Falling out of bed in a memory care facility

Posted by FWW @fwentz, Sep 17 8:08pm

My wife has been in a memory care facility for 4 1/2 weeks and has fallen out of bed 4 times, twice hurting her head (never seriously as far as we know). At home before she was admitted to the memory care facility she never wandered or wanted to get out of bed by herself. I put a chair back at the side of the bed so that she could sense that the edge of the bed was close.

She is in the very late part of the middle stage or in the early part of last stage of Alzheimer's disease. She was diagnosed in 2012 and I have been able to care for her (with lots of help) until recently. I'm 81 years old, she's 79, and I was beginning to be concerned about one of us being injured if she lost her balance while I was walking with her or transferring her.

I would like the facility to use restraints of some sort but they claim they cannot because the laws in the state of Washington require a licensed nurse in the facility 24 hours a day and they do not have one on the night shift.

Her most serious fall was last night. The facility director today told me they will work with the maintenance director to see if they can relocate the Quiet Care system so that it better alerts staff whenever she moves in bed. My daughter has said we might consider putting a mattress next to the bed or having her sleep on a mattress on the floor.

I believe she is in the best facility in our part of the state but I am going to explore some other nearby facilities further than I have earlier.

I'd like to see some brainstorming of some ideas for how to keep her safe. Thanks for your help.

Liked by kirstenhw

Hi FWW. My name is Virginia Naeve and I try to be helpful on these kinds of issues when I can. I remember when my mom, who suffered from Alzheimer's, was in a memory care and she fell out of bed and broke her arm. I was horrified and very sad. The facility told me that it wasn't legal in the state of California to have guard rails on her bed. I thought that was ridiculous. While we had the problem, we put soft blankets on the floor beside her bed and made sure the other side of the bed was against the wall. Eventually, she stopped falling out of bed.

I just saw something on line that I thought you might want to look in to. Look up Rehabmart.com. Search for Posey Patient Safety Roll Guard. It's a soft, pillow roll for the sides of the bed. I thought you could ask your mom's facility if they would allow that. Tell them that it's better than her breaking her arm! Good luck and tell us what they say! Virginia Naeve, http://www.anewpathformom.com.

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@virginianaeve

Hi FWW. My name is Virginia Naeve and I try to be helpful on these kinds of issues when I can. I remember when my mom, who suffered from Alzheimer's, was in a memory care and she fell out of bed and broke her arm. I was horrified and very sad. The facility told me that it wasn't legal in the state of California to have guard rails on her bed. I thought that was ridiculous. While we had the problem, we put soft blankets on the floor beside her bed and made sure the other side of the bed was against the wall. Eventually, she stopped falling out of bed.

I just saw something on line that I thought you might want to look in to. Look up Rehabmart.com. Search for Posey Patient Safety Roll Guard. It's a soft, pillow roll for the sides of the bed. I thought you could ask your mom's facility if they would allow that. Tell them that it's better than her breaking her arm! Good luck and tell us what they say! Virginia Naeve, http://www.anewpathformom.com.

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Hi Virginia. Thanks for the idea. I've looked at it and I think it would work well for me if Judy was still at home. But I think the facility director would consider it a restraint. At home I put a simple chair with it's back up by the bed edge near her elbow/waist area and the director said that was a restraint. She should call me later today so maybe we can work out some other ideas.

Like you did, we have one side of the bed next to the wall. You also had another idea with soft blankets on the floor. That's something like my daughter's idea of a mattress in the "landing area". Right now I'm thinking that if the facility can set up a motion detection system to alert the staff to Judy's movements, even if she moves out of bed they will quickly find her on the mattress.

Thanks again for your thoughtful response.

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Oh man. No one uses common sense anymore. A puffy things that looks similar to a pillow to be called "restraint"? Hard to believe. And YES!! I'm remembering that when family started putting in motion detection in their loved one's rooms, you should have heard the 'ding dings' at their attendant's station! Something like that may help and at least get someone to go in and look. You can buy pads for the floor that set off an audible signal if they put their feet down. Maybe that would help? It's not an easy problem. Let us all know what the director says!! Virginia

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@fwenty I just came across your posting mentioning falling out of bed. Unfortunately, the facility is correct. Almost all preventative measures are considered restraints. As a nurse in a hospital (before I retired), we spent MORE time trying to keep out patients safe while following all the rules. Usually we ended up having an aide sit with the patient the whole shift. The patient stayed safe, but we had to work short staffed the whole shift.
On a better note, there are now products that help keep patients safe. This website shows the Your wife will slowly become accustomed to the single bed. ( the web site was wrong so I have to fix it!)

