My parent is 91 yr old, frail, uses a walker, with bad hip-replacement. He has dementia and constantly wants to get up and walk around. He has fallen 2 times recently and fractured his clavicle bone. He gets angry and won't follow directions from the staff at the nursing home. Facility doesn't allow restraining him, so what can we do? We want to keep him from falling and fracturing his hip, and be more cooperative.
But. No nursing home is able to provide one-to-one care round the clock; and your father is a serious falls risk so he cannot be allowed to mobilise on his own.
Why is your father getting up? It is important to check that he is not in pain or otherwise uncomfortable. He should be helped to change his position frequently; and ideally he should be assisted to mobilise as often as practical.
There is no point in explaining falls risks to a person with advanced dementia, and directions that antagonise him are counterproductive. For example: if you ask him to sit down again when he wants to get up, he will resist. So, what about letting him get up, leading him to another chair, and asking him to sit there to rest "for a moment"?
Obviously this kind of thing is a tall order for staff anywhere; but on that point are you happy that this NH does have enough specialist expertise in handling dementia?
Its true I did. So I brought them both. the one with the commode was great when I took dad out. rolled him into a room, hallway or whatever and he was able to go . mom was the same. just pop the top off of seat and that's it. the seat belt one I brought to the nursing home . dad was doing the same as your dad. wanting to walk around and falling down. he did stay in it for a long time until he learned how to undo it. mom was totally different that dad. she laid in bed for three months and had every one do every thing for her.
As they get older they mentally get younger. there is no way to make them understand something . Their brains are being taken over with the diseases they have.
I had the nursing home put dads to the floor with cushions all around it so if he climbed out or fell he didn't have far to go.
but than they told me he would crawl like a baby around the halls till someone found him......cant win......
good luck......
We want them to be more engaged and active so WE feel better, but usually they’re content not be busy. You need to tell his Dr. all his symptoms. At this point in his life just knowing he’s safe and comfortable is the best gift of love you can give. It may also be time for the Dr. to ask Comfort Care to evaluate him. They understand what is going on in his body that makes him restless.
They were just what both my mother and I needed to make the best choices
for the last part of her life.
God bless and guide you. You’re not alone.
Melatonin does not work well with dementia and does not work with sundowning. Sequel is handed out like candy and can lead them having worse hallucinations so keep that in mind.
You have realized that there are NO good solutions to Dad’s desire to walk because he has become a serious fall risk.
SO- for better or worse, it’s time to try a less than good choice.
My LO was anxious and in constant, unfocused motion, and hostile to her caregivers, until she was assessed by a kind, quiet psychiatric PA., who recommended a trial of the LOWEST POSSIBLE DOSE of an anti depressant with tranquilizing properties.
I DID NOT want her “doped up”, and the therapist agreed. The effect of her medication was enough to give her a more peaceful outlook without depriving her of her sense of humor. She now uses a walker, and has still fallen occasionally, but with far less serious results, although ironically one of HER previous falls had resulted in a fractured clavicle too.
In the last two weeks, her comfort level has regressed a bit, but we will adjust her medication level up (or down) as circumstances warrant.
I’d give anything if there were another kinder, more compassionate, more fair way of dealing with my LO’s current problem, but if there is, I haven’t come up with it.
LO doesn’t warm readily to “strangers”, and dementia or not, she’d know the minute some smiling faced “helper” came up to her and asked her if she wanted to take a walk. The answer would be a polite, professional “No”.
Keep loving him and choosing the best of all the solutions, even when there aren’t any good ones........
Having someone walk and/or exercise with him with walker throughout the day as sitting gets old.
A seat/bed alarm with familiar voice that says something like, "Dad, please sit down, someone will be with you soon."
Decorating his walker with relevant stickers (for example: cars, army stickers, his name on the inside facing him), and/or "Washi tape" to personalize it and he can help decorate it. Studies have shown that this works to increase walker recognition and use. Keep it near his bed and where he is sitting.
The other possibility is that the trying to get up is a sign/symptom of agitation that he could possibly be medicated for. Medication not so much to make him groggy or in a stupor but medication that would relax him and make him less agitated.
Also if he is in a position where it is more difficult to get up, like putting the chair in front of a table. He can be given some sort of activity to do, drawing, puzzles, reading would all give him something to do.
During earlier stages of he Alzheimer's I depended on exercise to manage her behavior and she never needed a single narcotic or psychotropic. Exercise actually reduces falls. but there is no way you can completely eliminate them.
So I keep her off a wheelchair and only use it for transport purposes such as taking her to the mall and just wheel her around. AT home she sits on an easy chair with a hydrolic lift (cost me $800), and I use a walker to get her around the house, bathroom, teeth brushing, and so on.