My mother was moved into a nursing home about one and a half months ago and has already fallen 4-5 times! Is she being neglected?

Caregiver - both you & mom are new into the LTC system with mom being there just a mo & 1/2. If mom was in her home or living with family prior to the move, she likely was much farther along in her dementia than was obvious as she & family were on "remote control" on managing her day to day activity. She could be mainly OK in her tiny limited world at home but that itself must have gotten beyond whatever family could do as she is now in a NH. Moving from home to a NH has totally upended her tiny world and your role in that world. Then add in that most family are not at all used to dealing with staff or understanding how a facility functions. For some, mom is the first in the family to be in a LTC facility.

There should be a "care plan meeting" happening for mom to discuss her needs. It usually is done within the first two months. If it hasn't happened yet, I would suggest you send a fax over to the DON (director of nursing) to request one to be done ASAP. Btw the DON is the goddess & ruler at a NH. At the CPM, there usually is a rep from each of the departments or they send in a report. Like someone from nursing, dietary, SW, activities all have input at the CPM. If family have concerns they need to present them with as much specific detail as possible. CPMs are done on a regular basis - for my mom her first Nh just called about them but for moms 2nd and better NH they mailed out a letter a mo. prior about the schedule windows for the CPM. CPM can be done in person or via conference call. In the CPMs family should be asked to sign off in moms chart on moms care plan. You can actually write in things you want addressed into the chart above wherever your signature goes OR you bring in a typed sheet of concerns that you as moms MPOA go over point by point and it has to be put into her chart. Rarely is the medical director at the CPM, rarely is the DON either but you can request for both to be there. CPM anywhere from 15 -30 minutes. I'd bring in a snack for the CPM & another for the nurses station too - those type of gestures add up for staff to view you & mom more positively.

Just mentioning things to aides, techs or staff, is not enough to make things happen. Orders need to be written & in moms chart for things to be required to be done. CPM provide a way into getting this done.

There are many wonderful NH and a few horrendous ones. Family can move their parent from 1 NH to another. Go and look at other NH and do this beyond the cursory tour....sit in for lunch and an activity program. Is mom likely to fit in in how this NH runs? Some have busting activity programs, others more sedate, others big on music. Moms current NH may not be the best fit for her. For those on Medicaid, moving them from 1 Medicaid facility to another is pretty easy with a bit of planning. NH are very tough to be profitable, if your looking for profit margins that's in AL. Most NH have the minimum staffing required by the state or feds for the beds occupied as employees are the budget buster for costs. Medicaid average daily reinbursement for room & board is around $ 175 a day which is low. Some states medicaid pay less too. Your not going to get RitzCarlton on a Comfort Inn budget.

If you want mom to have a " shadow" or aide to be 1- on-1 with her, I'd bet the NH would be thrilled to have that done & you seperately private pay for that or you have mom in a totally private pay facility.

Freqflyer most excellently described what this entails. Most NH will have a short list of aides who are vetted and bonded who can be hired by family to shadow a resident.

Even at great NH stuff happens. My mom (lewy body dementia) fell & shattered her hip as she insisted on pulling her wheelchair behind her......my mom was active & mid stage lewy and there is only so much staff can do as residents have to be able to have some degree of self determination within a safe & secure setting. Then after the fall, she became bedfast and onto hospice at the NH. Even then with specialized low bed, padded flooring, bed sensors, she would still attempt to get out of bed......dementia just removes their competency.

People with Parkinson's fall. People with dementia sometimes lack the judgement or impulse control to exercise due caution. My spouse has Progressive Supranuclear Palsy—with Parkinson-like symptoms—and falls frequently in spite of oversight in a memory care unit. He can move very quickly and has stood up and fallen when I was sitting right next to him. Restraints are unlawful in Texas.

