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Mom lives in a restraint free nursing home. They will not let her use a wheelchair tray, even one that is easily removable as it is seen as a restraint. Her bed only has a small handle bar on each side. Bed rails are also seen as a restraint. She has dementia. If something catches her eye, she tries to get up to get it and falls. Falls from the bed happen in the middle of the night when no one is in the room with her. The bed and chair alarm are being removed as they consider the alarm startling to the residents. It is also an after the fact notification once she has moved. Any suggestions on how to keep her safe? I have requested mats be put down on the floor along her bed. I would appreciate any ideas you might have.

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Move her to a different nursing home. Mats on the floor are not going to do any good if she falls out of bed. If she's old and frail a broken hip can happen easily even with a mat on the floor. The 'No Restraints' movement in facilities has gone to the point of absurdity.
Side rails on a bed are not the same as being tied down to the bed. A tray attachment to a wheelchair or a posey (a type of vest or waistband that kept a person from slipping out of a wheelchair) are not the same thing a straightjacket.
If you want a better chance at keeping your mom safer, move her to a nursing home that has some common sense and knows the difference between immobilizing someone against their will and taking the most basic safety measures that a person with dementia won't even notice.
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bundleofjoy Aug 2021
totally agree!!!
it’s crazy what the current nursing home is doing!!!
almost asking for/wanting accidents/falls!!!!

hugs to all of you.

i wish your mother well jcarna. hug!! :)
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In regard to the alarm. Maybe check into the alarms that sing a lullaby - my friends husband was in rehab and she kept hearing a children’s lullaby type song played - she finally figure out it was the alarm on the bed for someone whom had dementia and that the woman would go from yelling and trying to get out of bed to singing the lullaby song and calming down? I had never seen or heard of it but maybe the staff would let you use an alarm
that was more soothing but still able to alert them?
I cannot for the life of me remember what song she said it was but it might have been Mary had a little lamb? Or something like that and that it gave the staff - Cna - nurse an alert with a song and didn’t disturb others.
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Momheal1 Jul 2021
You could also look at a pommel wheelchair cushion it’s meant to help someone not slide down in the wheelchair - it may keep her from getting up so easily and they may allow that? You would have to look at them to see if it would be safer or more of a danger (depending on her abilities to get up - maybe it could help - it’s worth looking at them - only you will know her mobility and if it could help. Best of luck
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Restraints aren't allowed to be used in nursing homes.

My father had vascular dementia in the balance center of his brain. He was falling before he went to assisted living, He fell often in AL and continued to fall in SN. I got increasing calls from AL and weekly calls from SN that dad had fallen again. Once he went to rehab from hospital - he not only fell the 1st night in rehab, he fell again the next morning. His falls usually resulted in superficial injuries - scrapes, bruises and minor cuts. Also at work with dad was being so stinking stubborn, weakness and AD.

Dad had a power lift chair that he loved, it went with him to SN. He'd hit the button and the chair would lift him and he'd just slide on down to the floor. I asked if they couldn't get him comfortable then unplug the chair (it was in his room at the time) but no, that was considered restraint by the state. However, shortly thereafter, they moved the chair to the common area; get him comfortable and unplugged the chair; when they noticed him trying to get out of the chair they plugged the chair back in and move him to his wheelchair.

Unfortunately there is nothing that can prevent all falls but the staff should be taking action to reduce the risk of falls. They can lower the bed closer to the floor and place mats down to cushion a fall. You may check into better chair pads or other wheel chairs that prevent falls that are better at keeping the person in the chair.

It is horrible to get those phone calls - it got to the point if a call came before 8AM or after 9PM, I was pretty certain who was calling and why. I wish you the best.
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I’ve seen and read about wheel chairs that tilt the person backwards with their feet elevated in the front, and with armrests at each side. It’s virtually impossible for them to get out of it. (And I sincerely hope that the wheelchair itself wouldn’t be considered to be a restraint)
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When my 94 year old mother with dementia was in short term rehab, in February, I notified them that she was a fall risk & they lowered her bed & put high fall risk bracelet on her. In the other nursing facility she was in before I took her home..they had bedrails & bed alarm…with song …she’s home now..so I have bedrails on her bed & keep one side of bed against wall. When in wheelchair, she has belt that buckles in back in addition to ankle wraps that are attached to the legs of wheelchair. Her last fall in February, she unbuckled her seatbelt that was in front & lifted her leg over wheelchair..& fell face down on hardwood floor. …requiring stitches..Perhaps the increase in medication to prevent agitation helps prevent her from falling…since she can hardly move or bear any weight. She forgets she’s unable to walk & hasn’t walked in 5 years.

I hope they can keep your mother safe ..talk to administrator & Nursing Supervisor about your concerns. Hugs 🤗
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BarbBrooklyn,

If your mother fell and had two aides with her, then they were not paying attention and doing her job. There is no excuse for that.
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This will certainly sound cruel, but when my dad was staying with my sister and BIL, I bought them a vest that loosely secured him to the bed. His arms and legs were free to move. He really didn't mind at all, he had advanced dementia and even though he had a fall mattress, they would find him under a table or on the floor mattress. A sundowner for sure. Once he knocked over a wood stove (luckily they didn't light any fires in it!). My BIL told my dad he didn't pay his heating bill and the vest was to keep him warm. He had freedom of movement, the vest stopped him falling out of bed. I'm sure any AL home wouldn't allow it, but it did work.
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Cover99 Aug 2021
So like a turtle on its back?
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By law, no nursing homes in the US can use physical restraints for any resident.

The mats are ok, and another possible help is to lower the bed as low as possible, or place a mattress on the floor.

”Fall proofing” is very tough to manage, even with 100% full time supervision.

I slept (well not sleep, really) on the floor by my mother’s bed for 6 months to keep her from falling.

A wheel chair tray is not legally “seen” as a restraint, it’s a restraint..
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The NH where my MIL is puts the mattresses right on the floor. I agree with AnnReid that there really aren't any other viable solutions.
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Beatty Aug 2021
Yep agree. Crash mats next to bed or wheelchair would be my suggestion.
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Have them lower her bed to its lowest position and use the mats. It's about the best you can do.

Yes, they have the tilted wheelchairs, too. My mom had one near the end of her life. They're extremely expensive and intended to keep people from slumping forward, but it would likely work.
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MargaretMcKen Aug 2021
Recliner chairs can sometimes do the same thing as titled wheelchairs, and may be more affordable.
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