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My husband uses a wheelchair but can walk somewhat with a walker. He has mild dementia and doesn't recognize that it's dangerous for him to try to get up on his own. Keeping the walker nearby is not a solution, he still needs help. I and his aide are tired of fighting with him every day and can't convince him that it's dangerous. Any helpful ideas would be appreciated.

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One more idea I was reminded of (by one of the posts below—

Skateboard shoes, like “Vans” may help. They are smooth, flat and weighted in a way that help with balance and truly reduce falls.
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Reply to ACaringDaughter
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Imho, opt for a wheelchair tray.
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Reply to Llamalover47
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How about finding him special ‘walker shoes’, and some different ‘sitting’ footwear that’s uncomfortable to put pressure on by standing up (you could stick a lump under the sole). That might remind him at the time when he needs to remember.
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Reply to MargaretMcKen
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Is there a reason for his trying to rise from the wheelchair? I would try to figure out if there is a pattern to this and get to the heart of his desire to get up and walk. Is he heading to the bathroom? The kitchen for some water? Is sit after he as sat for an hour...or two? If you can build in an assisted walk at the times he is more likely to want to walk, that is half the battle. The other thing would be to teach him some seated exercises, so if he is getting "antsy" he can do them instead. Last, he may need better cushioning on his chair. Last, there are specialized wheelchairs with headrest that can tilt back to a more reclined position to help lessen pressure points. Do he have a recliner to spend some time in?
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Reply to lynina2
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My Mom is now a fall out of the wheelchair risk since she came home from 21 day rehab that didn't do jack to rehab her - still bedridden at discharge.

The home therapist just got her to transfer from the bed to her wheelchair. I immediately grabbed the gate belt (we have an extra that's very large) and secured it around Mom and the wheelchair, fastening it BEHIND the wheelchair. I didn't ask, I just did it as if it was a normal part of the process. You might have the aide do it the first time like it's a normal thing. then you and everybody do it after that.
I'm guessing the seatbelts that come with wheelchairs fasten in front. I suggest an extrs long gate belt.
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Reply to babziellia
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Check out lap top cushion for wheelchairs on amazon. It fits in by the arm rests to keep someone from standing and serves as a table top too. There is also an item called pommel cushion. I think it tilts you back a bit to keep you from rising
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Reply to my2cents
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Lots of good ideas here for restraining him. I would like to add that I purchased a device for my Dad years ago that clipped on to his clothes and on to the wall behind him. If he attempted to get up, the cord would pull from the wall and a recording would tell him to sit down. You can record your voice or someone else’s firm voice saying sit down now. I recall my father looking for the person talking but he obeyed!
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Reply to KathleenQ
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This is a sign he requires constant supervision. You may want to get a chair/bed alarm that could be placed on the wheelchair so an alarm would sound every time he gets up and someone could be by his side when the alarm goes off. If he can walk with a walker, follow behind with a wheelchair so that you can immediately help him sit down when he starts to become unsteady. This is what they do in nursing homes. Using the wheelchair seat belt is a good idea. Any other form of restraint, in a nursing home, is considered abuse.

Unfortunately, even in a nursing home, one-on-one constant supervision is not available. You would have to provide it, or pay for a sitter to provide it.
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cweissp May 3, 2021
My father had a power recliner. He would push the button to get up and then just slide on down. And when he moved to SNC it continued (the chair was in his room). I suggested they get him comfortable in it and then pull the plug - but no that was considered restraint.

At some point they moved the power recliner from his room to the common area. They'd get him comfortable and unplug it, then when they saw him trying to crawl out of it they'd plug the chair and get him into his wheelchair.

While this cut down on his falls - remember from above he fell at least once a week - they didn't stop them. Even if someone had eyes on him 24/7 doesn't keep them from falling. In a second they're down.

