Mom keeps falling in assisted living. What are our options?

The shared experience here is very good, insightful; tho I don't see any mention of the piece of information I learned when my mother began having falls. It was shocking and upsetting at first to learn that average, Average, lifespan once an elder begins having falls is...6 months. Sparing you all the sad details it became true in my mom's case, who had just turned 79, and then again years later when my favorite uncle died, age 96, tho hale and hearty up to then, still driving, etc. So, sad and as hard as this info can be, I concur with one poster to 'let go and let God', which does not mean don't try to help your mom stop/prevent falls (PT is almost useless at this point if the patient cannot comprehend nor practice why to do their exercises.) Ask for a hospice determination, then place your mother where she will get the best comfort/safety care; have her treated when she falls, prepare yourself for her demise, whenever it comes. I often wonder what the very elderly did in olden times; it occurs to me that falling, especially when living alone, probably led to immobilization where they lay, with the person gradually losing consciousness from thirst/dehydration. The late, great Steve Irwin often said, "It's Nature's Way", which we try mightily as humans to defy/postpone, but a life 'winding down' ought to be respected, imho. The elder care 'industry' is a business, useful to a point, but not when it's merely prolonging the natural process of an individual's exit from this world.

Nobody can prevent falls, period. Not any SNF or memory care ALF, or home health aid, it's not possible, especially when dementia is involved and they forget they can't walk. That was the case with my mother who took 95 falls, literally, with some cracked ribs and sternum as her only injuries. Pt is pretty impossible w dementia too, bc they don't follow cues, can't retain new info, and have no motivation or interest in working hard w exercise.

Just bring in hospice so mom can get a hospital bed and other useful things to TRY to keep her safer. Hospice brought mom a bolster pillow type thing for her hospital bed that cupped her body a bit. It cut down on her falling out of bed a little. A new wheelchair that tipped backwards also stopped the falls from reaching 200. The toilet was another story. 9 out of 10x she would roll over to it in her wheelchair w/o help, climb on and fall off. Once she fell 3x in 4 hours.

Let go and let God direct this show for mom now. And get hospice on board If she qualifies. My company used "Senile Degeneration of the Brain" as the Medicare qualifier for mom's dementia to get services approved.

Best of luck

I just want to chime in on the "falls are going to happen" aspect.

To give context, but not hijack the thread, our elder has issues with dysautonomia, not connected to any disease. This means that when she lays down, her BP can go WAY up (scary), and when she stands up, her blood pressure can drop—sometimes precipitously, because she can faint. The latter has been the biggest issue; she's fainted and fallen four times now, across a number of years. In the process she's torn her rotator cuff, and broken her elbow. The other times, she couldn't get up off the floor and called us to help her.

Docs can't regulate her pressure. There's nothing wrong with her heart. Neurologists won't see her; even at Hopkins, they're so specialized they only see folks with dysautonomia adjacent to something else, which she doesn't have.

So, we've done all the things we can (and that she'll let us do; she's 83 and fully competent to make her own decisions) to help her stay as safe as possible. She insists on aging in place. She decided on her own not to drive, we have a chair lift to help her navigate the stairs, one of her sons lives in the house (but isn't there 24/7) and takes care of the house, does shopping, etc., there are bed rails to help her get in/out of bed, a commode that's bedside every night, and she finally agreed to wear an alert button.

All that to say that we, like others here, are doing what we can to help her live as long as she wants to, while having to make peace with the fact that something bigger than all of us is *clearly* in charge of this journey.

We know that she's likely to either die from a stroke, or from a brain bleed after falling and hitting her head. And, chances are she's going to be alone when it happens. That hurts my heart.

People, trying to be helpful, tell us we should "place her in care" where she can have someone always with her. Some of them have been medical professionals, with the most vocal of them being a visiting nurse who was freaked out by her BP. I'm often astonished that more medical folk don't come from a place based in reality, or who judge and react without understanding the fullness of the situation.

But, as others have said, someone can be with her every moment of the day and every step of the way, and she can still fall.

Short of confining her to bed to "keep her safe"—which, for her, would be a kind of death in and of itself—there's nothing we see that can be done.

So, for as long as we have her, we help her live the best life she can, we love on her as much as possible, we show up for anything she needs or wants, and we're letting go of trying to "fix" things, or push radical ideas to "protect her" or "keep her alive."

Sending you such big love as you navigate your journey.

