What’s a better way for a nursing home to handle patient’s fall risk than sleeping in chair in front of the nurses station, not in bed?

Well..well... someone else has FINALLY stated the truth. Sooner or later, your person with dementia is going to fall and it is NOT going to be someone elses fault. I have been in home health care for 20 + years and for so many years just so responsible for making sure they did NOT fall. Used gait belts...encouraged them but this is where I drew the line. Had a patient... female in 60's....overweight... pretty big around the middle... big buttocks. She had care 24/7. She used a walker, had to assist her to a standing position, walked behind her to the bathroom. She refused to wear gait belt. The bathroom? Tiny door, just able to get the walker through the door. This was the tiniest bathroom I had ever seen. Walker went through door, then her and me barely fit into the room. She would turn and insist on pulling her own pants down and we were to keep her standing. Problem with this? Nothing to hold onto to keep her standing. Of course, while pulling her pants down, she would take her hands off walker for support AND while doing this her whole body would move...I call it "wobbling". If she fell, she would fall on either the toilet, the little cart in front of her that was in there holding her items...or... she would end up falling on us. Again, she would always refuse to wear gait belt. I quit this job after two 12 hour shifts. And that was also when I realized.....and stopped feeling guilty because I realized we cannot control everything with our clients. She refused gait belt which then meant that if and when she fell, her fall was NOT our fault. SHE made that choice and all we could do in that situation was just do the best we can. And no more. I quit mainly because I did NOT want her to fall on me! Who is going to pay my medical bills? And other bills? Who is going to take care of me if she hurts me? She should have been in a facility and NOT at home. Remember, dementia clients are NOT thinking about you. When people get to a certain state in their dementia, they need to be in a facility. Staying at home... they won't take baths, change clothes... won't wash their hands, brush teeth...etc... and one person taking care of them at this point is just too much. They sometimes get angry even when you try to clean them up after soiling themselves. They won't even let you check their undies for soiling. Yes... at some point.... they need to be admitted to a facility not only for their sake but for the sake of everyone else.

My husband fell from bed many times in the nursing home. The low bed and a mattress on the floor prevented injuries after the first couple of falls. It took 4 staff members to lift him back into bed each time, so often they let him stay on the floor for hours, which was actually okay with him.

We took him home, bought a very low electric bed, and pay for 24 hour care. Someone sits at the bedside or watches him with a baby monitor if they need to leave the room; they sleep on a mattress on the floor next to bed. He rarely tries to get up since he's been home, but if he does the caregiver offers to help him sit on the edge of the bed or transfer to the wheelchair.

Fortunately, after a year he qualified for Medicaid and their In Home Supportive Services program, so they now pay for some of his caregiver hours. After another year, he also is about to receive more paid hours through the Home and Community Based Alternatives waiver program ("Waiver Personal Care Services"). If your MIL would qualify for these services, you might consider 24 hour care at home.

This is a common problem in long-term care communities. I would ask the home to lower the bed and put a mat on the floor next to the bed. This way if she does roll out of bed she is close to the floor and lands on a mat next to the bed avoiding an injury.

Families should NOT have to pay for a private duty caregiver for their loved one in a nursing home. If a family is going to do that they might as well keep them at home. The nursing home has options when a resident is a fall risk, making a resident sit at the nurses station 24/7 is NOT one of them!