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She like to wander.Two of her falls resulted in bumps to her head. One occurred when a care giver was at the breakfast table when she was arising. She somehow got tangled in a leg or something and went down getting a big bang on her noggin. Fortunately not a serious bump, though. The next time she got up in the middle of the night and put her shoes on and I guess then fell. She was found on the hourly bed check on the floor but no bumps or bruises were present. Sunday she wandered into bathroom on her own and was found on the floor she did have another bump on her head. She hasn't toileted her self in a long time so I imagine she just wandered into the space and wasn't looking to go the bathroom. The center said they are trying to keep her in a wheelchair but they do sit her in comfy chairs and she is at times capable of getting up and walking with the wheel chair as a walker. They say she gets restless and likes to wander but has been becoming more unstable on her feet. she isn't on a lot of meds and they have been ruled out as a reason for her falls as has a urinary infection. What can be done to prevent these falls before she seriously hurt herself? I know she thinks she is capable of getting around and just forgets she can't do it on her own. What have others done to help with this issue? What is the ratio of enough patient supervision to care-givers..

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Well, that is a tough one. My Mom hasn't been doing that on her own for a year now so not a problem. And I think she now feels more freedom as walking was at a very slow snail's pace. She can move the wheelchair faster and easier. She is sort of like a kid with a new kiddie car now when she starts moving around the center a big smile gets plastered on her face.
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You know, it's kind of a Catch 22. You want your loved one to stay on their feet and walk for as long as they can, and not be artificially confined to the bed or chair - yet there comes a time when they really are unsteady and need to be confined. I don't know that there a perfect answer to a problem like this. How do you convince someone who has dementia so bad that they don't even know they have it - that they shouldn't get up to go to the bathroom? .
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Since those falls there have been no others. She is now in a wheelchair full tim amd i dpnt thi k she can get up wothout assistance. On the plus side she really seems to enjoy moving thr chair with her feet and hss become more active.
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Oh what a dilemma. I will ask the Heavenly Angels to watch over you mom, and all the elderly. It is a very tough problem, not enough aides to be close enough, all the time. So it is inevitable, many many elderly will surely fall, and repeatedly. Society has to realize there is a good range of acceptable fall prevention. There is literally NO one place and NO aide quick enough and NO device that can prevent, or alert, ALL falls.
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Kwriter, the chair pressure pad sits under the seat cushion and go off when she rises from the chair, or makes a serious effort to anyway. She wouldn't even know it was there. But from your description, she could be sitting almost anywhere, couldn't she, and they couldn't put alarms on every chair in the place.

I love the sound of the unit, it sounds like a first rate place. However. Not great from a falls prevention point of view, especially with a person who is restless but can't walk around safely. Very, very tricky. What do the staff suggest? After all, it's their job to keep your mother from harm.
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My mother's nursing home claims they cannot use any restraints, and that includes many things that don't seem like restraints to me at all. They understand that my mother forgets she can't walk so they go to devious lengths to restrain her without using forbidden devices.

There are some sensible things that can be done to help prevent falls. But it is impossible to eliminate the risk entirely. One of Mom's falls occurred with an aide in the room within two feet of her. My husband fell often, even when I was walking with him. The best I could do was break his fall, but not stop it from happening.

Work with the staff to brainstorm ideas in how to reduce risks for your loved one. But also accept that falls are not 100% preventable.
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Mom is in what would be considered an assisted living place for dementia patients only. A call button would be useless since she'd never remember to use it. They have maximum of 16 patients per side and the residents can go freely from one side to the other through the kitchen areas. They are really only required to be on their side at bedtime and they do try to keep them on the side they belong on for meals though they won't argue with them if they want to eat on the wrong side. There are another 16 on that side too so a total of 32 if all are there. They also do take day-care patients and that number fluctuates. from day to day. Plus there are always a lot of visitors coming and going. They have 4 full time staff on each side plus a full time RN for the 2 sides and some others there part-time.

