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She will not call for help, whether she's lying down for an afternoon nap or if she's in bed for the night. She is completely incapable of walking on her own, (uses a walker or a wheelchair) but she will not stop trying to get out of bed to go to the bathroom, or (in the case of the afternoon nap) come out to the living room. SHE FALLS EVERY TIME. She has a whistle and a bell, but will not use either of them. She's going to a nursing home soon, and I would like to break her of this habit before she ends up in restraints 24/7.

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I have used a bed alarm with my grandma but I found that the sound would scare her and almost cause her to fall. I personally use and monitor her with a baby alarm. She thankfully has most of the time learned to call out for help although the other day I once again found her on the floor as she tried to leave her chair and fell out and landed on her butt not breaking anything. The baby alarm allows me to hear her when she's grunting. I have music on in her room near her but not too loud as I still want to be able to hear her when she's trying to get out of the bed. There are others that actually come on when there is noise on the other end. Her music messed with that a lot I have to say but I honestly perfer the baby monitor because when she calls out, I can see if she falls back to sleep before rushing out there to risk waking her in a sleeping state. The bed alarm though does work. What I found was to place it behind her back so when she sat up to climb out of her chair or bed, it would alarm but it is very loud and scary to an elderly patient who doesn't understand why an alarm is going off.

There are rails actually you can even put on regular beds to help. My grandma for a while had a small rail that we put on one side but we used it to assist her in getting out of bed to the bathroom back when she could handle it. We tried putting a string across her that pulled on a simple bell that would ring alerting us. She started to play with the string so that didn't work.

A rehab facility wouldn't use bed alarms or monitors. She had a broken leg so the one lady who worked there overnight would actually put real bells on the sides of the bed overtop the blankets. Then she made sure the ground was clear so when the bell hit the ground, she would know grandma had thrown back her covers to get out of bed. Didn't detour grandma but it alerted the staff to go make sure she was ok and to make sure to lay her back down.

Lots of ideas. I hope one works for you.
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We have a 98 year old Nanny living with us. My mom will turn 70 next week. My mom stays with her 24/7 as to not have her have to go to a nursing home. She fell and broke her hip in July. She is slowly going downhill. She is on hospice now. She had been sleeping in a recliner since she came home from hospital, until about 3 weeks ago. Now she wants to sleep with my mom and hold her hand while she sleeps. She insists on getting up at all hours of the night, but sleeps most of the day. She pinched my moms face (not hard), because my mom would not let her get up. Mind you, she can’t walk alone. The not listening and trying to get out of bed and chair has recently started. It’s like she is reverting back to being a child. My mom is exhausted to say the least. I try and help out when I get home. I let my mom go places with my daughter to get a break. I never knew how much spunk my little Nanny had in her. I guess that is why she is still with us at 98!!! I am going to have to purchase a video monitor to watch her and not get up EVERY time we hear her recliner move up and down.
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I am soooo new to this situation. My mom has Alzheimer's and lives with me in my 2 bdrm apt. I didn't know it was illegal to restrain her. I used a gait belt to keep her in her chair sometimes and not fall out during her frequent chair naps. Instead, I moved the chairs closer so if she should nod off and start leaning forward, I can catch her. Also, at night is the worse. She is on sleeping med but it doesn't last but 2-3 hours. After that, she is up and wandering in her room. I've removed everything except her bed and I lock her closet so she won't go in & get stuck. But those 'bumps' in the night are the scariest things of all. I jump out of bed thinking she's hurt herself. Then I can't get back to sleep. It seems I notice a new bruise every week. I know its not all about me anymore but lack of sleep doesn't help me during the day when I need to care for her. Thanks for all the advice.
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Thank you Jeannegibbs. I will call the doctor on Monday to find out. I was going to do that, too bad it's the long weekend. I hope she sleeps tonight. I find if she has a full stomach, she sleeps better too. That night she wanted to eat so bad that I fed her around 5:30 pm and I think by midnight she must have been hungry. So tonight I kept giving her food until she went to sleep. She has dementia and it is very advanced, but for some reason she eats more now than she ever did. She is always very, very hungry. She eats a lot. I guess, at least that's a good thing. Tonight, before she went to sleep, she changed my whole living room. From her wheelchair, she was pushing my furniture around the room. I could not get her mind off of moving my furniture. It was like she had to do it no matter what happened. I can't even imagine how she has the strength to do that since she only weighs 90 pounds and is very frail, but I guess when people with dementia get something in their head, they just can't help it. It is so hard to watch her. I feel like my mother died when she had the stroke a year and a half ago. She had signs of dementia already, but the stroke made it come much faster. This is not my mother anymore. I miss our talks and the stories of her infancy and youth. I will never hear those again.
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hepi22, talk to the doctor who prescribed Temazepam and explain that it is not working any more. Ask for another alternative.

