Back on Sept. 23rd I posted that my mom had fallen and broken her hip. She was sent to the hospital and had surgery. She was released to the facility where she and my dad each have rooms in the dementia unit, but they also have skilled nursing. So she now has a room in skilled nursing so that she can get rehab.
The director of the unit called to tell me that they'd called an ambulance for mom, she said that no one knew how mom broke her hip. her indformation was that mom had been up most of the night - probably because she had a UTI, and as of 6:30am, she was fine. they went in around 7 to get her up but Mom didn't want to get up for breakfast that day and then didn't want to get up for lunch, so that's when the nurse checked her and found her right leg looking shorter than the left, and turned outward. When I was talking to my mother about breaking her hip, she said that she was pushed and somehow managed to "army crawl" to the bed and get in. (?!)
Anyway, this morning I got a call from the dementia unit, saying that around 6:40 this morning my dad had fallen. He is not badly hurt, but has cuts/scrapes on his right arm. Dad told my brother this morning when he went by (we both have started going every day since mom is in skilled nursing) that he was pushed.
Now, I know that they both have dementia. I know their word is unreliable. But what do y'all think about this? Both events happened early morning during the week. Both parents say they were pushed. I certainly don't want to falsely accuse anyone, but I feel compelled to investigate further.
I guess my questions are: is it common for a dementia patient who falls to have the sensation that they were pushed? or is it common for a dementia patient to say they were pushed when they fall, even though there's evidence to the contrary? how much stock would y'all put in these reports by my parents? What would y'all do now, if anything?
p.s. when my brother went in later this morning, he spoke to one of the nurses who he says was clearly dodging his questions, saying that no one knew what happened and just found Dad on the floor with blood on his arm. Well, the nurse who called me about the incident earlier this morning had told me that she'd turned her back on him for a minute and he had walked out of his room and into another resident's room and had fallen in there. What is up??
I'm so sorry this happened to your parents. I would be very upset and I would talk to a supervisor and find out if they filled out an accident report. Yes, my husband who has dementia sometimes says the caregiver doesn't feed him and is mean to him but I know he has been fed and I talk to the caregiver all the time throughout the day. Can you check up on them each day for a while to make sure they are being well taken care of? Can you ask someone who works there that you can trust if they will keep their eyes open to any kind of abuse? Anyway, I would be there more if I could and I would set up a video like they do with babysitters and see what is going on.
I cannot really say for the home that no one abused them. It is something you may need to talk to the director about it.
However, since your parents both have dementia, it is very possible that they fell on their own and broke the bones. This is very common in late stage. My FIL began to fall often this year and finally he fell more in May and since then, he has stopped walking on his own. This is part of the decline for dementia/Alzheimer's. Losing balance makes your Mom said that someone pushed her... She just lost balance and could not walk so she fell and broke her hips. The problem is they stop walking and can no longer get up themselves. So they may crawl and etc. They need someone nearby to help. My FIL is now able to pull the ring to ask for help to get up. (In the beginning he couldn't so fell a few times and was not injured very badly.) The residential care director in my FIL's home told us some families do hire one on one caregiver to stand guard next to the bed when the elders get up in the morning. The worst time is when they get up. If your father falls regularly, he may need a walker or a wheelchair to prevent him from falling.
It is very possible that they both fell like that and you are in bad luck that this happened altogether. The problem is how come the caregivers didn't pay attention to this issue. First time is always a surprise, but they should try to take caution on this. Also, you need to lower your Mom's bed so she can get up easier.
This is a problem in nursing home because they don't have one on one caregiver to watch it every minute.
Please talk to the directors of the home to address this issue. The important issue is to let them know your parents now start having walking problems so they should be given some aid like walker, wheelchair or cane or whatever that helps. The thing about they may have been pushed is probably a little off, not that a crowd of people cannot push them off by accident.
Sorry that they both have walking problems now. Broken bones at this point are largely associated with walking problems. Gradually they will stop walking and need a wheelchair.
Sarah, it is hard to say from what you know what really happened. If you are uncomfortable please do ask for a full investigation or do some investigating on your own. You are the one that needs to feel comfortable with the answers you get.
I would be very skeptical of what a loved one with dementia tells you. You know that they don't "remember". They are giving you what their brain tells them to tell you. Mom broke a bone and Dad has scrapes. They must have fallen, there were people around, and the only way to explain it (in their minds) is that they were pushed. Since there is nothing wrong with them, it had to be somebody or something else. They don't remember but they do create scenarios that sounds plausible to them. As for the hip, I wonder if she fell causing the hip fracture or if the hip just fractures. It is not always caused by a fall and considering she broke her other hip, there could well be a weakness there. I learned this the hard way when walking with a resident. We heard the hip crack and then she fell on top of me. I know when the hip fractured and that is what caused the fall. So there are way too many variables here.
