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Medical Forum / Diseases and Disorders / Alzheimer's / December 2007Help! Mom keeps falling out of bed
Mom fell out of bed in the middle of the night a few weeks ago at the NH. She doesn't know she can't walk without assistance, tries to get up by herself and falls. So the NH ordered fall mats for the floor by her bed, but before they were delivered, she fell again. This time they suspected she fractured a neck vertebrae, but a CT scan showed she didn't. Now they're installing an alarm for her bed so they know when she tries to get up by herself. In this state (PA) NHs can't put on restraints. Are we just supposed to hope the alarm gets her help in time? > Mom fell out of bed in the middle of the night a few weeks ago at the NH. > She doesn't know she can't walk without assistance, tries to get up by [quoted text clipped - 4 lines] > up by herself. In this state (PA) NHs can't put on restraints. Are we > just supposed to hope the alarm gets her help in time? Sarah, The alarm helps if the staff responds quickly (not busy w/another patient, etc.). We had that issue for a short time w/my mom (late stage cancer that moved into her brain, not AD). Mom had a bed that got very low to the ground, like a foot or two and we kept it at that height except when helping her turn over, etc. The nurse explained that it minimized the potential for injury when kept that low. Is the bed height adjustable at the NH? If yes, have they tried keeping it at the lowest setting? If not, can her bed be switched for one like that? Adelle >> Now they're installing an alarm for her bed so they know when she tries >> to get up by herself. In this state (PA) NHs can't put on restraints. [quoted text clipped - 13 lines] > Is the bed height adjustable at the NH? If yes, have they tried keeping it > at the lowest setting? If not, can her bed be switched for one like that? Yes, her bed's been set on the lowest setting. But it has been discovered that it isn't that she rolls out of bed in her sleep and gets hurt. The problem is that she wakes up, stands, tries to walk, then falls and hurts herself. > Mom fell out of bed in the middle of the night a few weeks ago at the NH. > She doesn't know she can't walk without assistance, tries to get up by [quoted text clipped - 4 lines] > up by herself. In this state (PA) NHs can't put on restraints. Are we just > supposed to hope the alarm gets her help in time? The prohibition against restraints is meant to keep nursing homes from tying their patients to beds so they won't wander around and interfere with cigarette breaks, coffee hours and the like. Trust me, this *has* happened: I live in a state with *lots* of nursing homes (Florida) and every once in a while one of them (even a licenses one, from time to time) gets caught at it - usually because a family begins to notice bed sores on their LO. Hospice, here, has a program called "Crisis Care." Does Hospice work with nursing homes in Pennsylvania, and, if so, do they have that program? The Dowager seems temporarily to have lost control of her larger muscles and gets "tremors" that threaten to bounce her out of her bed: Hospice's Crisis Care nurse will be with her until the problem either goes away of its own accord or is treated so that it no longer endangers the Dowager's life. Blessed be, Baird > The prohibition against restraints is meant to keep nursing homes from > tying their patients to beds so they won't wander around and interfere [quoted text clipped - 3 lines] > time) gets caught at it - usually because a family begins to notice bed > sores on their LO. Pennsylvania is second only to Florida in the number of people over age 65. Allegheny County PA, for example, is second only to Dade County, Florida in the number of elderly people. So we have tons of NHs. And I agree that restraints should not be used just as a convenience. I worked in a NH back in the 1980s and I remember seeing the more recalcitrant patients later sitting in "gerry" chairs (a chair with an attached tray on wheels) with their wrists tied so tightly that they couldn't even scratch their nose. And they were so doped up they couldn't even raise their head off the tray. But now, NHs can't even put the bed's side rails up to keep people from rolling out at night, that's "too restrictive." Not even ONE of the rails. But in Mom's case, that wouldn't do her any good, anyway, and may even cause her more harm, because she's not rolling out of bed, she's actively getting out of bed. > Hospice, here, has a program called "Crisis Care." Does Hospice work > with nursing homes in Pennsylvania, and, if so, do they have that [quoted text clipped - 3 lines] > either goes away of its own accord or is treated so that it no longer > endangers the Dowager's life. Mom's been in hospice care once because she wasn't eating much, then we revised her meds, she wasn't so sleepy all the time, started eating better, and was taken off hospice. Currently she was evaluated for hospice again, but was declared not ready for that program yet. Her problem with getting out of bed isn't muscle tremors, but she awakens, swings her legs over the side of the bed, stands, then tries to walk without assistance. She is no longer capable of walking without assistance, but she's never been one to take telling even when she WAS all there! Sarah >> The prohibition against restraints is meant to keep nursing homes from >> tying their patients to beds so they won't wander around and interfere [quoted text clipped - 39 lines] > > Sarah Hi Sarah, We had that same problem with my mother in law, and in fact it was just that problem that finally pushed us over the edge to put her in a nursing home. She just couldn't wrap her mind around the fact she couldn't walk unaided any longer. They put her in a very low bed, then they put an alarm mat alongside it, so that an aide would come if she tried to get up. She still kept trying anyway. During the daytime the put her in a merrie walker, a kind of a contraption where she could walk or sit, but she couldn't get out of it and she couldn't fall down. She never got used to that and so they finally just put her in a wheel chair with a "lap buddy" which was a big foam cushion that was braced between the arms of the wheel chair. There are some kind of foam pads that can be strapped around the hips to prevent broken hip falls during the daytime too. It's such a difficult situation. You just have to rely on the help at the nursing home and hope they come quickly when the alarm goes off.  SignatureBest Regards, Evelyn Here are samples of the commercially available hip protectors. http://www.hiprotector.com/works.html There is some evidence that daily Vitamin D not only makes bones stronger, but seems to improve neuromuscular function, leading to older people being somewhat steadier on their feet. M. |
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