What can I do for my father who keeps falling, even while under 24-hour care?

Well, the higher level of care isn't stopping the falls, is it? So I'm not sure it makes sense to stay at that level just for that issue.

Is there padding on the floor, and no nearby nightstand or furniture he can hit? Is there a good night light so he can see to get out of bed?

Is his doctor aware of this problem? Did this start recently? Does your father have other sleep problems? For example, does he trash around, kick, or flail his arms?

Well...I'm just worried that if he moves into assisted living...there will be no one there to help him up if he falls. I planned to get him an alert device, but he is getting dementia and I am worried that he wouldn't think to ask for help. The padding is great, but he actually tripped on a mat before and fell..so it was more trouble than help.

I don't know how long this has been going on for sure. We discovered he was not taking care of himself and needed a high level of care several months ago and ever since he's lived near me he's fallen numerous times. I can't have him live with me because he has multiple health issues I can't competently deal with. In addition, I work and am raising a child, so that would be too hard.But, he's my dad and I want him safe...and I need peace of mind.

My mom falls a lot too. We are getting a bed that sits just a couple of inches from the floor so the fall is not so far. It will also prevent her from getting up so much cause it will be hard to get up from a bed that low. Right now I have a soft restraint across her at night to prevent nite time wandering. During the day I have a sort of seat belt for the sofa to keep her from getting up every 5 min and falling. She has done a lot of damage to herself with all the falls. I'm trying my best to protect her. The alarms wouldn't work for us cause by the time I heard the alarm and got to her she would already be on the floor. Hope you get some help with this. I know it worries you.

Jaccare..... If you Dad can afford assisted living, I am guessing he could afford to live elsewhere and pay someone to stay with him that will actually help him get up every time he gets out of bed. He's not going to get that kind of personal attention in a nursing facility and definitely not in assisted living. Good luck to you!

Cushioned mats and padded rugs are good, but you have to run tape around the edges so that they are flush with the floor.
Annt has a good idea about soft restraints until someone can get to him.
He should not be having that many falls at a skilled facility. He can't be the only elder who has these issues. Speak with the director and ask what technology is available to reduce fall risk.
The only way to ensure that he never falls is to have a live-in caregiver, if you can find them. (I would suggest hiring 2 or three who can work in "shifts.") For what you are paying at his facility, he may be able to afford this option and it would be worth it for your peace of mind.
Good luck

I know that this is a very simple answer to your question, but have the nurses at your Dad's facility just tried placing 2 urinals next to his bed withing easy reach for him? My husband is a stroke victim and is unable to get up at night by himself. I was getting up several times a night to take him to the bathroom, but had to come up with an alternate solution as I was exhausted during the day as was my husband. He is now able to use the urinals and go back to sleep. Sometimes we overthink a problem when the simple way turns out to be the best. God bless you and your Dad.

Has a physician checked all his meds; esp. if he is on multiple meds for multiple health concerns and is seeing several doctors. Is he actually taking his meds as scheduled (sometimes they don't get swallowed!). He could be dehydrated, need his ears checked, or any number of fairly-easy-to-address conditions.

It sounds like he gets dizzy or unstable when getting up from a chair or
bed. If he could remember to sit up for a few minutes before standing that might
help (IF he can remember to do so). Is he having to navigate around objects in his room? What kind of shoes is he wearing when he falls?

If he could not remember to use a urinal, perhaps a bedside commode chair would get his attention & keep him from trying to reach the bathroom.

For poorly lit or dark areas, there are nightlights that go on when motion is detected. We have them all around the room & in the hallway where our family member walks. (They work both day night.)

There are even special pads that can be put on people who are prone to falls.
The nursing home or a physical therapist should know about them or look at a website that specializes in products for elderly patients.

I'm lacking in experience with NH facilities however I am curious and suspicious by nature when I hear questions like yours. I realize that it is more common than not for our Elders with Dementia to frequently fall but how do you know he is having these falls? Are you there when it's happened? Does it happen at the same time every time? (like at night) If you see a pattern developing like this I would get a nanny cam so you can see what is exactly happening. No one should know about the camera but you. The suggestion for a couple of urinals or a bed side potty is a good one as well. Either that or some kind of restraints to keep him from hurting himself. I hope you can find a solution. Keep us posted and don't forget to take time to take care of yourself too.

