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Old 04-30-2013, 11:12 AM   #1
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chatykat58 HB User
Alzheimer's and frequent falls

My 77 yr. old mother was diagnosed with Alzheimer's...10 months ago, she had her first UTI...her symptoms worsened dramatically, overnight.
She started to wander outside to the parking lot in the assisted living facility that she was living in. Five weeks later, after being on antibiotics, she had not come back to baseline and we were told the AL couldn't care for her, because of her wandering.
We moved her to memory care in the same facility.
Since she's been in memory care, she has declined, has lost 10 lbs. (but they tell me she's eating good) she's now drinking 1-2 ensures a day, they haven't had a weigh in yet, so I don't know if she's gained any weight.
She seems to tire very easily. She's still continent, staff takes her to the bathroom every 2 hrs, she needs full care in her hygiene needs, bathing, brushing her teeth, wiping after using the bathroom, etc. Her eyesight is very poor.

She has lost all verbal abilities, she speaks in unintelligible words.

Here's my most recent worry, she has fallen at least 10 times since she's been in memory care, she has not gotten injured, just little tears in her skin. But she seems to be falling every week now. The last two times she fell, the staff found her on the floor, once in the dining room and last night in the t.v. room.

My question is, is the staff being neglectful in not watching her better, knowing that she has frequent falls? I also realize that they can't possibly hold her hand all of her waking moments. It just really bothers me that they "find" her on the floor.

Does anyone have a suggestion as to whether there are places out there that are better equipped to care for someone on more of a one on one basis? It would have to be a place that is lock down, so she doesn't wander out. I really don't want to move her, the staff knows her so well, and she seems to love them, but the frequent falls are starting to really worry me.

Any suggestion would be appreciated!!

 
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Old 04-30-2013, 11:49 AM   #2
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Re: Alzheimer's and frequent falls

This sounds like she is closer to the late stage/stage 7 for not talking and falling. Soon she won't be able to walk because she cannot balance herself and thus she falls. Could you try to make her use a cane? She just needs a cane to help herself. Later on she would need a walker and eventually she will need a wheelchair.
For now, I think you may want to ask the doctor for help. Get her some physiotherapy to help her to use the cane or even a walker. Not to recover her balance but to help her to cope with it.
I had seen a few times that in the memory unit some residents do fall suddenly and people were paying attention to the fall.
The caregivers in the memory unit work with ratio. e.g., 4 residents per caregiver or more. Sometimes they are not there 24/7 next to her.
I suggest that you hire a part-time personal caregiver to go next to her to help her.
If she can get used to use a cane, it would help her a lot.
No one can tie her up and stop her from walking, so she will continue to walk around and no one can stop her. Only a personal caregiver can watch her more often so that she may not fall. Even back home, my late FIL with late stage of Alzheimer's fell once while everyone was around. Once they lose the balance, it is very hard to keep at it.

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Nina

Last edited by ninamarc; 04-30-2013 at 11:50 AM.

 
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Old 04-30-2013, 05:26 PM   #3
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Re: Alzheimer's and frequent falls

ChatyKat, you seem to be describing my Mom. UTI's seemed to precede each of her major down turns. Her first UTI did exactly what it did to your Mom. She went down in abilities and started wandering out in the parking lot. She got better but not to base line and still wandered. This was when she ended up in a locked dementia unit. Shortly thereafter she started losing weight and lost her ability to communicate effectively. She ate well but would walk incessantly. We tried the Ensure but it cause diarrhea which lead to dehydration and only made it worse so we had to stop the Ensure. It did hold the weight while she was on it but she went right back to losing weight. Then she started to fall. She fell in frequently with only minor injuries. She did have a minor break in her hand but nothing major. Most times they found her down with no idea what happened. Like you I wondered the same things. Then one afternoon when I was there.... I walked away for just a few minutes, Mom got up, and fell in the living room floor. So the answer is... they are probably doing the very best they can. There is no way that one staff member can keep eyes on all their residents at all times.

I had an extended conversation with the staff regarding Mom's falls. The only way to prevent Mom from falling was to keep in seated where they could watch her at all times. That caused Mom major agitation. She loved to walk.. it was all she had left. So I did not want her restrained in any way. If she fell, she fell. The Alzheimer's affects their balance, their gait, their ability to navigate obstetrical, and the list goes on. It also affects their vision, especially the peripheral vision. So they become unsteady and can't see where they are going. Mom would actually walk around leaning dramatically to the right of left at times. But do you really want to restrain them when they are still ambulatory?

Mom made it to the last UTI without breaking anything major despite numerous falls. She only ended up at the ER once when she did a major face plant on the floor. Her entire left side of her face was bruised but no head injury. That was validated her hardheadedness! I could never bring myself to force her to sit. The last UTI literally knocked her off her feet. She walked half way to the bathroom on a Saturday morning and leaned up against the wall. The care manager caught her before she fell. She was in a wheel chair from then on making almost no attempt to get up even after the UTI was cleared up.

You mentioned your Mom was continent because they were taking her to the toilet every 2 hours. Mom was the same. That is one sign of a VERY good facility. There is nowhere else that Mom will have the freedoms she has there and the care she has there. Sometimes there are trade offs. I opted to let Mom walk despite the falls

Love, deb

 
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Old 05-10-2013, 11:47 AM   #4
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Re: Alzheimer's and frequent falls

Question: Besides the Alzheimers,' other problems might be present. Are they giving her seroquel or another anti-psychotic medication? When my father was in the nursing home, they were giving seroquel, and he fell a lot; then I discovered that dizziness is one of the side-effects of the drug. After I brought him home, anytime I had to give him seroquel he fell--every single time. Another thing, is she properly hydrated? Dehydration can cause a drop in blood pressure and lead to falls. Good luck.

Quote:
Originally Posted by chatykat58 View Post
My 77 yr. old mother was diagnosed with Alzheimer's...10 months ago, she had her first UTI...her symptoms worsened dramatically, overnight.
She started to wander outside to the parking lot in the assisted living facility that she was living in. Five weeks later, after being on antibiotics, she had not come back to baseline and we were told the AL couldn't care for her, because of her wandering.
We moved her to memory care in the same facility.
Since she's been in memory care, she has declined, has lost 10 lbs. (but they tell me she's eating good) she's now drinking 1-2 ensures a day, they haven't had a weigh in yet, so I don't know if she's gained any weight.
She seems to tire very easily. She's still continent, staff takes her to the bathroom every 2 hrs, she needs full care in her hygiene needs, bathing, brushing her teeth, wiping after using the bathroom, etc. Her eyesight is very poor.

She has lost all verbal abilities, she speaks in unintelligible words.

Here's my most recent worry, she has fallen at least 10 times since she's been in memory care, she has not gotten injured, just little tears in her skin. But she seems to be falling every week now. The last two times she fell, the staff found her on the floor, once in the dining room and last night in the t.v. room.

My question is, is the staff being neglectful in not watching her better, knowing that she has frequent falls? I also realize that they can't possibly hold her hand all of her waking moments. It just really bothers me that they "find" her on the floor.

Does anyone have a suggestion as to whether there are places out there that are better equipped to care for someone on more of a one on one basis? It would have to be a place that is lock down, so she doesn't wander out. I really don't want to move her, the staff knows her so well, and she seems to love them, but the frequent falls are starting to really worry me.

Any suggestion would be appreciated!!

 
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