She will not call for help, whether she's lying down for an afternoon nap or if she's in bed for the night. She is completely incapable of walking on her own, (uses a walker or a wheelchair) but she will not stop trying to get out of bed to go to the bathroom, or (in the case of the afternoon nap) come out to the living room. SHE FALLS EVERY TIME. She has a whistle and a bell, but will not use either of them. She's going to a nursing home soon, and I would like to break her of this habit before she ends up in restraints 24/7.
There are many, many alarm systems. The problem is they're useless unless someone is within arm's reach when they go off. All they do is alert the staff that someone is about to fall so they can hurry to the room. Unless they're already in the room it's unlikely they'll be able to prevent it. They do, however, make family members feel like something is 'being done'.
I once heard a geriatrician respond to the adult child of his patient who was demanding that he "do something" about his mother's frequent falling. He said, "old people fall, it's what they do." Sounds simple, but it's incredibly difficult for middle-aged people to really understand unless they've had a lot of experience with the elderly.
If you have the resources, you could have someone sit by your Mom's side 24/7. But I doubt she'd want to live that way. I wouldn't.
I'd certainly try giving Mom a sleeping pill at night, if it helps. But, whatever else you do, try to come to grips with the fact that your Mom will very likely fall. Given her restlessness, probably more than once. Don't feel guilty about it, don't blame the nursing home for it. "It's what they do."
You didn’t say if your mother was suffering from dementia or simply having issues with stability. My mother has Alzheimer’s and used to feel she had to do so many things that were impossible; like picking up her brother who died 11 years before. Sometimes she would calm down if I told her he just called saying a friend took him home and he would see her in the morning. Other times she was on a mission and no amount of white lying could give her peace. It was those times I cried buckets for her because it seemed so real to her and would not let her rest. Obviously, I couldn’t let her leave the house, but she was on a mission that wouldn’t be deterred. I knew if I could give her something for sleep, it would give her peace from the tortures of her mind. Problem with sleeping pills and the elderly with dementia is they often make things worse. Eventually, I did find a combination that sometimes helped, others it did not. In fact, she could still keep going on stuff that would take down an elephant. So, with the authorization of your doctor or hospice, give it a try, but be aware they may not give you the peace for your mother you are seeking.
However, what I finally resorted to, because I couldn’t sit with her 24 hours a day, was a wonderful monitoring system. We started out with the alarm that clipped to their clothing. Be sure and clip it to the back of the garment so they can’t reach it and take it off. It worked fine, except the string is so long that if she got up to go to the bathroom, the string ended up in the toilet. EWE!! Not to mention blaringly LOUD!!! It would scare my mom and set my nerves into hyper-drive as well, especially when you are jolted from a dead sleep.
My mother was in our finished, walkout basement. She had her own bedroom, kitchen, living room, family room and bathroom, so she wasn’t in a dungeon by any means. I still had to keep an eye on her and would be there to help her when she got up. Due to her kidney failure, she slept a lot during the day and for me to sit and stare at her was non-productive to say the least. Yet, I did need to keep an eye on her 24/7.
Our next step was to put a sound sensing monitor on her nightstand so I would hear when she got up. Do you have any idea how quietly they can get out of that bed? Unreal!! My next solution was to pin the monitor between the folded, double size, down comforter I had on her twin bed. That worked really well because the covering on the comforter was stiff so I always heard the rustle when she moved. Moving being the optimal word here. I found myself running full speed down two flights of stairs at 3am only to discover she had simply rolled over.
Okay, final solution, video monitors. I know it sounds like a terrible invasion of her privacy, but by then, I had done and seen things I NEVER wanted to with my mother, so privacy was no longer an issue, this was definitely a safety measure. She would even climb over the side rails or go out the foot. Side rails are, in reality, dangerous and definitely not the answer. The video was a Godsend. However, I did try to preserve her dignity and she never realized I was monitoring her escapes. It was cute because she was always so surprised and happy when I showed up just when she needed me. I could see her get up and know if she was going to the bathroom or what was happening and if she needed help. We had one in her bedroom and one in the hall leading past the kitchen to the bathroom. I knew if she was taking too long and could make sure she had her walker. It saved many, many, many useless trips and a lot of frustration. Before the monitors and she was at the “sundowner” stage, I would find her wandering the house at 3:30am. I was scared she would go outside and I wouldn’t catch her. The monitors gave me a measure of peace and rest. Well, as much as one can get caring for a person with dementia. At least, the three hours I did get helped.
The nice thing about them is the receivers are portable so you can take them outside or other parts of the house and still keep an eye on your loved one. Be sure and check the range of each prior to purchase, as some have longer reception than others. The minute the person wiggles, you can head to them and most times your feet can beat their escape from the bed.
I hope this works for you. It is certainly worth the few dollars to give you some peace……and rest. And definitely much, much kinder than restraints. Oh, and again, this may sound cruel, but until you have lived with a person with dementia and sundowners, you can’t begin to understand the challenges we face. To keep her in her bedroom, bathroom and kitchen area at night, we reversed the locks on the doors. She had freedom to go from each room to the other, but kept her away from any outside exits. To me this was MUCH safer while allowing her plenty of space to move. Our only problem came with the one section that did not have a door. We tied an old twin mattress across the opening, thinking it was soft and she could see over. Good in conception, bad in reality. Don’t ever let anyone tell you these people are stupid and that they are no longer thinking! When my mother couldn’t untie the knots in the ropes, she went to the kitchen, got a knife, cut the ropes, and escaped. I watched it all on the monitor. Was very inventive and funny, but after that night, all the knives and scissors were removed from the kitchen and we used wire to hold the barrier in place. She never figured out our slick way of releasing it, however, she did spend a few hours trying to formulate an escape. At no time was her life in danger because I was glued to the monitors and we could easily get to her by opening the doors. In fact, as I write this, I am watching my 2-year-old grandson on the video monitor in his room as he naps and on the other side of the room is the sound monitor in my FIL room because we are currently dealing with his dementia that is rapidly robbing him of his life.
I hate feeling like a spy, but they reach a point where they no longer realize and understand the phone, whistle, Lifeline alert bands, etc. At that time, you have to step in and do whatever you can to protect them from this insidious disease.
Wishing you luck and I hope you find a solution that works for you and your mother. I have learned to tap dance very fast having cared for three parents in our home, all suffering with dementia. It certainly isn’t easy for either the parents or the caregivers. I pray daily for a cure, or to be spared from being a burden to my children and their lives. Such an insidious and cruel disease.
As sad as it is , there are no easy answers. We are dealing with humans, that have significant disabilities. I do not suggest, that you not hold a care facility accountable, but as someone else mentioned, the elderly and frail will always be a fall risk. There are many different things that are tried, and certainly try to be in on the multi-discipline team to give your input, since you know her best. Remember at this time she can not advocate for herself, so she will need you to be her advocate, the best you can be. Keeping a brief diary of her habits, would certainly be helpful. Also remember that the change in surroundings, may escalate her behavior, as she tries to make sense of it. For some it helps to see their loved ones daily at first, for some it makes it more difficult. Also there is no right or wrong answer here. It is what is best for ALL involved in the situation.
There are a lot of caring individuals on the site that have given you some idea's. Hope that this helps, a little.
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