Nobody has asked you yet if you have "good" information about the reasons why he falls a lot or for that matter, why Annt's mom falls a lot.
Sometimes inner ear problems make a person dizzy, other health issues might make falling more likely. But many times it is because the person falling has little balance because of inactivity. I suggest you look into the value of a Mini Trampoline. They come with a bar one can hold on to, but often, when a person is weak, even paraplegics can benefit when placed on the trampoline, sitting on it, while another person bounces up and down. What happens is that the whole lymphatic system gets activated and muscles, too. I have seen elderly people go from only being able to sit while a family member gently bounced up and down, to being able to stand on the trampoline and jump up and down. Notice - I wrote bounce - initially it is bouncing - feet not leaving the mat. Jumping is feet leaving the mat and there are variations from very gentle to major jumping.
One of the things with this exercise is that you only do it gently as if sitting on a chair. You do not exhaust yourself. But over time you can do more and more but still only do it as if sitting in a chair, never exhausted. You build up to more over time.

Using the mini-trampoline really is the best thing for old folks, young ones too.
Maybe you like to search on the internet for "lymphasizer" and lymphatic system because you might discover why and how to regain health.

I forgot to mention that a mini trampoline is often also known a Rebounder.
You can find them for about $70 with the stabilizing bar. Used ones might6 be even less.
You might see some a lot more expensive, but the low end ones do the same job no matter what they tell you about being easier on the body, etc. I have used high and low end ones and they all seem the same to me.

Jaccare, since your dad is in a care facility, ask them to add a trampoline and offer their residents to sit on them and enjoy the benefits. But ask about it after you fortified yourself with information and can make your point. They just might find their residents improve mentally and physically. If they do it regularly - I guarantee it.

Get the Philips Lifeline Auto Alert Emergency pendant. This can defect a fall even if the senior can't or won't press the button for help. This can ease your mind.

But that's the problem I have with my mom. By the time the alarm goes off and I get to her she has already fallen and is often hurt. That is probably the same thing happening in the NH. They have alarms that go off when the patient get up, but getting to them before they hit the floor is tricky. My mom was in a Hospice respite home for 5 days to give me a break in the 24 hr 7 days a week care I give her and in the 5 days she was there she fell twice. They just could not catch her in time. The Law won't let them restrain her. Restraint can be done very gently. We're not talking about the old tie their arms and legs to the bed thing that horrified people years ago. But according to the law they have a right to fall if they want to. So to speak.

I had the same problem with my Mom when she was in a nursing facility.... although not so much falling out of bed but falling out of her wheelchair all the time and they wouldn't let us put a belt around her. To me it was the craziest law in the world that they have a right to fall.

We did find a solution to keep her from falling out of her wheelchair though. We ordered a tray that slid on to the arms of the wheelchair - pretty much like the ones on a baby's high chair. It also had velcro ties on each end that you connected behind the back of the wheelchair to keep her from pushing it off so she wasn't able to get out of the wheelchair without someone taking the tray off for her and helping her up.

To me that is the same as restraining her with a belt but the nursing home went along with it for some reason. It actually worked out pretty good because the tray also came in handy for keeping her water on so consequently she drank more liquids because it was right there in front of her all the time.

While we're on the subject, I should also mention that we purchased a Rock N Go wheelchair for her which is a very high back chair (kind of recliner chair size) that tilts back far enough that she couldn't get out of it without help. It was much more comfortable for her than a regular wheelchair but they wouldn't let us have it in the nursing facility (another crazy rule) but that's when I brought her home anyway. It really worked great but they're expensive ... about $1600. Also worked very good for keeping her legs elevated with the foot rests that come all the way up.

Good luck to everyone trying to figure all these crazy things out!!

