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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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Sedatives. It will be better than the alternative of breaking her hip....
Sorry this is a difficult phase.
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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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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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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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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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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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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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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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