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The bed area (where many falls occur) is my area of expertise. Many people get lightheaded when rising, lose their balance and crash. Some people wake up groggy (and in the dark), lose their balance and crash. Others have difficulties in repositioning in bed and crash to the floor. Sleeping in the same room and never getting a full rest will catch up to you. I would be glad to suggest items to help.
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Call the MD and get her in-home PT and OT. Get a complete neuro-psych exam. There will likely be another trip to the hospital; from there she should go to a skilled nursing facility, not back to your house. You have to make it clear to the discharge planner that you cannot do the 24/7 care.
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Does she walk OK with a walker or other device? When my mother gets up in the middle of the night and her walker is right in her path she uses it, decreasing her risk of falling. She has dementia, but still understands the need to use the walker.

If Mom got up at 3:30, used her walker (or cane, etc.) and wandered around the house a while, would you be OK with that? In other words, is it just the fall risk that is of concern? Or might she do something dangerous, or eat something inappropriate, or leave the house, etc.?

Is there a short guard rail on Mom's bed, for her to pull herself up on? This helped my husband and my mother pull themselves around to be in a good position to then swing their legs over and then stand up.

Here is a fact to consider. Old people fall. It is what they do. Old people who have been labeled a "fall risk" fall more often than others. There is no way to completely eliminate the risk, except maybe confinement to bed. Obviously we do not want our old loved ones to fall. Falling can have serious consequences. So we must take all reasonable and prudent steps to prevent falls. And we have to balance this with our loved ones living a reasonably independent life, to the extent that they can.

And we have to be well-rested ourselves!

Balancing all this is a huge challenge. I wish you the best of luck!
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Your profile indicates mobility problems, and your posting here is it the possibility of some dementia. Your mom was 90 days in rehab...but why was she in the hospital, what was she being rehabbed for?

You may need to get her a neuropsyciatric evaluation if she hasn't already had one when she was hospitalized. Her insomnia seems like "sundowning" which is a typical part of dementia for some people. But if you are going to keep her at home, you will need to deal with this because disturbing the sleep of other household members will quickly need to physical dysfunction. There are prescription medications that can be recommended to calm down the brain of a dementia patient, helping them to sleep and yet not making them drowsy which would increase their fall potential.
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Thanks for your insight. Right now we are still sleeping in the same room to assist her getting up. She is not sleeping during the day. She is waking up at 3:30 and won't get back in bed, so yes, our sleep is being disturbed. As for dimentia, she has not been diagnosed, but it is very possible. She often says she sees things that are not there ( spots, people, etc). She has a very bad cataract so her eye sight is very limited. On many levels though, her brain is right on the money. I am not sure where to go with this,
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Hi Mtjent,

Since your mom is a fall risk it may not be a good idea to give her any kind of sleeping medication at night. She may wake up groggy which will increase her chance of falling.

Does your mom sleep a lot during the day? If so, try to break her of this habit. It will require more work on your part to keep her awake but it may help her sleep better at night. Try to find something to entertain her. An interesting show on tv or a book or game.

How long has she been home? Maybe she's just adjusting to being at home again and the sleeplessness could work itself out in time.

Routines are very important. Does your mom have a nighttime ritual or routine? For example, at 9:00 p.m. she could begin to get undressed to go to bed, brush her teeth, wash her face, etc. A regular bedtime might help too. With a routine, always allow an amount of time for anything unexpected that might come up. If nothing does, great. If something out of the norm comes up she'll still be following a routine but allowing a little extra time to take care of anything that might arise (a bout of incontinence, bowel movement, a snack, etc).

When she's awake in the middle of the night does she roam around the house? Is your sleep disturbed as a result? I didn't read your information, does your mom have dementia? If not, can you advise her not to roam around if she's up in the middle of the night because she could fall? Are there things in her room to keep her occupied if she's awake in the night? A tv, a book, paper and pen? If she has dementia I can't think of anything that you can do to keep her from popping up in the middle of the night except hope for the best. If she uses a cane or a walker make sure these are placed by her bedside (but not so close where she'll fall over them). If she's just getting up to use the bathroom maybe a bedside commode would be easier, safer, and more convenient for her.
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