Liked by virginianaeve

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Thanks, Becky. I looked at the web site and that looks really good. It would be easy for the med techs to put in place and to move in the morning. I bought a Drive wheelchair locally and I bet that medical supply store might have these mats. I'll call them tomorrow and see.
The facility director and I didn't connect today so I'll check with her on Monday. By the way, my wife didn't fall out of bed last night, so we've got that going for us!

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@virginianaeve

Hi FWW. My name is Virginia Naeve and I try to be helpful on these kinds of issues when I can. I remember when my mom, who suffered from Alzheimer's, was in a memory care and she fell out of bed and broke her arm. I was horrified and very sad. The facility told me that it wasn't legal in the state of California to have guard rails on her bed. I thought that was ridiculous. While we had the problem, we put soft blankets on the floor beside her bed and made sure the other side of the bed was against the wall. Eventually, she stopped falling out of bed.

I just saw something on line that I thought you might want to look in to. Look up Rehabmart.com. Search for Posey Patient Safety Roll Guard. It's a soft, pillow roll for the sides of the bed. I thought you could ask your mom's facility if they would allow that. Tell them that it's better than her breaking her arm! Good luck and tell us what they say! Virginia Naeve, http://www.anewpathformom.com.

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My Mom was in memory care and broke her hip getting out of bed. It was the second occurrence of breaking a hip about a year apart. She died in tremendous pain after a few days from the second fall. I was incensed and couldn’t believe they could allow it to happen a second time. Why do we allow these politicians to make laws for something that should be a family decision, especially for someone that can be a danger to themselves? What’s worse, possibly creating some anxiety for the loved one, or having them fall and break bones and die?
Seems like a lot of states have this inhumane law that you can constrain someone. Very sad.

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@michaelgrinney

My Mom was in memory care and broke her hip getting out of bed. It was the second occurrence of breaking a hip about a year apart. She died in tremendous pain after a few days from the second fall. I was incensed and couldn’t believe they could allow it to happen a second time. Why do we allow these politicians to make laws for something that should be a family decision, especially for someone that can be a danger to themselves? What’s worse, possibly creating some anxiety for the loved one, or having them fall and break bones and die?
Seems like a lot of states have this inhumane law that you can constrain someone. Very sad.

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Correction: Seems like a lot of states have this inhumane law that you can NOT constrain someone.

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Can you have a hospital bed placed in there so there are rails preventing her from falling out?

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I’ve been told that you can’t because it might create anxiety.

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@michaelgrinney

I’ve been told that you can’t because it might create anxiety.

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Yes, the resident has "the right to be free from restraint".

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When we had my Mom in hospice and she could no longer get up on her own safely, we used the same trick as when our children were small, we rolled up a hospital blanket and placed it under the sheet (so it stayed in place) along the edge of the mattress. It was not considered a restraint by the residential hospice staff.
Sue

Liked by virginianaeve

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@sueinmn

When we had my Mom in hospice and she could no longer get up on her own safely, we used the same trick as when our children were small, we rolled up a hospital blanket and placed it under the sheet (so it stayed in place) along the edge of the mattress. It was not considered a restraint by the residential hospice staff.
Sue

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Thank you, Sue, that looks like a really good idea. I will be talking with the facility director today and will see if she agrees. If Judy was at home, I'd use that method too.

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They don't use bed mats "because they are tripping hazards…." They would not allow a rolled up blanket or bath towel because "those aren't firm enough". (It seems like they keep telling me what WON'T work rather than telling me what WILL work!

Someone suggested to me that I should tell the director "Judy enjoys having a pillow next to her side when she sleeps. I'd like to bring a body pillow for her to have next to her. Can we do that?" The idea was, if she enjoys it, it must not be a restraint against her will. And the director agreed! It's been in place for about a week and so far, no more falls!

They would also allow a "pool noodle" under the bottom sheet. It's about a 4" round hard foam about 4' long.

In the meantime, my daughter and I have found a better place for Judy and they will have an opening later this month. And we have other temporary alternatives if we need to move her sooner. Right now we think she is safe and we're keeping our fingers crossed.

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Yay! I love your persistence. Very very creative! Good job. Virginia Naeve

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