Since February 2020, while in assisted living, my 92 year old Mom has fallen and broken her hip and then had another fall and broke her leg. Currently in rehab, she fell out of her wheelchair this past weekend trying to get up by herself. Thankfully, nothing is broken. She has mild cognitive impairment that has been made worse by being isolated in hospital and rehab on & off since February due to our state restricting hospital and nursing home visitors due to the pandemic. I thought being in a wheelchair would help decrease falls, but not if she keeps trying to get out of it. I don’t want them to strap her to wheelchair. Has anyone experienced this? I am at a loss as to how to best help her.
States differ on their laws, but, you might explore if it's possible to get her a geri chair on wheels. It rolls around, but, looks more like a recliner. The seat slants back. You might also ask about chair alarms that go off if they get out of the chair. Those kinds of things may not be possible, but, I'd inquire about it.
It's very difficult to await of falls, ER, etc. But, for as long as they are able, this may happen. Eventually, they may not recover from an injury or they progress to the point, that like my LO now, she is unable to move at all.
What walking aids does your mother use when she needs to mobilise?
The Geri chair or even a reclining wheelchair may help since it will take her longer to get up when slightly reclined. Elevating her feet may help in chair. Also, the Geri chairs are big enough that her feet’s won’t touch the ground and again, that makes it harder to stand up. Her bed should be kept at lowest position and padded mats put around bed so she will land on them.
Falling ultimately killed my MIL. She had significant dementia. She was obsessed with going to the bathroom. She would never agree to a walker. She fell and broke her hip on way to bathroom. She had surgery and the bone healed but she was more confused and really never was able to walk well afterward. But she persisted to try to get up with repeated falls out of bed. She stood up suddenly in wheelchair in the dining room while at lunch table and fell over, hitting her head on sideboard. Nothing was fractured this time but she was in constant pain from the fall. She was already on hospice, so her pain was managed. She stopped eating and died within 2 weeks of the final fall.
I only tell that story to illustrate how this progresses. The facility was great with her but she was so determined. She was 92 years old, and only weighed about 95 lbs. I don’t mean to be fatalistic but there literally was nothing we could do. I am a retired nurse, from back in the day when we could used restraints and belts but they would get free of those and fall anyway. So maybe try the chair options even if you have to rent one. And have them check for UTI just in case. And be at peace that there is little you can do. Bringing her home is not the answer. She will fall there too and if family members who don’t understand want to lay blame, they will blame you.
I agree with most of the replies posted. A long, long time ago I worked in nursing homes myself and restraint of residents was a common place procedure when it was determined they are high risk for fall injuries. If you don't have the funds to hire a private sitter for your mother, her continued falling is probably inevitable and that is very unfortunate. We now know that elderly falls can contribute significantly to a shortened life span. My family is getting ready to put my mother in assisted living and I plan to give them permission to take want ever steps neccesarily to prevent her injury and keep her safe. That's the reason we're placing her there. Good luck to you.
It's nobody's 'fault' but my mother's that she keeps falling, in all truth. If she would agree to play by the rules, 80% of the falls could be prevented, at least. But as long as she's living and breathing, she will continue to do things 'her way' and as a result, we all pay the dues. "Tying someone down" to a wheelchair is no answer, either, b/c it's against the law. So just allow your mother to live life as SHE sees fit, while YOU keep visiting her at the hospital and rehab, what else can you do? You can't help a person who refuses to BE helped.
Good luck!
My mom had always been an active and strong person. In 2014, she was diagnosed with Alzheimer's and I moved her into an AL facility in early 2015 at the age of 90. She was completely mobile as well as able to dress herself. I still remember when she had her first fall, I was extremely upset even though she didn't get hurt other than a black and blue eye. Another year went by and she fell again - no injury. Another six months from that fell again - still no injury. It is so common for the elderly to fall. I know my father-in-law would fall and he was a big guy but, it was always upsetting. For me I just hated to think "how long were they lying there before anyone noticed?" - especially for my mom who would never push the "call" button.
