How do homes manage a high fall risk?

Discussion in 'I care for a person with dementia' started by flossielime, Mar 19, 2015.

  1. flossielime

    flossielime Registered User

    May 8, 2014
    201
    Re posted just to see if other people have experienced anything like this. My dad is a high fall risk.

    Well I've had a care assessment and quote for home live in care. This is using carers from overseas, so I was excepting it to it to more reasonable than it turns out to be. My dad would need a day carer and a night carer. The cost would be £1700 a week. So with the best will in the world I dont think the NHS or SS will pay that.

    So I went on to plan B. Re looked at the NH's locally. Still of the opinion that the 3 local ones are grim. but realise times are desperate so asked the manager of the most recommended one (by friends who have had partners/ parents in there) if they had a vacancy and would take my dad. Well they did not have a vacancy but what she then told me would be her conditions of taking him. These conditions floored me.

    My dad would need one to one care there (Ok so far). But the NHS wont pay this indefinitely (ok understandable) so this would be while 'his chair' is made. I was 'oh he is ok he doesnt need a special chair'. Oh how deluded was I. This is a special restraint chair. He will sit in this with a 'special belt' on whilst the carers are with other residents. I was HORRIFIED. So I said like a sort of straight jacket, oh yes but its all legal - they would write in a book the times he has the belt on and why, and they'd have a DOLs in place - oh well that is all reassuring!!!!! NOT

    OMG this is a steep learning curve. i thought we lived in a civilised country where the old and the ill were treated with respect. I am starting the learn that when you are old generally but especially old with dementia anything goes.
     
  2. Hibni

    Hibni Registered User

    Sep 16, 2013
    46
    That's horrific! I hope you're able to find a more caring NH for your Dad.
     
  3. Polly1945

    Polly1945 Registered User

    Oct 24, 2012
    261
    Hereford
    Hi Flossielime

    That is just awful.. My Mum has been in a wonderful care home (not self-funded but run for the Local Authority) The Home has a number of residents that are at risk of falling, including my Mum but I have never seen one of them strapped into a chair. If they are sitting in the lounge then they are in a normal fireside type chair and usually have one of those little tables on wheels (in front of them - with a cuppa on it) they also have their walking frames nearby. The carers are very watchful and will accompany the resident to the toilet or their room when needed.

    Any resident that has difficulty walking is hoisted into a chair by two carers, and they keep their eye on him/her.

    Perhaps you could keep on looking at care homes and maybe go further afield to find a really good one.

    ((hugs))
    Pauline
     
  4. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    This is not acceptable for anyone,let alone an old man to have to be tied into a chair all day.

    There are pressure mats which can alert staff he is trying to stand. If he is in the lounge then surely there should be at least two carers on duty to keep an eye on him and the other residents in the lounge.

    There should also be some kind of activities going on, usually in the afternoons which might interest him, even if only watching from his chair.

    I personally would not put any relative of mine in a home which tells me my relative would have to be restrained in a chair!

    As for a DOLs being put into place, I very much doubt that a DOLs would be given so that staff can strap him into a chair all day!

    xxTinaT
     
  5. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,967
    Brixham Devon
    No! NO! NO! This is not right. No one should be restrained in that way. My Husband was assessed as being eligible for CHC and one of his ;high' scores was for mobility problems. The NHS funded 2 x 2 hours of 1 to 1 care for him, but the rest of the time it was down to the CH to ensure he was safe.

    It makes my blood run cold when I hear of this kind of treatment. I'm sure this kind of restraint must be illegal?

    My advice? Steer clear of any home that uses restraint.

