81 Dad Keeps Falling in Rehab Center - They Say Can’t Restrain or Extend Bedrails

[Anonymous]

Anonymous wrote:I would try to pay for a 1:1. You really, really don’t want them getting an order for a chemical restraint — which absolutely IS legal in Md, unlike physical restraint.

On that note, demand to see his current comprehensive med list since he was admitted to rehab.

Sometimes overburdened facilities will ask for and get a new order for a calming drug. from the off-site consulting MD. Really sketch and common. ie, a bedtime dose of haldol or ativan for “agitation.” Getting out of bed multiple times makes a compelling case for “agitation” to an off-site prescriber.

Good luck

— an RN

NP. But there are NO facilities - rehab or otherwise - that have 24x7 supervision, unless you pay for a 1:1 caregiver/sitter. Even the memory cares cannot prevent these falls without restraints. So I understand your point that Haldol should be avoided, but when someone has dementia with agitation and is constantly trying to get out of bed, can be violent toward staff due to dementia-related hallucinations, etc - what is the alternative? What am I missing?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:wait. bed rails aren't allowed? we have those for my parents. why are they bad? should we get rid of them??

They lead to choking and death if the parent rolls into them. They have not been used in Florida facilities for many, many years.

The US Drug and Food Enforcement Agency has an article about this issue:

Bed Rail Entrapment Statistics

Today there are about 2.5 million hospital and nursing home beds in use in the United States. Between 1985 and January 1, 2009, 803 incidents of patients* caught, trapped, entangled, or strangled in beds with rails were reported to the U.S. Food and Drug Administration. Of these reports, 480 people died, 138 had a nonfatal injury, and 185 were not injured because staff intervened. Most patients were frail, elderly or confused."

So because 480 mainly frail, elderly, and confused people died out of 2.5 MILLION hospital/nursing beds in the US over the span of FOURTEEN YEARS. That is 34 deaths a year on average.

So now instead of 34 elderly and confused people who didn't have long to live anyways dying, you have thousands and thousands of nursing home employees working on their knees as they do duties such as:
administering medications,
turning and lifting residents,
changing linens and clothing, and
transferring residents to chairs and other devices.

Or loved one are told (like the RN who posted) "Hire a 1:1"

Then when people can't afford the thousands of dollars for a 1:1 the nursing home figures out the only way they can deal with the situation is to drug patients but of course the nurse says don't let the nursing home do that either.

The whole thing is so ridiculous. More people died each year from dog attacks than bedrails but we don't ban dogs.

Exactly this!!!!

This is such a problem. Some advocacy groups thinks they are being helpful advocating for elderly rights, when in actually they just screwed hundreds of thousands of elderly people and their families who are far WORSE off. Additionally, they made the working conditions for tens of thousands of nursing and rehab workers brutal. Lowering beds because there can't be bed rails so that minimum wage workers who are administering medications, changing patients, moving patients are working on their knees and/or bent over is absolutely cruel.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I would try to pay for a 1:1. You really, really don’t want them getting an order for a chemical restraint — which absolutely IS legal in Md, unlike physical restraint.

On that note, demand to see his current comprehensive med list since he was admitted to rehab.

Sometimes overburdened facilities will ask for and get a new order for a calming drug. from the off-site consulting MD. Really sketch and common. ie, a bedtime dose of haldol or ativan for “agitation.” Getting out of bed multiple times makes a compelling case for “agitation” to an off-site prescriber.

Good luck

— an RN

NP. But there are NO facilities - rehab or otherwise - that have 24x7 supervision, unless you pay for a 1:1 caregiver/sitter. Even the memory cares cannot prevent these falls without restraints. So I understand your point that Haldol should be avoided, but when someone has dementia with agitation and is constantly trying to get out of bed, can be violent toward staff due to dementia-related hallucinations, etc - what is the alternative? What am I missing?

I'm sorry but some people need chemical restraints. Nobody is allowed to be verbally and physically abusive. Even a frail elderly person can significantly physically harm someone. Plus, they can harm themselves. My grandmother had to be extremely medicated to be a decent human being after age 80. If someone is highly agitated and aggressive and needs medical care, no physician will work with that behavior. There comes a point where risk of meds is not nearly as bad as risk of no meds.

[Anonymous]

Bring him home with you!

[Anonymous]

Anonymous wrote:Bring him home with you!

You are telling someone who's parent is violent to move him in? Often those with dementia are WORSE to loved ones.

[Anonymous]

Anonymous wrote:Get a neurological-ideally an MRI. My grandmother developed something due to atrophy in her early 80s where she was constantly falling if not in a wheel chair.

PP, can you elaborate on this? I'm dealing with this with my father right now. He's in rehab, they're talking about discharge this week and he can't stand or walk far without falling. I recall the ER doctor saying he had some atrophy in the brain but didn't make it sound like that would be the cause of all the falls. Now I'm wondering. No one can tell us what else might be going on.

[Anonymous]

My mom was recently in a nursing facility and a retirement place (with skilled nursing) but she’s in NC. They gave us the same crap, can’t put in rails bc it’s against state law. Guess what? We raised enough hell that they put in the rails. This was a woman who could not get out of bed or to shower etc without something to grab onto. And she had fallen a couple times and did not want to again.

I didn’t read the whole thread so I don’t know if your parent has all their wits about them but my mom very much does. She was doing most of the hell raising. She’s 86.

[Anonymous]

You need to hire a private aid for him. It’s the only thing you can do. It’s tha or you or another family member needs to be with him at all times.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:wait. bed rails aren't allowed? we have those for my parents. why are they bad? should we get rid of them??

They lead to choking and death if the parent rolls into them. They have not been used in Florida facilities for many, many years.

The US Drug and Food Enforcement Agency has an article about this issue:

Bed Rail Entrapment Statistics

Today there are about 2.5 million hospital and nursing home beds in use in the United States. Between 1985 and January 1, 2009, 803 incidents of patients* caught, trapped, entangled, or strangled in beds with rails were reported to the U.S. Food and Drug Administration. Of these reports, 480 people died, 138 had a nonfatal injury, and 185 were not injured because staff intervened. Most patients were frail, elderly or confused."

So because 480 mainly frail, elderly, and confused people died out of 2.5 MILLION hospital/nursing beds in the US over the span of FOURTEEN YEARS. That is 34 deaths a year on average.

So now instead of 34 elderly and confused people who didn't have long to live anyways dying, you have thousands and thousands of nursing home employees working on their knees as they do duties such as:
administering medications,
turning and lifting residents,
changing linens and clothing, and
transferring residents to chairs and other devices.

Or loved one are told (like the RN who posted) "Hire a 1:1"

Then when people can't afford the thousands of dollars for a 1:1 the nursing home figures out the only way they can deal with the situation is to drug patients but of course the nurse says don't let the nursing home do that either.

The whole thing is so ridiculous. More people died each year from dog attacks than bedrails but we don't ban dogs.

Exactly this!!!!

This is such a problem. Some advocacy groups thinks they are being helpful advocating for elderly rights, when in actually they just screwed hundreds of thousands of elderly people and their families who are far WORSE off. Additionally, they made the working conditions for tens of thousands of nursing and rehab workers brutal. Lowering beds because there can't be bed rails so that minimum wage workers who are administering medications, changing patients, moving patients are working on their knees and/or bent over is absolutely cruel.

Beds in skilled nursing units are hospital beds-- they can be raised when necessary but are lowered so residents don't hurt themselves if they fall out. No one's pushing for a futon