What a great idea about the tray on the wheelchair and the rock n go chair too. I could not afford the reclining chair but it sure would be nice. Mom can sit up for a little while then has to lie down. I've put a seat belt of sorts on the sofa to keep her from getting up while I am in another room, like the bathroom for instance. Every time I left the room she got up, and over half of those times she fell. I absolutely have to go to the bathroom every now and then, you know? I'm not sure what the law is on what can be done in my home, but I know and my hospice people know that she is being cared for with love here. And a seat belt is not abuse.
Hope things improve for you Jaccare.

In addition to all of the great advice (LOVE Essent and the rebounder idea), determine if he is hydrated. The elderly for whom I care overnight have monitors and as soon as I hear the bedsheets rustle, baby, I'm running to the bedside! No falling on MY watch, thank you very much! ha ha.

Oh, guess I should finish the thought. Dehydration will cause dizzyness.

What kind of restraint do you use at night for the wandering? I don't sleep because I am afraid of the wandering and waking my girls. Thanks for letting me know. Carol

Darrobertson......

When my mother was under Hospice care and in a hospital bed, I had a very long mesh type fabric tie (12" x 12') that I used to tie across her waist area and completely around the bed - mattress and all. It was a very light fabric that I think was actually made to use in around the inside of a baby's crib to keep them from getting between the slats. I would tie it over the top sheet and then put the blanket over it so she wouldn't pay too much attention to it. It was on tight enough to keep her in place but loose enough that she could turn over. It seemed to do the trick as far as preventing her from trying to put her legs over the railings and climb out of bed - which she tried to do all the time.

I also researched a product that has been outlawed for use in nursing facilities (but I saw one for sale on ebay one time) that I thought would work pretty good. It was basically a shirt that would be put on backwards so they couldn't get to the buttons and it had ties extended from each side of the shirt that you could tie to the bed rails. It would work good to keep the person in the middle of the bed which was also a good thing because people have been hurt or killed falling down between the mattress and the railings. It seemed to me that it would be pretty easy to make one just by sewing some long ties on the sides of a shirt.

Maybe I'll patent my idea and make a million and we'll all go on a cruise!! :o)
Anybody with me??? lol

There is a catalogue you can order from called Posey.com. They have all sorts of alarms and restraints that are very user friendly and patient friendly. Since I had to quit my job to care for mom, I don't have much money and to me they are more than I can afford so I have to be creative. I have a long soft bathrobe belt that is tied on one side of mom's bed and I pull it across her waist loosely enough so she can roll over and it won't be uncomfortable, but it does keep her from getting off the bed. That is the only way I can get any sleep at all. I have a baby monitor in her room, but she is very quiet and I never hear the rustle of covers. Possibly because I'm so exhausted from caring for her all day. She is very well hydrated and has very good nutrition. Strokes, dementia and cancer has made her lose her sense of balance. Having both arms injured also works against her balance wise.

With all due respect, Ruth, that was a very insensitive and self serving remark. No falling on MY watch? How long does your watch last? Do you just care for them at night then go home in the morning? Are you being paid to watch them? Most of us caregivers are 24 hrs a day 7 days a week with no breaks in between.

Also most of us are not paid to care for our loved one. Most of us are financially strapped and have lost many of the pleasures of life that we once had. Some have helpful siblings but most don't. I have to beg to get my siblings to come stay with her for a few hours every once in a while for me to do errands or go shopping at the local Goodwill store.

I'm sure you were just joking with that statement, but for those of us who are mentally, physically and financially depleted, that sounded like you were saying that you are able to do something that we have failed to do adequately. That's hard to listen to. I am perhaps being a bit too touchy about it but chalk it up to sheer exhaustion and try to understand. Most of us are looking for support not judgement.

Jaccare, I hope you find the answers to your problems. Michfla317 sounds like we had the same idea. I have also rigged up a seat belt of sorts for the sofa. It is a fabric tie that my hubby used sort of like a bungie to hold boards together in his truck. I took the big buckle off and used one of my fabric belts with rings that the belt is threaded through and attached it to the fabric strap that I had attached to the back legs of the sofa and brought it up through the sofa. I can belt it aroung her so that she can sit up or lie down but not get up off the sofa. I also have taken a wireless door bell and put the push button on one of my grandkids wooden blocks and taped it down. If she needs me all she has to do is push the door bell and I'm right there. That gives me a chance to do dishes and laundry without worrying about her getting up and trying to follow me and then fall. I call it my Redneck Life Alert. Hey, you gotta do what you gotta do.