You can only love them and do the best you can.
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I see you have two options. First, tie him in with a belt or buckle that he can't reach (tighten behind him) and hope it works. Second, if he is so brain dead and stubborn, he is going to fall and there is nothing you can do. When it happens and he is put into the hospital, do not let him return home. Place him where he is safe. I don't think anything else is going to work.
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Reply to Riley2166
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We experienced the same challenges with my dad who had moderate AZ. You cannot explain it and expect the damaged brain to remember it. We had an actual seatbelt put onto his chair. Also, before this the 911 guys came out several times to get my dad up. They told him and me that that our situation and set up was not providing my dad the safety and help he needed. Threatened if they came out again they’d have to report neglect on my part and the state would necessarily get involved in deciding Dad’s care. Scared me and him! We went to an assisted living situation. He still fell even with that. Heck, he fell steps away from me- very tough. He wasn’t truly safe till we employed 24/7 help just for him (which is costly). I feel your pain; it’s so tough b/c we can only control so much and want only the best for our loved ones. Dad cursed the seatbelt, but couldn’t undo it due to arthritis in his fingers...Hang in there!
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Reply to DadsGurl
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Men like to feel independent which translates doing unsafe impulsive behavior. You could try an antidepressant but also know psychotropics also have side effects.

If he has Alzheimer's you can expect falls to increase as the disease gets worse; balance and coordination decline. Impulsive behavior increases especially at night known as "sundowning" which is extremely dangerous. Most people with Alzheimer's die of complications of this disease such as catastrophic falls or aspiration pneumonia.

Get a fall mat and put it near his bed. Most falls occur getting up. I also got a floor alarm. As soon as mom's feet go on the floor, the alarm would trigger. It saved her from a lot of falls. I prefer the floor alarm because bed alarms have far too many false alarms.

Now the MAJORITY of mom's falls occurred while I was right with her because when the disease was very advanced it would happen so fast I did not have enough time to catch her fall. It gets that bad. Still, I was lucky--I kept mom moving and she was bedridden for only 2-1/2 months but it was very very hard work keeping her mobile. I walked her in the park DAILY for 5 years with a specialized walker. I think it slowed her Alzheimer's disease progression but it cannot stop it. She died of the complications of insulin-dependent diabetes at age 90. She had stage 3 kidney disease for 10 years. No she did NOT die of the Alzheimer's. Irony isn't it.

I had to attend to mom 24/7 from the moment I woke up until I put her to bed. She was a lot of hard work, but I don't regret it. I sure love mom and she was the center of my universe. Still is...but God killed my mom. Still doctors were surprised my mom lived that long due to her insulin-dependent diabetes and she she died with perfectly intact skin.
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Reply to cetude
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My experience in the past two months placing my mother in a nursing home because I have had a bad reaction to covid, AND I wasn't sleeping much:

5 falls hitting her head on hard floor in NH
4 trips to ER
4 brain scans since March 5 and one MRI
multiple urine draws
sent to Geri Psych - then off to another ER because her heart rate was high


ER diagnosed her with:
dehydration
over sedation (aspiration pneumonia)
sepsis from UTI (none of 3 cultures showed anything)
now CHF from sitting in wheel chair for 2 months.

Two days ago sent her to memory unit for mild dementia and got hospice involved so there more eyes on her.
She still fell but at least it was on carpet and she is again using her walker

You have to WATCH everybody these days.
I am disgusted with them all.
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Reply to catherine439
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There is absolutely nothing you can do about it unless you restrain or keep him so medicated he can't get up which neither solution should be used.

You will just have to keep a close eye on him, whenever he is in his wheelchair.

You might as well stop arguing, fussing, fighting with him because he won't remember he needs help .

Juse when you see him trying to stand up you or an Aide just go over and say let me help you or say nothing at all and help him.

Buy him a nice recliner that he enjoys staying in.

Wheel chairs are uncomfortable to sit in for prolong periods even with a cushion.

Prayers
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Reply to bevthegreat
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Get a small wedge pillow. Place the big end under his knees and the small end to the back of the chair. This should make it harder to get up without assistance. Otherwise, place a belt on and make sure the buckle is in back of the chair.

It might be best to just let him use his walker and seat him in regular chairs most of the time.
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Reply to Taarna
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Dad suffered a stroke and was restrained in the hospital because he couldn’t stop getting up to use the restroom and he didn’t have the balance to walk safely. He was belted there also into a wheelchair instead of being allowed to walk.

The family was told he would be using a wheelchair permanently.

He learned how to open the restraints and then he wanted to run away. His speed prevented escape, but for Dad, the restraints were a bigger safety issue - instead of trying to get to the bathroom, he set his sights on the highway or the train station. .