    I hope you find somewhere appropriate

    Lyn T
     
  6. MrsTerryN

    MrsTerryN Registered User

    Dec 17, 2012
    773
    It is worryingly that there is such a chair . Mum is slowly becoming a fall risk she has had three in the last three weeks. I have never seen anything like this as a restriction .
    I suppose the closest thing I have seen is really elaborate chairs that is usually 45% degrees reclined with a type of seat belt
     
  7. Cath59

    Cath59 Registered User

    Jan 23, 2015
    46
    It's possible that these chairs might have a place to supplement proper supervision (even with one to one a carer might need to leave for a few moments), but not instead. I'm slightly wary to post this story, but am working on the basis that I'm anonymous, and that I know the people involved don't use this forum. My uncle had vascular dementia and his daughter was determined to keep him at home as he had wished. Something like this was brought in as a safety precaution when she had to be out of the house. He must have tried to unstrap himself, but ended up strangling himself. There's no one to blame. She did everything she could (and more) to do what was best for him with very little support and the coroners court described it as a tragic accident. I know the use of these chairs in a care home would be quite different as there would be carers around, but apart from the deprivation of liberty side, I really, really don't like the idea.
     
  8. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    I really really do not like the idea either - but realistically, how can CH/NH staff manage to keep residents safe from falling if they need to keep an eye on some of them 24/7 ???

    It is clear that falls are a major risk with dementia - and I just do not know what the answer is.
     
  9. Cath59

    Cath59 Registered User

    Jan 23, 2015
    46
    #9 Cath59, Mar 20, 2015
    Last edited: Mar 20, 2015
    Agreed. As I said, I think they may have a place supplementing proper supervision, but not if there's an attitude that once someone is in one they are safe. Maybe ask how often and how long they are used for. Ask to see the book? If it's occasional, when the carer's hands are full it might not be so bad. If it's for long periods everyday that would be horrible.
     
  10. flossielime

    flossielime Registered User

    May 8, 2014
    201
    I am glad to see most people agreed with me. It makes me feel better that this does not seem to be common practice. I really can't accept this for my dad.
     
  11. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,282
    SW London
    It is a very difficult and sometimes maybe insurmountable problem. Even with a very good staff to resident ratio, like in my mother's CH, falls will happen. There are just 9 in her section, and usually two staff, but someone will need to be taken to the loo, and the other carer may be making a cup of tea in the open plan kitchen, or helping someone to drink - with their back turned just as X decides to get up from her chair... I know at least one fall resulting in a broken arm has happened like this, one staff member had her back turned just feet away.

    She is largely past it now, but my mother went through long phases of wandering around, including during the night, even after a hip fracture when she was considerably frailer and more wobbly. She still had a 'need' to do it and trying to prevent or restrain her would have caused massive distress. It was bad enough at A and E once, when she was briefly strapped into a wheelchair. I would get a call maybe once a week to say she had fallen yet again - and sometimes she would need A and E for a cut - but what were the staff to do? We knew they could not watch her every minute.
     
  12. jasmineflower

    jasmineflower Registered User

    Aug 27, 2012
    335
    Hi Flossielime
    My MIL spent 6 weeks in hospital and was allocated a 1:1 HCA, she moved into a care home near us that was lovely but they couldn't manage her needs with their staffing levels and she fell 19 times over 3 weeks until we moved her into a super nursing home where she has 24 hour 1:1 care under CHC. Even though this is extremely expensive and she is exceptionally hard work for the carers, no-one has ever suggested "tying" her into a chair. As another poster mentioned, they often manage it by sitting her in front of a table.

    I would be horrified to find her restrained by a belt. What might start out as a few minutes while the carer helped with another patient, could end up as a permanent way of stopping your father trying to walk.

    I think your instincts are spot on and you should be looking elsewhere

    J xx
     
  13. Acco

    Acco Registered User

    Oct 3, 2011
    228
    Hello Flossielime, I am horrified. My MIL had dementia and was in a care home some 20years ago. The management of the care home were taken to task by SS when they noted MIL strapped into a seat, 'because she won't eat her food unless we strap her in her seat in front of her food'. I thought times would have changed for the better but clearly not. It is reports like yours that make me even more determined to cope with whatever arises in keeping my wife at home and in my safe keeping. Your post is particularly poignant in that my wife has started to loose her ability to walk, and loose her balance, and therefor could fall if left unattended. This is only within the last few days so I am presently having to think ahead all the time in trying to find the best way of washing her, dressing her, seating her, etc., etc., such that she cannot/does not fall over. And because of past poor experience with SS administration and management I am always conscious of what they may try to do should they ever get involved again.
     

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