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Mom has both hips fractured now as a result of her getting up from bed after the first hip surgery and not calling for help from the assisted living staff. Even with both hips fractured, she continues to try and get up from bed on her own. We have a 24/7 private CNA and a bed alarm. Due to financial reasons we cannot continue to keep the private CNA 24/7 and are looking to continue only at nighttime. Any suggestions on how we can keep Mom in bed?

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Perhaps her doctor will prescribe a sleeping pill so that she doesn't wake up during the night. The night CNA might have to wake her to take her to the bathroom if there is a chance of incontinance. During the day, the staff needs to check on her often to see if she needs anything. She may need to go to a NH where there is more staff present.Alarms can only help so much. The staff really need to be more attentive. I wish you the best. During the day she needs to be in a comfortable chair in a common area where it's easier for staff to see her if she tries to get up.
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A sleeping pill might do the trick at night. However, we had this problem, too, and it wasn't really any need to go to the bathroom. Or, for any reason at all. Just an impulse to get out of bed constantly. I don't think that going to a place where there's more staff will necessarily prevent a fall. Unless someone is sitting bedside 24/7 (and who wants to live like that!), it will happen the minute someone leaves the room and even with someone sitting right by the bed. Our father would ask the aide to pour him a drink and then try to get up while she was across the room. I hate to say this, but it's like someone quoted their mom's doctor as saying..."They fall. It's what they do."
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There are sensors (pressure, motion etc) that can sound alarms - if you have someone there to rush in.

You can also get concave beds which are incredibly difficult to get out of. This might help in terms of keeping her in the bed. Some beds also have sides that can be erected to confine the person - like a cot. These can cause more problems than they solve though as many people will just try to climb over (or through!) them and the results are often worse. I'd definitely see if a concave bed might be of help.

The ideal thing is for her to understand what is obvious to you, which is that she should not get out of bed her self. Unfortunately, you are unlikely to succeed in this argument. Reason doesn't always count I'm afraid. At the end of the day, you can (and should) try your best but there will always be a risk that cannot be mitigated.
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I had another thought...depending upon the AL facility and their rules (and licensing issues in your location) you may be able to hire someone privately to sit with your mom at a greatly reduced cost. This job doesn't really require the skills of a CNA, just an able-bodied, reliable adult. However, like I said, being guarded and confined every minute isn't much of a life. And, those concave mattresses are considered a restraint by some state regs. Likewise with bedrails (plus they're dangerous as 'stayingme' points out). Personally, I'd hate to be trapped in a bed if my strongest impulse was to get up. At some point, you have to accept a certain amount of risk.
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motion sensors are the only thing I can think of! This is a problem lots of folks have. The last time my Grandmother was in the hospital I stayed with her at night to avoid this. The one night I did not stay, because she said "Lassie you need to go home and sleep in your own bed", she fell.... Thank the Lord she did not break anything. We brought her home the next day and she stayed with us until she went to heaven. Encourage staff to check frequently but I would for sure think about motion sensors. take care...
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It may be that she is not suitable for an AL. I wouldn't be surprised if the AL contacts you regarding her needed a higher level of care - which means moving her to a NH - and that they have been overlooking this because of the CNA. Without the CNA she is a liability for the AL and a danger to herself. You might want to be proactive on this and contact the social worker at the AL regarding options and where she could get placed and how to pay for it and get the paperwork together if she needs to apply for Medicaid for the NH.

Some places do not allow concave beds unless they are truly ambulatory and capable of getting up & out of them or the bed is by MD prescription. I imagine this too is a liability situation.

None of this is easy or quick & starting this now will be so much stressful than having to do something with the dreaded "30 Day Notice" over you. Good luck.
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maybe she needs a pat.its doesnt have to be alive one.they have very life like ones now days,or a live one what ever works,
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my mnl when she was in hospital would slide between the bed rails constantly for no apparent reason n scare crap out of me. So, I stuffed fluffy pillows between the bedrailes to prevent her from slinding out. Can u put an alarm mat by the bed?
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Don't know the reason for the falls but many people get lightheaded when rising and crash. Sometimes it is only a matter of allowing them to "get their bearings" before venturing away from the bed (SuperPole or Friendly Bed would help that). I assume that she could use a four wheeled walker for more stability. Also a bedside commode would reduce travel to the bathroom if you had it next to the "balance pole".
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