thing and walk with assistance of a walker or aide. They eventually needed to use a Tattler do she would not get up unattended. Its a device that had a alarm attached and would scream a loud noise until staff turned it off. It is portable and battery operated, a pad is set under their body and it can move from a chair, to a bed, or wheelchair. Eventually she understood that she needed help until she was either strong enough to do it herself, or was cleared by her therapist.
Amelia09, my heart goes out to you. Yes, there is only so much everyone can do in their own capacity. Like the others wrote, signs, reminders, fall mats, bed rails, bed alarms, tying something to the walker that catches her eye like a lovely strand of beads, balloon, something cute that she loves...try everything you can. But some patients simply will not or cannot understand the risks. I'm sure you and others have also tried making sure the walker is RIGHT beside the bed so that she'd have to move it to get up, or have several walkers located by her favorite chair, the bed, etc. I wish there was a sure-proof way.
txcamper, awwww bless yoru momma, big smiles here. btdt with my father. He called it 'walking' when he was literally dragging himself along holding onto anything, everything; refusing to use his walker. We had the walker all decked out macho style. He had the coolest canes, located everywhere. I would use a walker when we went out to show it was okay (I had to do the same thing years ago to get him to use a cane). He said us demanding he use a walker or a scooter or wearing a medical alarm bracelet was us trying to make him OLD. This resulted in multiple falls, multiple false alarms of a broken hip, ER visits. He would use a cane outside but someone had to also be holding onto him on the other side...which really put a lot of strain on the 'holder' since his entire weight was on you, putting both in risk of falling. His pride was not due to ALZ, he has always been like this. His way or no way. At age 88 he had superior upper body strength so he sort of get away with it. Unfortunately, pride got the best of him, he slipped while holding onto a couch while moving from a chair, fell, broke his left hip and ended up with surgery and 2 months at a skilled nursing rehab center. Where he continued to fall (with fall pads, bed alarms, wheelchair alarms) because he insisted that he could walk and would lunge out of his wheelchair. He is hyper sexual and didn't want the nurses to see him frail so he wanted to show off and not seek their help. He even fell as he was trying to grope an aide, sigh. this left him 24/7 in a wheelchair, not even able to use a walker (this is pre-ALZ behavior, not due to ALZ disease). He would forget, like the others have posted, that he can't walk. Constantly coming up out of his wheelchair. We had big colorful posters, including pictures, reminding him to not get up. The nursing home had the wheelchair alarm on him, it made him furious and fighting and screaming. He only got angry. Pride along with ALZ and Dementia. Forward to age 90, just last month. Refusal to summon a nurse at night to go to the bathroom. Refusal to use the urinal by his bedside. His Roommate begging him to please call for a nurse. Again, cursing and mind your own business reply. He toppled out of his wheelchair and shattered his right hip this time. ER and Radiology reports show hip is beyond repair, and his bones wouldn't be able to support a hip replacement (plus he is now a Hospice patient and is dying). This man went from living in his own home using a cane and dragging himself around in 17 short months to a completely bed-ridden dying patient. And yes, just this week less than 3 weeks after shattering the other hip, he's trying to drag himself out of the bed...even tho he is now under Hospice, there is only so much they can do; if they sedate him even more, it compromises his COPD.
Also on the falling issue, is your gran on any medication? Many medications increase the likelihood of falls and some medications are unnecessary - suggest you review the list of meds and research the side effects and/or talk to a pharmacist about effects and drug combinations.
Does she really forget it? Or is it that she won't use it? My father won't use it. He has always liked his cane though. After many arguments we got him to use a quad cane which adds quite a bit of stability. Is this a possibility? I looked at it as better than nothing. By the way, my father has fallen and broken many bones, but miraculously he keeps healing and going on....
Nursing homes have bed alarms and chair alarms and are supposed to put the beds down as close to the floor as they will go with two mats on either side of the bed if an elderly person is a fall risk. It sounds like the staff is not doing their job. I would discuss this problem in a staff meeting and if nothing is done, go to the director of the nursing home. Bring a notebook when you go in and see her and write down the dates and time that you visited without these percautions being in use. When you bring the notebook into the staff meeting let them know that you have an Elder Attorney that you have confided in these issues and if it isn't corrected and your loved one suffers an injury that you are prepared to sue them. Keep bringing your notebook every time you go there, because the next thing that they will try to tell you is that your loved one is pulling the alarms off, yet they later discover it in the laundry room at the rehab.
Hi all - I love the idea of getting her a walker she loves, that stands out to her (also the sign is a great idea). If you can spare the expense, look for and buy (and/or, decorate as needed) one that tickles her fancy. I am so sorry that she and you all are going through this, it's scary. Good luck, and please let us know what happens.
Thats why I favour the pad - they can still get up but at least you can be there so they dont fall. I am just about to get my mum a walker with a seat on it. I have seen one that is bright pink and I thought fab and one that is a deep red - mother however wants a steel one - there is just no pleasing some peeps
Wow JudeAH53 - those are all GREAT suggestions! And freqflyer I love the idea of the blue walker - so cool :)
Also, on a more existential level I think we need to think about risk/benefits. Sometimes I think too much emphasis is put on safety and not enough consideration for freedom. People are chemically and physically restrained so they don't fall and hurt themselves, but what kind of a life is that?
Further, one of the root causes is there the staff to resident ratio in care facilities. There simply aren't enough workers to provide the high quality care required to keep everyone safe and happy imho.
