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Not the best facility due to money constraints / Medicaid. Mom has been there 6 weeks, over the past week she has had three BAD falls, one needing a trip to ER for head scan - which seemed ok apparently (even though she has the biggest lump on the back of her head I have ever seen!). Is this common? I am so frustrated with the lack of care she is receiving. I am sick to my stomach every single day.


The only thing that has improved is I have been able to sleep at night now (most of the time if I can stop THINKING and worrying so much).


What have others experienced?

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I'm so sorry to read your update that your mom passed away. You have my deepest condolences for your loss.
I wanted to tell you that my mother lives in Memory Care and has fallen a total of 46x; 36x in Assisted Living and now 10x in the Memory Care section of the same place. It's never been 'their fault'........it's due to her mobility issues, neuropathy in her feet/legs, dementia, and her refusal to ask for help, among other factors. So please don't blame yourself or say that you don't know if you can forgive yourself for something that wasn't your fault to begin with. You can't save a person from dementia, nor can you prevent them from falling. When I was working in a Memory Care home, the residents fell ALL the time, through no fault of the staff. Several people fell, broke their necks and passed away very quickly after being taken to the hospital. In a way it was a blessing because advanced dementia is nothing but suffering and heartache for all concerned.

Sending you a big hug and a prayer for you to find peace with all of this, my friend. Wishing you all the best moving forward.
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NanatoRandS Apr 2020
Thank-you for your kind words. I do believe that it was a blessing to take her now, that things happen for a reason - and some dementias (maybe all?) are a horrible way to spend the last days of anyone’s life.
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*Update*  Mom had another fall on 3/13/20.  It was just after the "lockdown" of the memory care facility - and the EMTs determined that she did not need to be taken to the ER since she was responsive and they didn't want to expose her to the ER with the COVID-19 issues that were beginning to log-jam the ERs everywhere.  We did see her via facetime and through windows several times in the following days - and aside from a nasty bruise on the side of her face and head, she did not seem all that different.  She was very confused about the lock down and why we were not visiting her, and her anger issues did seem to be getting progressively worse.  Then on 3/29/20 her Dr. called from facility to say that her shoulder was x-rayed due to her favoring it for the past two weeks, and although there was no broken bones, she did have some tendon and ligament damage and would be in a sling to help support the arm.
On 4/5/2020 she was taken to the ER because she was unresponsive at 7AM at the facility.  That was the first time I got to see her since 3/12/2020.  I was told that she was having seizures and a CT showed that she had a fractured skull and brain bleed.  She was put on anti-seizure meds and the following day moved to hospice (as her advanced directives are clear that she did not want to have any unusual means taken to sustain her life). 

