We are worried and have spoken with them about our concerns. Mom has alzheimer’s and osteoporosis. She has broken her hip and her femur in the past. Staff said the in house doc visits once a month and has said her bones are good. We aren’t comfortable with that answer. What can be done to ensure her safety? We’ve asked that she is forced to use a wheelchair instead of her walker. They say they encourage the patient to walk as long as possible and we agree but we know if she’s allowed to continue like this it’s not going to end well. She wouldn’t know how to self operate a wheelchair. Siblings were required to sign forms acknowledging the home isn’t responsible for falls and injuries that occur.

Would appreciate any advice.

Thank you.

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My mom was in AL. With TWO aides in the room. She fell.

Elders fall. Falls cannot be prevented. She would fall at home and she will fall in the NH.

When I complained to the discharge nurse at the hospital about mom's falling with aides present, she said "honey, my mom fell with three RNs in the room and one of them was me". She went on to explain that at times, elders break a bone and THEN fall, not the other way around, which, looking at mom's xrays may well be what happened.

For me, my mom's last 5 years were a journey to acceptance that things were going to get incrementally worse; that we needed to create opportunities for joy when and where we could. NOT "fix" things.
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Nursing homes are not allowed to use restraints (except in emergency situations) so even if they put your mom in a wheel chair, that doesn’t mean she would use it or stay in it. We were told that the state is even cutting down on the use of bed alarms. Side bars on beds are also considered restraints.

I think the laws have swung so far in trying to correct mistakes from the past (my grandad was kept tied in a wheelchair in the mid 70’s in a NH) that it’s now making it very hard to keep patients safe. BTW, even tied my grandad fell (trying to climb out of the wheelchair) & broke his hip. Died just after surgery.
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Fivates, there comes a point when one is aging that they will start falling, that is what they do. With or without dementia. There isn't anyway it can be prevented.

My Mom's brain kept telling her that she would stand up and walk, but in reality she couldn't, so there were constant falls. This would have happened if she were living at home or living in long-term-care.

Even being placed in a wheelchair, Mom would bend over to pick up something her mind thought was there, and she would tumble out.

Mom's bed had to be lowered to almost ground level with rubber fall mats on the floor next to the bed. Yet Mom would still get skin scrapes from the metal sections of the hospital bed. It was the norm.

The facility tried using a seat-belt for the wheelchair, but the first time in use the Aids heard that familiar unclicking of the seat-belt. Mom remembered how to do that, which she did for most of her adult life with Dad having seat-belts in the car since the 1960's.... Mom hated to wear them.

The only thing that worked for Mom was a Geri-recliner where the Aids placed a pillow under Mom's knees. That kept Mom in place for awhile as it took time for Mom to pull out the pillow from under her knees. Mom also was placed at the nursing station, and even then, Mom could fall quicker then the Aides/Nurses could rush over to her. It was the norm.

My Dad was still sharp, but he was a tumbler due to his age. Reach down to tie his shoes, he would fall out of his recliner. Be outside pulling weeds while sitting on a stool, tumble into the dirt. Trying to walk into the house from the garage, he would tend to fall backwards trying to manage the one step from the garage to the house. A rolling walker became his best friend.
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Keeping a senior who has dementia from falling is very challenging. People try lots of things, but, it's still very challenging and I'm not sure there is any real way that makes a huge difference, however, you can try various things to see if they help. I'll just share what I discovered.

My LO was similar to your your mother, except my LO was quite young when she got dementia and in her early 60's! The problem is that people who have dementia often forget to use a cane, walker and even to stay in a wheelchair. They'll get up and just try to walk when they can't, fall and get hurt. There are few ways to really prevent this, since most restraints are not legal. Even if someone stays right by their side, they can still fall and get hurt. Once, my LO let go of her walker and walked to the other side of it while I was standing with her! She started to fall straight back, due to loss of balance, when I caught her and broke her fall, but, that was a fluke, If I had been sitting a few feet away, I couldn't have prevented it. Eventually, she did continue to fall, got multiple fractures and went to a wheelchair. Then, her falls were less frequent, but, she still got a couple more fractures once in the wheelchair. due to getting up in the night and falling, but, you can't make someone stay in a wheelchair if they are mobile. Once she gets to the point that she is wheelchair bound, the staff may be able to place her near their work station to keep an eye on her, but, even that doesn't always work.

An MC unit might be able to monitor and supervise her more than where she is now, but, that's not for certain. You might explore it.

Does she ever fall during the night? If so, figuring a way to help her sleep more soundly might help or ensuring that she stays dry at night and isn't prone to get up for bathroom. Also, a bed alarm that alerts staff when she gets up in the night might help.

Maybe, others will have some suggestions. I know that falling and injuries by my LO tortured me for a couple of years. Lots of lost sleep and tears. When the LO can't remember to be careful or use rails, walker, etc. it makes things so frustrating. Of course, they are suffering too, but, there seems no way to really help prevent it. Oh yeah. One more thing is to check her medication and see if she's taking meds that cause dizziness, weakness, sedation, etc. Adjusting the medication MIGHT help.
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