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Dad has dementia that is getting worse so I don’t know that he would remember to use a call button pendant or wrist BUT his memory care facility doesn’t use them or anything similar. Dad used a wrist button frequently when he was in assisted living a few months ago. Anyway dad still is continent and hates to use the diaper but has no way to call for help. His voice is very soft and low so I doubt he can yell loud enough to get them in there. When I’m visiting he will always tell me he needs to go and I’ll track down help. I can imagine that most in memory care are not concerned about diapers or call buttons and it might not be long before dad is the same way. But for now I feel like they aren’t offering a good solution. What do other memory cares do? I could buy something I suppose like a personal keychain alarm. Even a big school bell might work.

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Ask for a care plan meeting to address this, if he is in a facility where the attitude is "just go in your diaper" that's a big red flag. Is there not any kind of call button in his room or in the bathroom? Is there a toileting schedule where he is taken routinely?
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Marydys, you have accidentally trodden on a very tender corn of mine!

The day before yesterday a client took one look at me and called out to her husband to come and help her mobilise. "Problem?" I asked. "Look at you. You'll never get me off this bed." I sighed inwardly and got her off the bed.

The point is that if mobilising requires "a strong guy or two strong women" you are doing it wrong (and potentially putting your client at risk, never mind yourself). As a matter of fact I am a lot stronger than I look, but that really isn't the point: moving and handling are all about technique, and nothing at all to do with physical strength.

Supporting a client with standing and walking progresses thus:
verbal prompting
minimal physical support with assistance of one person (AO1)
minimal physical support (AO2)
plus use of mobility equipment such as profiling beds, riser-recliners, bed sticks, stand aids, turntables and so on

So that until your father loses the ability even to maintain a standing position with his bottom resting on paddles, it will be possible to transfer him to a wheeled commode. He can then either use the commode, or the commode minus its bucket can be pushed to the bathroom and positioned over the toilet.

And in fact, I myself used a hoist to transfer my mother to a commode. So that, in fact again, as long as your father is continent and able to ask for support with toileting in time, there is no reason for him to be forced to "go" in his pad.
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Not a single one of my dozens of clients in memory ever used the call button.
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They use a toileting schedule at my dads memory care.
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You need to take this up with the facility. It makes me angry when they advise someone to “go in your diaper” leading to skin breakdown and bedsores which can further become infected.
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Countrymouse May 2021
Not to mention a person's right to dignity. It's a revolting practice and it makes me see red.
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Even if he has a call button it is doubtful if they would respond readily because most residents in those places just push the button because it's there. Most long-term care facility institute toileting schedules; however, due to high patient loads (like one CNA to an entire hall of total care patients) it is doubtful they are carried out.
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Usually residents with continence issues are put on a schedule. This means they are assisted to the bathroom every 3 hours while they are awake, Those who require incontinence clothing are usually checked throughout the night as well.
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RedVanAnnie May 2021
That sounds like pretty good attention to the problem. I'm not sure a lot of facilities do that well.
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The head nurse station is your best bet. OR a hired CNA on the side-- perhaps paid for by the VA if he was a soldier and has at least 3 ADL issues-- assisted daily living ( I think--) My mother got around $1100 plus ( now $1144 ) for anything she needed help with-- an Eldercare CNA would come over and sit with her for more than a few hours. We used the whole thing on the nursing care. Also it is wise to visit at staggered hours to see if anyone is doing their job-- and--- eat with him once or twice a week -- lunch is best. See if her needs help while eating or if his plate is being taken before he finishes. A lot of times they end up spacing out and not finishing their meals. A CNA always sat with my mother and sometimes even fed her.
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Thank you, I will ask for a toileting schedule. Yes they have buttons up high but no strings attached. I was told they are choking hazzards (similar to the dumb rules about bed rails). There is one in the bathroom but the problem is he can't get to the bathroom by himself.

I appreciate knowing what other places do while the patient still feels the urge
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cetude May 2021
Bed rails are actually *very* dangerous. Not only can their legs or arms get caught in them and fall out that way, thereby fracturing or dislocating a joint, some patients will try to crawl OVER them and have a much worse fall.
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My mom's place takes everyone to the bathroom two hours in order to avoid having the caregivers running around whenever someone needs to go.

They also have no call buttons, as I assume half the resident would be pushing them all the time, and the other half (my mother) wouldn't have the slightest idea what they're for.
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