Mom died on 4/14/2020.  After only 70 days at a Memory Care facility.  I am heartbroken and I don't know if I will ever be able to forgive myself.  The only thing I keep hanging on to is that as she was falling deeper and deeper into the horrific time she was having with dementia (she was diagnosed with late onset bvFTD) - she would, during her more lucid moments, beg God to take her.  She hated what was happening to her, and did not want to live any longer.  Being able to be with her during those last nine days - I feel it was her last gift to me - even though she never regained consciousness, she seemed so peaceful and calm.  I talked to her, read to her and listened to music with her - and she passed as I was holding her hand.  I don't think there was a moment during those days that I didn't pray and hope that she would open her eyes and be "better", but deep down I knew that even if she did open her eyes, she would not be better.  She would not be the mother I have wanted to have back for the last couple years.  That woman was already lost, I could not have her back.  So it was time for her to shed this 'broken' shell of a physical body - so that her beautiful spirit could pass on to the next life.  She is with her Mother now.  Her sister who she loved dearly, and her best friend Shirlie.  She is also back to being my guiding light - the mother I wanted back.  It took her death to get her back.  But I miss her so much.  I know she would want me to forgive myself for moving her to Memory Care facility, I just need to figure out how to do that.
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My 97 year old mother in AL with advanced dementia falls often, with only two falls resulting in her being taken to the hospital to suture a head laceration and the other making her look like she got worked over in a boxing ring - twice! It was just bruising, though, and she recovered in a couple of weeks. Mom has figured out how to fall like an accordion, and most of the time she just needs to use her medical alert to ask for help in getting back up. It is really, unfortunately, just part of the process, and I know her care is excellent. Hang in there......
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Jannner Mar 2020
After my mother fell, the therapist taught her how to fall to do the hopefully least serious damage. I imagine most places do that. But the fact they expect more falls and prepare for them sure shows its common and not 100% preventable . If your mother has vascular dementia she’s probably on a blood thinner so any bump , bruise or fall is going to look like she lost in a boxing match . I kept seeing these bruises on my mother, even from something like an IV, and wondering what was going on, never thinking of the blood thinners🙄
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To NanatoRandS who responded to my post below PLUS anyone else interested in the bed my mother has and how it was acquired. To begin with we are in Australia and have a major ongoing investigation into the aged care sector and providers are implementing every new suggestion that comes out of that commission. Yes, there have been some horrible things uncovered but that is not the norm. On the whole we have a pretty good aged care system here, especially in the private sector.
......
My mother is in an aged care facility as averse to a nursing home. They are slightly different where the law is concerned, basically have the same services (apart from memory care units which can be difficult to find). My mother had sufficient assets to be able to pay a big bond into a really good aged care facility, has been in memory care unit for almost the entire 12 months she has been there.She suffers 3 types of dementia, possibly a 4th, sometimes is really compliant and lovely, other times she becomes the devil incarnate. At those times she is very difficult to deal with so the staff keep investigating ways to keep her safe.
One of the problems the government investigation has been looking at is falls and how to combat them. It is the norm now for all facilities to have hospital-type beds which can be raised and lowered according to needs as well as being adjusted for sitting and for raising of feet level. But they usually are still about 2' off the floor at their lowest extension. In the memory care unit it is usual for crash pads and bed alarms to be used, although in the open section these are limited.
My mother was continually falling out when she was agitated. Even when in hospital where they DO use restraints in some circumstances, she would still try to get out of bed and had a few falls. As a result she also has to be specialed every time she enters hospital. Even they do not have these special beds.
The facility has been trialling a new bed which has all the usual bells and whistles but the bed frame can be lowered to be sitting on the floor. Add to that a thin mattress, put the crash pads around her and she more or less rolls out of bed and down no more than about 8" or 9". Yes, she occasionally sustains a skin tear but these seem to be more associated with a slip/tantrum throw out of her wheelchair.
My mother pays well above the basic fees and has the back up of being a gold card war widow, so it is possible that is how the facility managed to meet the expense of the bed. Staff are really pleased with the result. Yes, my mother is still labour intensive because it takes two staff and a sling lift to get her up, and she often objects - vehemently! But by and large it is saving many trips to the hospital and the dreadful impact that has on people with progressive advanced dementia.
I can thoroughly recommend these beds for those with elders in this situation. But I believe the cost is prohibitive so that will stop a lot of facilities even entertaining the thought of investing.
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Yes, it is common. My friend's father fell twice in two days requiring two trips to the hospital. In my state, facilities must be restraint free so fall prevention becomes complicated. The other factor 8n falling is the decline 8n functioning due to the disease itself. I would speak with the facility and if appropriate, request a physical therapy evaluation.
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My experience - my mother was in a SNF for 10 - 11 days upon which they called a family meeting (I had been living there out of state for 6 months, my one brother finally arrived day before meeting, they said to my mother "Ma'am, you're too well to stay here." WRONG ANSWER! DEAD wrong as less than 48 hours after that statement, my mother suffered an ischemic stroke and she did not live.

