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She will not call for help, whether she's lying down for an afternoon nap or if she's in bed for the night. She is completely incapable of walking on her own, (uses a walker or a wheelchair) but she will not stop trying to get out of bed to go to the bathroom, or (in the case of the afternoon nap) come out to the living room. SHE FALLS EVERY TIME. She has a whistle and a bell, but will not use either of them. She's going to a nursing home soon, and I would like to break her of this habit before she ends up in restraints 24/7.

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First of all it is ILLEGAL to physically restrain her. I would suggest other methods. There are safety devices that can be use. A side rail on the bed would be a simple thing IF she would not try to climb over it. There are also pressure pads that you get to put on the bed under her or her bed pad... you turn it on after she is in bed, if she started to get off the pad, it sets off an alarm to alert the care giver to assist. There are also floor pads, you put beside the bed. If she stands on it, even one foot touches it, it sounds an alarm... alerting the care giver. Another option (cheaper) is to get a motion sensor. They are only a few dollars, set it above the bed, so if she sits up, it will trip the alarm and alert the caregiver! There is another one that is an alarm that is fastened to her bed/chair, etc. it has a pin (like a hand grenade!!) that has a string attached to it, with a clip that fastens onto their clothing. When they try to get up, it pulls the pin and the alarms sound! Hope these options help! :)
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As others have mentioned, active, physical restraints are not used in a good nursing home. Side rails can be more dangerous than a fall would be. There are thick mats that can be placed by the side of the bed, but they're controversial, too. There are passive restraint systems; beds that are difficult or impossible to get out of for a person without much strength. At the community I'm associated with, we consider all of those to be restraints and don't use them.
There are many, many alarm systems. The problem is they're useless unless someone is within arm's reach when they go off. All they do is alert the staff that someone is about to fall so they can hurry to the room. Unless they're already in the room it's unlikely they'll be able to prevent it. They do, however, make family members feel like something is 'being done'.
I once heard a geriatrician respond to the adult child of his patient who was demanding that he "do something" about his mother's frequent falling. He said, "old people fall, it's what they do." Sounds simple, but it's incredibly difficult for middle-aged people to really understand unless they've had a lot of experience with the elderly.
If you have the resources, you could have someone sit by your Mom's side 24/7. But I doubt she'd want to live that way. I wouldn't.
I'd certainly try giving Mom a sleeping pill at night, if it helps. But, whatever else you do, try to come to grips with the fact that your Mom will very likely fall. Given her restlessness, probably more than once. Don't feel guilty about it, don't blame the nursing home for it. "It's what they do."
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We used a notion sensor for my Dad. It was placed so if one leg came over the side of the bed an alarm sounded. Worked good. Didn't keep him in bed but did let us know he was on the move. You can't tell some people they can't walk without help. My 96 year old Mother has broken both legs because she wouldn't use her cane or walker. After 3 years I still catch her creeping around her room holding on to whatever comes under her hand, sturdy or not. For the sake of my nerves and mental well being I have given up and when she falls I call the Fire department for help and if she breaks something else I will call an ambulance. Don't beat yourself up. You will always be her kid and parents don't mind kids. This is from a 73 year old kid. I am sure the nursing home will know how to handle her and she just might listen to them.
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I glanced thru the responses and did not see this solution which is used in nursing homes: a very low bed close to the floor so if they fall out or get out, they can't hurt themselves., I would post a link but this site will delete it. so query low beds fall prevention elderly.
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There are alarmed bed mats, alarmed floor mats, and monitors. Most are under $200. The alarm is wireless and is not activated in elder's room but to a remote for the caregiver.
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Hello Harrah. I completely understand your situation; I had the same with my mother. No matter how many times I reminded her she needed to use her walker, to call me if she needed to get up, she forgot and til the day she died she thought she could walk, even though she bounced off all the walls she was so unstable. Alzheimer’s is a terrible, terrible disease and torments the patient with thoughts that seem so real, but so false.

You didn’t say if your mother was suffering from dementia or simply having issues with stability. My mother has Alzheimer’s and used to feel she had to do so many things that were impossible; like picking up her brother who died 11 years before. Sometimes she would calm down if I told her he just called saying a friend took him home and he would see her in the morning. Other times she was on a mission and no amount of white lying could give her peace. It was those times I cried buckets for her because it seemed so real to her and would not let her rest. Obviously, I couldn’t let her leave the house, but she was on a mission that wouldn’t be deterred. I knew if I could give her something for sleep, it would give her peace from the tortures of her mind. Problem with sleeping pills and the elderly with dementia is they often make things worse. Eventually, I did find a combination that sometimes helped, others it did not. In fact, she could still keep going on stuff that would take down an elephant. So, with the authorization of your doctor or hospice, give it a try, but be aware they may not give you the peace for your mother you are seeking.

However, what I finally resorted to, because I couldn’t sit with her 24 hours a day, was a wonderful monitoring system. We started out with the alarm that clipped to their clothing. Be sure and clip it to the back of the garment so they can’t reach it and take it off. It worked fine, except the string is so long that if she got up to go to the bathroom, the string ended up in the toilet. EWE!! Not to mention blaringly LOUD!!! It would scare my mom and set my nerves into hyper-drive as well, especially when you are jolted from a dead sleep.

My mother was in our finished, walkout basement. She had her own bedroom, kitchen, living room, family room and bathroom, so she wasn’t in a dungeon by any means. I still had to keep an eye on her and would be there to help her when she got up. Due to her kidney failure, she slept a lot during the day and for me to sit and stare at her was non-productive to say the least. Yet, I did need to keep an eye on her 24/7.

