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My mother, in assisted living facility with my Dad and has severe dementia, has been falling a lot and hitting her head. She won’t stay in the wheelchair because she doesn’t think she needs it. Every time she falls and hits her head, she is brought to the nearest hospital for a CT scan, per protocol.
Has anyone experienced this with a LO? How do we keep her in the wheelchair chair and safe?
Thank you-

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My mother had to go from the ALF into their Memory Care section recently after too many falls, dementia, and a hospitalization which resulted in her becoming wheelchair bound. The Memory Care section has a TON of caregivers who keep an eye on her, plus they have an alarm on her recliner and in her bed, at my request, to alert the staff if/when she tries to get up on her own. My mother does not feel like she 'needs' the wheelchair either, which creates problems. In the 2nd week she was there she fell in the shower! And just yesterday she's saying how she's 'slipping' in the shower STILL and 'almost falling', if not for the care giver catching her. Meanwhile, it's almost impossible to fall in her shower, the way it's configured, and we've put down a large non slip mat on the floor. She's 92 and has fallen over 3 DOZEN times over the past few years, never having a serious injury that required hospitalization, believe it or not. She did fracture a few ribs and her sternum, unbeknownst to anyone, however, because she was able to get herself up after those falls so nobody knew! Your mother's ALF may be wanting her to move out soon due to the liability situation with all the falls. There's no way to 'keep' her in her wheelchair, either, but at least in Memory Care, they're all urged to come out into the great room area every day and do activities together. The caregivers keep an eagle eye on them, taking them to the bathroom religiously every hour (even if they're in their rooms, they're checked on hourly). But in reality, there is no surefire way to prevent falls with the elderly.
With my mother's ALF, there are a few couples where the wife lives in the memory care section & the husband lives the AL section, so that may need to happen with your folks, if such a situation exists. The MC section is just across the parking lot so visiting is quite easy.

Best of luck!
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My Mother with Alzheimers was falling a lot in Memory Care facility. Could not understand how to use walker or wheelchair. Facility hired a special one-on-one physical therapist who worked exclusively with my Mother on strength and balance for 6 weeks. NO FALLS now for about past six months !!!!!
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snowy1 Aug 2019
That is great! How did you actually get your mom to agree to doing the PT? I know my mom could stand up correctly as I saw her do it with PT last week but mom doesn't want to do that. She refused my offer for me to pay for her to receive additional PT privately as her Kaiser only gave her that one visit with PT and he just told her to practice but she doesn't comply even with my sister who is her caregiver 24/7. Sister does great but needs her surgery and I am one that will be with mom that evening and already feel stress about it.
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Robinchoell, my Mom [98] was having the same issue. In her case, head trauma accelerated her dementia from beginning stage to final stage. Thus, her brain was telling her she could walk, but physically she couldn't even stand up without falling.

My Mom was also trying to get out of wheelchair. The Staff at long-term-care tried to use a seatbelt, but a couple seconds after it was put into place they heard the "click" and the belt was off.... [sigh].

Eventually the only thing that worked 75% of the time was placing Mom into a geri-recliner, and placing a pillow under Mom's knees. Thus it made it more difficult for my Mom to get out of said recliner. She would tug and pull at the pillow and once in awhile was able to remove that pillow.

Sorry, there isn't a whole lot the Staff can do to keep a person in a wheelchair due to State laws about confinement. You can have a room with nurses, Aides, and family, and sure enough, that elder will find a way to fall in a split second.
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Technically the AL facility cannot "keep" her in the wheelchair (or bed, etc) as this implies tethering of some sort and this is illegal. Ask the facility for their advice. She may need to move to the next level of care. Does anyone know what's wrong with her balance? Is she just very feeble and unsteady on her feet? Is she getting up at night to pee? Ear infection? UTI? There may be other strategies to deal with these issues.
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I'd explore if she needs more supervision. Regardless of where she is it will be a challenge to keep her from falling if she is bound to get out of the wheelchair. It's almost impossible to have someone by her side 24/7 to prevent her from falling.

I went through it with my LO. You can discuss it with the facility to see what is legal in your state. Some offer alarms that buzz when the person gets out of the chair. That way, staff can go to assist her before she falls and guide her back to safety. But, there are laws about any kind of alarm or safety device that could be considered a restraint. You can check with an attorney to be certain of the laws in your state and what is allowed.

Sadly, from all that I have read and seen with seniors or those with dementia who insist on walking when they can't, they somehow continue to fall, sometimes getting fractures and that usually really sets them back. I know it involves so much stress on the family. The only time my LO's falling stopped was when she was no longer able to get out of the chair.
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My husband wears a soft helmet that protects his head when he falls. It doesn't seem to bother him as he's been wearing it over a year now. You might want to consider one of these.
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Yeees! I can relate to all of you. My parents were together in AL, mom with moderate AD and dad with slightly milder dementia. Till one week when his dementia and pride got in the way of using his rolator and he fell on his head three time in three days. Lost consciousness the first time, eleven staples to his head the second time. As a result he lost his ability to help mom (she also has an ileostomy), and they were both moved to skilled care. The falls changed his personality and they had to be separated; Mom was moved to memory care. Now dad continues to fall 3-4 times/week on average. Just forgets he can’t get out oh the wheelchair without help. He has long had orthostatic hypotension, refuses to drink enough water, so his balance is poor, and with weight loss is losing strength in his legs. The facility has tried rehab to build strength on multiple occasions but he just won’t cooperate. It is just part of this miserable slow deterioration that comes with dementia (and now TBI too). Because dad cannot understand the need to remain calm for a CT, and would not be a surgical candidate anyway, we have it on record that the facility is to contact us before sending him. We have both parents on palliative care only at this point. Neither of them are enjoying any part of their lives anymore. My heart is with you all.
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Survive101 Aug 2019
I know how you feel with your parents both being so miserable. I’m so sorry that you have two going through it. My mom is so sad, scared and miserable too. She has Parkinson’s Disease with dementia and does not know her limitations. She gets up constantly. After she broke her sacrum, ankle and both hips, with multiple trips to ER, surgeries plus rehab, and having severe delirium while in hospital, we had to hire private 1:1 caregivers for 24 hour supervision - she’s like a 1 year old child. She hates the caregivers hovering and begs them to leave her alone.
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I’d question the facility. There should be a monitoring system in place and a bed alarm pad in her bed and chair. It’s a life saver for me! If she gets up or out of anything They’ll be alerted by flashing lights and a alarm sound. They should be aware of the situation and address it immediately! You should not have to worry about anything like that if she’s in a facility. “In my opinion “ you’re paying to not have to worry about her. Hold them accountable!
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An alert pad by bed and in front of wheelchair which will alert she’s on the move. Though if she’s like my dad - she will learn to navigate round the pad - then fall! I’m afraid there’s no sure fire way to stop them - though the recliner with pillow a good move. Whilst it’s natural to worry about their falling - I’m afraid they see it as a challenge and a wheelchair versus a determined person who is convinced they don’t need it isn’t much of one.

Ideally 1-1 care 24/7 is needed at that stage - whether affordable is another matter. I did it for my dad for a while but it was very hard as I had no help.

In total dad fractured his ankle, and hip - twice, along with a load of bruises, cuts to head, black eyes etc. The last hip fracture was in a nursing home, where despite my demands for medical care / intervention, they made him walk on it for 14 days leading to his early demise.

Thinking of you all,
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More supervision, more alarms, soft cushions next to the bed, and maybe a helmet. I really hate restraints, but vest restraints keep people seated in their chairs when properly used. Also consider more exercise to tire her out.

If she is somewhat able to ambulate, maybe she would use a walker with supervision.
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