This can be the straw that breaks the camels back. Not sleeping through the night might be the factor that means you cannot keep her at home with you any longer. Exploring all possible safe drug options is worthwhile, in my opinion. For my husband the answer was Seroquel, but that certainly is not the only possibility and is not the right choice for everyone. But the doctor treating your mom must be told that the current drug is no longer effective and that this is a very serious matter.
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I have the same problem with my mom, but she does not sleep at all during the night. She gets up every 15 minutes. She sleeps maybe from 9 pm to midnight, but then wakes up every 15 minutes or just doesn't want to sleep all night. When she falls asleep at 9 I have to do everything I was not able to do when she was awake during the day. So I usually will go to sleep at midnight which is the time she wants to wander around the house. She has dementia and it's pretty advanced. She does not make any sense when she talks and has a hard time understanding us. She has fallen many times, but is lucky that she hasn't broken anything yet. Just little cuts on her head, and bumps and scratches.
She always wants to go somewhere. She repeats "let's go" for hours at a time. So I think she wants the same thing at night.
I see all the suggestions here. The alarms are a good idea even though I really don't need them since I sleep in the same room and see her getting up, but I need my sleep too. If I had an alarm, I would still be up all night like I am now. I need an someone to tell me what I can do to keep her from getting up at night. She takes Temazepan, but it doesn't work anymore. She tries to jump over the railing if we put it up, so that doesn't work either. I really don't know anymore. I need help!!
Not to mention, I have other people to take care of in my life.
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My dad is in the nursing home, restraints are illegal from what I was told, I am in Tennessee. Anyway, when he first went in I asked them to put a seat belt or something on him so he wouldn't be able to get out of his wheelchair but they can't do that. He was also falling because he would try to get out of bed, they took his bed frame away from him and put a pad beside his bed. He eventually "graduated" to his bed frame again, but with it on the floor he wouldn't get hurt if he tried to get up, he couldn't get up at that point.as far as his wheelchair, maintenance raise the front part of the seat so it inclines and he can't get up from it. They even went so far as getting him a rocker recliner wheelchair which is very nice and comfy. Hope this helps.
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Placing a swimers noodle under the edge of the mattress creates an incline for the person to navigate. some people can still climb over. I would put another mattress on the floor right next to the bed in case they are able to climb out. but this would make enough noise for any monitor or alarm to sense. if a noodle is not available, just rolling up a large blanket would work or go to the fabric store and purchase foam wedges cut to your specificiations. the choice of how high a wedge would be totally your choice. Hope this helps!
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Just one Caveat with the alarm ideas. I have them on mom's doors and the doors to the outside, and before I was used to them, I would bolt out of bed, like for the phone. The problem is ... it is the middle of the night and I am jumping up from a dead sleep.... once I fainted and hit the door frame. It could have been stitches easily. It raised a pretty good walnut on my head.
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You can't stop this. What you can do to help your mom is to get a bed that can be lowered to the floor. Put the bed so that the head and one side on on walls. Put a mat on the floor--they make a mat for this purpose...it's pretty cushioned. So when she is in bed, you move it down so that it is nearly on the floor. The worse she can do is to roll out of the bed about 4 inches onto the nice mat. If she can crawl over to a chair or something and then pull herself up then maybe make sure anything she could pull her self up with is not in her sleeping room. But at least if she rolls onto the floor that will give you time to get in there.