As Savannah 1978 mentions, there is desperate need of good nursing assistants to receive better pay (I crack up when I hear Micky D's folks want $15 per hour for their work compared to those working in a nursing home, who certainly deserve it). I had mom in a local memory care center a few years ago, where she stayed 15 days, (but we decided I'd get a caregiver contract with an eldercare lawyer, and she's been back with me since that time). The first night there, she fell; they found her near the bathroom covered in feces. The nurse had to call and tell me, of course, but she sounded surprised (?) that she fell. Long story short, there is simply not enough staff to watch each patient and give them the care they need. My sister actually works there at the front desk and is trying her best (as are many good RN's and aides left there) to find another place to work as upper management continues to put as little money as possible into this place - parking lot needs work, new outside cheaper food service and housekeeping hired with their service being not so great, cable TV's were down for 2 weeks recently since Time Warner was not called right away to fix them so no TV for residents, sorry maintenance staff). On top of that, last year a difficult to handle male patient was found dead and had been beaten; the case is still ongoing but you know someone working there had something to do with it. So now to help get their "points" up on the listing for the state (they're way down the list for the state of Ohio), this place has removed all alarms/restraints on the patients, so just think how the already overburdened staff will have to scramble to keep patients in their wheelchairs and out of trouble. My sister says the worst of the worst patients from other nursing homes are being accepted (more on the violent side and harder to deal with since the "nicer" places don't want them. Very sad state of affairs. There are supposedly nicer Alzheimer care places in my vicinity, but I'm sure all are having problems from what I've found out from folks who have their loved ones there. I'll be trying to keep mom with me until she's nearly dead, I guess, but I feel much better caring for her myself as best I can with outside help when necessary and pray things get better out there. Imagine how many more folks are gonna need these services down the road. I don't know about you guys, but I can't help but wonder what will become of my generation when faced with the situation, so many more people will need care if they continue to live longer lives.

Lol! That should be my mom does NOT fall quite as often. Sorry.

Over forty years ago when my grandma was in a nursing home I can remember a woman who was strapped into her wheelchair so she wouldn't fall out. As Sunnygirl said, these days this would be considered a unlawful restraint most likely. But there are some things that can be done to lessen the chance of a fall - if only marginally. Still, it is better than doing nothing. Yes, my mom still falls with the "fall plan" in place, but she does fall quite as often.

There is a way to prevent falls, hire an Aide to sit with the patient and watch the patient for their 8-hour shift, then another Aide will come in for the next shift, again for the night shift, which would add an add $200 or more per day or $6,000 per month cost to the already expensive bill of between $10k to $20 for the facility. Medicaid would come to a screeching halt.

As I had mentioned in a prior post, falls can also happen at home with a love one or two trying to do the 24/7 care.

One time someone had mentioned on the forums that her Mom had fallen while there were Nurses and Aides in her room.... it can happen that quickly.

I agree. Try to get a fall plan in order. See if your state allows things that are not normally allowed. Many things are considered restraints. That's one reason people fall a lot is that there can't be anything preventing them from falling, because it's considered a restraint. The nursing home director and the social worker certainly should know what options there are in extreme cases.

Caregiverhelp - well, at least the SW was honest instead of blowing air up your skirt - but yes, a pretty sad response. In my mothers situation the nursing home pretty quickly put a "fall plan" into place. If the place your mother is staying at doesn't bring up something alone that line, you should ask for one. At the very least it will show the home you are fully aware of the situation and are monitoring the goings on.

Thanks for those of you that answered my question. This is a very difficult time and it IS difficult to know what exactly is going on in the nursing homes when I am not there. They do all seem to be short on staff. I went to see my mom last night after work. She had brusies near her eye and a bump on her forehead.

I briefly talked to the Social Worker on my way out. I was surprised she was still there. But when I voiced my concern about my mom's falls, she basically told me they are not a facility that can monitor my mom 24/7 or one on one.

Well, I thought that was a sad response. Shows how much they care. They seem to be real quick at giving some type of excuse, and sadly, it's like that
at the majority of the nursing homes.

I can't believe there are not stricter laws to protect the helpless elderly people that have to stay in a nursing home.

If she's fallen that many times and has a black eye and head trauma I would bet my life shes being abused or not being watched and proper care. Please please look into it. I've been there and know all about the abuse going on in all these facility's. Most of the people working in these places don't have the proper skills and training or just have no empathy for our loved ones. And the ones with Alzheimer's dementia get it the worst cause they don't have the Patience for them. Please look into her falls.

