What does your Memory Care do to avoid falls at night?

The first place I would start is to see if there is something causing the falls.

With my family member, we got a call from MC almost every day/night about LO falling.

I was determined to find the "cause". It was actually the medications. After some adjusting meds ..... the falls ceased.

You will never be able to stop the falls. My mom was bi-polar and stubborn as a mule. She knew what she wanted and did what she pleased. I lived about 8 miles from her and it got to the point that I was having to go down to her house just to pick her up from the floor or yard, night and day for about 3 years. She insisted on a garden and would fall over in it. Her doctor told her she had to have help but when the home care nurses came, she pulled a gun on them and refused to open the locked gate. She kept threatening to kill herself and really got bad after we searched the house and removed all weapons. She even told her dr. she was going to kill herself. The dr. told her on her last visit that either she stopped saying that and start using her cane or walker or she would be sent to a hospital for evaluation and at her age and health problems, she would probably end up in a memory care unit. On Dec 23, 2016, I was coming home from doing my Christmas meal shopping and had meats in the car needing a fridge. I was stopped at a red light when the call came. She had fell again and needed me right then to take her to the hospital. I asked if she was bleeding or had broken anything that she knew of or if she needed an ambulance because I had a trunk loaded with groceries that had to go to the house first unless she was in an emergency state. She got angry at me but informed me she had cleaned up and changed clothes since the fall and that a neighbor had picked her up out of the yard and she might have broke her shoulder again. She was so angry and told me to just forget it she would walk to the dr. (She was good at pulling the guilt trip on us). She hung up and I called an ambulance to pick her up and went to my house and literally threw the bags across the kitchen so I could see what was needing the fridge. I was at her house before the ambulance got her prepped for transfer and she was raising cane. I followed the ambulance the 22 miles to the hospital er. She had broken her right wrist again and her right shoulder was thrown out of socket. She cursed the dr when he pulled it back into place and put a brace on her wrist. She decided to get up and go home and pulled the shoulder back out. The dr. ended up having to put it back in 2 more times then wrapped her in a folded sheet so she couldn't get it off again. By then it had been about 4 hours and I was exhausted, hubby had came home and called looking for his dinner and my niece who had POA was able to come over. Moms dr. came from her office and talked to us because the er dr wanted to send her home. Bless my moms dr. she told them no way could she go home. She admitted her until after Christmas when she was transferred to a NH for rehab. She was doing really good but still falling. And she got a UTI that set her back. Dementia and alzheimers set in and she ended up in a MC at the same place for the last year of her life. She fought them over everything. She fell regularly. They put a fall mat in and lowered her bed and it didn't help. At one point, she managed to get the window to the courtyard open and crawled over a 6' fence! It took 4 adults to get her back inside. I was there at least once a week. I had to quit taking her to her dr appts because she was threatening to open the door of the car and jump out and yes, she would have. She refused to have anything to do with anyone and even had to be placed in a room by herself. She stabbed one person with a fork because they reached toward her plate. They started letting her eat in her room but, she would try to take the tray to the nurses station and of course she would fall. Her last fall was in June or July, 2018. She fell backwards and hit her head on the bed railings. She was never the same after that. She could blink her eyes for yes or no but that was it. She had to be fed and tended to like an infant and I know she hated it. The evening before she passed, I got to tell her we were leaving and that I loved her.