I did not find that the alarms worked in the nursing home--unless your mom understands when the alarm beeps she has to stop and lay down again and call for help. My mom does not have that ability now with the dementia. Just have them instructed to put the bed to the floor.

If you don't have a special bed now I suppose you could just put the mattress on the floor or the mattress on top of the box spring on the floor with a soft mat the side. The mat should have a sloped edge so she won't trip on it.
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JeanneGibbs-- I think it's hard to say what are "appropriate times" and what are not, e.g. is four times in the night to go to the potty appropriate? What we're aiming for here is to keep her in bed while she summons us, and she has three means (bell, whistle, voice) to do that, and we always answer.

I like the floor on the bed idea. Have had that several times in my life and always thought it was cool. Not sure how well it works when it comes to getting her up from there-- she has no muscle tone any more. But anyway, thanks for all the help as well as the info. For now, the baby gate between the U-bars is working well, although she resents it.
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The only issue with using bed rails is that some people are so desperate to get out of bed they climb over them and then fall from a greater height because of the lack of stability. If the person is aggressive about getting up then suggest being somewaht thoughtful on this first. The bed rail pads are a very good idea, they do proveine good protection but sometimes the person can feel closed in.
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@Darcy, I have recently had the same issue of my mother getting out of bed and falling at the Nursing home where she lives and this happens almost on a daily/nightly basis. It got so bad that i asked the nurses if they could install bed railings to keep her safely in her bed. She has fallen numerous times and been hospitalized. They told me the law here in PA. has declared bed railings as "illegal restraints" and the nursing home is not allowed to use them at all. I asked them if that would still be true even if "I" as a legal family member" specifically asked for the railings to be uses!! The answer was the same "They are bound by the law, something to do with hipa or something. This in my opinion needs to change. I persoannly do not see any harm in using bed railings because it is for a safety reason and any family member should have the right to insist they be used for the safety of a parent or other family member needing them.
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I'm assuming you have a hospital bed with 1/2 rails. The full rails are more of a risk factor, in my opinion.
As sad as it is , there are no easy answers. We are dealing with humans, that have significant disabilities. I do not suggest, that you not hold a care facility accountable, but as someone else mentioned, the elderly and frail will always be a fall risk. There are many different things that are tried, and certainly try to be in on the multi-discipline team to give your input, since you know her best. Remember at this time she can not advocate for herself, so she will need you to be her advocate, the best you can be. Keeping a brief diary of her habits, would certainly be helpful. Also remember that the change in surroundings, may escalate her behavior, as she tries to make sense of it. For some it helps to see their loved ones daily at first, for some it makes it more difficult. Also there is no right or wrong answer here. It is what is best for ALL involved in the situation.
There are a lot of caring individuals on the site that have given you some idea's. Hope that this helps, a little.
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I went through this for about a year with my Mom. I hung bells on her bedrail and on a chair next to her bed, and I even hung them from the ceiling on yarn so I heard her move or try to get up. Finally I got her adjusted on the right medication and she started sleeping all night, phew. I hated that running in the nighttime to avoid a fall (which can kill them), but I did it, and then got up for work at 5:45am, it was Hell and I feel for you. I slept on the floor until I thought of hanging bells, they worked great. Good Luck, my Mom sleeps 12 hours a night now so it does end.
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One additional suggestion, (to be used with the lowered bed and mat) Get a body (full length ) pillow. Place it in the bed next to your Mom and wrap a sheet around her and the pillow to keep her in bed. This should follow regular toileting and be accompanied by regular check ups.
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My dad is in the nursing home, when he first went in he refused to stay in the bed. He would limb over the side rails, scoot to the end of the bed and down he would go. The nursing home tried everything, until one day I came in and his mattress was on the floor without a frame. If he feel out of bed it was only the width of the mattress that he was going to fall. Plus it was harder for him to get up o he would stop trying. He also had real thick mats beside his bed. I am proud to say he "graduated" and he now has his bed back. He was so happy they even gave him a little "graduation" party. Oh by the way, he also has severe dementia.
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I glanced thru the responses and did not see this solution which is used in nursing homes: a very low bed close to the floor so if they fall out or get out, they can't hurt themselves., I would post a link but this site will delete it. so query low beds fall prevention elderly.
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I can relate to this question. I have a mother suffering from Alz, who would get up during the night also. It got to the point that I began sleeping on the couch in order hear her, and to ensure she didn't wander during the night. Also, my mother is prone to falling, thus if left unsupervised, she would often fall when she got up. For safety reasons, this could not continue. Plus, I was becoming physically exhausted from lack of sleep. My solution to the problem was this: (1) I bought a baby monitor for my mother's room so I can hear her during the night. (2) I purchased a hospital bed with rails. I've also purchased bumper guards, placed up against the rails to prevent my mother from becoming entangled within the rails. I know some are against use of rails, but it works! Since I began utilizing the hospital bed, my mom has not gotten up during the night. I hope this helps...
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It sounds like when she wants to get out of bed are appropriate times -- at the end of a nap, or to go to the bathroom. You really don't want to keep her in bed -- you just want to make sure she has help as she leaves the bed, right?

