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He is in assisted living. He is getting out of the hospital today after a week, with a broken arm. The assisted living facility advised us to get a private sitter to stay with him from 7pm-7am to help him to the restroom if he has to go. It's $25/hr, so $300/day for the foreseeable future! Just because he will not call for help or use the urinal! He doesn't seem to understand or to care about how much it costs! What should I do??

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Well, my mother is 93 and lives in a Memory Care Assisted Living place for the past year, and in the regular Assisted Living annex for four years prior. She's fallen 46+ times so far, and I've lost count now, truthfully. I've tried everything, including a bed alarm and a chair alarm. By the time the CNA gets to her room after hearing the alarm go off, she's already on the floor. If and when I send her to a Skilled Nursing Facility, the same events will happen THERE as happen in the ALF.

What's the moral of the story? You can't prevent a person from falling no matter WHERE they are. At home, at an ALF, at a SNF, at rehab. Nowhere. You also can't prevent a person from exercising a stubborn behavioral trait. Trust me, I've tried everything on God's green earth for that too. To no avail. Trying to get a stubborn elder to pull a cord or push a button to ask for help is akin to asking them to climb Mt. Everest, for some odd reason unbeknownst to me.

When dad was alive, he'd fall out of the bed and crawl to the bathroom rather than pull the cord to ask for help.

It is what it is. I wish I had some brilliant, fool-proof answer for you but hey, if I did, I'd have used it myself rather than suffer through all of The Phone Calls for All of The Falls. Last month, I got two calls in one day! And she's NEVER been to the hospital for a fall YET. Honestly. She's had broken ribs and sternum bones as a result of some of the falls, but no trips to the hospital b/c she's also a wonderful actress and capable of hiding the truth. Which means she's fallen a lot MORE times than we're aware of and has managed to get herself up w/o help. Ergo broken ribs & sternum bones which were revealed during one of her many hospital stays unrelated to falls (via CT scan). The doctor was kinda scratching her head saying, hmmm, your mother has all sorts of broken bones in various stages of healing, I wonder why? Yeah, me too doc.

Wishing you the best of luck with a very, very, very difficult situation. Is marijuana legal in your state? :)
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Houghd62 Jun 2020
Thank you for writing this. I am early in this scenario but my dad is 93 and I’m going thru the same thing, Take him to doctors and get surprises because he hides things. He is currently in skilled nursing/rehab for shingles on face which have possibly caused damage to his eyes. When we told him we needed yo take him to ER he stated he would wait to go to eye doctor on Monday and he could crawl to the bathroom and bed until then. He is beyond stubborn.

Thank you, I now know I’m not the only one dealing with stubbornness.

Debbie
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Thanks everyone for your comments. I think a nursing home or moving him into the memory care unit will be the best answer for us. It sucks to see your loved ones in such a decline.
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Harpcat Jun 2020
Yes, because you will be paying more with AL and a caregiver than the fees for a NH room.
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This may be cruel but most likely it will ring true. If he is so stubborn or mentally deficient, nothing is going to make sense to him and he is not going to do what he should do. So he falls and something happens, then he will be put into a facility that will be able to deal with him. The cost of caretakers will bankrupt you. Let him end up in a nursing home or whatever - remember, what you sow is what you reap. I don't have much compassion for stubborn people who do not cooperate.
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Davenport Jun 2020
Thank you for being brave and honest, Lockett. Yeah, my mom is also stubborn and selfish and lacking compassion for her 3 daughters (me), who worry and work almost full-time to figure out how to enable her; I also fear coming across as 'cold, cruel, insensitive', etc., etc. I learned PAINFULLY, the reality of it was that the logistical, practical, physical aspects just plain overpowered ALL emotional and sentimental stuff, until finally, I realized that I was the final, last, human between my mom and me--and it was on me alone to accept, accept, accept--and be the 'bad guy'. But really, my concern was that of other, outsiders, thinking me the bad guy. I had to do the work that I wasn't the bad guy, and others' opinions musn't affect the rest of my life and my self understanding. This shit is HARD!
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Same thing happened with my dad. The assisted living staff would not respond to a bed alarm that I suggested, so I ended up moving him, but not to a nursing home. I moved him to a residential care facility AKA Board and Care. They can meet more 1:1 needs than an assisted living. There, he uses a bed alarm, and the staff come right away in the night.
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Concerned43 Jun 2020
Thank you for your post about a residential care facility.Not familiar with that particular one so I will do some research.My dad has been in a SNF three times and an ALF once after a stroke,falls,etc.
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Carabobara72, breaking an arm is extremely painful, and there is still pain no matter what pain meds one is given. Plus you can feel helpless, and in a fog from the meds.

I was in my 60's when I broke my arm. Oh my gosh, the pain was terrible and here I always had a high pain tolerance. Sleeping at night was difficult, I had to prop pillows around me so I wouldn't roll over. Going to the bathroom was difficult because it was my primary arm that I broke, so doing things with my other arm felt awkward. Thus I can fully understand why your Dad doesn't use the urinal, he probably can't.

For men, it can be difficult for them to "call for help", for some it makes them feel weak. They rather chance a trip to the bathroom on their own.

Now, with that broken arm, it will take longer for the arm to heal as we get older. Chances are your Dad will need rehab to help get back the use of his arm, as the muscles will freeze in place. My rehab was 3 times a week for a couple of months. It was painful but I knew it wouldn't be forever.
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I got a bed alarm for my mom. Every time she got out of bed it rang and the psw could get to her and assist her. It lies under the sheets ( or bed pad)
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Clearly he needs a higher level of care. Either he goes into skilled nursing or memory care (if applicable), or you pay for the night sitter.
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I have the same problem with my 84yrold father.The last night time trip to the bathroom resulted in a fall ,and a trip to the hospital .He hit his head when he fell requiring two staples.

Even after the initial fall he would still get up.As of now he has stayed put at night and wears nighttime depends with extra bedliners to protect the bedding.

Hopefully,This will become the norm.
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My mom broke her shoulder among other injuries when she had a severe fall. She too has to get up to go to the bathroom at least two times each night. She has a tension pole next to her bed and a bedside commode near her bed. She can get out of bed with the help of the pole and keep her hand on the pole to take a few steps to reach to sit on the commode. Then the same to get back in bed. Nobody needs to help her now. It took a couple weeks of a private caregiver to make sure she had enough balance and control to be independent in this manner though. That was an expensive two weeks especially since most of the night the caregiver is just sitting there watching Mom sleep. Hope this helps.
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MEN... They sometimes have too much pride for their own good...

So, it boils down to that, I believe. He has too much pride...Why should I call for help? I know how to get to the restroom. I have done this since as far as I can remember. Maybe 3 or 4? So, why can I not go by myself now? I am an adult, you know. Ok, so my balance is a bit off, but I'm ok.. I can just get back up..hopefully...

But, wait, what happens if I cannot get back up? No, I will not think about that. That never happens.
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bolliveb Jun 2020
Right. "I'm careful".
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