You will never be able to stop the falls. My mom was bi-polar and stubborn as a mule. She knew what she wanted and did what she pleased. I lived about 8 miles from her and it got to the point that I was having to go down to her house just to pick her up from the floor or yard, night and day for about 3 years. She insisted on a garden and would fall over in it. Her doctor told her she had to have help but when the home care nurses came, she pulled a gun on them and refused to open the locked gate. She kept threatening to kill herself and really got bad after we searched the house and removed all weapons. She even told her dr. she was going to kill herself. The dr. told her on her last visit that either she stopped saying that and start using her cane or walker or she would be sent to a hospital for evaluation and at her age and health problems, she would probably end up in a memory care unit. On Dec 23, 2016, I was coming home from doing my Christmas meal shopping and had meats in the car needing a fridge. I was stopped at a red light when the call came. She had fell again and needed me right then to take her to the hospital. I asked if she was bleeding or had broken anything that she knew of or if she needed an ambulance because I had a trunk loaded with egroceries that had to go to the house first unless she was in an emergency state. She got angry at me but informed me she had cleaned up and changed clothes since the fall and that a neighbor had picked her up out of the yard and she might have broke her shoulder again. She was so angry and told me to just forget it she would walk to the dr. (She was good at pulling the guilt trip on us). She hung up and I called an ambulance to pick her up and went to my house and literally threw the bags across the kitchen so I could see what was needing the fridge. I was at her house before the ambulance got her prepped for transfer and she was raising cane. I followed the ambulance the 22 miles to the hospital er. She had broken her right wrist again and her right shoulder was thrown out of socket. She cursed the dr when he pulled it back into place and put a brace on her wrist. She decided to get up and go home and pulled the shoulder back out. The dr. ended up having to put it back in 2 more times then wrapped her in a folded sheet so she couldn't get it off again. By then it had been about 4 hours and I was exhausted, hubby had came home and called looking for his dinner and my niece who had POA was able to come over. Moms dr. came from her office and talked to us because the er dr wanted to send her home. Bless my moms dr. she told them no way could she go home. She admitted her until after Christmas when she was transferred to a NH for rehab. She was doing really good but still falling. And she got a UTI that set her back. Dementia and alzheimers set in and she ended up in a MC at the same place for the last year of her life. She fought them over everything. She fell regularly. The put a fall mat in and lowered her bed and it didn't help. At one point, she managed to get the window to the courtyard open and crawled over a 6' fence! It took 4 adults to get her back inside. I was there at least once a week. I had to quit taking her to her dr appts because she was threatening to open the door of the car and jump out and yes, she would have. She refused to have anything to do with anyone and even had to be placed in a room by herself. She stabbed one person with a fork because they reached toward her plate. The started letting her eat in her room but, she would try to take the tray to the nurses station and of course she would fall. Her last fall was in June or July, 2018. She fell backwards and hit her head on the bed railings. She was never the same after that. She could blink her eyes for yes or no but that was it. She had to be fed and tended to like an infant and I know she hated it. The evening before she passed, I got to tell her we were leaving and that I loved her.

Imho, I am so sorry that she's fallen and no doubt will continue to have fall events if not monitored. Prayers sent.

My dad is living in an assisted living memory care locked down facility.
First thing I did was buy a SMART complete cordless bed exit monitoring system
from Amazon. I put the pad part under the mattress pad near his shoulders. The alarm is at the nurse station with his name and room number.
It uses batteries or electrical which is extra. When he sits up the alarm goes off and they can go check on him. It can also be put in their chair and alarm when standing. The last fall my dad broke his arm. He was put on hospice for pain management etc. They put a fall mat by his bed. And replaced his bed with a hospital bed. They raise the rails at night and lower the bed. Two things: Get the pad for safety and check to see if she qualifies for hospice. She should get her own CNA for bathing and feeding.
My dad takes zero meds but does not want to eat. He is alert. But wonders why all these people are in his house.
He wandered too. Doing ok for 95. Hang in there. One day at a time.

This is so frustrating and yes it's not if but when they will fall. It's a fact of life. Several suggestions as this sounds so similar to my dad. They need to be sure the bed is lowered as close to the floor as possible when she is napping or sleeping at night and the fall mat placed by the bed. Are they placing her call button so it is easily accessed? I realize seniors can be stubborn and forget to use it. One thing we had them also do with dad is to ask staff to NOT leave his wheelchair near his bed so he could attempt to get into it by himself. Also, when he was in skilled rehab after a fall and fracture, we had to ask them to remove the walker from easy access. Or else up he would get and help himself and then fall. They are often not that cooperative in PT and it is hard to make them do it or be motivated when they have dementia. Even though medicare has rules on numbers of hours per day, my dad would insist they never took him to PT because he could never remember being there. It was what led him to be placed in LTC in the end.
Is there any medication or combo of meds that could be contributing to her fall risk? Worth asking her physician.
Being in a LTC facility is less than 24/7 private care. It's all expensive!

Unfortunately, there is no way to really prevent a fall. I was within grabbing distance of my Mom once and by the time I went to grab her she'd done the most beautiful back flip over the coffee table that I'd ever seen. Quite amazing. Thank heaven she didn't break anything although it took me 15 minutes to get my breathing back to normal.

Even with a bed lowered to the floor, I've had residents roll out of the bed, push themselves into a semi standing position and then fall over. Rubber mats on the floor beside the bed sometimes help but had a number of residents trip over them .... and then fall!

Balance generally becomes an issue as we age, sometimes even for athletes who keep up their daily regime, so falls become a much higher risk.

My mother has fallen 50+ times in Assisted Living & now Memory Care. No matter what steps are taken to help her, she finds ways around them. She knows 'better' and winds up falling. She 'doesn't need' the help she's paying for, and so she falls. Just Friday evening, I got a call from the night nurse that she fell off the bed. But it 'wasn't her fault', it was the 'stupid girl who didn't know what she was doing'....it was HER fault that my mother fell off the bed. Plus, she didn't need the night nurse to come haul her up off the floor either..........but the 'girl insisted' when she could have gotten up by herself. And on and on we go.