You've done the first sensible step, by giving her ways to call for help. Either because she forgets or she doesn't believe she needs help, that has not worked. Sigh.

Having someone being there when she is ready to get up is great, but not always practical. The various alarms and monitors people have described to you can make it possible to get there quickly, but whether it would always be quick enough is a big question. If her nap time is consistent enough, and she always gets up between 3:30 and 3:45, for example, you could schedule yourself to be in the room at 3:25.

To minimize my husband's nighttime falls, I park his walker right in his path to the bathroom. Someimtes he uses it, and sometimes he pushes it out of the way. Sigh. I've recently added a small rail to the bed to act as a grab bar. He really does use that consistently to help himself out of bed and into it. (It is about a foot wide -- nothing he would be tempted to climb over.) But still, he falls sometimes, so I have replaced/removed anything in the vicinity that would be painful if he fell into it. For example, instead of a plastic or metal wastebasket next to his bed I use a woven basket that would collapse (and has!) if he fell on it.

I would not worry about "breaking her of this habit" before she goes to NH. As the others have said, they will not use restraints in any case. And they've had a lot of experience with folks who need help in the night.
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The motion sensor alarms are better and cheaper than the pressure pad alarms because they sense when someone moves whereas the pressure sensors only resppnd when the person is up (or down)- and that's too late. I worked with alarms for many years and agree they are largely useless. Getting out of bed and falling is very common. You can also get a low bed, which is almost on the floor and that means someone who rolls out of bed does not fall and most likely has to call for assistance to get up. Couple that with a motion sensor alarm and also look to 2 other items. 1 - make sure the slip / trip hazards such as loose cords, throw rugs are gone. 2 - provide her with some level of personal protection, be it hip pads or helmet to protect in the event of a fall if she will wear them.
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Hello Harrah. I completely understand your situation; I had the same with my mother. No matter how many times I reminded her she needed to use her walker, to call me if she needed to get up, she forgot and til the day she died she thought she could walk, even though she bounced off all the walls she was so unstable. Alzheimer’s is a terrible, terrible disease and torments the patient with thoughts that seem so real, but so false.

You didn’t say if your mother was suffering from dementia or simply having issues with stability. My mother has Alzheimer’s and used to feel she had to do so many things that were impossible; like picking up her brother who died 11 years before. Sometimes she would calm down if I told her he just called saying a friend took him home and he would see her in the morning. Other times she was on a mission and no amount of white lying could give her peace. It was those times I cried buckets for her because it seemed so real to her and would not let her rest. Obviously, I couldn’t let her leave the house, but she was on a mission that wouldn’t be deterred. I knew if I could give her something for sleep, it would give her peace from the tortures of her mind. Problem with sleeping pills and the elderly with dementia is they often make things worse. Eventually, I did find a combination that sometimes helped, others it did not. In fact, she could still keep going on stuff that would take down an elephant. So, with the authorization of your doctor or hospice, give it a try, but be aware they may not give you the peace for your mother you are seeking.