Be very careful.
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When my mother was in a SNF, I went every day. If I didn’t like something, I’d let Head Nurse in charge know. If it was not fixed, then I’d go to Nursing Supervisor. If still not resolved, Nursing Director. It sounds like she needs more care & supervision than she would get in memory care facility. In the SNF, they would have a particular song playing every time a patient would get off their bed. Also, I remember there was a woman who would constantly get up from her chair & walk into walls or wherever...& she had a CNA assigned to watch her & sit with her at ALL times!!! I even resented this “special “ treatment & went to Nursing Director to suggest if one CNA was one on one with a patient, then have one extra CNA on the floor....you know what? She agreed with me! So my advice to you is look into getting her into a Skilled Nursing Facility instead of a memory care facility. She needs more care & attention than memory care can provide. Good luck & hugs 🤗
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Just like many of the others responding here, my Mom fell in Memory Care three times in a ten-day period a few summers ago. One of the falls was right in front of the hospice nurse; there was nothing she could have done to prevent it. It's just so terrible with the Alzheimer's added; she couldn't remember to call for help, and she was strong enough to get up, but not strong enough to steady herself. Besides using a "chair buddy" to keep her from sliding out of her wheelchair, it was a blessing when she finally couldn't get up any longer; I'm really sorry to say that if it sounds harsh, but my adrenaline would race every time my phone rang. I was so jumpy because every time the facility called, it was bad news.
Please don't be too harsh in your judgement of the home; it's a lot of work and not necessarily an upgrade to move her at this stage. Also, some facilities might not accept her (and you) if you come across as being angry with the current facility and speak badly about them; your Mom is also a big risk for a new place to take on, considering all the falls recently, and that you may be blaming the staff. Just some things you might want to carefully consider.
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I got my friends Beth and Jim into a memory care apartment in June, 2015. By the start of August, they advised me to get a wheel chair for Beth and where I could get one less expensively. By September, she needed a reclining wheel chair and the facility had one for her to use. She had frontal temporal dementia which was taking away so many of her abilities at the end. Those wheel chairs took care of any fall problems, thankfully. She passed in late October and was in hospice care at the time and in a hospital bed in their memory care apartment. Her husband is still there, misses his wife, and never falls yet. At age 93 his physical health is quite good, he just can't remember anything short term. Beth's wheel chair is folded up in their kitchen waiting for the time he may need one.
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My dad (89) went into memory care 04/19. In July he had 6 falls, two were bad requiring tripS to hospital. I came unglued with admin there. With two people on at nite, and 3 in the day, how could no one be aware until he’d already fallen? Place said he would get up at nite and not make solid transfer to his chair n end up crumpling or falling down. I had our Dr. write an order saying Dad MUST have two person transfers and not be left alone in bathroom- staff could keep an eye just out of the room itself. Staff put alarm on his bed and wheelchair to alert them when he was trying to get up. Annoying at times- It can go off if move around in bed, but keeps him safe! It took awhile for all the caregivers to get onboard; unfortunately higher staff turnover than I’d prefer, but we finally got it happening consistently. Dad also has a button on his hospital bed he can push for help. His problem is he doesn’t think he needs help. This has been our answer, maybe it can help you too? Good luck!
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After reading all the responses, it makes me more leery than ever to place my mom!! I brought her from Ohio to California, where I live. She has been with me for three and a half years after falling and fracturing her neck.

Since bringing her here, she has only had one fall, which was bad enough to take her to the ER - a few scrapes and bruises and a broken nose.

I had to go two blocks to pick up her prescription, but as her Dementia has worsened, she couldn't find me, so tried to go outside to find me and fell down the two steps off of our porch. Luckily a neighbor heard her and was tending to her and had called 911 as I came home.