After several falls in the shower that looks literally like a fortress, and that the caregiver helps her in and out of, I bought her water shoes. She hasn't fallen since.

She has chair alarms and bed alarms installed by the AL. By the time the alarm goes off, she's ALREADY on the floor. Then the team has to come in to pick her up, or else the night nurse who's a marine & weighs about 250 lbs and stands 6'
4" is called in to pick her up. She once fell TWICE in one night and he came both times. She weighs in at 190 lbs so he has quite the stamina.

Believe it or not, she's never been to the hospital for one of her 50+ falls (that we know of; God knows how many falls she's taken in REALITY). She hid a few falls from the staff by getting back up by herself and not calling for help. During a couple of those falls, she broke a few ribs & some sternum bones. We had no idea why she was constantly asking the staff for Icy Hot patches day & night, for 3 months. When she had a CT scan for pneumonia about 18 months later, we learned exactly WHY.

She went into a wheelchair in May of 2019 and I thought, AHA, the falls will stop now! Nope. Since then, she's taken about 12 falls, at least, because of not playing by the rules.

There is no way to prevent falls, as evidenced by this comment. If there was, by golly, we would have found it by now, after 50+ falls in 5 years at the same AL! You can put her mattress on the floor, but she can trip over it. You can put padding down on the floor around her bed, which is yet another tripping hazard. That's about all you can do, that I know of, to perhaps ward off SOME of the falls, depending on which types of falls she takes.

Good luck. I know how it feels to keep getting these calls.

There's really nothing they can do to prevent falls, short of having someone sitting within a meter or so staring at them 24/7. Stand up from your chair. Took like 3 seconds right? That's how long it can take someone to try to stand and fall.

After 3 trips to the emergency room in the middle of the night Mom's Memory Care placed her mattress on the floor, she cant stand without help. Plus there is carpet in the room and a mat by her bed. They also have motion sensors in each room so at night, if the resident moves around in bed someone can go check on them, help to bathroom, etc.

My BIL is a hospice chaplain and told us "old people fall, it's just a fact of getting old."

I can answer what most facilities do with "fall risk" clients, but every place has differing resources so some options will not be employed. It used to the standard to prevent falls at all times and people lost jobs when clients fell. This created an impossible burden on staff. Now, most places expect falls and the expectation is to prevent injuries as much as possible.
1 - Bed: in lowest position (almost on the floor), with bed rails down (since folks climb over them anyways), and wheels locked. That way she is more likely to "roll out of bed" than fall.
2 - Floor: Thick mats on both sides of bed (or 1 side if bed against a wall) so any fall is cushioned when trying to get out of bed.
3 - More frequent checks (most folks void every 3 hours while awake) when in bed to make sure she is toileted or helped if she is awake. This may not be feasible with COVID pandemic and staff are all stretched thin.
4 - "Eyes on supervision:" staff member keeps visual check on "fall risk" clients at all times during the day, especially if given medications that impair judgment or cause drowsiness.
5 - Restraints: this used to be a big thing decades ago. Thank God they are discontinued for the most part since it puts folks at risk of skin problems and didn't really prevent falls.
6 - Tables: avoid bedside tables that clients may fall against or use to get out of bed as a crutch, wheelchair, etc.

If your mom gets a sleeping agent in the evening. She should be checked on for 1-2 hours after administration until she is fully asleep. Groggy clients tend to fall more easily.

My mom never was in memory care but a strategy sometimes used in nursing homes is to have a bed which lowers to within 6" of the floor, very few older people are spry enough to get up from that level and if they do fall out of bed the damage is minimized.

My mother went into her memory care using a walker, and fell two days later in the early morning hours, splitting her head open and getting 28 stitches. Honestly, I'm surprised she hadn't ever fallen before, but she was in a skilled nursing facility before that and there was a lot more staff around to supervise her as she shuffled to and from the bathroom.

The decision was made to just have her use her transport chair from that point on. It was just a matter of time before she became wheelchair-bound, and I really didn't know how we'd know when that day would come, but the fall made the decision for us. Mom can get up out of the chair with assistance to transfer to the toilet or to her bed, but for all intents and purposes, her days of walking are over. She did manage to fall out of her wheelchair last week while leaning over to try to pick up something off the floor, but she just rolled out and onto the floor instead of splitting her head open.

As far as nighttime trips to the bathroom, she is now in diapers and gets changed at night rather than the aides trying to get her up and to the bathroom in time to avoid an accident. It's sad to have to make those decisions, but honestly, it's made her life much easier as well as that of the caregivers. She can be cared for in a more scheduled way, and she's much safer from falls in her chair than she was on her feet.