However, what I finally resorted to, because I couldn’t sit with her 24 hours a day, was a wonderful monitoring system. We started out with the alarm that clipped to their clothing. Be sure and clip it to the back of the garment so they can’t reach it and take it off. It worked fine, except the string is so long that if she got up to go to the bathroom, the string ended up in the toilet. EWE!! Not to mention blaringly LOUD!!! It would scare my mom and set my nerves into hyper-drive as well, especially when you are jolted from a dead sleep.

My mother was in our finished, walkout basement. She had her own bedroom, kitchen, living room, family room and bathroom, so she wasn’t in a dungeon by any means. I still had to keep an eye on her and would be there to help her when she got up. Due to her kidney failure, she slept a lot during the day and for me to sit and stare at her was non-productive to say the least. Yet, I did need to keep an eye on her 24/7.

Our next step was to put a sound sensing monitor on her nightstand so I would hear when she got up. Do you have any idea how quietly they can get out of that bed? Unreal!! My next solution was to pin the monitor between the folded, double size, down comforter I had on her twin bed. That worked really well because the covering on the comforter was stiff so I always heard the rustle when she moved. Moving being the optimal word here. I found myself running full speed down two flights of stairs at 3am only to discover she had simply rolled over.

Okay, final solution, video monitors. I know it sounds like a terrible invasion of her privacy, but by then, I had done and seen things I NEVER wanted to with my mother, so privacy was no longer an issue, this was definitely a safety measure. She would even climb over the side rails or go out the foot. Side rails are, in reality, dangerous and definitely not the answer. The video was a Godsend. However, I did try to preserve her dignity and she never realized I was monitoring her escapes. It was cute because she was always so surprised and happy when I showed up just when she needed me. I could see her get up and know if she was going to the bathroom or what was happening and if she needed help. We had one in her bedroom and one in the hall leading past the kitchen to the bathroom. I knew if she was taking too long and could make sure she had her walker. It saved many, many, many useless trips and a lot of frustration. Before the monitors and she was at the “sundowner” stage, I would find her wandering the house at 3:30am. I was scared she would go outside and I wouldn’t catch her. The monitors gave me a measure of peace and rest. Well, as much as one can get caring for a person with dementia. At least, the three hours I did get helped.

The nice thing about them is the receivers are portable so you can take them outside or other parts of the house and still keep an eye on your loved one. Be sure and check the range of each prior to purchase, as some have longer reception than others. The minute the person wiggles, you can head to them and most times your feet can beat their escape from the bed.

I hope this works for you. It is certainly worth the few dollars to give you some peace……and rest. And definitely much, much kinder than restraints. Oh, and again, this may sound cruel, but until you have lived with a person with dementia and sundowners, you can’t begin to understand the challenges we face. To keep her in her bedroom, bathroom and kitchen area at night, we reversed the locks on the doors. She had freedom to go from each room to the other, but kept her away from any outside exits. To me this was MUCH safer while allowing her plenty of space to move. Our only problem came with the one section that did not have a door. We tied an old twin mattress across the opening, thinking it was soft and she could see over. Good in conception, bad in reality. Don’t ever let anyone tell you these people are stupid and that they are no longer thinking! When my mother couldn’t untie the knots in the ropes, she went to the kitchen, got a knife, cut the ropes, and escaped. I watched it all on the monitor. Was very inventive and funny, but after that night, all the knives and scissors were removed from the kitchen and we used wire to hold the barrier in place. She never figured out our slick way of releasing it, however, she did spend a few hours trying to formulate an escape. At no time was her life in danger because I was glued to the monitors and we could easily get to her by opening the doors. In fact, as I write this, I am watching my 2-year-old grandson on the video monitor in his room as he naps and on the other side of the room is the sound monitor in my FIL room because we are currently dealing with his dementia that is rapidly robbing him of his life.

I hate feeling like a spy, but they reach a point where they no longer realize and understand the phone, whistle, Lifeline alert bands, etc. At that time, you have to step in and do whatever you can to protect them from this insidious disease.

Wishing you luck and I hope you find a solution that works for you and your mother. I have learned to tap dance very fast having cared for three parents in our home, all suffering with dementia. It certainly isn’t easy for either the parents or the caregivers. I pray daily for a cure, or to be spared from being a burden to my children and their lives. Such an insidious and cruel disease.
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Wow, thanks all. I didn't think anyone was going to answer, then all of a sudden-- Christmas!!

