My grandmother (94) forgets to use walker at times, falls a few times per month (usually during the night) it has to stop! Ideas?
I have a fairly unique situation- I'm a 39-year-old single guy and my 94-year-old grandmother lives with me. I insisted that she move in with me about three years ago because she was falling so much that her cardiologist took her off of blood thinners. Amazingly, she has fallen dozens of times in the last few years and not broken anything...yet! But she has done some permanent damage that may cause her pain for the rest of her life.
She fell about 10 weeks ago and landed on her tailbone. She seemed okay at first, but a few days later began having horrible pain in her lower back and hip. I was terrified that she had broken her hip. Before we could see her doctor, she developed a UTI and was hospitalized for four days. While in hospital, I had them x-ray her hip and lower back and it showed no damage to any bones (thankfully).
After she recovered from the UTI, she had horrible hip and lower back pain intermittently and it eventually started shooting down her right leg. An MRI showed that the L4/L5 disc was pressing against the nerve causing her pain. I took her for an epidural and she got immediate relief for a few days. Then the pain returned but not as severe and it wasn't constant. Even after this ordeal, she still managed to fall twice (on her tailbone)! I have repeatedly explained to her that another fall could do further damage and pain that an injection won't fix. Even worse, she could break a hip and that would be the beginning of the end.
But when she wakes up during the night to use the bathroom, she often forgets the walker and ends up on the floor! I've begged her to call me (button mounted on her nightstand will page me (but she doesn't). She uses a bedside toilet at night (I lock her bathroom door at night so she doesn't have a choice) but she has still fallen using that. When she is sick or recovering from a hospital stay, I usually end up staying up all night waiting for her to wake up to use the potty so I can help. I've stayed up for 48 hours at a time before and it isn't a viable long-term solution.
Moving her to any sort of care facility is out of the question. I work from home most of the time and when I go to the office (or to see a client), I have a friend stay with her or hire someone for the day. So I need to figure out what to do within my home to keep her from falling and to prevent her from getting out of the bed alone at night.
I'm thinking that a bed alarm (that sounds in my bedroom) is a possibility. But I also need something to keep her in the bed until I can get in there. I don't know if adding rails to the sides of her bed is the way to go or maybe just getting a hospital bed with rails? It may be necessary for her to start wearing adult diapers at night just in case.
The problem that I have no clue how to solve is not using her walker during the daytime when she's up and around. She will walk somewhere in the house using the walker, then suddenly reappear without it and I will find it in the middle of the room she just left. Short of following her every move around the house (which would be miserable for both of us), what can I do???
I have done everything possible to remove fall risks around the house. There are no throw rugs anywhere, I have rearranged her bedroom to allow plenty of room for the walker everywhere, I even bought a smaller dining room table to give her an extra two feet of clearance to pass by it safely. I also installed safety bars in her shower, at her toilet, along the bathroom wall going to the toilet and I've even considered some type of railing in the kitchen but that would only encourage her NOT to use the walker....any ideas here would be greatly appreciated! Short of wrapping her in bubble wrap, I'm out of ideas.....
Warning - being woken by a bed alarm will be tough on your nerves.
She probably wont want to use the diapers.
First, a bed alarm.
Secondly, a question. How strong is gram? Depending on her strength and ability to navigate, a hospital bed with rails might help -- IF YOU RAISE THE HEAD AND FOOT OF THE BED.
That certainly prevents my mom from getting out of bed. For mom, I raise the head because it's easier for her to breath; I raise the feet because she has congestive heart failure, her feet swell during the day from all the sitting, and raising the feet is a heart-sparing little trick. That MAY work for gram. If she's too strong, however, it may ALSO encourage her to try to climb over the bedrails if she has dementia -- which I'm pretty sure she does.
She can't walk alone. Period. Uses a walker and gait belt with me behind her everywhere she goes. She forgets that if left to her own devices -- which is how she broke her hip five months ago. I belt her in her wheelchair every.single.time.
Another idea: Make sure one side of the bed is against a wall. If she's falling out of bed, take off the box springs so she has a shorter distance to fall. Put a mattress or gym mat right next to the bed to soften her fall. Being that her knees will be somewhat higher than her hips with that configuration, she may be unable to get out of bed at all. That, combined with a bed alarm, ought to minimize her risk.
Just curious why moving you grandmother to any sort of care facility is out of the question? I would think since your grandmother is still sharp but just has mobility issues, that she would enjoy being in a senior home with other women her own age to talk about their own generation, and to make new best friends. And enjoy the senior home activities.
My parents are in their 90's and still live in their own home, and Dad has had his share of tumbles. I feel so sad for my parents because they are missing out on the wonderful things that are being offered at this one retirement village just down the road, and missing communicating with other people.... all they have are each other and my daily phone calls. But it's their choice.
I agree with the rest of the pack about a hospital bed with rails. However, being a nurse I have seen patients get out of the bed with the rails up. Someone can do it if they're determined enough. So don't expect the rails to solve your problem, just hope that it slows your grandmother down enough to get her to push the button that alerts you.
When someone is in a nursing home the beds have rails, there is a call light within reach and still people fall all the time. Do your best to put up as many safeguards in place but know that you can't prevent her from falling 100% of the time.
Does her walker have a tray on it so she can carry things from one room to the next?
The mindset behind a fall is: "I can do this. I've been doing this all my life. I don't need any help. I'm only walking to the living room from the kitchen for crying out loud, what do I needed a walker for? I only need to use the bathroom and I don't need any help in that area thankyouverymuch! And I certainly don't need my grandson/daughter/son helping me." And this is something you can't change.
You can put up rails around the house, get a bed with rails, pad the entire house with mattresses and wrap your grandmother in bubble wrap but you can't do anything about someone's desire for and entitlement to their own independence. That's been ingrained in your grandma's mind for 94 years.
From what you are doing, it sounds like you will burn out soon. It's great you care so much, but you might consider how bored your grandmother may be in the house with just you and care taker when you are gone. A nice place where she can have interaction with other people would seem a good idea. I would explore whether the stimulation she would get from being around others would boost her mental health. Just my thoughts, based on my LO going into assisted living.
What if you ask her for her input on what would stop her from getting rug burns on her nose [i fall a lot too]? As her what she thinks will help. My neighbor ride a small four-wheeled chair in the house. He can't walk at all without a cane. It's always on the other side of the room, but that chair - he scoots / pedals with his feet, around everywhere in it. [the medical model is called a Whinney Walker - it has 4 wheels, handle brakes, and a seat. You can see the 3-wheel version at most drugstores or Sam's Club. Med supply stores have them -- a script from the doctor would cover the cost, if she's not had one before. It's great when you can walk, put on the brakes, turn around and sit. i use one.
Would TWO handrails in the hallway help - if your home can accommodate that set up? i had to use that double-bar set up in PT - i felt like a ballerina. But actually, the bars were spaced to permit me to walk between the bars, one hand on each bar, while learning to walk again. It sounds like your g/mother may not be lifting her feet high enough ... similar to the condition called "foot drop or foot drag." If that's the case, a rubber soled slipper on wood might cause her to trip -- like "stubbing one's toes" when we were kids. i know that with the depth of concern, care and love that you have for your grandmother, nursing home is out of the question.
Can you ask her doctor for a recommendation for Mobility aids? Or, call or visit a company and pick their brains for a solution. i'd stay away from social workers, or you'll be visited every time they feel like it, and evaluate you and your home for anything they choose. PS - you've got my most sincere admiration, and i thank you for the ideas you've given me, that i can use. Blessings ~