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My mother is in a NH with Parkinsons, dementia & stroke. She can`t stand alone and hasn`t walked in 9 months. She`s obsessed with the idea that if she can walk she can leave the NH, buy another house and have live in staff. The dementia is pretty much full blown. In the occasional lucid moment she knows she must call for assistance but she keeps trying to get out of bed or her wheelchair and on the floor she goes. The staff are wonderful, there`s an alarm on the bed and a seat belt on the wheelchair, but they can`t stand over her 24é7 and it`s just a matter of time before she seriously injures herself.
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In reading this forum, many family members don't know what to do about risk. They are afraid they will face anger and rejection. Professional caregivers have to tread a fine line between restraint and abuse. Both groups are confounded by a sneaky patient, who silently waits for the opportunity to get away with breaking the rules and getting what they want.
If you take away the car, you are accused of stealing it.
If you restrain patient to a bed or chair, families howl abuse.
But if they drive, the victims can sue you when others are injured.
If the patient falls, you are massively investigated.
I took away the car. She was mad. So what.
She says if she goes to a NH we won't get any money when she dies.
Guess What? She's going, the money be damned.
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What do you mean by risks? My mother-in-law is 93 years old, blind and lives in an ALF. She has fallen three times this week while simply walking with her walker. Fortunately, she has not hurt herself seriously any of these times, but a few weeks ago, she fell and broke a rib. Apparently, she is taking a risk each time she tries to walk, but what can be done to change that? There are various levels of risks, and some are unavoidable.
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If they have not been deemed incompetent and you do not have legal authority over them, you cannot prevent them from taking risks until they do something where they or someone else gets hurt. You can share your thoughts, give advice, try to communicate and work with their physicians behind the scenes and alert neightbors and authorities to watch out for them in your absence, but you cannot DISallow anything! I learned this caring for my parents. I found the local police being called for 'welfare checks' the best actions, as they will never say 'who' called them, and if it's unsafe in the home and they can see it, they will call adult protective services, consult with the caller or even remove from the home, depending on the situation they see. And, I am assuming by 'patients' you mean someone you are 'caring for' as a non professional in a community situation. As a retired RN....if it were a 'patient' I was responsible for in a working situation, then that's an entire different answer from me.
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?????
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You will have to be more descriptive in your question for me to answer this and I'm a nurse. Everyone takes risks everyday of your lives by the food you eat, drink, and environment in which you live. Be more specific please...
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I don't know where you're going with your question because you didn't supply any background information, but I'm going to forge ahead because this is kind of a hot button issue for me.
I often run into folks who seem to want their parent to be wrapped in cotton balls so they're 'safe'. To them, everything - from little mishaps to serious injuries - is the nursing staff's fault. They should have 'protected' their parent. I remember a geriatrician once telling me that "old people fall, that's what they do."
As ferris1 points out, we all take risks every day we get out of bed. And, when we're old and frail, those risks are many times greater. But, what's the alternative?? Life is to be lived. Living includes taking risks.
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Could you be more specific in your question?
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I have a different situation. My husband in is a state nursing where they prefer their patients to travel in wheelchairs thus eliminating any falls. Walking is what my husband does best. But because they keep him in that wheelchair he is becoming less and less able to walk. I take him to the doctor and he walks but if this wheelchair situation continues I won't even be able to do that because he wont be able to to walk.
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stumble they prefer wheelchairs because staff have 12 or more residents apiece to get dressed and to the dining room for meals. If their shift starts at 7 a.m. and breakfast is at 8.15 they have no time to guide "sort of" walkers to the dining room. It's done for speed.

Since breaking a hip last spring my mother can;'t walk and never will. At one point an aide would hang on to her while she shuffled along in her walker while another aide followed behind with the wheelchair but that hasn't happened for a long time. Staff are overwhelmed and do the best they can.

Unless you want to attend all the time and walk him it is what it is.
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