I wouldn't want my loved one bedbound because she's a fall risk. The risks to being bedbound are huge, in and of themselves.......pressure ulcers, for one, which is a biggie. Plus she'll be isolated from others and lose what's left of her mobility due to atrophied muscles. Facilities do not allow restraints of any kind, so it's impossible to keep her in bed if she doesn't want to stay there, anyway.

Get hospice involved in your wifes care now. They'll provide a high backed wheelchair that tips BACK, making it much harder to fall out of. If she's not approved for hospice, buy such a wheelchair yourself for her use. It made a huge difference for my mother who fell 95x during her AL and MC years w/o significant injuries, believe it or not. Once hospice brought her that wheelchair, she stopped falling out of it. Thank God. And she was able to eat meals in the dining room with the others, etc.

Best of luck to you
Helpful Answer (9)
Reply to lealonnie1

I had a very elderly Aunt (100) who could still walk when supported by 1 person (with a belt). She had advanced dementia. We had to put an alarm on her so that if she attempted to get out of her chair, the string would detach from the alarm as she rose and a loud alarm would sound. This didn't stop her, but it alerted her caregiver. We had a wheelchair for her but she would always attempt to get up and out of it. At night we had her bed "fortified" with all sorts of rails and mattresses and barriers. Yet one random night she shimmied past all of them and got out of bed in the middle of the and fell, breaking her hip.

She continued to climb out bed at rehab. She passed away in her sleep at that rehab, perhaps from a clot. All this to say it will be very challenging to get your LO to stay put, but maybe the special wheelchair mentioned by Leolonnie will be a solution. My MIL has one (paid for by Medicaid) and they are big (if it's the same type). I have no idea what they cost -- but probably cheaper than endless trips to the ER and rehab. They make concave mattresses that make it difficult for elders to climb out of. Also consider putting the mattress on the floor.

I have read where others use a type of cross-lap tv tray device to keep them seated. But if they're like my AUnt she was able to figure out how to disable some things. It is not legal to "restrain" anyone in such a way for any reason, so if someone came into your home and saw this, they may be required to report it.
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Reply to Geaton777

My mother (96) lives with me - she has dementia and naturally doesn't know that she's a fall risk. Same with your wife.

There are some things that you can try in order to at least slow her down to give you time to get to her before she falls.

You can purchase a bed rail. That didn't work for my mother because she would just shimmy around.

The things that work for me are - One side of the bed is pushed against the wall. A bed alarm lies underneath her and when she lifts up, it goes off. I bought a huge set of firm pillows from Amazon - one of them goes along her side on the edge of the bed. The other one sits on the floor by the bed and a I push a chair up against it. I tuck her sheet and comforter in between the mattresses. All of that combined are enough to slow her down and I can get to her in plenty of time to help her.

For me, it's been trial and error along the way. Your wife may be more stronger and more agile than my mother and you may have to resort to other means.
Helpful Answer (5)
Reply to southiebella

Since she is at home you can use bed rails.
A hospital bed can have half rails or full rails.
You can also lower a hospital bed so that it makes getting out of bed a bit more difficult and it can also make getting in and out easier when it is raised to the right height.
*There are wedges that can be put under the sheet that make it m ore difficult to get out of bed.
*There are "bumper pads" that sort of make a circle around the person so it is more difficult to get out of bed. (same thing can be accomplished with "pool noodles"
*There are bed alarms and floor alarms so that if the person places a foot on the floor alarm it will send an alert to the caregiver. The bed alarm will go off with movement so that might not be practical.
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Reply to Grandma1954

Age old question.
If you find the answer let us all know.

When there is an inability to retain info for the patient he/she will continue to attempt the exits.
Unfortunately, side rails and other restraining devices are now forbidden by law often enough due to the injuries and even deaths they have caused confused patients.

One of our member's had her husband in ER recently and there was actually a robot minding him, reminding him not to exit the bed.
That will likely work overall as well as anything else.

In my brother's rehab when he was recovering from an accident a gentleman with constant falls was placed in his room because he was "with it" and could report when the gentleman was attempting to get out of bed. There were rubber mats placed below the bed of the escapee.

