My husband uses a wheelchair but can walk somewhat with a walker. He has mild dementia and doesn't recognize that it's dangerous for him to try to get up on his own. Keeping the walker nearby is not a solution, he still needs help. I and his aide are tired of fighting with him every day and can't convince him that it's dangerous. Any helpful ideas would be appreciated.
Skateboard shoes, like “Vans” may help. They are smooth, flat and weighted in a way that help with balance and truly reduce falls.
The home therapist just got her to transfer from the bed to her wheelchair. I immediately grabbed the gate belt (we have an extra that's very large) and secured it around Mom and the wheelchair, fastening it BEHIND the wheelchair. I didn't ask, I just did it as if it was a normal part of the process. You might have the aide do it the first time like it's a normal thing. then you and everybody do it after that.
I'm guessing the seatbelts that come with wheelchairs fasten in front. I suggest an extrs long gate belt.
Unfortunately, even in a nursing home, one-on-one constant supervision is not available. You would have to provide it, or pay for a sitter to provide it.
At some point they moved the power recliner from his room to the common area. They'd get him comfortable and unplug it, then when they saw him trying to crawl out of it they'd plug the chair and get him into his wheelchair.
While this cut down on his falls - remember from above he fell at least once a week - they didn't stop them. Even if someone had eyes on him 24/7 doesn't keep them from falling. In a second they're down.
You can only love them and do the best you can.
If he has Alzheimer's you can expect falls to increase as the disease gets worse; balance and coordination decline. Impulsive behavior increases especially at night known as "sundowning" which is extremely dangerous. Most people with Alzheimer's die of complications of this disease such as catastrophic falls or aspiration pneumonia.
Get a fall mat and put it near his bed. Most falls occur getting up. I also got a floor alarm. As soon as mom's feet go on the floor, the alarm would trigger. It saved her from a lot of falls. I prefer the floor alarm because bed alarms have far too many false alarms.
Now the MAJORITY of mom's falls occurred while I was right with her because when the disease was very advanced it would happen so fast I did not have enough time to catch her fall. It gets that bad. Still, I was lucky--I kept mom moving and she was bedridden for only 2-1/2 months but it was very very hard work keeping her mobile. I walked her in the park DAILY for 5 years with a specialized walker. I think it slowed her Alzheimer's disease progression but it cannot stop it. She died of the complications of insulin-dependent diabetes at age 90. She had stage 3 kidney disease for 10 years. No she did NOT die of the Alzheimer's. Irony isn't it.
I had to attend to mom 24/7 from the moment I woke up until I put her to bed. She was a lot of hard work, but I don't regret it. I sure love mom and she was the center of my universe. Still is...but God killed my mom. Still doctors were surprised my mom lived that long due to her insulin-dependent diabetes and she she died with perfectly intact skin.
5 falls hitting her head on hard floor in NH
4 trips to ER
4 brain scans since March 5 and one MRI
multiple urine draws
sent to Geri Psych - then off to another ER because her heart rate was high
ER diagnosed her with:
dehydration
over sedation (aspiration pneumonia)
sepsis from UTI (none of 3 cultures showed anything)
now CHF from sitting in wheel chair for 2 months.
Two days ago sent her to memory unit for mild dementia and got hospice involved so there more eyes on her.
She still fell but at least it was on carpet and she is again using her walker
You have to WATCH everybody these days.
I am disgusted with them all.
You will just have to keep a close eye on him, whenever he is in his wheelchair.
You might as well stop arguing, fussing, fighting with him because he won't remember he needs help .
Juse when you see him trying to stand up you or an Aide just go over and say let me help you or say nothing at all and help him.
Buy him a nice recliner that he enjoys staying in.
Wheel chairs are uncomfortable to sit in for prolong periods even with a cushion.
Prayers
It might be best to just let him use his walker and seat him in regular chairs most of the time.
The family was told he would be using a wheelchair permanently.
He learned how to open the restraints and then he wanted to run away. His speed prevented escape, but for Dad, the restraints were a bigger safety issue - instead of trying to get to the bathroom, he set his sights on the highway or the train station. .
I could see how unhappy he was to be tied up like that and just wanted to get him home (and unrestrained).
He had only been “allowed” to walk briefly at physical therapy. I went to all the sessions and attentively watched how the therapists worked with him using a safety belt.
At discharge the PTs also worked with me, instructing me how to walk him, so he might be able to move a bit at home.
Once home, Dad continued outpatient PT.
I repeated every session, to the best of my ability, several times a day, after getting home. My kids would repeat this too - Dad got stronger and his balance improved.
He improved so much, that the PTs said he far exceeded their expectations. They had never seen an elderly stroke patient do that well.
His physical improvement helped his moods too. His mental function improved. Everything improved.
He eventually only needed a cane when out - he got around well without one at home.
Belting through his pant belt loops would be a good suggestion, as it will be much harder for him to undo it without help.
The pad would need to be secure on the chair and be enough incline to seriously hinder his ability to get up.
The wheelchair tray would need to lock into place on the wheelchair - he may be able to figure this one out, but it will slow him down a bit!
Watching him 24/7 isn't feasible. We have to use the bathroom, prepare food, tend to various house tasks throughout the day. Anything that would at least make it harder for him to get up will be a help. An alarm would be good as well, so you would be alerted to the fact that he is attempting his "escape", giving you a little time to get there and perhaps prevent the fall.
My father was the same way. We're talking about a man who would walk without his walker, furniture surfing throughout their IL apartment. He fell shortly after moving into IL(pre walker days) off a step stool while hanging a picture (cracked a couple of ribs). He fell going to the IL library (compression fracture in his back). He fell several times getting out of bed. Come to find out he'd had undetected strokes in the balance center of his brain.
Because of the falls he and mom moved to AL. They provided him a hospital bed but he usually slept in his power recliner. Of course his falls continued. Only one of his falls resulted in an injury other than scrapes and bruises. He fell picking up silverware off the floor so someone else wouldn't fall because of it. He evidently bent over and just kept going hitting his head on the table edge. As his balance got worse and his dementia got worse and he got weaker he was given a wheelchair - and yes he could still walk some. One time while still in AL he was in hospital and transferred to Rehab - which was the SNF. He fell the first night there - about 30 minutes after getting there and again the next morning.
By the time he was in SN his dementia was worse. He fell and he fell and he fell. I use to say he fell whether he needed to or not and that his bones must have been made of rubber - however the last year they were more slides than falls.
I don't tell this story to freak you out. It is what it is. Try not to stress yourself out more than you already are, I know it's frustrating. Maybe you can get him in a routine or learn to read his body language to get to him before he gets himself out.
Best of luck.
Maybe a slanted cushion having it slant to the back of the chair. Makes it hard to get out of. Someone said on the forum there are wheelchairs that slant.
Perhaps you could thread a seatbelt through a back belt loop on his pants without him noticing?
My Mother has supervised walks to the dining room & bathroom which seems to help her need for movement somewhat. (She has insight of her mobility limits though).
My other relative (who has way less insight...) has fallen MULTI times getting out of bed or leaning.
I really don't have an answer, sorry 😔. Falling is a known hazard for the less abled & elderly. I can only add: Minimise as many risks as you can. Accept this will not be 100% or even close.
It makes me sad to even mention this, but I honestly don't know what you can do when your LO does what they want--and it's unsafe. Mom was in a wheelchair post-hip replacement and she kept sliding out of it. They were not allowed to restrain her at the rehab facility, so she slid out on the floor all the time. I couldn't believe that a rehab place couldn't manage to keep their patients in their wheelchairs. But we were told they could not, legally, restrain patients.