I could see how unhappy he was to be tied up like that and just wanted to get him home (and unrestrained).

He had only been “allowed” to walk briefly at physical therapy. I went to all the sessions and attentively watched how the therapists worked with him using a safety belt.

At discharge the PTs also worked with me, instructing me how to walk him, so he might be able to move a bit at home.

Once home, Dad continued outpatient PT.

I repeated every session, to the best of my ability, several times a day, after getting home. My kids would repeat this too - Dad got stronger and his balance improved.

He improved so much, that the PTs said he far exceeded their expectations. They had never seen an elderly stroke patient do that well.

His physical improvement helped his moods too. His mental function improved. Everything improved.

He eventually only needed a cane when out - he got around well without one at home.
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Reply to ACaringDaughter
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cetude May 3, 2021
Stroke can have improvement with physical therapy...but with Alzheimer's function only gets worse no matter what. Daily exercise can slow the decline, but it will not stop it.
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My mother does the same thing (with advanced dementia) and she kept falling when she tried to get up. She doesn't remember that she needs to wait to get help. Her facility is now putting her in a Geri chair for her, which they tip back a bit. Geri chairs are medical quality. Check with Medicare - with a prescription they may pay for it. In her facility they are not allowed to use restraints like straps or seat belts. The chair looks comfortable, and it puts the person in a passive position when you tilt it back (even a little bit tilted) and they are unable to do things for themselves. Some people don't like this. These chairs also have a tray that can be attached in the front to put food, or activities. You can set them to be upright or tip them back to recline. For my mother, if she will be attended, she seems to like being in a wheel chair better if she wants to be awake. You might want to give him a bell that he can ring if he needs help.
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Reply to NancyIS
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IF, as your profile says, he is living at home, then the 3 best suggestions would be a belt of some sort, a pad that tilts him back and/or a wheelchair tray.

Belting through his pant belt loops would be a good suggestion, as it will be much harder for him to undo it without help.

The pad would need to be secure on the chair and be enough incline to seriously hinder his ability to get up.

The wheelchair tray would need to lock into place on the wheelchair - he may be able to figure this one out, but it will slow him down a bit!

Watching him 24/7 isn't feasible. We have to use the bathroom, prepare food, tend to various house tasks throughout the day. Anything that would at least make it harder for him to get up will be a help. An alarm would be good as well, so you would be alerted to the fact that he is attempting his "escape", giving you a little time to get there and perhaps prevent the fall.
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Reply to disgustedtoo
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Search online for “laptop desk for wheelchairs” and “wheelchair lap trays”. Some previous posters have said they’re a Godsend for helping a wheelchair-bound loved one to happily stay in the chair without trying to stand up, kind of a gentle mental blockade. Good luck! Let us know if you come up with a solution.
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Reply to BeenThroughThis
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I'm sorry to say you might be in a losing battle. If he is at home you may be able to seat belt him. But yes they can't use seatbelts in facilities because it is illegal. They're in trouble for restraining a resident and in trouble when the resident falls.

My father was the same way. We're talking about a man who would walk without his walker, furniture surfing throughout their IL apartment. He fell shortly after moving into IL(pre walker days) off a step stool while hanging a picture (cracked a couple of ribs). He fell going to the IL library (compression fracture in his back). He fell several times getting out of bed. Come to find out he'd had undetected strokes in the balance center of his brain.

Because of the falls he and mom moved to AL. They provided him a hospital bed but he usually slept in his power recliner. Of course his falls continued. Only one of his falls resulted in an injury other than scrapes and bruises. He fell picking up silverware off the floor so someone else wouldn't fall because of it. He evidently bent over and just kept going hitting his head on the table edge. As his balance got worse and his dementia got worse and he got weaker he was given a wheelchair - and yes he could still walk some. One time while still in AL he was in hospital and transferred to Rehab - which was the SNF. He fell the first night there - about 30 minutes after getting there and again the next morning.

By the time he was in SN his dementia was worse. He fell and he fell and he fell. I use to say he fell whether he needed to or not and that his bones must have been made of rubber - however the last year they were more slides than falls.