I was unaware that people are not allowed to be restrained in Nursing Homes any more-- that is comforting. And alarms would be great, but I think, like some have said, she'll be on the floor by the time anyone gets to her. She slides down pretty gently, so it's not a big deal while it's happening. The big deal is getting her up-- that's gotten very hard, and we do call on the Fire Dept.from time to time! Everything with her is changing so rapidly lately, it's tough to keep up with what to do about it all. Right now, I kind of like the sleeping pill idea, as opposed to one of us having to be awakened (by an alarm!) for the 15 minutes it takes to get her to her potty chair and back...
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We used a notion sensor for my Dad. It was placed so if one leg came over the side of the bed an alarm sounded. Worked good. Didn't keep him in bed but did let us know he was on the move. You can't tell some people they can't walk without help. My 96 year old Mother has broken both legs because she wouldn't use her cane or walker. After 3 years I still catch her creeping around her room holding on to whatever comes under her hand, sturdy or not. For the sake of my nerves and mental well being I have given up and when she falls I call the Fire department for help and if she breaks something else I will call an ambulance. Don't beat yourself up. You will always be her kid and parents don't mind kids. This is from a 73 year old kid. I am sure the nursing home will know how to handle her and she just might listen to them.
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As others have mentioned, active, physical restraints are not used in a good nursing home. Side rails can be more dangerous than a fall would be. There are thick mats that can be placed by the side of the bed, but they're controversial, too. There are passive restraint systems; beds that are difficult or impossible to get out of for a person without much strength. At the community I'm associated with, we consider all of those to be restraints and don't use them.
There are many, many alarm systems. The problem is they're useless unless someone is within arm's reach when they go off. All they do is alert the staff that someone is about to fall so they can hurry to the room. Unless they're already in the room it's unlikely they'll be able to prevent it. They do, however, make family members feel like something is 'being done'.
I once heard a geriatrician respond to the adult child of his patient who was demanding that he "do something" about his mother's frequent falling. He said, "old people fall, it's what they do." Sounds simple, but it's incredibly difficult for middle-aged people to really understand unless they've had a lot of experience with the elderly.
If you have the resources, you could have someone sit by your Mom's side 24/7. But I doubt she'd want to live that way. I wouldn't.
I'd certainly try giving Mom a sleeping pill at night, if it helps. But, whatever else you do, try to come to grips with the fact that your Mom will very likely fall. Given her restlessness, probably more than once. Don't feel guilty about it, don't blame the nursing home for it. "It's what they do."
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There are alarmed bed mats, alarmed floor mats, and monitors. Most are under $200. The alarm is wireless and is not activated in elder's room but to a remote for the caregiver.
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(I worked as a nurse for many years in a nursing home....) Physical restraints are considered abuse! If a nursing home would go that route, I would seriously NOT go there! That is horrible. They are more likely to chemically restrain her...(sedative) and even that is controversial....and illegal in some places. I do give my mother Ativan at bedtime only... as she has a horrible time sleeping at night, always has, but now it is a safety issue as well. If you would like I could research any of the options above for you, as to where to purchase. I am sure you could just do a search for "bed alarms" in health care supply sites, etc. "Safety alarms" etc.
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First of all it is ILLEGAL to physically restrain her. I would suggest other methods. There are safety devices that can be use. A side rail on the bed would be a simple thing IF she would not try to climb over it. There are also pressure pads that you get to put on the bed under her or her bed pad... you turn it on after she is in bed, if she started to get off the pad, it sets off an alarm to alert the care giver to assist. There are also floor pads, you put beside the bed. If she stands on it, even one foot touches it, it sounds an alarm... alerting the care giver. Another option (cheaper) is to get a motion sensor. They are only a few dollars, set it above the bed, so if she sits up, it will trip the alarm and alert the caregiver! There is another one that is an alarm that is fastened to her bed/chair, etc. it has a pin (like a hand grenade!!) that has a string attached to it, with a clip that fastens onto their clothing. When they try to get up, it pulls the pin and the alarms sound! Hope these options help! :)
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