Aant.... I'm cracking up here about your "Redneck Life Alert." I think we'll go with your invention instead of mine...... you are the true inventor...... pretty ingenious for sure!! lol

In defense of Ruth, I have to say that I see Ruth on here quite a bit giving genuine support and positive advice and she always seems to be upbeat, seems to love her work and I can almost hear a song in her voice. When I read her statement "not on MY watch" I thought she was saying it tongue in cheek and because I feel like I have gotten to know her personality here a little bit, I could hear her laughing as she typed it. I don't think she meant it the way you read it.

Oh my gosh.... I thought I was the only one shopping at the Goodwill!!! lol

Saying a prayer for a quiet, relaxing evening for all...... God Bless!!

Yes, annt, Ruth does get paid for caregiving. Yes, she does get to go home when her shift is over. If I hired her to watch my loved one overnight so I could get some sleep, I would want/expect her to have the attitude that he wasn't going to fall on her watch! I'm sorry that you took this as a criticism of full time caregivers who have to sleep at night. I didn't read it that way at all, and I kinda doubt Ruth meant it that way.

I'm sure you're right Jeanne, but I also hope you can see how the exhaused 24 hr caregiver might feel like that was a little bit of 'this is what I can do so you should be able to do it too' attitude. I didn't mean to attack her and I even said it respectfully and said I probably don't know what I'm talking about. I simply said this is what I feel about what she said. Don't feel you have to defend her. I wasn't attacking her I was just letting her know that her choice of words might actually hurt someone. We have to be very caring about the tender feelings of the ones in the trenches day after day with no let up. As I said to her, I'm probably too touchy about this cause I'm so tired and mentally drained. Don't worry, I'm not the type to start a feud on this or any thread.
Again Respectfully,
Ann

You're probably too touchy about this cause you're so tired and mentally drained. Been there, understand that. "Insenstive and self serving" sounded a wee bit like an attack to me. And yup, words can hurt.

But I think that everyone is staying on track here, in sharing tips on preventing falls by the elderly, frail, or demented. And it sure isn't easy, is it? I love your redneck life alert idea.

Annt makes a very valid point - tired and mentally drained or not, and with no disrespect intended to paid caregivers (most of us would LOVE being able to afford a paid caregiver) - but its apples and oranges.
Paid Caretakers (PC) vs. Family Caretakers (FC)
A PC is doing a job they were hired to do and is being compensated for that work, sometimes with benefits. Most family FC positions are not paid, (in fact it costs families BIG BUCKS to care take - you can look it up), and many must hold either PT or FT jobs outside the home in order to support the family.
A PC has another life when their shift ends, same as the person who works on the assembly line or checks your groceries. The PC gets to leave - they get to go to dinner with friends, or cruise the mall, or go on a date, or spend an uninterrupted evening of amore - anything they want. As long as they remember to set their alarm clock and return to their job on time - their time away from the job is theirs to do as they please. Most FC live in the home of their elder, or their elder lives with them. Some are all alone in this - some have other family members around - some have other family members around who will occasionally help them. Others have family members around who resent the time and attention paid to the elder and make this fact known.
A PC can take a vacation, call in sick, or quit. Their obligation is that of an employee - not as a son or daughter or other family member. A FC doesn't have these options. Many rarely leave the house, don't have the option of staying in bed with the flu, and know if they quit (which many fantasize about doing), their elder will be forced into a NH (possibly substandard and/or not nearby), or taken by another family member whose main interest is to clean out the elders bank account. Many FC did not CHOSE their roles, but had it thrust upon them by circumstance. They do what they do because it needs to be done, and they have a sense of moral obligation.
A PC is not carrying on the necessary, ongoing, and routine work of an entire household. They may make a meal, wash a dish, do some laundry, and the like. But most aren't trying to figure out how to pay the electric bill, cleaning the upstairs bathrooms, changing the kitty litter, or mowing the grass, etc. FC's either have to let these things slide (you should see my grass with all this rain) or they accomplish them when they should be resting.
A PC may develop an emotional attachment to the elder (and one would hope they would). But a FC has had an emotional attachment to the elder, in my case, for more than 50 yrs. Sometimes this is a loving attachment i.e. "Mom did so much for me growing up - how could I not do this for her?" Sometimes FC's end up caring for elders who weren't so loving - they were abusive, or absent, or addicts, or indifferent - we still have emotional attachments to be sure, but they may include bitterness or resentment or even hatred for wrongs FC's may even find unforgiveable. A PC does not have this history, or this complexity.
I could go on and on about the differences between the PC and the FC, but alas, as a FC my daily priority is my elder - and heaven forbid she has fallen while I was writing this - when I should have been resting. But I learned a long time ago - and I have been at this for YEARS - that it is impossible to watch my elder 24/7. I do my best to keep my elder safe and clean and warm and fed and well-tended, and I strive to do it with kindness and understanding. I can't afford a PC. If I could, the most basic of assumptions I would make about their services is that they would not let my elder fall. In the meantime I keep 911 on speed dial so I can get some assist in helping her up if she does.