I don't tell this story to freak you out. It is what it is. Try not to stress yourself out more than you already are, I know it's frustrating. Maybe you can get him in a routine or learn to read his body language to get to him before he gets himself out.

Best of luck.
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Reply to cweissp
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JustDaughter May 2, 2021
Excellent advice about watching body language. Yes, it is what it is but also this too shall pass.
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My mum used a scarf which she tied in the back out of my dad's reach. It seemed to make him feel more secure as he didn't complain about it... everything else, but not the seatbelt
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Reply to FarFarAway
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You could use a seatbelt. Its a private home so ur not under the State laws concerning residents in NH. I saw them used in Moms NH. According to my daughter, RN in rehabs, they have to be able to get out, then its not a restraint. Just don't let him see how you buckle him in. The one I saw was like the old seatbelts where you just pulled up on the top and it unhooked. Not like that button thing.

Maybe a slanted cushion having it slant to the back of the chair. Makes it hard to get out of. Someone said on the forum there are wheelchairs that slant.
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Reply to JoAnn29
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It sounds as if the problem is that he very much can do it without help - voila! - but everyone wishes he wouldn't. Is that the case? If he actually can't get out of his chair, presumably this would be more of an irritation and less of a physical risk to him.
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JustDaughter May 2, 2021
He might actually be able to get out but that first step probably ends on his rear end or his face.
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I'm not sure how mild his dementia is that he wouldn't catch on to this trick, but when my kids were little and always wanted to climb out of the seat in a grocery cart in spite of the seat belt, I started clipping the seat belt through the back of their overalls or a belt loop. They'd try to climb out, but they couldn't figure out what was holding them down. They could see it wasn't me holding them down, so they'd finally give up and sit stop trying to climb out.

Perhaps you could thread a seatbelt through a back belt loop on his pants without him noticing?
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Reply to MJ1929
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Regular toileting & regular short supervised walks? Maybe after meals?

My Mother has supervised walks to the dining room & bathroom which seems to help her need for movement somewhat. (She has insight of her mobility limits though).

My other relative (who has way less insight...) has fallen MULTI times getting out of bed or leaning.

I really don't have an answer, sorry 😔. Falling is a known hazard for the less abled & elderly. I can only add: Minimise as many risks as you can. Accept this will not be 100% or even close.
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Reply to Beatty
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My mother has moderately advanced dementia and no longer realizes it isn't safe to try and lean over the bed or bend down in the wheelchair, and so she falls constantly. You can't explain anything to a person with dementia, so don't bother trying. The caregivers pick mom up when she falls in her Memory Care Assisted Living, or they call the night nurse whose 6'4" and weighs around 275 lbs to pick her up. They've also put pads down around her bed to cushion her when she slides out of bed, even with the bed alarm. 32x in the past 22 months. In other words, there IS no way to prevent falls with elderly dementia patients that cannot comprehend danger and have no sense of what safety means.
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Reply to lealonnie1
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That’s a tough situation. My LO had a similar experience. You’re right that trying to convince him to stop trying to get up without help won’t help. Why not just keep an eye on him at all times and assist him as he tries to get up? Don’t discuss it, just do it. He obviously isn't able to mentally process it. Also, you might explore a seat alarm to alert you or the assistant that he is getting up. I’d check to see if they are legal in your state. Is your DH in AL or at home? I recall how scared I was that my LO would fall getting up without help....and she did. Several times. Eventually, she lost the ability to do it though and the falls stopped. I hope you get some more responses.
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Reply to Sunnygirl1
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This kind of seems helpless--the only thing that came to mind was a 'seatbelt' of some kind that restrains dad in a gentle way. So he CAN'T just 'jump up' and start walking. It gives him a barrier and buys you some time to deal with him.

It makes me sad to even mention this, but I honestly don't know what you can do when your LO does what they want--and it's unsafe. Mom was in a wheelchair post-hip replacement and she kept sliding out of it. They were not allowed to restrain her at the rehab facility, so she slid out on the floor all the time. I couldn't believe that a rehab place couldn't manage to keep their patients in their wheelchairs. But we were told they could not, legally, restrain patients.
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JoAnn29 Apr 30, 2021
They could have given her a cushion that slants backwards. Harfpd for them to get up. My Mom was given a special chair that did this.
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