What would you do? - Falling out of bed

[HarrietD]

My dad tries to go to the toilet during the night, but keeps falling because his legs can't support him. Mum is worried that he'll really hurt himself - what should we do?

What would you do in this situation?

We're planning to include more real life experiences of dementia in our Living with Dementia magazine and we'd love to hear from you.

Please do add your comments below, and we may feature it in the next issue of the magazine.

Thanks

Harriet

 

[komera]

Ideas from a health professional

Have you had any input from a community occupational therapist of physiotherapist? They might be able to identify equipment that would help to support him as he gets out of bed and to the toilet/commode, and find ways to improve his leg strength at the same time. If you are connected to your local older people's mental health service, they are most likely to have the professionals with the most relevant experience, though these days more and more non-specialist community teams have many OTs and PTs with this experience too. I wish you all the best in trying to find a solution for your Dad.

 

[JenniferW]

Sensor pad on the floor

When my mother moved into a care home, one of the things they told us they could do would be to use a sensor pad under the carpet beside her bed. So her weight coming down onto it would set of some sort of warning to care staff, who could zoom along to her room to help her.

Also, her bed was positioned so she could support herself from a fixed table top, for example, and she'd use those things rather than use her walking frame.

 

[cragmaid]

Could Dad use a bottle? That way he would not need to stand up. Could Mum help to position a bed pan?
Poor Mum will have to get up to help with whatever method they use.

 

[Teuchter]

My dad was fiercely independent about this and would accept little advice on night time toilet excursions. My dad did accept some helps and also made a new routine of drinking less near bedtime.
What I did lastly was turned his bed to the wall so that dad could only get out one side in the direction of the toilet with no obstacles in the way, I also installed motion sensor led lights so dad did not have to find light switches. I think what we forget going to the toilet through the night in an automated process we give little thought too. Unfortunately as with my father and us all there will come a time when this is no longer physically possible.

 

[chrissiesixty]

I would get him a 'travel urine bottle' like one on the completecareshop.co.uk site (sorry - I'm not allowed to post a link )
My late husband had one towards the end of his life, and it meant he could stay in bed or on a chair whilst releiving himself.

I believe they are available on prescription as well

Hope this is helpful

 

[tweetypie]

What would you do in this situation?

We're planning to include more real life experiences of dementia in our Living with Dementia magazine and we'd love to hear from you.

Please do add your comments below, and we may feature it in the next issue of the magazine.

Thanks

Harriet

Putting a zimmer frame at the side of his bed may work, one with wheels on, he can use it to help pull himself up and if he's given that sort of information he may agree to using it. Position it near to where he'd sit up, so it's very close to the bed.

 

[GrannyAnn]

I would get him a 'travel urine bottle' like one on the completecareshop.co.uk site (sorry - I'm not allowed to post a link )
My late husband had one towards the end of his life, and it meant he could stay in bed or on a chair whilst releiving himself.

I believe they are available on prescription as well

Hope this is helpful

Funny this should come up because at 3am today my husband made his way as usual to the toilet which is en-suite, and when getting back into bed his hand slipped and he fell on the floor at the end of the bed, hitting his head on the chest of drawers on the way. I called 999 for help in getting him up, and paramedics came and lifted him into bed and glued the 3cm cut which was bleeding profusely on the back of his head. They were gone by 5am, and since sleeping he has forgotten all about it. Our NHS is wonderful!

 

[Greyone]

I would place a mat by the side of his bed and use a pressure sensor and maybe one under his pillow and on the door. A colostomy bag would probably be unsafe but in my mothers nursing home they use disposable night time nappies.

It would also be worthwhile looking into bladder infections as well as bladder control generally. The problem might be minimised by controlling what he has to drink in the evenings and making sure he goes to the loo before going to bed.
Other problems he may face will be forgetting to put the light on and slipping over in the dark.

Another important question to deal with is does he sleep on his own. if not is his spouse getting enough sleep ?

 

[WirelessPaul]

Yes agree with the pressure mat either in Bed or on the floor. We used a lightweight fold up chair commode next to the bed for a while.
Paul

 

[Sharonk43]

Pressure Mats

Pressure mats are a good idea if your mum is having to get up during the night anyway but we found when using one with my dad who was also a falls risk he would get up at night for no reason at all and not just once or twice, so everytime he stepped on the mat the alarm sounded and woke us up. This can begin to get to you if you are being woken all night and not getting much sleep. I think either place a wheeled zimmer by bed for him to use or use a bottle.
Or the safer option is for him to wear inco pants during the night which hold well aslong as he is washed properly in the morning.

 

[missmo]

My partner got up in the night and with having parkinsons was very unbalanced and fell, I have him use a convene, he didn't like it at first but he is fine with it now, I put it on for him and there is no need for him to get out of bed.

we tried using bottles but most of it went on the floor as he was half asleep.