When Mom was still living and I was working part time I had a paid caregiver not call me when Mom was complaining of chest pains. I was upset to say the least.

I'm not criticizing paid caregivers. Just sayin'...

ya know what . sometimes u think u can hear dad hollaring . zoom i go runnin , huhhh he s sleeping real good . i swore up and down i hear dhim . even hubbyhears him hollaring every now and then . zoom to find him watching tv all happy . oh hiiiiii he says , di du hollar ? noooooo he says .
so sometimes we shake our head and thinkin its our imagainary and oops he is realy hollaring .
as for falling down . not on my watch hahaha . thats funny . it realy is funny . cuz once dad was walkin with his walker , i dare not to be far from him , walk behind him cuz he would stumble backwards . just so happen i wasnt watchin him within a blink of an eye boom he fall backwards ! holy crap ! how in the world did that happen ? i was just right behind him ! so my watch is always screwed up .
rith u better knck on the wood cuz now maybe ur watch will be screwed up .
i felt so so bad and cried at my brother . honeslty i never want dad to fall waaaaaaa . he said oh linda it just happens , he knows cuz he was watched dad down down hill for the last 30 yrs of begin with him . says maybe dad did that on purpose to see if u ll catch him ? phhhht . not on my watch mmmmm never say never cuz it happen to me too .
i understand pc and fc is totaly diffrent . aint that the truth ! there has been time my brain just shuts down and i was dead and didnt hear dad hollar and hollar , he even goty into my face and screamed , i was dead . hubby came and shook me so hard i woke up , he sai dman linda didnt u hear dad ? i said no i didnt why ? he said he s been screamin bloody murder how could u not hear that ? oh hun im so tired my brain just shut down . i honestly felt like i did died to sleep forever , good ole hubby shook the helloutta me , said he had hard time wakin me up . so i am Fc , i will never be a pc or fc when all this is over .
not on my watch hahahaha ......

Linda, you are so awesome!! Love you, Girl!!

My dad falls and we watch him closely. When he was in rehab we asked them to put an alarm in wheelchair and bed. We were told he had the right to fall! Guess what, he did fall and then alarms were put in place. Even with alarms installed in rehab, he would still fall and of course every time this happened we would get a call. I don't know how many calls we got, couldn't keep track! We asked for a soft posey but they refused. There were so many staff around in rehab that one would think repeated falls wouldn't happen. It is impossible to be able to hear alarm run to see what is going on in time to avoid the fall. Even if I was superglued to Dad that wouldn't help either because we would both go down. Must be some "state of the art" folks out there to never have a fall on there watch. Wish I was one of those, but sadly I am only human and my average human family the sole caretakers of Dad. Can't afford PC and even if we could, I am sure there would still be mishaps. Comes with the territory!