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It is becoming apparent that he needs full time care. If I moved him to a nursing home, would they be with him all the time to ensure that he would not get up? Is my only other option paying for someone to come be with him? Thanks for any suggestions...I know I have to do something!

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The only way to have someone with him 100% of the time is hiring someone. Even nursing homes do not have one on one care. It can be very expensive but worth it. Sorry you are going through this is so hard to make decisions like this one.
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The reality is that people still fall in nursing homes, and unless they fall where they are among other people they can still lay undiscovered until someone checks on them. If he is doing fine at home you could look for one of the call buttons that have fall detection built in and call automatically when a fall is detected.
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