My aunt started hospice. She fell 6 times in a month, hurting herself but no broken bones. The new bed has full rails, but she's refusing to use them. Suggestions?

Is the bed a "low bed"? A lot of hospital beds can be lowered almost clear to the floor. Most people are too weak to be able to stand up from one in that position. Also a fall mat by the bed and there are scoop mattresses that are raised on the sides making it difficult to get out. Also pad or magnetic alarms might be helpful and add peace of mind so you can sleep. Hospice can provide all of these

Hey thank you all for your advice but we figured it as ll out ....Auntie is doing better!! I keep the bed against wall with one rail halfway down...with wheelchair pushed up against the open space .Auntie is doing so much better!! And Auntie wears a xtra long pad during awake time and a depend at sleep time but actually We are extreamly lucky she uses the toilet or commode. 95% of the time My Aunt always makes it to toilet ect....although shes in the bathroom for about 1 hour every time!! she remembers that !! Thanks again for all ur help everybody

Excuse me but she needs to wear an adult diaper to keep her from getting out of bed and falling

Diagnosis is Apherscelosic Calcification Alzheimer's Among other troubles .Thank you for advice . I have solution for the bed rails I just leave them half way down and park walker & wheelchair up agaiol)nst open end of the bars...

Lorraine: How on earth are you able to focus with just 3 to 6 hours of sleep a night? Good grief~you'll crash and burn.

My aunt has a half rail, which helps her pull herself up and not restrict her going to bathroom.  It is not part of the bed, but is held up with tie-straps under the mattress and below the bed frame.

I feel like I’m missing something here. What is she on hospice for?
Side rails are a restraint and we no longer use them in nursing homes in my state because of this but mostly because of the deaths that have happened when one gets entrapped in them and doesn’t have the strength to get out of it themselves.
If it’s a choice between night time incontinence and falling I’d definitely choose the brief at night. If you’re the only main caregiver and not sleeping because of this it’s another reason that a brief would be fine at night in my opinion. The care and well being of all involved are a concern here.
A fall mat by the bed if she is unable to walk by herself. Placing the bed as low to the ground as possible too. But if she is sometimes able to make it to the toilet by herself then a bedside commode by the bed would be better.
Waking her up every 2-4 hours to have her assisted to toilet with you is yet another idea, then you could set an alarm and wake her before urgency to toilet and incontinence takes place.
It really depends on exactly why she is falling and looking at trialing many different things until you find something that works for her. Analyzing the cause of each fall and the exact time of the falls would be very helpful. Your hospice nurse should be trained to do this and come up with solutions to prevent injury with you. To help prevent incontinence us secondary to prevention of falls.

Yes I am careing for my mom as well.and yes I am the day time caregiver also so I try to get as least 3 to 6 hours sleep a night all the family has jobs or school so they will help alot if they are here on saturdays they take care of Auntie and let me sleep in.my mom is with it so she takes care of herself but I prepair and serve her meals I have to shower her. And do her Laundry & take her to dr appt.its like shes Assisted Liveing lolha but moms conjestive heart failure makes her weak and tired and she has scoliosis and osteoarthritis,but mostly its me as caregiver.Thank you all for your concern it feels so good to talk to caregivers in the same boat or worse and your advice is Great!! Your right her feet and legs look worse at the end of the day Im just afraid she will end up sepsis ..

Sadly, That’s exactly what would happen to her in a NH with the supposed full staff. The diapers. . . because no one would get there in time everytime with a call button. Only it wouldn’t be a “whoops I had an accident”, it would be more like a “might as well.” Lots of stress.
( Perhaps there are exceptions to this, that’s just my observation).
On the other hand if aunt wore the pull-ups and couldn’t quite make it, the clean up wouldn’t be so bad. Often when the patient stands, the pee starts, so the absorbent pad is helpful. I don’t know how my mom managed so well but she did.
Since your aunt is on hospice and has fallen so often, I would probably try to manage her fluids a bit if possible. If she has a condition that requires her to be bedbound, you might be able to chart her meals, time of voiding etc, keep her on a schedule and be proactive on getting her to the pot. If she is up during the day, keeping her feet up is helpful as all that fluid that drains to her feet gets emptied sooner.
Are you still taking care of your mom as well as your aunt?
Regardless of what aunt wants, when you know you can’t stay up, I would put the rails up. You can’t burn both ends against the middle indefinitely without paying the price.

You don't put a diaper on a person who is not incontinent just because she can't get out of bed unaided. You help her transfer to a bed pan, bedside commode or the bathroom, whichever is most practical.

If she can’t get up out of the bed and make it to her potty without falling then an adult diaper would be necessary...or a bed pan...

Get your aunt an alarm so that she can call you (or another caregiver) when she needs to get up. If hospice provided the bed they should be able to supply a suitable call button, too.

If you are doing the night shift you must sleep during the day; but then do do the night shift, and do get a full measure of sleep. In the end this boils down to staffing hours - how much support are you getting, apart from family members?

Can you take a good look at where she will be getting up for the commode? Perhaps remove furniture with sharp corners and put there a bean bag that would be easy to all onto? Or make sure that there are grab rails to help her stand up? Good Luck!

HI 97yroldmom; THANK YOU ! for your advice and quick answer ...

My mom used a hospital bed the last two years of her life. She kept her rails up on one side and down on the other. She had CHF so slept with the head elevated. She used the lowered rail to assist getting up and down to use her bedside commode during the night. (Lasix so up 3 or 4 times a night). She only fell once. Didn’t hurt herself.
I can understand your concern since she has fallen so often. I’m really not sure what you should do but I suppose if you want her to wake you when she needs to get up I’d probably go with the half rail while you are there and rails up if you have to leave the room.