Mom is 97, dementia, been in MC at ALF for 1 year 4 months. She was mobile at placement but has had 9 falls in since placement. All falls have been face forward resulting with goose eggs on forehead and bruising masks around eyes and nose. Never is observed when falls but is transported to ED for CT Scans. Luckily has not broken any bones. Has anyone ever requested to view tapes from cameras to confirm that no events are occurring that would create a fall. Mom is oldest resident on the unit and is still mobile where many residents are wheelchair bound. Really concerned she cannot recover from many more forehead injuries.

My mother lived in AL and then Memory Care AL (same facility) for 7 years and had 95 falls during her time there. I never asked to see 'tapes' of anything, either. My mother was old, had neuropathy in her legs and feet, refused to use her walker, and had her own way of doing things that did not include following directions. When her dementia set in, things started REALLY going downhill with the falls. The staff bent over backwards to prevent her from falling, and installed bed alarms, chair alarms, all sorts of things which did not work. Mom kept falling, through nobody's fault but old age, infirmity, neuropathy and a hard head.

Once she moved into Memory Care and became wheelchair bound, that's when she took the majority of those 95 falls; off the toilet, out of bed, off of her wheelchair, etc. For me to ask to see 'tapes' would show a distrust of the Memory Care and to insinuate blame on their part for her falls. That was not the case at all; falls happen ALL the time to very old people, especially those with dementia going on. So to answer your question, no, I didn't ask to see tapes b/c I knew why mom was falling and didn't need to analyze anything. She thought she could walk which she couldn't, and so, she kept trying to get UP from a sitting position or from bed and WHAM, down she went.

Any managed care facility can only do what they can do to keep a resident safe, but they cannot monitor them 24/7. Even if they could, the resident would STILL fall b/c that's the nature of the beast with advanced old age and disease.

My mother never went to the ER for any scans when she fell b/c she never hit her head, so it was not required. The fact that your mother is still mobile at 97 tells me she WILL fall no matter WHAT the MC does to help prevent it. Nature of the beast and all that. At 97, she WILL die from something, one way or another, so it's impossible to prevent it, unfortunately. That was my take on all my mother's falls and all the phone calls and all the hand wringing for all that time. Ultimately, she passed away in February from advanced dementia and a very tired and worn out heart that gave out. Not from any of those falls, believe it or not.

I know how difficult it is to deal with all of these falls, trust me. But it's impossible to prevent them. Unless this MC is blatantly leaving trip hazards out for mom to fall over, they're not at fault. Old age is the culprit. Accidents happen continuously at 97 years old b/c their balance is dreadful. Plus, they don't pay attention to what they're doing or where they're walking. Before mom went into a wheelchair, she'd look all over BUT where she was walking, and walk into walls all the time. It about gave me a heart attack to watch her stumbling around. It was truly a miracle she didn't break her neck long before nature took it's course and she died at 95.

Wishing you the best of luck with a difficult situation.
Helpful Answer (17)
Reply to lealonnie1
Mymomsthebest Sep 18, 2022
Well ..falling off toilet is def negligent since they should have known not to let her there unattended. This happened with my mother -in-law who was luckily not badly hurt , just very very bruised . We arrived just afterwards and the staff said they “told her to pull string for help back to bed”. She was a documented fall risk and had dementia. I said , as I had told them many times prior.. she might sweetly nod her head and say “oh I understand” but the minute you leave the room she has all ready completely forgot what you told her, that there is a call string and even that she has any difficulty walking !
I installed a very inexpensive ($20?) camera in mom's memory care apartment. Not so much for falls, but to track her "stolen" items and show her the "thief" is actually her. If/when mom starts to fall, it will be very helpful to show how the falls happen. The facility cannot prevent you from installing a camera, but it is on you to make sure there is a wireless connection in her room. This was already part of the installation of mom's TV/phone, so I was covered there. I will warn you - it can be very depressing watching your loved one's "life".... my mom mostly refuses to participate in the multitude of activities and just sits around all day.
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Reply to scrabblequeen

The sad fact is that falls happen in the extreme aged population.

So many reasons;
physical & cognitive
- Reduced eyesight / changes to vision
- Reduced muscle strength
- Reduced balance
- Dementia - memory but also dementia brings damage to the areas in proprioception areas of the brain (sense of body position)
- Confusion, delusions
- Arthritis, stiffness
- Fatigue
- Legs giving way
- Stroke, TIAs
- Heart attacks
- Blood pressure changes

Then there is impulsivity & lack of insight into walking ability.

Preventing all falls is sadly not always possible. Not even with someone right there, as it is near impossible to safely 'catch' someone. Both can get injured.

But trying to prevent as many as possible is always a good goal. Looking for a common theme could help. Eg most falls are on waking at 6am, or during staff handover, or middle of night in bathroom.

I'd try to phrase it that way with staff - that you are looking to investigate the falls in order to help identify a common cause. (Better to have staff on side & helpful, rather than defensive).

The usual strategies are ruling out medical issues & adding MORE supervision.

Supervision can include being sat in a day room in view of staff, bed & chair alarms to alert staff quickly, adding in regular supervised walks & bathroom trips.

