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I'm a full-time caregiver for my 89-year-old mom with Parkinson's. I have hired an agency to have a CNA sit with her when I'm gone for any length of time. I have been relying on her LifeAlert when I'm gone for less than an hour to run errands. The agency is suggesting she's too great of a fall risk and should have someone there 24/7. I'm not sure we can afford that. Anyone have a similar situation?

I hate to say it but to me it sounds like the agency is, on purpose or not, kind of "upselling" you on hiring them for more shifts thus giving them more money.

The reality is there is no perfect system, you have planned for various contingencies according to your best judgement, and there is only so much money.

I think I would give this agency info about the intricacies of your family's schedule and the finer points of your personal household arrangements only on a purely need to know basis. To be perfectly frank, they are the hired help.
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sandola Feb 19, 2019
I'm with SnoopyLove. It sounds like they are trying to make more money. I had one that tried to get me to use them 24/7, when I was only using them for overnights and private CNAs (who cost less) for the rest. It was my gut feeling their "concern" was for billing for as many hours as they could.

They were good at their job - it was one main person who came - and I like the woman at the agency and I will use them again, but for $20/hr I use them as little as possible. Mom only has so much $ and it only goes so far. The other people who I knew personally were only $15/hr, but they couldn't do overnights. Anyway - I don't see how this agency can report you, OP. In fact, you can tell them that you now always have someone with her. How would they know?

Edited to say that my mom has Phillips Lifeline and I don't know if she would push the button if she fell. I don't know if she would remember that she has the bracelet on. She won't wear the necklace with fall detection.
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I got my mom a life alert button. She managed to fall and was on the floor all day long until I came after work to visit and found her there. I asked her where her life alert button was and found it on her dresser. She didn't even remember what it was for. Thank God she wasn't hurt. Told me she had just laid down to take a nap (on the floor?) It was after that, that I moved her into assisted living. The buttons are only good if they wear them and remember how to use them.
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Val3rie Feb 15, 2019
My MIL fell in her apartment...she said she didn't but she forgot she had her life alert on her wrist and it wasn't until no one could get her to answer her door [in an apartment building] that someone was able to check on her.
No one called those of us who have keys.
She is eligible for 2 hrs of care a week.
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Hi Kbuser,
My mother also had Parkinson’s Disease. Although I wasn’t her “caregiver,” I did provide some daily assistance to help her while my dad was away at work. I would go to spend my lunch break with her and bring my kids over after work until my dad got home in the evening. She had both a Life Alert and cell phone strapped on her at all times. I could see the potential of her falling. I encouraged my dad to get someone to come sit with her. All he would agree to was 3 days a week. Good enough. Better than nothing. On one afternoon that the sitter wasn’t there, while making her lunch, she fell in the kitchen and broke her hip. She used her life alert to contact emergency and my dad. Within six months, she was gone. Were there possibilities of her falling if the sitter was there? Yes and no. If the sitter was there, she would have had less chances of a fall because the sitter would have been there to ASSIST her with her needs. That fall was preventable every way I look at it. In my mom’s case, my mom was left for hours by herself. I wish that I had known the things that I know now. My dad never made the house safe for her walker, because he didn’t know any better.
I am now my dad’s caregiver. I have companion help while I’m at work. When my dad first came home from the hospital, they sent someone out to assess the house to ensure it was safe for him and his walker. My parents home has laminate floors with large area rugs and thick throw rugs everywhere, including the kitchen. It all had to go. Changes in the arrangement of furniture etc was recommended. I followed everything they suggested. My dad has had two falls in two years. Both times, I was there, but not in the room. No injuries. Preventable? No. The falls just happened. Was there anything he could knock his head on? No. It’s all been moved or removed.
There are times that I have errands to run as well. I sit him in his recliner with the remote, cell phone, Life Alert, water, and clear instructions not to move around. I also call him while I’m away. It provides reassurance in his case. I also have both of the neighbors phone numbers in case I have to call on help. The other alternative I have available is the two teenage girls that live down the street. They sit with him and chat, or play UNO, while I’m away. It’s a lot cheaper than the companions from the agency.
Okay, I’ve said much more than necessary. Just wanted to give you a well rounded view of my experience.
Take Care & Best wishes to you and your mom.
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Sherryram Feb 18, 2019
Don't feel guilty about your Mother's fall. My first husband was a paramedic and he said, more than once, that most of the time Seniors don't fall and break their hip. Usually, he said, their hip broke and then they fell.
Some accidents are just no preventable. Thanks for your good words of advice.
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A couple thoughts,

I used to work for Podiatrist and most our patients were seniors. I would chat with the care givers that brought the frailer patients into the office. A common remark was that Mum or Uncle Jim and fallen and refused to push the button. We had this happen in our family too. Aunt Ruth fell when she got up during the night, her alert necklace was on the bedside table and she could not reach it. She was found 2 days later, still alive, but in kidney failure. She lived entirely alone (no dementia) until age 96.

Would your Mum push the button if she fell, or would she wait for you to come home? How do you have the Life Alert set up? Does it call directly to emergency services or do it call you first? How long would it take you to get home, then how long would it take for an ambulance to get there, if you could not get her up or if she was injured?

Even if your mother was in a nursing home, she would not be under the gaze or within arms reach of the staff 24/7. Even the caregivers who you pay to come watch Mum have to use the Loo, make meal and otherwise are not within arms reach at all times.

