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My mom is 94. She uses a walker. She is in good physical health, but short term memory is lacking. We transitioned her from her apt with live-in aide to an AL 4 months ago because we thought it would be better for her and easier for myself/my sister to manage. It has been worse. AL does not perform contracted services satisfactorily (despite repeated meetings with mgmt), but bigger issue is that my Mom has fallen 3 or 4 times since moving in. She did not seem to fall with the aide (unless aide did not tell us). Every time she falls they take her to the ER. My sister lives near her, I do not. This is putting a real strain on her. I think we need to make a change, but not sure what to do. SNF? Move to a different facility? What questions to ask?

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Countrymouse -- Thanks for your reply (and everyone else). To answer your question, although my Mom's one-on-one care was pretty good, she was not getting out much, so she we just basically sitting around the apartment all day long. We thought she would have a better quality of life if she could she could enjoy the activities at an AL. Also, we had indications that the aide we had was going to leave. We thought that an affordable replacement would be hard to find. Every time she goes to the ER she has a CT done. So far they have all come back negative.
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Mm - when you say you thought the move from her own apartment with one-to-one care would be better for her, what was it about how she was living that needed to be improved? In what way did you think it would be better for her?

I'm wondering if she had begun to deteriorate, perhaps subtly, while she was still living at home and that was why you thought she needed more structured care? But in that case, her more frequent falling now could be explained by physical decline.

The whole falls issue is *monumentally* stressful and frustrating and you and your sister have my whole-hearted sympathy. If I were either of you, I think I would ask for a detailed medical assessment of your mother's current condition and prognosis. Did any of the ER visits result in a CT scan of her head, for example?
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The nurse had it written at the AL, that Mom was to have a walker at all times. I went to visit and many times she was without it. I talked to the Nurse about all the times Mom was in ER. I asked that they wait awhile before they sent her. Mom suffered from arthritis in her back. Of course she was going to hurt after a fall, don't we all. The only time they wouldn't wait was if she hit her head. Once in the NH they weren't as quick to send her out.
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Moving is very hard on the elderly, disorienting. I have a hunch she had lived in her home for many years and accustomed to the layout. She is now in a new place. She had one on one care, the very best she could have. She will not receive the same level of care in a facility as there are others that also need care.
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xwords, elderly who tend to fall will fall no matter where they are living. That is the norm. You can have a room filled with nurses and aides, and an elder will find a way to tumble in a split second. Thus it doesn't matter how many different places to move Mom.

Both my parents were falling on a regular basis at their home. Many falls I never knew about until I found my Dad's diaries. Oh dear.

My Mom moved into long-term-care due to a serious fall, and she continued to fall even there. She forgot she couldn't walk, but was determined to do so. Nurses eventually founds ways to limit the falls.

My Dad had around the clock caregivers at his house, which limited almost all the falls during that time frame, but at $30k per month, it was eating its way through Dad's wallet. Dad then decided to move to Independent Living, but as Dad aged his falls were happening more. Plus he would forget to use his walker. Then a move to Assisted Living/Memory Care, falls were less as he spent most of his day in his recliner watching TV, which he was content to do.
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