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Mom fell several months ago and broke her hip. Since the fall she has gotten full blown dementia. We have put her in assisted living and she is also on Hospice. We have added a bed alarm to her bed, but somehow she still falls out of the bed with rails and falls out of her lift chair that is sitting flat. I get a minimum 1 call a night and some during the day hours to alert me she has fallen. So far she hasn't gotten hurt, but every time the phone rings I'm afraid that it's going to be the call that she has. We've asked/told her not to get up without paging for assistance, but she never does. Last night the nurse had just gone in to check on her and was getting her medicine. Ten minutes later she walked back into mom's room with her medicine and found mom on the floor.Mom tells us she needs to clean or take care of the children that she thinks is in the room or bed with her. She has the alert necklace and bed alarm. My next step is to get a baby monitor that will stay with the nurse that is assigned to her. I'm trying to get that approved now. The doctors are tweaking meds, etc. I'm at wits end and don't know what else to do. Any suggestions out there?

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My Mom's AL would allow no kind of restraint. I had a small "rail" (if you want to call it) to help her pull herself up in bed. Yes, it helped to keep her from falling out but when the AL found out it was there, I had to take it out. No alarms on chairs. I was going to suggest a lower boxspring. Mom's was only five inches high. She liked the mattress she had that was only about 6 or 7 inches high (unlike the new ones that are 10 to 12) So this made a shorter distance to fall. Have they thought about a sleeping pill? I think getting the lower bed and mats on the floor is as good as you are going to do. Even in longterm nursing here in NJ, they are not allowed to put sides up on beds. Mom has a concave mattress and mats on the floor.
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Hi, baby monitor, is great along with tha bed alarm pad and chair. It has help us a whole lot these past weeks. Hope it helps.
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We had the same issue with my mom in AL with 24/7 aides. In the end, it was clear that she needed NH care at that point. She hasn't fallen since she was admitted there.
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Huge sympathy. I pray for someone to invent an alarm that will tell me that my mother is about to get up, rather than that she has just done so. The temptation to strap her down…

Does it help to know why she's doing it? Not sure it does help, really, unless it points to some way of preventing it. It could be she's not comfortable in her lying/ sitting position, and her brain creates some reason why she needs to get up - that's the only thing I can think of that might be worth having a look at, since everything else seems to be covered.

In the end, if it happens, it happens. Once you've done all you can you're left with accepting whatever risk still remains. Sorry, I know how nerve-racking it is.
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Best wishes to all- it is a very difficult time to all family members. Nursing homes are needed but I wouldn't wish them on anyone. My father spent almost 3 years there (he was almost 96) before he passed (dementia/alz). He kept insisting he could walk (just help me stand) but he hadn't stood in close to 3 years.
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As you mention full blown dementia I wonder is she falling out of bed and chair or getting out? My mother, who hasn't walked in 9 months and never will, is obsessed with the idea that if she can walk she can buy another house, new furniture and have live in servants so she keeps climbing out of bed and her wheelchair and of course ends up on the floor. Weak and very frail it's amazing how much strength determination gives them.
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I sympathize with your situation. I went through this with my Dad. The nursing facility tucked a bolster next to him on the bed which made it difficult for him to get up or accidentally roll out of bed. The bed was lowered, the mat was placed on the floor too. While in a chair, he had the alarm that was inconspicuously clipped to his shirt that would only give him about a foot of forward motion before it set off. Since he had a hip replacement too, he wasn't able to lean forward very far. Since restraint is not allowed, the nurses attached a table on his chair to play cards, hold his beverage etc. It also prevented him from trying to stand up. He suffered with sun-downers so the nurses and aids kept him close around that time of day.
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The NH calls me for every little thing. After a lifetime of stress I had a mini stroke. Now I take the phone off the hook around 5 p.m. Great staff at the NH 24/7 and a hospital 4km away. I live on a dirt road, pitch black, currently surrounded by snow and ice and I have physical issues, whatever can wait until tomorrow.
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Thanks for all the great tips! Hospice got my mom a lower bed and a pad for the floor. So far, so good! I'm almost afraid to say it, but I haven't been called in a week!
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I use a baby monitor with my Grandfather. I carry my end everywhere I go thru the house. We also use bed and chair alarms. I guess my Grandpa is not the only "sneaky ninja" out there. ;) Good luck.
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My mother's nh has her on a sort of inflatable mattress pad for bedsore prevention that inhibits her ability to get out of bed.
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My mother has had dementia for years and it's now pretty much full blown.In a NH, she broke a hip 9 months ago, had a stroke 3 months ago and can no longer sit up or stand alone. When she's lucid, which isn't very often now, she understands she must ring for assistance but still tries to go it alone and ends up on the floor. She has a bed alarm but of course by the time staff get there she's on the floor again. In the last while she's got out of bed, fallen and been taken to hospital for stitches to a finger and in the past week she's been out of her wheelchair twice, though no harm done. Due to the dementia there's no reasoning with her and it's only a matter of time before she seriously injures herself.
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find the source of her agitation. its usually caused by loss of control. staff and everyone involved might try making her think she rules the world by asking her input and advice on completely irrevelant matters and of course her own needs. she needs to feel in control, imo..
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I really sympathise. What needs to be invented is an alarm that will call you BEFORE the person gets up, not after! Anyone who comes up with that wins a Nobel Prize, it's a shoo-in.