Usually they use one side for activities etc. and let the sleepers of which there are a lot. Many of the residents snooze most of the day away. The acitivities seem to move by which side seems the most sleepy. Those awake are encouraged to try the activities. Mom often doesn't like doing them much though nor does she like sitting with the sleepers but prefers to wander off. I think she prefers being where it is quieter and away from all the people thus she goes down the hallway which is quiet but still has atmosphere with nice furniture and décor. She has a bedroom of her own that she shares with another lady. She really is only in there to sleep, and can't find it on her own anyway. I don't think she can open the door and negotiate her way in anyway.
She really can't get up on her own from the recliners and sofas but can muster up the strength sometimes from the wheelchair. She gets bored being on the couch etc. She likes to move and can use her legs to move the wheelchair around. An alarm on the chair might work but she really likes to pick things off and I know that was a problem with my FIL we couldn't find an alarm he couldn't disarm.
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hi all, my father had 3 falls in 4 days last August. the last one he fractured his hip and ended up in ICU for a week. He has been recovering in a skilled rehab facility. There is talk of him coming home and he is much more like my dad again. But quite frankly, I'm afraid this is going to happen all over again. I would be interested in those who use bed or other types of alarms. His facility is also restraint free. What helped in the beginning is pushing the bedside table by the bed on one side and a chair on the othe side. they also lower the bed to the lowest level available. there is also a body pillow available. but one of the stnas told me that is also considered a restraint. I did not get that but would love input from those who have any alarms.
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I just remembered that my brother in law printed a huge color picture of himself with a very large lobster ( he's a scuba diver) and taped it to my mother in law s cabinet in the nh where she could see it. It said something like, "if you try to get up, I'll throw you in the pot with this lobster". She would see it, it would make her laugh and she'd remember she should use the button.
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That's weird: how does an alarm restrict anyone? I suspect that DON wants a firm talking to - Health and Safety type authorities get fed to the back teeth with people misinterpreting guidelines, and it can get difficult to believe they're not being intentionally thick. Or at least disingenuous, when their actual problem is they don't want the hassle.
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On another thread, a member sent me a PM, saying that her mom is falling in NH, DON says NO restraints and NO alarms are permitted. that if she wants to move her mom to another facility, SHE has to pay for another evaluation and tranportation out of pocket. Can anyone comment on that? Are there places that won't use a chair/bed alarm to keep an elder safe?
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Ah yes, Terry, that was a story that the discharge planning nurse at Danbury Hospital told me. MY mom fell with two aides in the room, and the nurse told me that HER mom fell with THREE RNs, one of them her, in the room. Elders fall.
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I remember reading on this forum where there were 4 nurses in a room, one of which was the daughter of the elder, and the elder still fell in the room. Unless someone is joined to the hip with that person, it is very difficult to keep someone from falling unless they are tied down, and who wants to do that.
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Oh my goodness my mother was admitted to the hospital on Sept 9th and died 9 days later from a "mysterious fall." The coroner report said she died of "Blunt Force Trauma to the head and 4 brain hemorrhages." This is NOT TO BE TAKEN LIGHTLY! The facility is not doing their job correctly for this to keep happening.

Your mother can be belted in the wheelchair so she cannot get out, I have seen some patients put into an almost lying position to keep them in the wheelchair at the home my mother was in. At night there are bed alarms that need to be turned on so they go off when she gets out of bed and she could be moved closer to a nurses station so they could keep an eye on her.

Because she has fallen 3 times they need to be watching her closely and someone needs to help her sit and get up to prevent such entanglements. You sound as though you are a very kind person and do not want to be harsh with these people but you need to have a talk with administration or head of nursing or someone and basically demand that they figure something out and put it into action NOW!

I cannot even begin to tell you the guilt you feel when your loved one dies like this and you start thinking to yourself...Oh if only I had said something more or done something more, it is horrible. This is a form of neglect on the part of the nursing home, but if you don't say something and demand something be done, you are as much at fault as they are. I do not mean to be nasty but I am still dealing with my mother's death so this subject for me is a raw spot and I just want everyone to realize that there are countless deaths due to falls and they may be Mom's fault but they may also be from neglect and abuse.

God Bless You All!
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Sorry to say but their are not doing all they can. I worked in many nursinghomes they over work their staff. there no limit to how many patient they can give you. their are a few simple thing they should have done. they have bed and chair alarms.do you know how often they check in her. most nursinghomes don't get in trouble for falls or even bedsores like you would if you were taking care of them at home. start going in at 7 am if you smell urine they are not a good place. what is the patient to caregiver ratio if it is higher then four to one, you see why you loved one is falling. they make nice money make them work for it. Tell the nursinghome she need more care and by the law they have to give it to her. I hope this will help you.
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I completely sympathise. My mother (living at home with me) has pressure pad alarms on her bed and two armchairs, and a call button (ha-ha very funny) that she wears on her wrist. She's had three ambulance trips to ER in the last eighteen months because of falls, two of them after we got the alarm system in place. What I need is an alarm that will alert me in good time ***before*** she gets up…

The trouble is, the only way to prevent any falls is for someone to be standing over her 24/7. And even then, as they say, "gomers go to ground" - bewilderingly, she will find a way of falling. So for the sake of your hair colour and your blood pressure, work on accepting that there will be an element of risk that cannot be eliminated. I can vouch for the extreme difficulty of doing this, but try. Breathing exercises (I am not joking) help.