So if placing her in a facility causes three falls a day or a week - don't know if I can deal with that. Mom is not aggressive or angry. Most often happy and content. Has Sundowners, which causes confusion an sometimes weepiness in the afternoon and/or eveningbut I can handle that.
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worriedinCali Mar 2020
Your mom is going to fall no matter where she is. Elderly falls really can’t be prevented and placing them in LTC isn’t necessarily going to make the falls increase.
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After my MILs last fall in my home, and her subsequent stay in the hospital and transfer to a facility, she was transferred to a different facility for memory care. I thought "Great, she will be safe from falling" and get better care than I could give her. I was wrong about the falling. She falls more there than she did here, but I have finally accepted that falls are to be expected, because of several factors and in my MILs case, progression of this horrible disease.
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I don’t know that you can necessarily chalk it up to bad care. My mother refuses to use her walker even though she fell a year ago and needed surgery ( she doesn’t remember any of that experience) . She doesn’t think she needs it but her balance is awful as is her judgement. She fell because she was standing up putting her pants on, never thought to sit to do it. Personally, I think the alternative , being bedridden , is worse. Not really a great alternative.
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Here is another consideration for this chronic problem(falls): Consider a smaller 6 bed facility where staffing is 1:3. More attention, less commotion... often is a nice remedy.
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It used to be that every facility was "dinged" when a client fell as "bad care". Now, we realize that folks with poor balance and poor judgment will fall. Every facility tries to minimize injuries through: training and use of walkers, beds in lowest positions possible, thick mats of sides of bed when client in bed, wheelchairs as needed... I hate to think that anybody expects their loved one to be tied into a chair to keep him/her from falling. That tends to create problems with bedsores on their bottoms.
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They fall. They fall all the time. It is not the facilities fault and as you said, your mother fell while she was at home. I won't tell you our sad saga but when you have a parent that has dementia, cannot cooperate, cannot remember what they can and cannot physically do, the worry is for what might happen. Lots of bad stuff might and probably will happen; which is part of this horrible disease. Her falls are not the result of lack of care; she fell because of her dementia. Not your fault and there is no one to blame with this disease either. It is difficult; I know that, my mother is in a facility, my MIL died of dementia post hip fracture in October and my FIL is still in facility where he is wheelchair bound but thinks he can walk. Not being cavalier about this but all you can do without making yourself crazy is to understand that there is really very little you can do to alter what might be a bad outcome. She could fall and break her hip, fracture her skull or her neck. I am just not sure that anything can be done unless you sedate them to the point of them not moving. I am not advocating that of course, just saying I don't think there is anyway to stop it. So take melatonin or whatever to help you sleep at night; try to avoid computer screens before bed because the blue light contributes to nighttime "monkey brain" and understand that this is a really tough journey to be on.
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XenaJada Mar 2020
^^THIS!^^
So much this!

I was guardian and conservator over an aunt with dementia who was in a MC facility. In two weeks, she fell about 6 times! Most of the falls happened in her room at night. One happened during the day. An aide had just helped her get settled into a chair and walked away. My aunt promptly stood up, made a noise, the aide turned around and saw her tumble. I began to jump out of my skin every time my phone rang because it was always bad news about yet another fall.

The only way to totally prevent a fall is
a. Stay awake all night and stare at her and be ready to jump up and catch or prevent her from getting up and falling
b. Hire someone to do the above
c. Sedate and strap them to bed or chair
d. A combination of the things above

All of these are untenable. Therefore falls are going to happen.
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Can she be placed in a wheelchair rather than allowing her to walk? A wheelchair(some of them) can be reclined a bit so it is more difficult to get out of and or there are chair alarms so if she does try to get up the staff will be notified.
Bed can be lowered to the floor so if she tries to get up there is less risk of injury.
Mats are also typically placed on the floor to cushion any fall.

Falls are common and for many reasons. And some are unavoidable.
Medications
Forgetting to use a walker
trying to stand up forgetting that they no longer have the ability
tired
weak
poor balance
and on and on.

Have you looked at any other facilities that would accept her? If so do they have a waiting list? If so put her name on the list.
Have you had a Care Plan meeting to discuss your concerns and to get the facilities take on what they are going to do to minimize future falls? If you have not had a meeting I suggest that you call and make an appointment for one so that you can get this out.
Your direct care-giving is over you have moved into the role of advocate and that can be even more of a challenge.
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My husband falls and/or quickly lies down on the floor and has been doing this for over two years now. I believe medication initiated and enhances this behavior. He wears a soft helmet, and elbow and hip pads and has two mats on the floor in his room to soften his falls. Thankful he's had only minor cuts and abrasions so far.
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They still fall in nursing homes..happens all the time. If they take psychotropics and/or narcotics the risk of falling is much higher. The worse their Alzheimer's gets, the more they can fall due to poor reflexes..and they will fall more and more.
Sometimes they can fall when you are right next to them because it happens so fast you have to have lightening fast reflexes to catch them. So even at home with all the safeguards in place (lighteing, uncluttered room, fall mats, floor alarms, etc) they can still fall but mom rarely fell. REGARDLESS, it only takes one fall to be the big "game changer" when something breaks.

