Can AL facility force someone to be wheelchair bound because they are a fall risk?

[Anonymous]

I would also talk to the OT or PT about your concerns. Say he has had a recent decline in function and see if they can work with him a few times. Often times if it comes from an OT or PT that a resident can stand or can participate in x,y,z the aides feel more comfortable allowing them to do so. Unfortunately coming from someone who works in a hospital - it’s ausualtl the employees who are reprimanded with a patient falls

[Anonymous]

I'm so sorry. My MIL had dementia and could not remember that she needed a walker. She would push it out of the way. Unfortunately she did have some terrible falls and it precipitated her passing. Her rehab care was horrible because very few places are equipped to provide rehab to someone with dementia.

[Anonymous]

Anonymous wrote:Please keep arguing or move him.

My father just passed. I know exactly what you are going thru except my dad was at home with home caregivers.

We had to consistently push back on this sh&t. Unfortunately we did not understand the dynamic. The agency brought in a geri chair and had him sit in at all day long and did not let him stand up or walk. Reason being they did not want to deal with the liability of the risk of falling. We did not understand what was happening exactly. By the time we did, he was so disabled from the lack of being allowed to stand or move that he could not walk. He also had bed sores from being in the same chair all day long. Then they insisted on bed level care and Hoyer lifts. We had to push back against that and insist they move him between a broad wheelchair, a recliner, and his bed (only at night).

It is awful. They literally disabled him out of fear of his being a fall risk.

We are pushing back more with my mom and making sure they continue to allow her to stand and walk.

Hugs. It is very hard to argue with these damn people. They just care about not having a fall liability risk but I would have rathered my dad kept walking and fallen than waste away for years in that damn geri chair, which I did not realize at the time is effectively a restraint.

Don't listen to the poster who is assuming the best of the agency, saying it is to keep him safe. it is BS. It is to keep the agency or care facility from having a lawsuit and a fall AND it cuts down on the number of people they need to hire to care for people because they don't need to help him transfer, stand up, etc.

I'm sorry. it all sucks.

I'm not clear on what you wanted them to do instead of Hoyer lifts. Were you arguing for patient care providers to lift him themselves, or to stabilize him themselves (this is a frequent cause of rotator cuff and back injuries in the provider when the patient falls unexpectedly)?

[Anonymous]

Hey OP im sorry you’re going through this.

Just FYI those rolling walkers are called Rollators (yes, really, lol)

[Anonymous]

Haven't read all the responses, but sounds like at AL you also have 1-1 aide. I would see if there is any sort of release from liability for fall you can sign. People are really litigious and nursing homes were a goldmine years ago for lawsuits. It probably is better for him to attempt walking, but you need to be willing to assume all risks and that includes a fall that can lead to serious injury and at that age the injuries can be pretty awful.

[Anonymous]

Anonymous wrote:I'm so sorry. My MIL had dementia and could not remember that she needed a walker. She would push it out of the way. Unfortunately she did have some terrible falls and it precipitated her passing. Her rehab care was horrible because very few places are equipped to provide rehab to someone with dementia.

Np. The reason the falls are such a big issue is that they can be deadly. I had one grandfather who broke a leg at home and that's what caused his transition to assisted living (hospital bed status) for the rest of his life. Also my great-grandmother broke her leg at an assisted living apartment and had to go into the hospital and then hospital bed assisted care. And in a group care facility, people do blame the medical care providers for people falling. Particularly if the aftermath is hard to live through and for others to watch.

[Anonymous]

He cannot use a walker with dementia. You need to go daily and walk him.

[Anonymous]

Are there facilities that you sign a waiver so your parent with dementia can decide on their own risk tolerance?

Adventurous retirees should take up motorcycling and skydiving before they develop dementia.

[Anonymous]

OP referred to the facility as “memory care/assisted living.” These terms get thrown around a lot and can be confusing. The response to OP’s question may depend in part on what category the facility actually is and who is paying for it.

“Assisted living” typically is a private pay facility that offers what the name implies — “assistance” with activities of daily living, laundry, housekeeping, medication management, an in house dining facility, etc. They generally offer at most only a lower level of what qualifies as “skilled care” and if the person’s needs exceed that (or if the person or their family become too much trouble or a liability risk) they typically send them away. I haven’t checked lately but my sense is that “assisted living” facilities are less heavily regulated than higher level facilities.

I think “memory care” is a cynical marketing term, but it seems to take place in skilled need facilities, i.e., “nursing homes.” These can be private/insurance pay, Medicare and/or Medicaid. They are heavily regulated, and patients typically have rights at least on paper. If a patient becomes a “problem,” however, it is far from unheard of for them to be manipulated into a hospital stay and then find that there magically is no space when they are ready to be discharged.

If I had a person in the situation you described, I would start by finding out precisely what category the facility falls in. Then I’d research the patient’s rights in that kind of facility under federal, state and local law. There are professional care managers who might be able to help with this. An attorney affiliated with the National Academy of Elder Law Attorneys (NAELA) could be helpful. If you want to claim that the care provided is inadequate, you’ll probably need one or more outside doctors who agree with your treatment preferences.

Even with all of this, you’re probably better off as PP’s have suggested, trying to find a different facility that is a better fit. If you can afford it, you may want to pay for an outside rehabilitation/restorative nursing person (or as a PP suggested you may be able to go walk your person around yourself).

This is a very tough situation. Allowing an ambulatory, continent person to become chair/bed bound and in diapers, and not infrequently riddled with bedsores, is not suitable care. But neither is allowing a demented person to stumble all over, falling down and getting hurt.

I think the most obvious problem here is that you don’t feel like you’re being heard or getting any effort to meet you half way. That can be a hallmark of a not great facility. Getting some independent advice should be helpful in clarifying whether what you want is reasonable and if so where you might be able to get it.

[Anonymous]

This is not assisted living. It’s a safety issue. With dementia they cannot make their own choices. This is normal with dementia

[Anonymous]

If you are having to pay fue one to one care for him and the cost of the facility, is it any cheaper than having him at home with aides?

Look around the facility, are there any unstable patients walking around? Probably not. What you are describing is unfortunately really common. The facility won’t have records of falls that they are mandated to report and it is easier to manage patients in wheelchairs who aren’t wandering around.

[Anonymous]

PP. I agree, in my post, I blended some terms. My elderly relatives were at big places that offered all types of care onsite - assisted living, nursing homes, quasi-hospital-like services.

[Anonymous]

I know this is really hard to watch. Give up on the rollators. They don’t allow them because they are dangerous to people with a fall risk as well as to the other residents. They are obligated to keep him from falling as well as inadvertently injuring their staff or other residents.

Your likely only options are:
- Take him for walks yourself.
- Hire private aids a few hours a day to walk him.
- Pay for private PT to work on walking with the walker. Medicare and insurance won’t pay for PT or OT if the patient is not progressing which it sounds like he wasn’t.

If he won’t follow instructions it is also unlikely you are going to be to private pay for very long as they will also not want to be liable for him getting hurt.

[Anonymous]

My dad had Parkinson's with both physical and cognitive symptoms, and we were able to hire a PT wh came and walked with him every day, BUT my dad was willing to use a walker

[Anonymous]

There's no easy solution. You could pay for the personal aide to walk your parent. We had a parent who insisted on aging in place with aides and those aides allowed the freedom you seek. Lot of emergencies calls due to falls and a simple fall leading to a hip break an ordeal from h$ll. Be careful what you wish for.