Oh and the walker sorry taht was the bit you asked about duh! you can get a seat that has a buzzer when someone raises themselves of it. They are called pressure-sensitive chair alarms and even if your mum forgets it will give the carers a chance to get to her before she falls
There is a clear path to follow here Amelia - you must ask to see what plans are in place to stop your mum falling or at least limit the risk of harm. She should be wearing a band that says assistance or is a specific colour which indicates the same. She needs to be managed until she uses a buzzer every time she wants to move because thats when falls occur. if she falls from bed then there are several options often used in combination - firstly a very low bed (about the height of a futon) that way she wont be able to stand without calling for assistance and providing she has a buzzer that is not abuse. Secondly crash mats made of firm memory foam that will keep her safe from harm if she does fall. Possibly safety rails round the bed (although my very frail 92 year old mum climbed over those! dont ask how no one has a clue! Most importantly the nursing home must have a documented plan and you should ask to see that and demand that you all reiew this to ensure it is working. it may be that she waits to long to go to the toilet - atthis point the elderly get very shaky legs so perhaps getting her on to the commode regularly might help. Nothing however replaces vigilance and that has to be in the plan somewhere. Additional ask them to test for infections high proteins low sodium in urine - there may be a medical problem you are unaware of. There should be an OT attached to the nursing home - if so they will have the most current and best advice but whatever you do let the nursing home know you are watching and diarying - every incident should be recorded so ask to see their records re your mum - hope that helps
Amelia09, question.... is the walker a rolling walker [4 wheels with hand brakes and seat] or a regular walker? When I do volunteer work at a hospital I notice those who come in with a regular walker are struggling with it... but not those who use a rolling walker [depends if Gran has the hand strength to use the brakes].
My Dad had a regular walker but he always would forget to use it, so down he would go.... once I got him a bright blue rolling walker, you'd think I had purchased him a Shelby Mustang he was so happy with it... likes the basket and the seat. He can shuffle along pretty quickly with that thing.
My Mom didn't want Dad using that walker outside... good heavens, what would the neighbors think.... bet they would think "it's about time".
Your profile doesn't say if your grandma has dementia but if she doesn't you may think about putting up a sign in her room, maybe on her door, saying something like, "DON'T FORGET YOUR WALKER!!!!!!"
I really have no answer for you, but a little funny story. My MIL will hold on to furniture, wall, people - whatever she can just to keep from using her walker. Why? Because walkers are for old people!! She's 93.
When less restrictive means of insuring a resident's safety have failed, then a nursing home can legally use bed rails or other means of restraint if they can document that the benefits outweigh the risks. The patient's physician must order that rails be used, and the nursing home must closely monitor the patient and regularly re-evaluate the need for bed rails. If the patient's need for the rails changes, then use of rails must be discontinued.
It is important to remember that even when family members request that bed rails be used, the nursing home cannot use such a request as medical justification for using them. Regulatory agencies will hold the nursing home accountable for giving every resident the most independence possible. Use of "restraints" that are not medically necessary, including bed rails, is not permitted.
my note:There are things that NHs can do before resorting to rails. They lower the bed to within inches of the floor and place mats over the hard surface of the floor. It is more difficult to rise from that level and if they fall out, there is the mat and not so far to fall. There are also mattresses that have raised edges to help keep the patient from rolling off. And other tricks of the trade.
According to Centers for Medicare & Medicaid Services (CMS) a fall is defined as failure to maintain an appropriate lying, sitting, or standing position, resulting in an individual’s abrupt, undesired relocation to a lower level.(that's a shock I never knew that!!!!!!!)
Preventing falls constitutes a significant challenge in nursing home settings and requires a substantial interdisciplinary team effort. Every facility should have a fall prevention program that, at the minimum, addresses the following three elements:3
1. Assessing residents for risk of falling
2. Identifying and implementing interventions to minimize risk of falling
3. Identifying and implementing interventions to minimize risk of sustaining an injury as a result of a fall
ASSESSING FALL RISK Regulatory guidelines require that a comprehensive patient assessment, the Minimum Data Set (MDS), be completed within 14 days of admission to a nursing home.
Certain items on the MDS will indicate that a resident is at risk of falling
When the MDS is completed, a resident who has one or more of these items (also known as triggers) will trigger a falls Resident Assessment Protocol (RAP).
Assessment instruments such as the RAP may provide clues to possible causes of falls.
So that is what the care facility should be doiong hun good luck xxxx
Have seen one they kind of remind me of 50's era bicycles
off. It is portable and battery operated, a pad is set under their body and it can move from a chair, to a bed, or wheelchair.
Eventually she understood that she needed help until she was either strong enough to do it herself, or was cleared by her therapist.
Also, on a more existential level I think we need to think about risk/benefits. Sometimes I think too much emphasis is put on safety and not enough consideration for freedom. People are chemically and physically restrained so they don't fall and hurt themselves, but what kind of a life is that?
Further, one of the root causes is there the staff to resident ratio in care facilities. There simply aren't enough workers to provide the high quality care required to keep everyone safe and happy imho.
My Dad had a regular walker but he always would forget to use it, so down he would go.... once I got him a bright blue rolling walker, you'd think I had purchased him a Shelby Mustang he was so happy with it... likes the basket and the seat. He can shuffle along pretty quickly with that thing.
My Mom didn't want Dad using that walker outside... good heavens, what would the neighbors think.... bet they would think "it's about time".
Good luck!