Make sure her physiologic needs are met. If they are constipated they feel uncomfortable and will wander trying to find relief. UTIs can make them more agitated and confused...or extremely lethargic which means they need to get checked for it in a HURRY.
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Falls and old people go hand in glove I am sorry to say. My mother has been in memory care for almost 12 months and her falls have been steadily increasing. There are several scenarios to her falls..
1 Her knees are too weak to support her despite physio, sometimes she will have a UTI, sometimes delerium, sometimes she is confused, sometimes she wants to pay back staff for some imagined transgression and falls purposely.
2 When she gets too tired of being in her lift chair or wheel chair, or if she is having a dummy spit, she stiffens her legs and simply slides to the floor. Sometimes she will co operate with staff in the lifting process, other times she is aggressive. Our instructions are to leave her on the floor until she calms down, but then she accuses staff of putting her there in the first place.
3 Mother simply gets agitated and rolls out of bed. The facility has brought in a bed that folds down to floor level, tbey put crash pads around the bed, have alarms around the bed. Sometimes they find her crawling on all fours or pulling herself around on her bottom. Sometimes she insists on remaining on crash pads, she is given a blanket and pillow and will sleep much better than in the bed.
She has been known to fall several times a day for many days in a row. We estimate she has had in excess of 50 falls. Many of the calls from staff come in the middle of the night because mothers circadian rhythms are totally out of wack.
Our instructions are that she only goes to hospital if she hits her head, otherwise staff deal with any skin tears, monitor her closely for 4 hours. The trip is too confusing for her, she cannot answer questions, she often cannot follow simple instructions such as open her mouth and say Ah, so there is no point when they will only monitor her, no scan if there is no head injury.
I never thought I would say this, but it is all water off a ducks back, now. When the staff identify themselves in a phone call my response is usually a What has she done now? Said in a semi joking manner.
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NanatoRandS Mar 2020
My mom was falling some at home, and we did notice that some of her falls appeared to be deliberate. I thought it was my imagination, but seeing what you said - maybe not.
my Mom is in a Memory Care facility - but we do not seem to have the same things available to her as you are mentioning (alarms on bed, crash pads, lower / floor bed (??). Since she hasn’t been there long, and this is my first experience with working with a facility for her care - I really don’t know how aggressive to get with them - for example : the Dr. diagnosed a level 1 pressure wound (bed sore) last Friday, ordered skilled nursing to treat it & she didn’t see anyone for treatment 4 1/2 days! By then it was of course worse!! She’s suppose to ONLY get finger foods because she is having difficulty with cutlery - and if someone tries to help her she gets angry & aggressive - but we have been there at meal time several days where she did not get finger foods and had to tell them! We wonder how often this happens, since she does not know enough to ask.
She has been diagnosed with Late Onset bvFTD & is on Geodon as well as an antidepressant. She is under the care of a psychiatrist and does see a therapist weekly - although they have had little success working with her so far.
We kept her home as long as we physically & safely could, but I feel like it may have been too long & she will never settle. Did we do her an injustice by keeping her home too long? Shouldn’t Drs be more forthcoming with these types of things and help make more informed decisions? Now I feel we are just waiting for her to die and there will be little to no joy, no calm or peacefulness left for her.
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My Mother in Memory Care used to fall a lot but then she got physical therapy to strengthen her muscles and things were fine for about 6 months...YEAH !!! Then she started falling again and Memory Care hired physical therapist again, but my Mother's Alzheimer's has gotten worse and now she did not understand the physical therapists instructions, so physical therapy was stopped. Since my Mother cannot follow instructions and does not understand how to use walker or wheelchair, the staff at Memory Care just does their best to keep an eye on my Mother. Sad situation. Do try physical therapy because even if it only works for six months, that is six months of peace of mind !! Good Luck :-)
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My Mom was in long-term-care, and she was always falling. Mom would slip or fall out of bed.... fall trying to stand up.... fall out of her wheelchair, etc. It was all part of her illness, and unless one was glued to Mom's hip, there were no ways to prevent the falls.

Since nursing home cannot strap a patient into their bed or a wheelchair, the Staff had to hope for the best. Eventually the Staff found that stuffing pillow around my Mom when she was in bed helped a lot.... but it became painful on her back as she couldn't roll over in bed [twin size bed lined with pillows].

Mom would tumble out of her wheelchair trying to reach down onto the carpet thinking the pattern in the carpet was something solid and she wanted to get it out of the way. The Staff tried a seatbelt but my Mom was the master of unclicking the belt, especially riding in a car.

Pillows under her knees helped as it would take a lot of time for Mom to wrestle those pillows out.