Our next step was to put a sound sensing monitor on her nightstand so I would hear when she got up. Do you have any idea how quietly they can get out of that bed? Unreal!! My next solution was to pin the monitor between the folded, double size, down comforter I had on her twin bed. That worked really well because the covering on the comforter was stiff so I always heard the rustle when she moved. Moving being the optimal word here. I found myself running full speed down two flights of stairs at 3am only to discover she had simply rolled over.

Okay, final solution, video monitors. I know it sounds like a terrible invasion of her privacy, but by then, I had done and seen things I NEVER wanted to with my mother, so privacy was no longer an issue, this was definitely a safety measure. She would even climb over the side rails or go out the foot. Side rails are, in reality, dangerous and definitely not the answer. The video was a Godsend. However, I did try to preserve her dignity and she never realized I was monitoring her escapes. It was cute because she was always so surprised and happy when I showed up just when she needed me. I could see her get up and know if she was going to the bathroom or what was happening and if she needed help. We had one in her bedroom and one in the hall leading past the kitchen to the bathroom. I knew if she was taking too long and could make sure she had her walker. It saved many, many, many useless trips and a lot of frustration. Before the monitors and she was at the “sundowner” stage, I would find her wandering the house at 3:30am. I was scared she would go outside and I wouldn’t catch her. The monitors gave me a measure of peace and rest. Well, as much as one can get caring for a person with dementia. At least, the three hours I did get helped.

The nice thing about them is the receivers are portable so you can take them outside or other parts of the house and still keep an eye on your loved one. Be sure and check the range of each prior to purchase, as some have longer reception than others. The minute the person wiggles, you can head to them and most times your feet can beat their escape from the bed.

I hope this works for you. It is certainly worth the few dollars to give you some peace……and rest. And definitely much, much kinder than restraints. Oh, and again, this may sound cruel, but until you have lived with a person with dementia and sundowners, you can’t begin to understand the challenges we face. To keep her in her bedroom, bathroom and kitchen area at night, we reversed the locks on the doors. She had freedom to go from each room to the other, but kept her away from any outside exits. To me this was MUCH safer while allowing her plenty of space to move. Our only problem came with the one section that did not have a door. We tied an old twin mattress across the opening, thinking it was soft and she could see over. Good in conception, bad in reality. Don’t ever let anyone tell you these people are stupid and that they are no longer thinking! When my mother couldn’t untie the knots in the ropes, she went to the kitchen, got a knife, cut the ropes, and escaped. I watched it all on the monitor. Was very inventive and funny, but after that night, all the knives and scissors were removed from the kitchen and we used wire to hold the barrier in place. She never figured out our slick way of releasing it, however, she did spend a few hours trying to formulate an escape. At no time was her life in danger because I was glued to the monitors and we could easily get to her by opening the doors. In fact, as I write this, I am watching my 2-year-old grandson on the video monitor in his room as he naps and on the other side of the room is the sound monitor in my FIL room because we are currently dealing with his dementia that is rapidly robbing him of his life.

I hate feeling like a spy, but they reach a point where they no longer realize and understand the phone, whistle, Lifeline alert bands, etc. At that time, you have to step in and do whatever you can to protect them from this insidious disease.

Wishing you luck and I hope you find a solution that works for you and your mother. I have learned to tap dance very fast having cared for three parents in our home, all suffering with dementia. It certainly isn’t easy for either the parents or the caregivers. I pray daily for a cure, or to be spared from being a burden to my children and their lives. Such an insidious and cruel disease.
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My dad is in the nursing home, when he first went in he refused to stay in the bed. He would limb over the side rails, scoot to the end of the bed and down he would go. The nursing home tried everything, until one day I came in and his mattress was on the floor without a frame. If he feel out of bed it was only the width of the mattress that he was going to fall. Plus it was harder for him to get up o he would stop trying. He also had real thick mats beside his bed. I am proud to say he "graduated" and he now has his bed back. He was so happy they even gave him a little "graduation" party. Oh by the way, he also has severe dementia.
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I'm assuming you have a hospital bed with 1/2 rails. The full rails are more of a risk factor, in my opinion.
As sad as it is , there are no easy answers. We are dealing with humans, that have significant disabilities. I do not suggest, that you not hold a care facility accountable, but as someone else mentioned, the elderly and frail will always be a fall risk. There are many different things that are tried, and certainly try to be in on the multi-discipline team to give your input, since you know her best. Remember at this time she can not advocate for herself, so she will need you to be her advocate, the best you can be. Keeping a brief diary of her habits, would certainly be helpful. Also remember that the change in surroundings, may escalate her behavior, as she tries to make sense of it. For some it helps to see their loved ones daily at first, for some it makes it more difficult. Also there is no right or wrong answer here. It is what is best for ALL involved in the situation.
There are a lot of caring individuals on the site that have given you some idea's. Hope that this helps, a little.
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(I worked as a nurse for many years in a nursing home....) Physical restraints are considered abuse! If a nursing home would go that route, I would seriously NOT go there! That is horrible. They are more likely to chemically restrain her...(sedative) and even that is controversial....and illegal in some places. I do give my mother Ativan at bedtime only... as she has a horrible time sleeping at night, always has, but now it is a safety issue as well. If you would like I could research any of the options above for you, as to where to purchase. I am sure you could just do a search for "bed alarms" in health care supply sites, etc. "Safety alarms" etc.
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The only issue with using bed rails is that some people are so desperate to get out of bed they climb over them and then fall from a greater height because of the lack of stability. If the person is aggressive about getting up then suggest being somewaht thoughtful on this first. The bed rail pads are a very good idea, they do proveine good protection but sometimes the person can feel closed in.
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