I hope someone has some ideas for you but this old, retired RN hasn't a CLUE what to tell you.
Helpful Answer (5)
Reply to AlvaDeer

Following up from previous posts - Please don't just go out and buy a tilting wheelchair, an occupational therapist will fit the chair to each person's body size and their physical needs, and will also know how to access any benefits available to defray the cost. An OT should also have suggestions on devices to help with falls.
Helpful Answer (3)
Reply to cwillie
Fred3202 Feb 15, 2024
The first thing to do, as I had to, is to get a bed alarm. It will notify you by chiming whenever the patient leaves the bed, or just gets weight off of the base devise. The only problem is that the person may be halfway out by the time you reach the bed - so you need to insure that there is something for her/him to hold onto for a few seconds. I'm fortunate in that we have a dog that will come notify me the moment my wife starts to remove the covers. So I normally get to the bed even prior to the alarm sounding, sometime - and the dog does not leave her side.
My wife is in a skilled nursing facility and is a fall risk. The SNF is not allowed, by law, to use any restraints -- even bed /chair alarms or wheelchair belts. The only thing they can do legally is put her mattress on the floor (which, of course, does nothing to keep her from trying to get up from her wheelchair). It's a huge Catch 22: the SNF is legally responsible for her safety but then, legally, they can't do the things they need to do to keep her safe. Just another thing for a caregiver to have to deal with...
Helpful Answer (2)
Reply to WalterDeemer
Grandma1954 Feb 15, 2024
Using a Tilt Back Wheelchair will make it more difficult for her to get out of the wheelchair.
In your home you can use anything you want. Only in facilities are there laws governing what can and cannot be used. When my Mom was in a NH they used a concave mattress, mats on the floor and lowered the bed. She had a geri chair that bottom slanted back so she could not get out.
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Reply to JoAnn29

My mom has vascular dementia and Alzheimers, uses a wheelchair and forgets it isn't safe for her to walk since she has depth perception issues, spatial awareness disorientation and her balance is poor. Whether in bed or seated, she thinks she can and should walk so she stands up, takes a step and down she goes. Over the last few years she has fallen many times, so I'd also love to know how to keep it from happening and sympathize with you. However, as long as possible I want to avoid her becoming bed-bound due to the risk of bedsores, further muscular atrophy, blood clots/dvt and general decline in health and mental status associated with the lack of movement and social contact. It is such a dilemma!

One facility where she was living used a bed alarm and a chair alarm; at her current facility, they don't use bed alarms or chair alarms but have a motion sensor in her room. In any case, those don't guarantee safety - she gets out of bed or from her wheelchair in less time than the caregiver can possibly get there. Thankfully, there is good padding under the carpet in her apartment and since she moved there she hasn't injured herself badly like she did when she was still living at home. I know her condition will continue to decline, so this remains a big concern.

Another person here mentioned getting a wheelchair that leans back, which sounds like is a good option for those who use one for mobility, so I'm going to look into that for my mom, maybe it would help keep her in her wheelchair during the day. Her bed... that's another matter, but the concave mattresses mentioned sound like a good idea, also putting her bed up against the wall and a long pillow and a bed rail on the other side of her, which was recommended by her neurologist and is not considered abuse or restraint, only protection for her.

As this progresses, if you care for her at home it may take three shifts, with you and if possible, another family member taking a shift and hiring an outside person for the third. I hope that you will be able to find help so that there is someone always by your mom's side when she wakes or wants to get out of her bed or chair.

Honestly, unless there is one-on-one care around the clock for a loved one so that they are never ever on their own even for a second, there is always the risk of a fall. Our loved ones can't help it and it is so sad! Even if you are in good health and strong physical condition, it is not humanly possible for you to be awake and with your loved one every moment of the day and night, so you need the help of an additional caregiver in order to prevent falls. Wishing you the very best on this very difficult road.
Helpful Answer (1)
Reply to DoingMyBest2

My Dad has a pad next to his bed, probably an inch or so thick. He's fallen MANY times on it and never a break. He seems to bounce well on it. :)
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Reply to SueZ1250

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