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My mother is 91 and lives with my sister and her family. She needs asistance to get around and dozes most of the day, however, once they puther to bed. she doesn't go to sleep and gets out of her bed during the night falling on the floor. We've been lucky with only bruises but she broke her wrist a few months ago and we are worried about a more severe injury in the future. We've tried a child's bed rail and she got all caught in it trying to get out of the bed. She's even getting nasty about bed time. Any suggestions would be greatly appreciated. We've also tried to keep her up during the day as she sits in her chair. She had dementia also.

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Thank you all for your input! I really appreciate it! I will discuss the options with my family and see what would work best with our Mom.
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We just bought a bed alarm for o client of mine. The alarm is wireless so you keep the station by you where ever you are in the house. If she tries to get up the box pings. It also came with pad for her chair so the box will sound when she tries to got out of wheel chair also. Garden is correct about the fall mats, they are widely used and can easily be purchased online again they are called fall mats. You could speak to doc about meds, she sounds like she may have sundowners which creates more anxiety in dementia patients in late afternoon early evening. Lower the bed is also a good option. You could do as others suggested and lower jer bed or get a hospital bed but make sure it is one that is automatic and not the older crank type as the crank ones dont go down very far. The electric ones go way down so she would be safer. Medicare will pay for hospital beds under certain conditions, if her doc orders it. These are a few options hope they help. But know even with all the best safeguards as Ashlynn stated older folks fall a lot. Do your best but once you have dont beat yourself up if she falls again, nothing less than a plastic bubble to keep them in would prevent all falls.
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Remove the bed frame and put the box spring and mattress on the floor. In Nursing homes, they can lower the adjustable bed within inches of the floor. That prevents falls because the patient cannot get UP on their feet. The worst they can do is roll onto the foam mat.
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I recall reading on other posts that nursing homes put mattresses on the floor next to the bed to cushion any falls.

I imagine she wakes up during the night because she sleeps so much during the day, but as you're trying to keep her awake, I'm not sure there's much else that can be done other than planning activities to keep her awake inbetween naps.

The other issue is whether any of the meds she takes in the morning make her more drowsy and if the evening meds make her more alert. And if she's awake at night, she's more tired during the day. So the process has to be reversed, but it sounds as though it's not that easy since she's become "nasty" about bedtime.
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Even in a nursing home, with care 24/7, there are falls. My late mother had parkinsons, dementia and had had numerous strokes. Her room was by the nursing station, her door kept open and there was an alarm on her bed. By the time the alarm sounded and staff came running she was on the floor ... again. I don't know what the answer is.
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