She is now 95. After she nearly died from severe dehydration and getting the COVID virus in April, she has fallen at least seven times in two months. She is too weak to walk so now she has a wheelchair but, always requires assistance. They can't restrain her. Maybe it's so no accusations can be made - I don't really know. But, the problem is when she as well as your mom are trying to get up on their own either because they don't use their "call" button or they don't want to wait for someone to come and assist them. In my mom's case, they pushed one side of her bed against the wall so that eliminated one way of falling out and then hospice provided a "fall" mat which they place beside the other/open side of her hospital bed at night. That's when she fell most often - I suspect she wanted to use the bathroom even though she wears depends. However, now that hospice has given her a low dose medication to help take some edginess off (as she would get agitated/combative occasionally) and to help her sleep through the night, the amount of times she's fallen has significantly decreased. She has fallen maybe once or twice during the day but, I know my mom - she's a very independent person who was the oldest of 8 siblings - so she gets up even when she knows she shouldn't! But, I don't think I will ever come to terms with this aspect so I feel for you especially, because your mom has broken her hip and leg which as we know can cause a quick decline or worse. I'm sure there are a lot of others on this forum who will be able to help you and I wish you and your mom the best!
So sorry this is happening.
Even if they are in the "High vis" area with someone in attendance, unless they are virtually glued to the person's side, a fall can still happen. In order to have someone "glued" to their side, it would likely have to be a hired person, adding to the enormous cost of MC, and even then, that person will need a break, even if just to use the bathroom.
No really good solution to this issue. It's one thing if someone is just obstinate, but dementia brings a whole new issue, since they will forget they can't stand or walk.
We used to think that people fell and then broke their hips. Studies have shown that many of those falls are the result of osteoporosis; the person's hip fractures under their weight and the person falls afterwards. The same may also be true of falls with leg fractures. Please have your older loved ones evaluated and treated for osteoporosis.
It is likely she had a couple of minor falls when still living alone. I didn't get to see the bruising (YB wasn't smart enough to take a pic!), but she did bruise one of her knees. By the next visit from me, the bruising was gone. The last injury at home was, in a sense, a bit of a godsend because it allowed us to present a fib to get her to move to MC. She bruised her shin and developed cellulitis. At that point, dementia overrode her previous plan to move to AL - she refused to consider moving anywhere.
Since moving to MC, she has had falls, more often than not just tumbles, with no real injury. Maybe just lucky, who knows? Initially she walked unaided and was able to dress, shower, and get around okay, it just wasn't safe to leave her in her home alone. After a few years, she decided she needed one of "those", pointing to another resident's rollator. I brought the one she still had from dad, but it took many months before she really started using it (more likely felt she needed it to 'fit in' than a real need.)
Many months ago (she has been there 4.5 years now) she started having fears of standing and walking on her own - more likely mostly anxiety and weakness from NOT walking enough (she likes to sit and read most of the day!) The aides would "help", but merely be touching her, but it progressed enough that she's in a wheelchair now. No falls as yet from that, but has had 1-2 times at night, apparently trying to get to the bathroom.
I had guardianship over a relative who was in a Memory Care facility. She fell 3 times in one week, each time requiring an ER visit. She finally broke her kneecap, which was the beginning of the end for her.
Everyone's suggestions of a bed that is low to the ground, padding around the bed at night, furniture with rounded edges and pulled away from the bed at night, geri-chair, etc. You can do things to mitigate the risk, but sooner or later, it WILL happen.
My mom has a custom w/c which is extremely comfortable. It is more comfortable than her recliner. Physical Therapy was amazed how functional it was for elders with potential for decubitus ulcers . My mother travels a long distance to see her urologist and she has no complaints of pain. She was able to go on long vacations due to this chair. She could not with other chairs for they were quite uncomfortable. This particular w/c gives her a high quality lifestyle. She has severe spinal stenosis and does not have pain when she sits in it. Would highly recommend this chair for elders with potential for breakdown, pain and safety!
I’ll have to check with her doctor about bladder relaxing. I don’t know if her bladder needs relaxing, but it’s worth finding out more about this. Thank you for responding.