My Grandmother had many falls. Loss of conscious (suspected TIAs). Supervision & company couldn't prevent them.

I hope you can find some solutions & improvements.
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Reply to Beatty

My mom falls often, too. I placed a Wyze camera in my mom's room. It connects to her wifi and I have an app on my phone so I can check on her anytime. I did not ask for permission and they have not said anything. The Colorado Ombudsman for Long Term Care actually recommended one, after I had placed the camera, so I'm assuming that they may be permissible in one's private room in Colorado. You should call you state's Ombuds office if you want clarification. What I learned from witnessing her falls is that sometimes she just falls over. I've seen her just sit and fall too. The worst was when it appeared she fell asleep in her chair and fell out of her chair directly onto her face. I'm not sure there is anything that could be done to prevent my mom's falls. I've also seen a lot of tenderness from the care staff. They cover her with blankets when she is sleeping and always are very kind to her. The camera gives me peace of mind.
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Reply to aermay

My mother had a hospital bed that lowered from regular height all the way to the floor. It also had rails around it. On both sides of the bed there were vinyl (or similar) foam mats much like those used in a gym for gymnastics. All of this made falls less likely because even if she managed to get over the rails (unlikely), she couldn’t raise herself to standing and the mats cushioned the floor if she fell from the lowered bed while trying to get out. This equipment might help your mom, but she’ll almost certainly still fall at times. They can go limp when being supported even by two or three people. They can tip over at the slightest opportunity. It’s quite common and the attendants do the best they can.
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Reply to Fawnby

Residents fall in memory care because there are usually 2-4 staff on to manage 10-15 residents. I had an approved camera in my moms room at a very upscale memory care facility and can tell you that she was left alone for hours on end to get into all kinds of situations. Sometimes she had fallen and spend hours on the floor before someone came in to check on her. Everyone with a loved one in a memory care facility should have a camera. You are their only advocate and trusting complete strangers to be his/her voice makes no sense. The reason elderly have so many falls in any of these facilities is because they are not receiving appropriate care which for most dementia residents is continuously checking and monitoring their activities and bathroom schedule.
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Reply to jimlindac
help2day Sep 17, 2022
"The reason elderly have so many falls in any of these facilities is because they are not receiving appropriate care..." Actually, that's not true. The main reason elderly people fall is they are elderly. Their muscles are getting weak and they will lose their balance. Why do you think many have walkers? My own mother had THREE walkers and would never use them! She tottered around grabbing onto furniture, tables, walls, etc, to get from room to room. She hated using them.

Gravity is a real problem when you get old and sit all the time. Muscles weaken and many elderly people have arthritis and/or osteoporosis that weaken their bones. No MC or NH is going to have eyes on your loved one 24/7. Just isn't possible.
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I’d be surprised if there are tapes. Camera in her room ?

when my mother started falling more, the MC put an alarm on her chair / bed if she got up. They had talked of moving her room closer to the center of things. But things progressed rather quickly for my mom.

maybe time for hospice to be involved? She may qualify and receive the benefits. As things progressed for my mom, a wheelchair arrived, a bed table, a hospital bed.. better yet more eyes on, a CNA twice a week , a nurse visit weekly, clergy visit weekly, social worker monthly, depends, pads , lotions etc… you may not see your mom as needing hospice, I didn’t… but as I said , things progressed quickly for her.
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Reply to babsjvd

Have you seen the facility fall reports? I would assume the falls are reportable to the state as in NYS when I worked there. States have a procedure to safeguard against falls. Careplan needs to be set up by the facility. Ask to see that. I also might consider doing a call to the state surveyors to review her case. My mom at 89 has falls but she is off balance and using a walker. Her Lewy Body Dementia raises her risk. She fell showering alone so the care plan now states when they shower her {her time not theirs} and every effort is made to avoid her trying to shower alone. Good Luck
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Reply to Sadinroanokeva

Beatty gave a very thorough answer.

I would want to know if the falls are occurring at night. If so, one solution is to put her mattress on the floor. Or there's such a thing as a concave mattress. If it is happening during the day as well, then that's a different challenge.

My 100-yr old Aunt has advanced dementia and still believes she can get up and walk -- and often attempts it. We have to watch her all the time! When she's in her recliner watching a dvd we have an alarm on her in case she attempts to get up. If she does, she just falls -- she cannot walk unassisted. She broke 2 bones on 2 separate occasions even with family caregivers right there with her. All the more a challenge in a facility unless you hire a private aid to stay with her all day.

My Aunt's dilemma is that no one can legally be restrained in a facility or in their home. Until she qualifies for LTC and can no longer get out of bed or a chair on her own, falling will continue to be a risk for your Mom. I would discuss strategies with the admins, as she is not their first case regarding this situation.
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Reply to Geaton777

Have you considered putting a camera in her room? I have Wyze cams all over my mothers house, and they are extremely helpful. Cost about $30. They can see in the dark as well as during the day. With memory cards, which cost about $6, it’s possible to look back and see what happened.
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Reply to Spinster

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