It is a fine balancing act and I do not see anything wrong with the system you have in place. You ensure there are people there when you have to be away for a long period of time and you have a safety device in place for when you just need to make a quick trip.
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My aunt fell and sprained her knee. Not bad but still a fall and a bit of a recovery. She had a Medialert bracelet that she wasn’t wearing. After the fall the company upgraded her to a pendant that she wears around her neck tucked in her blouse. It is supposed to call automatically if she should fall. No need to press the button. I’m not 100% convinced that would actually happen but when she presses the button accidentally, they are there very soon. They call me to let me know and since I also have cameras, I can see that she is fine.
If a care provider tried to intimidate me I would let them go and find another agency. Your mom sounds fine. As others have said, anyone can fall at any time. You aren’t gone for days, just a couple of hours I imagine.
My mom was one who fell and wouldn’t use the button. She waited for my brother. She knew she wasn’t hurt and didn’t have any confidence that she could get the ambulance driver to listen to her and not take her to the local ER where we all believed real danger existed.

But my mom had neighbors who did need an ER and used theirs and got the help they needed.

Many seniors are home alone and not under the watchful eye of a daughter or a Medialert as it is their right to be. You are obviously doing a great job.
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Hi KB, yes I am in a similar situation. I care for my motherinlaw who is 94 and has Parkinson’s. She has her mental faculties but has a lot of difficulty walking. She uses a walker in the house. We hired in-home care a couple of days a week for about 4 hours so that I can get out and get some stuff done, but that doesn’t cover everything that needs doing. So when I need to run out to the grocery store or drug store I give her the life-alert button and tell her to keep it on her while I’m gone. She often says, “don’t worry about me, I’ll stay right here” (in the chair or bed), but 9 times out of 10, when I get home she is not in the same place I left her. Thus the need for the life alert button. When we were first looking into help at home, a home care nurse said, What if there was a fire? Could she get out of the house by herself? The answer is, probably not, and I worry about that sometimes. So the button gives me peace of mind when I leave for an hour or so, and for the longer spells of 3-4 hours out, we have the agency caregivers. I wish you and I could share a cup of tea and swap stories. It’s nice to know someone else who’s in the same boat.💕
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cwillie Feb 15, 2019
Mom's former caregiver had many sad stories about clients living on their own who were pretty much unable to even get up from their chair without help but only qualified for a couple of hours of help each day - isn't it funny how that was seen as acceptable by the powers that be but as soon as family steps in to provide extra care we are vilified for leaving them alone for less than an hour?
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I don't see anything wrong with leaving her for short errands. You being home won't really prevent any falls. Nothing reasonable can prevent falls. It's whether she can be cared for after the fall. It's not like you will be leaving her on the floor for 10 hours. Many facilities don't check on people more than every couple of hours. I've been in ERs where the alarm goes off and no one comes by for a long time.

You can do technological things. Install cameras so you can check in every few minutes or constantly if your mobile data plan is big enough. Just glance at your phone every few minutes to check in on mom.

Instead of a life alert I would get an iwatch. It has fall detection and they are working on other things like heart conditions. So they will be able to detect problems even if there is no fall. The watch can contact you and/or emergency services. You decide. Apple is talking with health insurance companies to possibly issue them to the elderly. Since monitoring people this way is far cheaper to paying for a human sitter and you get better data. A gait detector can actually detect a fall before it happens. Which a human isn't really good at.
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NeedHelpWithMom Feb 15, 2019
Camera is a great idea!
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Some other responders have mentioned this point, but many life alert systems do have an option for automatic fall detection as well as responding when a button is pushed. Usually the monthly charge is higher, but not extremely much so. You can get both features on the same pendant, which is probably less expensive and less complicated than having a special watch to detect falls automatically. (You almost certainly can get a watch with both features, also, although I haven't personally looked into it.)In any case, you should need only one piece of equipment to have both functions. I know that the automatic fall detection is not 100% reliable, because the companies offering it usually include that warning in their literature. However, you can't ever protect someone all of the time. My mother fell out of a chair and had her 3rd broken hip while her caregiver went to get something for her from another room. And while it's certainly not an ideal situation, if your mother did fall, and if the fall was not detected, and she was there alone for 30 minutes or so while you were on an errand, everyone might be upset, but it's very unlikely that the outcome would have been different if she fell and you were there. It's not unreasonable to take finances into account and decide that it's just not very cost-effective to have a caregiver there 24/7!
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I can't tell you how much I appreciate you all and your helpful and comforting answers to my question! Thank you! I feel much better about the whole situation. I will definitely look into an Apple iwatch instead of life alert. A gait detector sounds amazing! I'm not sure mom would know to press the life alert button if she fell, but I'm never gone more than an hour. I will look into a different agency, this agency does seem to be trying to intimidate me. There are a ton of home care agencies nearby and all have the same rates. It's so comforting to hear your stories and experiences that are similar!
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I love all the responses! It gives me a feel for what everyone's experiences are and makes me feel not so alone:-) my mom rarely gets up during the night, and my bedroom is next to hers so I would hear it and get up to help her if she did. I'm a light sleeper, too. Probably because the cat gets me up half a dozen times during the night. Mom does have some dementia, so whether she'd be aware to press life alert if she needed to, I'm not sure. I can try taking her with me on quick errands, she is relatively mobile that way. Might do her good to get out of the house. I do think the agency is up selling, and I realize they couldn't report anything because there is nothing to fort. She actually fell when a nurse from the agency was with her. Thanks again for all your input! I love all of you caregivers!
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con3ill Feb 18, 2019
If your mom fell when a nurse from the agency was with her, that agency shouldn't dare to try to upsell you. I suspect they're trying to reduce their exposure to liability while trying to get more money out of you. Did you share the falling incident with the agency? If it were me, I'd not only have shared the experience but challenged them for having a heck of a nerve trying to convince you to buy more services.
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