"My brother was convinced Mom’s facility was not providing proper care because she fell so many times. Although possibly the care could have been better at times, we are learning that she may (and probably will) fall where ever she is."
Hopefully the WE in 'we are learning' applies to your brother. As many have stated here, there is no foolproof way to eliminate falls. They happen in their/our homes, even when family is care giving, they happen in NH, AL, MC, rehab. It just goes with aging and especially when dementia factors in.
Hopefully when rehab is done you will consider moving her to MC, not back to AL. AL can assist with some needs, but isn't geared to watching anyone all day every day. There should be more staff per person in MC, so she would have more eyes on her, but there is no guarantee that she won't fall there either. IF she is still in the early stages of dementia, perhaps you could get PT/OT set up after she moves to MC. Mom had knee pain, interfering with standing and walking, and they were able to get her mobile again, for a bit. Once she started fearing standing and walking, they tried again to work with her, but she wouldn't do anything they asked her to try - their last attempt was met with YOU do it!
There was a woman in mom's MC who was still able to manage her TV, use a computer and phone, and walked with a rollator. She was 99 when she moved in and almost made it to 101! I interfaced with her a lot when visiting with mom. She was a lot more "with it" than many in the MC area. Clearly as she neared 101 I could see some decline, but the last time I saw her, a week or 2 before she passed, she had a terrible fall. The side of her face and down her neck was badly bruised (I think she hit some furniture in her room on the way down.) She had other medical issues ongoing and was on hospice as well, but this fall was certainly a catalyst in her passing.
I have thought about memory care but all the memory care units I have seen in my area are locked units. Thankfully, Mom doesn’t wander. And she is still mentally with it enough to recognize that the unit is locked, the knowledge of which would be very upsetting to her.
Yes , I’m definitely going to get physical and occasional therapy going when she leaves rehab.
She also may need more "supervision" than she is getting in AL.
Chair alarms. Bed alarms. Placing the bed lower to the floor. Putting a mattress on the floor next to the bed will provide a "softer landing spot" if she tries to get out of bed unassisted.
They can not "strap her into the chair" that is considered a restraint and are not legal to use virtually every where.
But as you have gathered from the responses a fall is inevitable. With luck with no injury.
Yes, I can see a downward spiral with my Mom. I tell her over the phone (she is in a facility for rehab currently) not to try to get out of bed (or wheelchair) by herself, but I feel like it is not sinking in.
Thank you for responding.
Anyway, I’ll look into WC alarms. It is still unclear how much she will be using a wheelchair versus walking with a walker, but I’ll definitely look into WC alarms.
Thank you for responding.
Both times my Mom fell at a facility. As far as I know, the emergency EMS came fairly quickly. Arrival time didn’t seem to be affected at all by the pandemic.
Thank you for responding.
Later, after many falls and fractures she ended up in a wheelchair, though not due to falls, but progression of her dementia. Sometimes, she would try to get up from wheelchair and fall. Somehow they were able to use a belt alarm to alert when she tried to get out of the wheelchair. It was said it was legal, because she was able to unsnap the belt. Even with substantial dementia and no speech, she would play jokes on the MC staff. She would get this devious look on her face, disconnect the belt...it would alarm...a staff member would head down the hall towards her location, but before she got there my LO would reconnect the belt, so it’d stop alerting..,then she’d grin real big! Like she got one over on them! I couldn’t help but laugh.
Yes, I think your Mom’s dementia worsening might contribute to the falls. (I think my Mom might have the same issue.)
I’m curious what a ‘board and care’ is? I live in New York State and am not familiar with that term. I am wondering how it differs from an assisted living facility.
Thank you for your response, and best of luck to you and your Mom.
Thank you for your response.
I'm surprised they don't have an alarm on her wheelchair. The alarm lets the caregiver know immediately when the weight comes off the chair.
However, I think others have mentioned that straps are no longer legal in nursing homes.
I honestly don’t know why they do not have an alarm on the wheelchair??? Something to look into.
Thank you for your idea and response.