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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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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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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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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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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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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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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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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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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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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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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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