Do people with dementia always appear to be falling out of their chairs?

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My grandma has a lot of things going on with her. She has severe dementia, congestive heart failure and pneumonia. Recently, she has started this sitting up in her chair on the very edge, then if you watch her, she appears to be falling asleep sitting up but she really isn't. She just sits there and keeps doing falling reflex over and over again jerking to sit up. She will sit and then just start to fall forward and quickly jerk herself to sit up. I know at night time, (she sleeps in a recliner since she is afraid of beds after being in rehab a few years ago), she slides out practically out of her chair to the point of where her feet are flat on the floor and shes' flat on her back. Is this normal? Is there a reason it's happening? Do I encourage her to sit back and relax? I'm just worried it's another sign of her getting closer and closer to dying or becoming sicker and I'm missing it.

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Your grandma is weakening. My spouse has developed difficulty in holding himself up. An evaluation concluded since he spends more time in a bed or chair and less time up and moving around, the core muscles of the trunk weaken. They loose muscle mass that previously gave him strength to keep upright. Many others at the snf have difficulty staying upright in their chairs. Some are quite alert, some are not.
Facilities don't provide modern wheelchairs and other devices to everyone who can benefit from chairs with seatbelts or baby high-chair/table-type restraints.

Restraint methods are a violation of various laws and policies and the jerry chairs kind of get around this sticky issue. In the past various restraints became a de facto method of behavior control that, when left unsupervised, may be hazardous to some. The snf where my spouse is uses "jerry chairs" that are like a recliner on wheels for patients who tend to slide off their chairs. These persons are too weak to pull themselves out of the chair, so restraints are not necessary to keep them safe. Is your grandma able to use this type of chair?
A doctor at the hospital and a therapist at the snf agree my spouse needs to be upright more often to keep his strength. Otherwise the core muscles of the trunk continue to weaken until he just would not be able to sit upright.
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My dad has dementia but he doesn't have such issues. However, my mom started having trouble with leaning to one side when sitting in a chair, to the point where she would almost fall over. She could walk, but became less steady and needed increasing amounts of assistance, and began spending most of her time sitting in a recliner with high arms. She would sometimes slide down and would need help scooting back in the chair, and sometimes her head would hang forward and she couldn't raise it. As time progressed she then couldn't walk and could stand only with assistance (a hoyer-type lift) to get onto to a commode. During this decline we took her to a number of doctors and many tests were done, which in part indicated that she'd had some small strokes. Also two separate neurologists said that she has a degenerative neurological disorder similar to Parkinson's. Eventually she couldn't even stand with assistance and became bed-bound, and she is currently on hospice. Perhaps some doctor(s) could find a reason for what is happening to your grandma?
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I'm so sorry to hear what his happening with your grandma. My dad also had heart failure. He always like to lean his legs to the side over the bed while sleeping and I never understood this. He too also passed away within months. I know its hard to see her elders getting weaker and weaker. I hope hospice can help you.
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My mom didn't sit on the edge and fall forward - she was always all the way back in her recliner with her legs elevated to help keep the swelling in her ankles and calves from occurring. But - mom did start to sleep in her recliner leaning to one side - I've no idea why that started. The staff at the nursing home and everyone else who visited my mom would make sure she had a pillow tuck in next to that side to help prevent the leaning from occurring. It certainly didn't look very comfortable but my mom seemed unaware she was even doing it. Whether it's a coincidence or not, I just don't know but this leaning did start about six weeks before she passed away.
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I don't know if this is a dementia issue or not. She probably wants to sit up as straight as possible because it is easier to breath. Does she have oxygen?
My best guess is that she is actually falling asleep and for now is able to jerk awake before she falls. Make sure she has something soft to fall on, she does not need something broken to add to her problems.
I don't know why she slips out of the recliner. Does it have a slippery surface? Can you put a blanket under her that will provide some traction.
also placing a pillow under her knees may help too.
Have you considered having hospice come in as they can help with these problems. it sounds as though her condition would make her appropriate for admission.
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