I'm told, but haven't got one, that as part of the bed/chair pressure pad alarm system you can get an automated reminder. So, for example, if your mother starts to lift herself up in the chair, the alarm cuts in and a recorded message says "[her name] - call for help, wait 'til they come."
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Thanks for all the great tips! Hospice has ordered a new lower bed for my mom. The bed also is made in a way that mom will have a hard time getting out of it. They have also gotten her the mats to help in the event she does fall. I haven't heard of the hip protector, but I certainly will ask.
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Treat the osteoporosis for one thing! Place mats around where she is likely to fall, remove things with sharp edges or pad them (e.g. furniture corners) and if she would wear a hip protector it *might* help, I think the evidence for that is +/-. Have her out at the front desk directly observed until she is more drowsy and ready to fall asleep. Most people with significant dementia or sundowners don't - and can't be expected to- remember they are not supposed to get up without help. Yeah, it sucks..
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I will check into the chair alarm. Hospice has recommended the baby monitor. I'm waiting for approval from the assisted living facility. Hospice is tweaking her meds as well. She currently takes seroquel nightly and Xanax if needed. Her medicines have been changed several times since her fall. She is highly sensitive to medications. Some of the medications tried have really agitated her. The Hospice physician wants to take it slow on the medication changes. At times my mom is very normal. I'm afraid that if she has a doll when she is normal it would really upset her. When she is normal she talks about the other patients and some of things that they are doing. Also, I know this is selfish, but I don't know if I could handle seeing my mom with the baby doll and I know that it would be very upsetting to my brother as well. My dad died when I was very young. My mom has been my mom and dad for the past 45 years. It is extremely hard to see my mom like this and it's also extremely hard to let go.
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Chair alarms are louder you can attach them to the wall and a chair if it gets set off by them sitting up or leaning forward it may alert someone faster. Getting her a baby doll to care for may help with some of the need to get up and care for the children.
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I would definitely look at the meds with the doctors. My mom had a fall and break last year. She was put on pain meds, which caused almost constant confusion. After all pain meds were out of her system, she slowly got back to her old self, just alittle slower. Did they change her meds in anyway after your mom's fall? Sounds like she is forgetting she is older now and has limitations and continues to get up to function like she did earlier in life (getting up to take care of the kids). She probably isn't refusing to follow instructions of not getting up, just forgetting those instructions. I hope looking at her meds will help, if not adding med to sedate some may help as stated on a previous comment. I'm sure the facility has had to deal with this many times. So glad they are willing to work with you. Praying for you and your family.
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Sedatives. It will be better than the alternative of breaking her hip....
Sorry this is a difficult phase.
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