The convene works for us and we get them from our Doctor FOC.

mo

 

[David Porter]

Dressing

Good day,
The problem I had (my beautiful wife passed away a while back) was that for three years I had the greatest difficulty in getting her clothes changed. Every morning and night she would raise her arms to shoulder height and then bring her hands down to her shoulders making it almost impossible to undress her. Once undressed there was no problem in getting her washed but sometimes she took the same stance when I tried to dress her. I never found a solution to that - it was a real headache and I pity anyone who has the same problem. Perhaps you have a solution (for others -sadly my ordeal is over)..........Wishing all you carers well but when she/he is gone life doesn't get any better.........David

 

[SandyLee]

Falling out of bed

I think it was the Occupational Therapist who arranged for us to have a pad and alarm both for the bed and for his armchair. My husband has both dementia and mobility problems so he doesn't remember his legs don't work very well. Also having the bed alarm means that I can sleep in a separate bedroom and go to sleep in peace as the alarm will awake me if he's attempting to get up. It's a free service, and the company who provides this is very quick to respond if there's been a problem with the equipment, and they also service it once a year, and replace any batteries if needed although I have the portable alarm unit plugged into the mains all day to recharge. I don't know whether this is available everywhere but I do know I couldn't manage without it.

 

[Mannie]

What would you do in this situation?

We're planning to include more real life experiences of dementia in our Living with Dementia magazine and we'd love to hear from you.

Please do add your comments below, and we may feature it in the next issue of the magazine.

Thanks

Harriet

Baby alarm can also be helpful

My parent was getting up many times without having the strength in their legs. This was caused after an infection, it made their body clock all mixed up.

In the end we had to get a night waking carer for a month. We also discussed wi the doctor and they prescribed some meds to help with sleeping , Trazadone.

Unfortunately this can have the effect that they don't wake when they need the loo, so we have to use inco pads and washable bed pads

You must also consider the affect on any carers, since this can wear them down. This can be part of the discussion with the doctor.

If this starters suddenly , bear in mind that it may be a temporary phase that improves, again work with doctor, occ therapist, care agency but don't assume it will be forever because it may not.

 

[gardengirl]

Hello!

My thoughts would be to ask,if you have one,your social worker or community nurse, to advise on beds that have rails in the side - they are easy to manoeuvre into place. This would then stop your dad getting out of bed at night with the possibility of falling. Also see your GP and ask for appointment for bowel and bladder nurse, who will check if any cause for infection and explain types of continence pads available for night use or convene (which is similar to a durex but has tube attached to a bag which collects all urine) waterproof mattress protector and waterproof maxi absorb pad, bit like a seat cover, will stop the need for changing sheets at night! Hope this helps!

 

[CocoShae]

Hi... I had the same problem with my grandfather a couple of years back... Can I suggest that he use a walking frame... Or even maybe a commode in his room for night time use...it helped with my grandfather... Sending positive vibes your way...x

 

[sistermillicent]

Rails on beds tend to make matters worse as a confused person will often try to climb over them, sustaining nasty cuts and a worse fall. I think/hope they are no longer in use in hospitals and care homes.
Mum has, in her care home, a special bed which goes up and down in height and when she is in it they have it as near the floor as possible, so she is lying only about 10 inches off the floor. Covering the floor the full length of the bed is another small mattress so that if she were to fall out she would not be injured.
I don't know that this would be much help if someone was able to walk a few steps but it would cushion the fall if they tried to get to their feet and found they couldn't.
There isn't any point in trying to stop someone with dementia from getting out of bed if they are determined to do it. I think an alarm mat is the most sensible idea but unfortunately by the time anyone gets there to help the fall may already have happened.

 

[Annie Chester]

Falling out of bed

It happened to my husband on several occasions - he was quite unable to get from the floor to his knees or feet at all due to arthritis and weakness generally. We were supplied with a safety bar to help stop it (by the memory clinic staff) but he was able to 'wiggle around it' and it made him 'frustrated' and cross. He never hurt himself but towards the end stages of him being at home it often took us (my disabled daughter and I) an hour to walk him on his bum to the top of the stairs so that I could go down below him and eventually get him on his feet. This was obviously putting us both in danger of falling backwards.

This was part of his life at home with us for about six months before he was finally unable to climb the stairs to bed and an ambulance took him to hospital one night for 'assessment' and he was never home again. Two weeks in a totally unsuitable ward (his dementia made him want to come with us every visiting time and he followed the staff everywhere - but they did like him and he was able to walk. But as it was now a case of 'In his best interest - not our wishes' - he was found a place in an EMI home (he was 80 then). Such a traumatic time for us all - I could still cry as I type this - and his swift deterioration both mentally and physically (he stopped walking and became chair bound after six weeks) still makes me wonder if I should have fought harder to keep him with us -my brain says no but my heart still wishes for a better solution.

He has been in a wonderful Nursing Home with the most caring staff for 20 months now - he is still not walking and no longer knows who we are at visiting. He talks constantly to himself in a self answering way - is confused if you respond and no names, pictures, personal items elicit a response. But he makes the nurses laugh and they hold 'fantasy' conversations with him on his good days. On his noisy shouting days he is best left to himself. But I miss him so much my husband of 52 years and friend and confidant!

 

[furball]

Although it's very important to try to prevent the falls happening in the first place, I think you need to be prepared for the falls when they do happen because no matter how careful you are, they will happen. If the person has no power in their legs at all, they will fall beside the bed so it is important there is a safe zone beside the bed where there are no protruding edges they can fall against. Putting up rails in an attempt to stop the person getting out of bed could make the situation worse if they try to climb over them.
Picking someone up off the floor is one of the most difficult things to do even for a fit and able person and it gets more difficult as the fallen person becomes less able to co-operate. A community alarm is essential in this situation. Even if the person with dementia didn't think to use it, if there is someone else in the house it could be used to summon help to assist in picking the person up.