Meanwhile, I agree with Maggie, discuss the issue and revise your mother's care plan. Keep it under ongoing review. If you're like me, you will be tempted to request that they strap her into her chair (!) when she isn't being supervised: they won't, so don't waste thought on it. This is a 'deprivation of liberty', and in our system - I expect yours will be similar - there is a plethora of formal applications and authorisations required before that can happen. You won't get approval for it simply to prevent falls.

You can also feel less helpless researching the vast range of devices and aids available, from walkers to alarm systems. There are alarms that will allow you to record a message so that as she gets up from her chair a disembodied voice says "Mary, sit down and press your call button!" The idea is that she will comply. My suspicion is that my mother would jump out of her skin - but at least the picture gave me a giggle. More usefully, there are also gizmos that you attach to the person's clothing that will tell you when her body position departs from the perpendicular; but, again, they won't tell you before it happens.

I understand your questioning the ratio of patients : caregivers, but this returns to the point that unless there is someone with her literally continuously she will always find opportunities to go a-wandering. So keep it in mind that you can reduce the risk, you can try to think of everything, but in the end if it happens, it happens. Take deep breaths, and some consolation from the way her staff are already dealing with it - they're on the scene quickly, they are checking on her regularly, and they are reporting diligently. That actually sounds pretty good.
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You might try a lap buddy. It fits across the lap when one is seated in a wheelchair and makes it almost impossible for your elderly loved one to get up on their own. At night, I second the idea of a bed alarm. And, a walker is always a great idea.
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Does she have a walker? They are really a great help with elders that can walk but whose balance is a problem. Those bumps on the head can have a serious effect on one's brain and contribute to increased dementia. Walking with a walker helps her to keep her legs strong. However, getting out of bed will still pose a threat of a fall. Even with a walker, my mother-in-law still has an occasional fall. Falling is a serious problem, and one hard to guard against. Best of luck. If you find a solution, please share it on this forum.
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Bed alarm. Chair alarm. Mom broke her hip because she simply forgot she couldn't walk on her own. She had to go to the bathroom. Judging by my experience when mom was in the nursing home for several months for rehab after that break, that's most often the reason people get up - and then fall. They have to go to the bathroom. And forget.

Mom was in a wheelchair all day, with the foot supports extended. Her nursing home had a huge dining room with a 72" TV open morning 'til night. It was right beside the nurses' station. They wheeled her in there to watch TV in the morning at breakfast and most often kept her there...pushed up to the table, feet up, wheels locked. No restraints allowed at this nursing home (nor in the whole state, as a matter of fact). But the dining room table acted as a restraint. It worked.

Others more nimble could unlock the wheels and push away from the table. They often did that if they needed to use the bathroom. Just an automatic reflexive action. Then their seat alarm would sound. Anyone in earshot, including visitors, knew what that meant and rushed to their aid.

With mom, in bed, they would raise her feet and head. In mom's case, she was too weak to get out of bed in that position. But if people tried? Their bed alarm would sound and aids would come rushing in. They put her room close to the nurses' station to make it convenient for staff to monitor serious fall risks.

Call a meeting with the Director of Nursing. Find out exactly what they are going to do DIFFERENTLY to protect your loved one from falling. A broken hip or serious head injury is right around the corner.
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Please help me get where she's at. What type of Memory care center? Skilled nursing home or some other type of facility.

she thinks she is capable of getting around and can't do it on her own.
I face a similar issue at home.

Common side effects of Aricept® include frequent urination;drowsiness; headache; dizziness; confusion; changes in behavior; and abnormal dreams; fainting, trouble urinating

MY ADW has been on Aricept for years. Made a change during the early years. Now she may be showing the side effects. Dr is tapering her off with the goal of stopping the Aricept to see stopping health problems.
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