Have you noticed any other bruising or contusions that are unexplainable? Do they have a fear of going in their rooms? Is there a particular care giver that they do not seem to like. Remembering is a problem so they will not remember the details of an incident and it is difficult to trust their remembering. But they do have intuitive learning. They will fear places they have been hurt or shy away from care givers that have mistreated them. This is not a cognitive memory that they can recount but rather a basal instinct of survival. Watching these reactions will not always give you the whole story but it is a start.
So go with your instinct, not just related to these incidents but from the beginning. How have they been treated until now? How do your parents react? ... not verbally but emotionally. How clear are the answers that you get? Have they filed an incident report? Ask to see the incident report Talk to as many people as possible who might have been there or have information. Then be watchful of any signs of mistreatment.
But were both of them pushed,in different units, on the same night... If mistreatment is that wide spread you would probably have noticed it before
Very hard to tell, but I agree that you can't go just by what your parents are saying. Being asked if they were pushed, could even be remembered as "I was pushed."
If in different units, does this mean that there were different people on duty for both incidents? It might be a lot more unlikely for there to be two dishonest workers than one.
Are there any other signs of physical instability? In my experience, it is not unlikely for falls to begin to show up in the evening. My husband is extremely disoriented when he wakes in the night. Even when he was home, sometimes he'd start to get up and fall. Lowered light levels and being somewhere different than their "home" makes the situation worse. Last year his nursing home tried to use the bed rails and lowered the bed to reduce the risk of falls during the night, but my husband has still fallen a few times. The nursing home is required to report to the family when a patient falls, and I've been getting a good number of "morning reports" at 5:30 in the morning. (I experienced night-time falls when he was home, so I know this isn't something caused by the staff.)
At least in our state, a state investigator also looks into injuries that occur in a nursing home. My favorite aide was once very nervous about an injury that had occurred when a patient fell in another patient's room with no one watching. The aide was telling me that the investigators really grill the staff. If there have been a few accidents, the grilling is really severe. I visited my husband once when another patient fell in a bedroom, requiring stitches. I've been in their lounge when patients who appear to be unable to walk have suddenly gotten up and staggered (fortunately, one was caught and another one fell against another soft chair). I've also seen patients suddenly shove each other, which you'd never expect of some of the ones who appear timid and weak. This stuff does happen in Alzheimers' World.
It's also not surprising that the staff may not have been comfortable talking to your brother about the accident, since everyone is so sensitive about lawsuits and regulatory complaints these days. The facility may even have a rule that only designated people can talk to the family about accidents.
I'd monitor the situation closely, to see if there is any indication of other injuries as Gabriel suggested. If you see family members of other patients, I'd ask them if their loved one has had injuries. You're not accusing anyone -- just collecting information about the level of monitoring. I think this is a particular concern with the evening shift, who may not be as diligent or check everyone frequently enough once they think the majority of their patients are sound asleep. You can ask the facility if there was an accident report.
I'd say the odds are against it being something nefarious, but like any loving family you need to develop comfort with the facility.
Thank you everyone for your responses! I realized while reading them that I really should have edited it.... it was confusing!
My mom fell about 3 weeks before my dad did. It was not on the same day, but at the same TIME of day. that's why we are interested in seeing if it was the same people on duty.
Beginning, I appreciate your comments... and they make perfect sense. I can only imagine how I'd feel if someone's sweet parent fell on my watch... I'd feel terrible! And you're right, I can see the staff being careful about what is said, especially since he's made no bones about the fact that he's a lawyer. (i am too, but I'm not as proud of it as he is... )
I think I'll just try to find out who all was working each time just to see if there's any overlap, and just take it from there. Which may be no where!
Thank you all for hearing me out!
p.s. Dad lost a tooth today... apparently it didn't bleed or anything, he was just holding it at breakfast in his hand. He's lost 6 pounds since August when they moved in, and was 132 lbs (he usually weighed 40 pounds more in his heyday), and is now 126. He's 5'6" now probably, but used to be taller. I'm getting the feeling that the end for him is sooner rather than later.
Sarah... Yep you are doing the right thing. You are checking out the possibilities. If it was the same person both times then there might be something to be concerned about. In reality they fall. My Dad (vascular dementia) had 5 falls in 3 months that required trips to the ER. None turned out to be serious. It had nothing to do with staff neglect and everything to do with his instability. I had a decision to make. Restrict his movements or let him move and fall. He also loss weight... lots of weight. At 6" he started at 185 pounds and was down to almost 130 at the end. Yet he was content and aware until the last few days. He also lost some teeth. I wish they had come out that easily! We averaged having one a year extracted over the last three years. Mom has also lost weight... from 130 down to 105. She is quickly approaching the unstable phase. She has had a few falls but nothing serious. I tell them to let her walk I do know that night seems to be the fall hours. Most of Dad's falls were at night and all of Mom's have been at night. It is when they are tired or when they attempt to get up alone at night. Or that is what I have seen with both of my parents.
Hope you have an easy time with both of your parents for a while Hang round!! Enjoy having you here.