Mom is 97, dementia, been in MC at ALF for 1 year 4 months. She was mobile at placement but has had 9 falls in since placement. All falls have been face forward resulting with goose eggs on forehead and bruising masks around eyes and nose. Never is observed when falls but is transported to ED for CT Scans. Luckily has not broken any bones. Has anyone ever requested to view tapes from cameras to confirm that no events are occurring that would create a fall. Mom is oldest resident on the unit and is still mobile where many residents are wheelchair bound. Really concerned she cannot recover from many more forehead injuries.
Once she moved into Memory Care and became wheelchair bound, that's when she took the majority of those 95 falls; off the toilet, out of bed, off of her wheelchair, etc. For me to ask to see 'tapes' would show a distrust of the Memory Care and to insinuate blame on their part for her falls. That was not the case at all; falls happen ALL the time to very old people, especially those with dementia going on. So to answer your question, no, I didn't ask to see tapes b/c I knew why mom was falling and didn't need to analyze anything. She thought she could walk which she couldn't, and so, she kept trying to get UP from a sitting position or from bed and WHAM, down she went.
Any managed care facility can only do what they can do to keep a resident safe, but they cannot monitor them 24/7. Even if they could, the resident would STILL fall b/c that's the nature of the beast with advanced old age and disease.
My mother never went to the ER for any scans when she fell b/c she never hit her head, so it was not required. The fact that your mother is still mobile at 97 tells me she WILL fall no matter WHAT the MC does to help prevent it. Nature of the beast and all that. At 97, she WILL die from something, one way or another, so it's impossible to prevent it, unfortunately. That was my take on all my mother's falls and all the phone calls and all the hand wringing for all that time. Ultimately, she passed away in February from advanced dementia and a very tired and worn out heart that gave out. Not from any of those falls, believe it or not.
I know how difficult it is to deal with all of these falls, trust me. But it's impossible to prevent them. Unless this MC is blatantly leaving trip hazards out for mom to fall over, they're not at fault. Old age is the culprit. Accidents happen continuously at 97 years old b/c their balance is dreadful. Plus, they don't pay attention to what they're doing or where they're walking. Before mom went into a wheelchair, she'd look all over BUT where she was walking, and walk into walls all the time. It about gave me a heart attack to watch her stumbling around. It was truly a miracle she didn't break her neck long before nature took it's course and she died at 95.
Wishing you the best of luck with a difficult situation.
So many reasons;
physical & cognitive
- Reduced eyesight / changes to vision
- Reduced muscle strength
- Reduced balance
- Dementia - memory but also dementia brings damage to the areas in proprioception areas of the brain (sense of body position)
- Confusion, delusions
- Arthritis, stiffness
- Fatigue
- Legs giving way
- Stroke, TIAs
- Heart attacks
- Blood pressure changes
Then there is impulsivity & lack of insight into walking ability.
Preventing all falls is sadly not always possible. Not even with someone right there, as it is near impossible to safely 'catch' someone. Both can get injured.
But trying to prevent as many as possible is always a good goal. Looking for a common theme could help. Eg most falls are on waking at 6am, or during staff handover, or middle of night in bathroom.
I'd try to phrase it that way with staff - that you are looking to investigate the falls in order to help identify a common cause. (Better to have staff on side & helpful, rather than defensive).
The usual strategies are ruling out medical issues & adding MORE supervision.
Supervision can include being sat in a day room in view of staff, bed & chair alarms to alert staff quickly, adding in regular supervised walks & bathroom trips.
My Grandmother had many falls. Loss of conscious (suspected TIAs). Supervision & company couldn't prevent them.
I hope you can find some solutions & improvements.
Gravity is a real problem when you get old and sit all the time. Muscles weaken and many elderly people have arthritis and/or osteoporosis that weaken their bones. No MC or NH is going to have eyes on your loved one 24/7. Just isn't possible.
when my mother started falling more, the MC put an alarm on her chair / bed if she got up. They had talked of moving her room closer to the center of things. But things progressed rather quickly for my mom.
maybe time for hospice to be involved? She may qualify and receive the benefits. As things progressed for my mom, a wheelchair arrived, a bed table, a hospital bed.. better yet more eyes on, a CNA twice a week , a nurse visit weekly, clergy visit weekly, social worker monthly, depends, pads , lotions etc… you may not see your mom as needing hospice, I didn’t… but as I said , things progressed quickly for her.
I would want to know if the falls are occurring at night. If so, one solution is to put her mattress on the floor. Or there's such a thing as a concave mattress. If it is happening during the day as well, then that's a different challenge.
My 100-yr old Aunt has advanced dementia and still believes she can get up and walk -- and often attempts it. We have to watch her all the time! When she's in her recliner watching a dvd we have an alarm on her in case she attempts to get up. If she does, she just falls -- she cannot walk unassisted. She broke 2 bones on 2 separate occasions even with family caregivers right there with her. All the more a challenge in a facility unless you hire a private aid to stay with her all day.
My Aunt's dilemma is that no one can legally be restrained in a facility or in their home. Until she qualifies for LTC and can no longer get out of bed or a chair on her own, falling will continue to be a risk for your Mom. I would discuss strategies with the admins, as she is not their first case regarding this situation.
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