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My mom is in the number one care facility in NJ. My mom is in the memory floor due to her not being able to follow directions since her dementia has progressed. She has falling over 33 times in both the assisted and memory units.
Here is what I do not get. I have been researching devices to help the staff with notification of when she starts to move. She cannot walk and just gets up and falls. Falling is going to kill her.
Why under the laws, are devices that do not restrict movement considered restraining devices. I want to place a bed alarm under her sheet so that the gals at the desk receive a alarm that she is moving. I know that it may take some time to get to her but then there is times when it may be immediate and prevent the fall. Please do not tell me about mentally if affects they movement. I do not buy that. The cost of healthcare is skyrocketing. Elderly patients constant visits to the ER on a weekly basis.
I have read all that there is to read on devices, laws etc. We need to do better for the elderly, especially those with dementia.
Someone, please give me some insight on this topic.

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My mother lived in a wonderful Memory Care Assisted Living facility which allowed bed and chair alarms (Which are not considered restraining devices) and she STILL fell 95x. Truth is, it's impossible to prevent an elder with dementia from falling bc they are unable to remember they can't walk. By the time the alarm goes off and a staff member arrives, they're on the floor and require being picked up and checked for injuries.

Mom died at 95 from CHF and dementia, not from fall injuries. Amazingly enough. I didn't blame the MC for her falls, but the dementia and her mobility issues.

Restraining devices are not legal in managed care settings for safety reasons. States laws differ somewhat, but they are what they are.

If our mothers got mangled in a bedrail device, we'd be upset a restraining device was used in the first place. Fact is, it's a no win situation when dementia is at play. Horrible disease.

If mom qualifies for hospice, they have a few tricks up their sleeve like a large bolster pillow to go on top of the bed that cups the body a bit, preventing falls from happening so often. High back wheelchairs which tilt back, keeping them from falling off the seat as often, etc. Look into it....hospice is a godsend and another team of eyes and hands on our loved ones towards the end of their lives.

I feel your pain and frustration. I was getting ptsd from all the phone calls I was getting about moms constant falls. Every time my phone rang my heart sped up like a racehorse.

Best of luck to you
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babsjvd May 2023
My MIL in memory care , on hospice , was falling , hospice got her a hospital bed which has helped tremendously..
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I completely agree with you. I bet you, that if it was THEIR mom or dad, they would feel the same way as you, and make more effort to change the laws. By the way, these laws on so-called restraints aren’t the same in every country; goes to show that many people around the world agree with you.

Some falls are completely unnecessary and preventable!

In fact, statistically, some countries are much better than others, in facilities, at preventing falls, preventing negligence generally, abuse…

For example, so long as facilities aren’t punished for clear cases of negligence, they’ll just continue. What do they care?

But once there’s a real risk to be caught for negligence (some falls REALLY are caused by the facilities’ out-right negligence), and pay a big penalty, then they’re magically more careful.
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AnnReid May 2023
It WAS my mom, and I LEARNED that there are NO 100% solutions that perfectly solve the problems of every resident.

The pandemic has made circumstances even harder in even the best residences, and

”Some falls….” ARE ”…unnecessary and preventable…” but SOME types and overuse of restraint are EQUALLY PROBLEMATIC.

Hopefully EVERY resident of EVERY care site gets the best care available, and we all want our LOs to get the services that are needed for their safety and comfort.

I was able to have a change made in the use of my mom’s wheelchair by signing a release of responsibility for a specific modification, based on her height and mobility skills. I went through channels and the end result was satisfactory (not perfect) for what she needed.

To function “in the system” I needed to do my research, suggest alternative solutions, and accept some compromises, and it worked.

Good luck with finding a solution, ATCJIM.
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Birds chirp, dogs bark, cats meow, old people fall. It’s just the way it is.
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bettty May 2023
This comment hit home to me today. My mom fell in rehab yesterday. It IS stressful when you get that call.
ZippyZee, I typically just breeze past your comments. Today I can't.
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My mom fell in Memory Care WITH a bed alarm and with TWO aides in the room.

When I expressed my dismay about this situation to the nurse who was running the discharge unit in the hospital where mom was having her broken hip repaired, the nurse said to me "my mom fell with THREE RNs in the room and one of them was me." She went on to explain that sometimes, a spontaneous break CAUSES the fall, as opposed to the fall causing the break.

It is sad but true that elderly folks, especially those with dementia will fall no matter what.
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Have them put her mattress on the floor, or ask for a concave mattress (which makes it much harder for them to get out of the bed). I don't have any suggestions for when she's in a wheelchair.

Right before Chrristmas my 100-yr old Aunt with advanced dementia, escaped her bed (in her own home) that we tried to make inescapable. She fell on carpeting and broke her hip. In rehab she was also still trying to escape the bed WITH a broken hip. It slowed her down but didn't prevent her from being determined.

Have you thought about hiring a private companion aid for her during the day? I don't know how to keep her in a wheelchair if she uses one. I wish you success in protecting her from herself.
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Bed alarms can go off so easily and it can be disruptive. (Imagine 3 or 4 bed alarms going off at 2, 3 or 4 am waking other residents.) Same thing with a floor alarm.
Lowering the mattress to the floor or as low as possible can help prevent falls.
If the person is in a wheel chair changing the standard wheelchair to one that reclines a bit makes it a bit more difficult to get out of the chair.
Also placing a non slip pad on the chair also makes it more difficult to get out of the chair.
While restraints are not generally permitted if they are a "doctor's order" they may be allowed. You might want to ask about that.
It is far to easy to use restraints in an appropriate manner and it is also very easy for them to be used improperly....for the "ease of the staff"
Falls happen. It does not matter if it is at home, in the hospital, in a facility. It can happen when a person is alone or surrounded by caregivers.
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When my FIL with dementia was in the hospital they had bed alarm on at night . He moved , the alarm sounded , he thought it was a fire alarm and he climbed out of bed. So there is that .
Lower the bed to lowest it can go . They also have mats that can be put on the floor next to the bed .
Unfortunately falls happen .
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