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She has to be transferred because she can no longer walk. The staff has put an alarm on her bed and chair after about her 3rd fall.

The nurse called me today telling me she fell last night. She has a hematoma on her forehead and bruising around her eyes. They said she is very sleepy since the fall, but they talked to a doctor and he ordered a UTI, a chest x-ray, and did a neurological check. She said her pupils were responsive.

Then she asked if I want them to send her to the ER and I asked what does the doctor suggest and she said with the neuro exam it seems she is okay, so I told them to leave her in nursing home and monitor her and take the other tests they said they were going to give her.

Should I conclude that she is not being given the proper care or assistance since she has fallen so many times? She is 86 years old. She has Parkinson's and some dementia. I am very concerned for her safety and well-being.

It seems most the nursing homes are so understaffed.

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There is a way to prevent falls, hire an Aide to sit with the patient and watch the patient for their 8-hour shift, then another Aide will come in for the next shift, again for the night shift, which would add an add $200 or more per day or $6,000 per month cost to the already expensive bill of between $10k to $20 for the facility. Medicaid would come to a screeching halt.

As I had mentioned in a prior post, falls can also happen at home with a love one or two trying to do the 24/7 care.

One time someone had mentioned on the forums that her Mom had fallen while there were Nurses and Aides in her room.... it can happen that quickly.
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Caregiverhelp - well, at least the SW was honest instead of blowing air up your skirt - but yes, a pretty sad response. In my mothers situation the nursing home pretty quickly put a "fall plan" into place. If the place your mother is staying at doesn't bring up something alone that line, you should ask for one. At the very least it will show the home you are fully aware of the situation and are monitoring the goings on.
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I'm not sure what the answer is. Sometimes seniors start falling and there doesn't seem to be anyway to stop it. Has she already fallen by the time her alarm went off and they got to her? Unless someone is standing right by her 24/7, there is a chance she may fall. What you might do is discuss the options that are legal in your state. If the doctor prescribes it for safety reasons, can they place a safety belt on her wheelchair? There are laws about restraints, but there are some exceptions for safety reasons with doctor's orders. OR could she sit in a geri chair instead of a wheelchair? It slants backwards so it's not so easy to get out of.

Keeping her safe at night is another issue. I agree with pamstegma in that they will likely put her low to the floor. I'd talk to the Nursing home and ask for all options that could be tried. Bed rails are considered unsafe in most states, but you can ask about it as well as other options. Certainly, they deal with this all the time. I'm not sure I would blame the facility.
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My moms mom was in every nursing home in our city of savannah ga. And was abused in every one of them. She had Alzheimer's and a very bad case of it at that. So the nurses knew she couldn't and wouldn't remember the abuse. Black eyes broken hips broke a finger to get a ring off We took one of them to court with pictures of my Nana's black eyes busted head and bloody scalp broken hip and this was all done in one nursing home by a big black colored woman who use to abuse and rough up the patients. She actually got to keep her job! We were awarded 12000 for all that was done to my Nana and we used that to bring her home and hire nurse to help us take care of her. I've seen it all in nursing homes. They would sit the food in front of patients who couldn't feed themselves so me and my mom and sister would go around trying to feed and help as many as we could. They would leave them sitting in urine soaked diapers leave them sitting in chairs naked in showers cold. I could never put my mother or anyone in a nursing home after all I've seen and witnessed. And this was 5 different nursing homes. And all were supposed to be "good" nursing homes. The private ones too. Not enough is being done about the abuse that goes on in these places. The ones with dementia and Alzheimer's I believe to get it worst. Because their minds are gone and these "nurses" or caregivers working for minimum wage mostly with rap sheets don't give a f**k about our loved ones. That's my experience and opinion.
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You should conclude that her dementia has gotten her to the point that she cannot keep herself safe. She doesn't know enough to push the call button and wait for help. They will probably lower the bed all the way down so she cannot get to her feet, and put a pad next to the bed. This is late stage dementia, so sorry. Time is short for her.
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My mom goes through phases with falling. She will fall several times over roughly a two week period and then go a month or longer with no falls until the cycle repeats. I agree with pamstrgma that at least in my moms case - she forgets that she needs help for even the shortest transfer. I also agree with Sunnygirl that unless someone is at her side 24/7, that it's going to happen. It just seems to go along as a part of the disease of dementia. Unless your seeing other signs of neglect I wouldn't assume that is the cause.
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I agree. Try to get a fall plan in order. See if your state allows things that are not normally allowed. Many things are considered restraints. That's one reason people fall a lot is that there can't be anything preventing them from falling, because it's considered a restraint. The nursing home director and the social worker certainly should know what options there are in extreme cases.
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My Mom was in the nursing home due to a serious head trauma due to a fall in her own home, my Dad couldn't get to her quick enough [he was a fall risk himself]. And they refused outside help. Mom was eventually placed in long-term-care and it seemed like once or twice a week I would get a call from the facility saying she had fallen.

It's the nature of the beast, once an elder reaches the last stages of dementia, they forget they cannot stand up and walk. Mom was either falling out of bed or out of her wheelchair.

The bed was lowered and fall mats were placed, and Mom would tumble out of bed. No real injuries, maybe a skinned ankle. So pillows would be arranged around her to keep her in the bed, but somehow she would get sideways in the bed. In the wheelchair she would reach for some imaginary object on the floor and she would roll out.

Eventually a geri-recliner was used with pillow propped under her knees to keep her in that chair... occasionally she would pull the pillow out and try to get out of the chair. The nurses tried a seat-belt but Mom would unbuckle that in an instant. The nurses had my Mom at the nursing station to keep an eye on her.

No different than if Mom was at home, you would go to the bathroom and she would find a way to fall in another room. You would go to the kitchen to fix a meal, Mom would fall. You would go to bed at night, and Mom would fall out of her bed. You can't be glued to the hip 24 hours a day, no different then the Staff at a nursing home.
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Thanks for those of you that answered my question. This is a very difficult time and it IS difficult to know what exactly is going on in the nursing homes when I am not there. They do all seem to be short on staff. I went to see my mom last night after work. She had brusies near her eye and a bump on her forehead.

I briefly talked to the Social Worker on my way out. I was surprised she was still there. But when I voiced my concern about my mom's falls, she basically told me they are not a facility that can monitor my mom 24/7 or one on one.

Well, I thought that was a sad response. Shows how much they care. They seem to be real quick at giving some type of excuse, and sadly, it's like that
at the majority of the nursing homes.

I can't believe there are not stricter laws to protect the helpless elderly people that have to stay in a nursing home.
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Over forty years ago when my grandma was in a nursing home I can remember a woman who was strapped into her wheelchair so she wouldn't fall out. As Sunnygirl said, these days this would be considered a unlawful restraint most likely. But there are some things that can be done to lessen the chance of a fall - if only marginally. Still, it is better than doing nothing. Yes, my mom still falls with the "fall plan" in place, but she does fall quite as often.
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