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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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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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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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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cetude May 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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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.
Helpful Answer (4)
JustDaughter May 2021
Excellent advice about watching body language. Yes, it is what it is but also this too shall pass.
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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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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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.
Helpful Answer (3)

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.
Helpful Answer (3)

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.
Helpful Answer (3)

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.

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