My moms mom was in every nursing home in our city of savannah ga. And was abused in every one of them. She had Alzheimer's and a very bad case of it at that. So the nurses knew she couldn't and wouldn't remember the abuse. Black eyes broken hips broke a finger to get a ring off We took one of them to court with pictures of my Nana's black eyes busted head and bloody scalp broken hip and this was all done in one nursing home by a big black colored woman who use to abuse and rough up the patients. She actually got to keep her job! We were awarded 12000 for all that was done to my Nana and we used that to bring her home and hire nurse to help us take care of her. I've seen it all in nursing homes. They would sit the food in front of patients who couldn't feed themselves so me and my mom and sister would go around trying to feed and help as many as we could. They would leave them sitting in urine soaked diapers leave them sitting in chairs naked in showers cold. I could never put my mother or anyone in a nursing home after all I've seen and witnessed. And this was 5 different nursing homes. And all were supposed to be "good" nursing homes. The private ones too. Not enough is being done about the abuse that goes on in these places. The ones with dementia and Alzheimer's I believe to get it worst. Because their minds are gone and these "nurses" or caregivers working for minimum wage mostly with rap sheets don't give a f**k about our loved ones. That's my experience and opinion.

My Mom was in the nursing home due to a serious head trauma due to a fall in her own home, my Dad couldn't get to her quick enough [he was a fall risk himself]. And they refused outside help. Mom was eventually placed in long-term-care and it seemed like once or twice a week I would get a call from the facility saying she had fallen.

It's the nature of the beast, once an elder reaches the last stages of dementia, they forget they cannot stand up and walk. Mom was either falling out of bed or out of her wheelchair.

The bed was lowered and fall mats were placed, and Mom would tumble out of bed. No real injuries, maybe a skinned ankle. So pillows would be arranged around her to keep her in the bed, but somehow she would get sideways in the bed. In the wheelchair she would reach for some imaginary object on the floor and she would roll out.

Eventually a geri-recliner was used with pillow propped under her knees to keep her in that chair... occasionally she would pull the pillow out and try to get out of the chair. The nurses tried a seat-belt but Mom would unbuckle that in an instant. The nurses had my Mom at the nursing station to keep an eye on her.

No different than if Mom was at home, you would go to the bathroom and she would find a way to fall in another room. You would go to the kitchen to fix a meal, Mom would fall. You would go to bed at night, and Mom would fall out of her bed. You can't be glued to the hip 24 hours a day, no different then the Staff at a nursing home.

My mom goes through phases with falling. She will fall several times over roughly a two week period and then go a month or longer with no falls until the cycle repeats. I agree with pamstrgma that at least in my moms case - she forgets that she needs help for even the shortest transfer. I also agree with Sunnygirl that unless someone is at her side 24/7, that it's going to happen. It just seems to go along as a part of the disease of dementia. Unless your seeing other signs of neglect I wouldn't assume that is the cause.

I'm not sure what the answer is. Sometimes seniors start falling and there doesn't seem to be anyway to stop it. Has she already fallen by the time her alarm went off and they got to her? Unless someone is standing right by her 24/7, there is a chance she may fall. What you might do is discuss the options that are legal in your state. If the doctor prescribes it for safety reasons, can they place a safety belt on her wheelchair? There are laws about restraints, but there are some exceptions for safety reasons with doctor's orders. OR could she sit in a geri chair instead of a wheelchair? It slants backwards so it's not so easy to get out of.

Keeping her safe at night is another issue. I agree with pamstegma in that they will likely put her low to the floor. I'd talk to the Nursing home and ask for all options that could be tried. Bed rails are considered unsafe in most states, but you can ask about it as well as other options. Certainly, they deal with this all the time. I'm not sure I would blame the facility.

You should conclude that her dementia has gotten her to the point that she cannot keep herself safe. She doesn't know enough to push the call button and wait for help. They will probably lower the bed all the way down so she cannot get to her feet, and put a pad next to the bed. This is late stage dementia, so sorry. Time is short for her.