I hate to say it but..
Falls WILL happen
There could be an aide standing next to her and she could fall.
This might even continue if she were confined to a wheelchair, she would try to get up and fall.
This may be the start of the slippery slope that will eventually end your mom's life.
The fall in January probably did more damage than thought. She may now be having mini strokes and if it is not a fall it will probably be a stroke
My Husband had Alzheimer's and I suspect Vascular dementia and I suspected that each fall he had was a mini stroke that would cause a steep decline. (literally overnight there would be a marked decline)
This all is your probable "worst case scenario" But do expect the falls to continue.
((sorry))

Sadly once a person is a fall risk they will continue to fall even if someone is with them 24/7.
Case and point...I was my late husbands 24/7 caregiver for the last 4 years of his life, which meant I was home with him all the time. He fell a lot. And usually I was somewhere near by.
There was a span in July and Aug. of 2018, that I had to call 911 nine times so the EMS folks could come get him off the floor and back into bed. And yes I was often in the same room as he was when he fell.
So unless you want someone to be glued to your moms side 24/7, you're just going to have to accept that falls are going to happen.
It's the sad truth.
It was almost a blessing when my husband became completely bedridden as I no longer had to worry about him falling anymore.

Hospital bed to floor at night and mats by bed.

Most Assisted living facilities we found out/ including rehab no longer use a clip that lets them know if someone is getting up. We were told the patient has the right to fall. Very sad because it allows the caregivers in these facilities to ignore the calls for help when patients need to use the bathroom.

The "worst case scenario" may be your best solution. There really aren't good ways to keep forgetful seniors safe from getting up and falling. Recently been there, done that with my 100-yr old Aunt (mod/adv dementia) who we had to watch all day with a family aid, an alarm connected to her when she was watching tv, and bed "barriers" (which she sometimes got around). Finally she got up in the night, wiggled past our barriers, fell and broke her hip. Surgery not an option at her age and state of dementia. We were about to transitiion her from rehab (which she wouldn't do) to a permanent LTC facility, but she passed peacefully in her sleep before this could happen. FYI, most states' Medicaid programs will only cover LTC. A doctor would assess your Mom's need for this level of facility care.

The admins of your Mom's facililty need to help you come up with some solutions, none of which will cover her 100% or perfectly. For instance, she can be seated in a wheelchair and a "tray" can slow down her ability to get up out of the chair. Her mattress can be put on the ground (many facilities do this); or there are concave mattresses that make getting up and out much more difficult. There are alarms, as I mentioned. The best is to hire an aid to be with her during the day. I wish you peace in your heart as you do the best you to protect her.

My heart goes out to you and your mom.

* Hire outside caregivers if you can afford it (to supplement nursing home care).
* Get her in Hospice if she isn't already for extra care. She doesn't need to be terminal to quality for Hospice (depends if MD will do).
* Bed restrains - in San Rafael, CA - 1/4 bed restrains are allowed. They may not be enough to keep a person from trying to get out / falling out of bed though.
* I got a body pillow and put near to the open part of the hospital bed-frame. It worked out very well. The N-Home MD was quite impressed saying "I never thought of that." It worked although by then, my friend/companion didn't move around much although the pillow WAS a barrier between the two ends / sides of the bed-frame. 'JUST' be sure that the staff know what the pillow is for . . . too often I would find the pillow against the wall ... on the other side of the bed.

* My friend likely tried to get up and out of bed forgetting that he couldn't stand-up / walk. I believe this is why he fell out of bed twice (before the pillow although he had the 1/4 rails/bed rails). It may not be 'movement' causing someone to fall out of bed. They may be trying to get up and out.

* Be sure to work with Ombudsman in your area should standards of care be inadequate. I did ... sending her photos and description of situation (no call button and no water available / in reach) ... 3-5 x / week ... only to find that the Licensing board of nursing homes could not use any of my information/witnessed situations due to being 'a third party.'

I find that the best way to get attention and care for a loved one is to create good relationships with management / staff / line staff, CNAs. Of course, it helps if the administrator is on the ball...

Gena / Touch Matters

Worst case scenario is mom needs to move into Skilled Nursing if She requires more care than this adult foster home is capable of providing. BUT, oftentimes a facility like this WILL allow the resident to stay until death IF hospice is coming in for extra care. That was the case with my dad. Find out before hand and don't get gobsmacked!