Repeated Falls: Tell it to Me Straight

tootz

My Dad with advanced dementia is in MC and has been having repeated falls, mostly in the night. After two separate week long stays at the hospital, followed by 3 weeks of skilled nursing, we brought in hospice services. He has declined quite rapidly. Last night he fell twice, both times hitting his head. He is on meds for suspected UTI (he winces in pain when he has to pee) and takes Serequil, with a small Ativan dose before bed (to help him relax and sleep and stay in bed). I know falls are not preventable (he is mostly in a wheelchair now) but he forgets he can’t walk unassisted when he has to use the bathroom…. I’m leaving out a lot here but for those of you who have had a loved one falling multiple times a week and this post connects with you… can you please help me realize what’s coming and how to help my Dad? Tell it to me straight. I need to hear it. Can I do anything? We are following a comfort plan… we want him to have his dignity. This SUCKS!!!!!!

April23

Ugh, I’m so sorry. This is my dad’s journey in a nutshell. UTI, falls, fractures, then rehab, rinse, repeat. We were finally directed to an infectious disease doctor who got my dad’s UTIs under control. And he actually did great with no infection for over a year. But the damage was done so to speak.

The dementia complicates things because they don’t remember they can’t get up and walk, that tendency has never left my dad no matter how debilitated. So we have had to use safety belts on his wheelchair (he can open it so not a restraint, just a reminder) and use chair alarms to alert the staff if he tries to get up.

The bathroom was eventually his undoing, they simply are not safe in there unassisted, especially males who tend to pee all over the floor, which they will do especially if they have a UTI.

A mistake I made was putting my dad in MC AL with a private bathroom. He did rehab well enough initially to walk with a walker but he had a terrible fall in his bathroom unassisted. So I made the decision to place him in an RCF which only has 8 residents so that he could receive more individualized attention (and safety belts and alarms are allowed) and he has lived there 2 years now with no falls.

A smaller facility with more individualized attention was what worked for us. If he is able to get out of bed unassisted at night, then that is going to always be a problem I’m sorry to say. My dad has a bed alarm to alert the staff so if that is allowed at his MC I would look into it. Some won’t allow alarms but they will allow baby monitors so that could also be an option. Also if he has a room with his own bathroom then I would switch to one with no bathroom so he doesn’t have access. One of the ALs I toured was all shared bathrooms for safety and I should have heeded that advice early on.

Also you can ask hospice to look for a hospital bed that goes low to the ground and lower it at night, it’s actually more difficult for them to get out of a low bed than one at regular height. You can also have fall mats on the floor so if he does fall maybe it’s lessened (although they can also be trip hazards so I would discuss with the MC). If night is when he is falling, then that will be the biggest issue to solve. Talk to the MC and hospice nurse to see if they have other suggestions. I’ve had many sleepless nights, I know what you’re going through!

tootz

thank you. I appreciate you taking the time to respond. This is so heart breaking 💔 with no good solution. My Dad is in MC which is connected to my Mom’s apt in IL. For many reasons we can’t move him. We just hired a night aide for now… today he slept all day and we wonder if that’s from a concussion or possible brain bleed or UTI. It’s all so sad and nothing is easier than the other option.

April23

Yes a night aide was a thought I had but it’s also usually not a sustainable long term solution for most. I’ve employed them myself. If he has a bathroom maybe it can be “out of service” and made inaccessible. I’ve also considered using furniture around dad’s bed to block his access but then if he did get up, that could be a problem too. Bed rails have their own dangers. It’s really an impossible situation. I purchased a special bed that can be lowered to floor level and that along with a bed alarm is finally what worked. I hope your dad recovers, my thoughts are with you.