Of course, with State rules, some nursing homes had to call the contact person [me] every time Mom had fallen. Just wished it wasn't 2 in the morning especially if Mom wasn't injured in the fall.... [sigh].
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Judy79 Mar 2020
Where my mom is now, she has been there for almost 3 months, they have called me 1 time at midnight when she fell out of her recliner. I didn't hear the phone but they did leave a message. She was fine, I found out later. Par for the course? I am my mom's healthcare rep and my oldest brother is her financial rep. Guess that is why they called me and not him.
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Since going into Assisted Living in 2014, my mother has fallen 36x, never having a serious injury as a result, believe it or not. Since moving to the Memory Care section this past June, she's fallen 5x. It's never been 'their' fault, either........she has balance issues and authority issues as well. In other words, she refuses to listen to what she's told and so, she falls. Now that she's wheelchair bound, I thought Hey, she'll stop falling so much! But no, she's fallen 5x since because she insists she's able to transfer alone, which she isn't, and that's why she falls.

It goes with the territory for elders to fall, I'm afraid. I had ONE incident since 2014 where it was the ALFs fault that my father fell; the nurse was trying to lift him up alone and he fell. It was her fault, and she took full responsibility for it, and he wasn't hurt.

It is what it is. If you don't like the facility, look into moving your mother. But before you do, find out why she keeps falling..........is she slipping out of bed? Is she not following orders to use a walker? Is the floor slick with water? Otherwise, you will wind up moving her and finding the same fall issues in the next place.

Best of luck!
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Yes it’s common and no amount of staff can keep elders especially those with dementia, from falling. There is someone here who’s mother has fallen 40+ times.
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Yes, I agree it may not be the facilities fault. My husband forgets to keep his walker with him and as DollyMe suggests his legs don't hold him up. He doesn't do much walking and is legs get weak. My husband has had 3 fall in a week ( 2 within 2 days). Fortunately no injuries. I think because he played soccer he has learned how to fall. Just be thankful she is in memory care. If you were caring for her at home it is very difficult to pick her up. All the best
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My step father falls on a regular basis, his legs just don't hold him up, he kind of collapses, it can happen anywhere, it is not the homes fault, he is just old and the parts are wearing out.
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There’s only so much you can do to prevent falls with some dementia patients. Even the best facilities are not staffed enough to prevent most falls.

My mom had very mild dementia but could not understand that she needed help to get up and walk and wouldn’t use a walker. She started falling at home, finally got her in assisted living where she had 2 or 3 falls per week. We tried everything, I even hired a private sitter for 4 hours a day.

With each fall and injury her dementia deepened and she would try to walk even more and fall each time. It was maddening. I’ve sometimes wondered if there wasn’t some subconscious death wish going on with her. Mom died after four months of assisted living and memory care.

Its all very tough. You just do the best you can.
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3 falls all of a sudden to me suggests she may need to see doctor.  Did falls happen at night?  during day?  Does she need to start using walker?   Try to get more information and agree with pp, start first with what can be done?
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NanatoRandS Mar 2020
She does use a walker, and has for a couple years now - but honestly never got really proficient with it No matter how many pt sessions she had to use it. She forgets to use it as well. She was falling at home too, and is one of the reasons we could not keep her home any longer.
we just had a care plan meeting last week & keeling her in the wheelchair is an option, especially late in the day, however she is already showing signs of level 1 pressure sore (aka bed sores) - so they’d like her to walk more with assistance.
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I was just talking to someone about this very thing, only it was from the staff's perspective. It is an unfortunate fact of life that old people fall even with the best of care, sometimes even when there is someone right there. Three falls is a lot but instead of blaming this on poor care and going in with guns blazing you will be better served to dial it back a bit. Ask for a care conference to calmly discuss what is going on - what exactly is leading to these falls? What measures are being put into place to stop it from happening again?
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You bet, and laying in bed with your mind refusing to shut off has forced me into taking sleep aides. my LO has been found on the ground a couple times, the nursing home calls me to let me know. So far nothing has been
as bad as your mothers. Not certain this will help but I’d seek out the ombudsman person to share your concerns, as well as asking for a care plan meeting with the facility to see what can be done differently.
There are a plethora of ppl on this site with an abundance of knowledge, and hopefully they can offer you better advice.
Good Luck
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