How to deal with person sliding off chair - Carers calling ambulance each time

EONONLY

Registered User
Nov 26, 2007
23
0
Kent
Hi,

My Father has Alzheimers etc - Can't walk unaided, 4 double carer visits per day and happy at home. He has a thing that he wants to sit on the floor, he does it by shuffling to the edge of the chair, slides off the edge and sits on the floor. Sometimes he will then roll from the sitting position to one side. He does this many times in a given week. Never once has he hurt himself, he just happens to prefer sitting on the floor sometimes.

This in itself is not an issue, problem is that the carer company has a protocol of "patient on floor equals ambulance" under no circumstances are the carers allowed to pick them up using the slings, sling sheet and crane which is there. It is to be used to transfer from the chair to bed or bed to chair only. They say it is not an issue of whether he has hurt himself. They say only the ambulance staff have the systems and means of getting someone up from the floor (seated or laying) up into a chair.

Is this a carer company policy issue - an equipment issue - or something else? Are all carer companies the same, I don't want to change them because of this single point but its becoming an issue now as he wants to sit on the floor more frequently (no underlying problems, pressure sores etc).

We can't strap him in of course, tilting him back a bit we've tried - any more would be either a fall or hurt his neck looking forwards - He likes being at home and I wonder how they may be better equipped to deal with this in a care home (if at all). I can't think they would put him on 24 hour surveillance and even then when he's on the floor what would they do that our carers double handed cannot. Chemical cosh?

Sorry about the ramble but want to get all the details out there in the hope someone will have dealt with this before - if not, perhaps all other carer companies would just reseat him once established that he has not fallen, but slid off the chair which is pretty much what this amounts to given the kit is there.
 

Jessbow

Registered User
Mar 1, 2013
5,718
0
Midlands
I don't suppose they are trained to pick someone up off the floor, neither do they have many instances of someone choosing to sit on the floor.

How do you get him up?

I cannot imagine its easy to get the sling around him when he's on the floor , to use the crane safely.
No care agency will take unassessed risks
 
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EONONLY

Registered User
Nov 26, 2007
23
0
Kent
I don't suppose they are trained to pick someone up off the floor, neither do they have many instances of someone choosing to sit on the floor.

How do you get him up?

I cannot imagine its easy to get the sling around him when he's on the floor , to use the crane safely.
No care agency will take unassessed risks


We sit him upright and put an arm under his arms and lift him the 10 inches or so back onto his seat. However, if we wanted to we could roll him onto his lifting sling blanket and crane him to wherever we want to (as you would to move him from the chair to bed - only difference being its a lot easier when he is on the floor rather than in a chair. Stupid thing is they lift him about to put the sling under him when he is on the chair).

Falls (proper falls) are very common in Elderly I understand.

I can't really see how an ambulance is considered neccessary because he sits on the floor. It must cost a lot of money to put him on his chair those few inches - especially with a crane hoist in place...

Any idea how they deal with this in hospitals or in care homes? If its equipment, what is it - can't be numbers of staff. He's only 9 stone - the crane takes 30 stone. I know you couldn't have a rule based on weight - but thinking about that, the crane is there, they use it when it suits to move him about, whats the difference given they know he has not fallen.

Hopefully my points are clear - I understand my care company won't do it - Equipment or change care co or other practical ideas appreciated
 

Kevinl

Registered User
Aug 24, 2013
6,306
0
Salford
Any idea how they deal with this in hospitals or in care homes?

Constant supervision is how care homes deal with it, last thing they want is an "unwitnessed fall". When one happens they don't touch the person until one of the qualifier SRN grade staff comes and does an assessment before anyone tries to get them up, only then can they get them up, usually by hand not with a hoist.
Unless somebody knows how the person came to be on the floor you have to assume the worst and that it's a fall and there may be injuries.
Although it could be the person slid from the chair (and 90% f the time that's what happened), I have seen people get out of a chair then fall, it's usually a hand slipping off the armrest as they stand up.
Unless they actually see what happens they have to assume the worst, if they got it wrong and put someone with a broken hip back in a chair they could get sued.
K
 

EONONLY

Registered User
Nov 26, 2007
23
0
Kent
What type of crane do you have?
Does it reach the floor?


Its electric (charges up), supplied by the OT new in the last 6 months - I don't recall seeing the name on it but it looks a little like an engine hoist. Purpose built of course and it does reach the floor. He did previously have a standing hoist but they rarely used it and he does not self support now so moved on to this one to transport him the 12ft or so from chair to bed
 

EONONLY

Registered User
Nov 26, 2007
23
0
Kent
Constant supervision is how care homes deal with it, last thing they want is an "unwitnessed fall". When one happens they don't touch the person until one of the qualifier SRN grade staff comes and does an assessment before anyone tries to get them up, only then can they get them up, usually by hand not with a hoist.
Unless somebody knows how the person came to be on the floor you have to assume the worst and that it's a fall and there may be injuries.
Although it could be the person slid from the chair (and 90% f the time that's what happened), I have seen people get out of a chair then fall, it's usually a hand slipping off the armrest as they stand up.
Unless they actually see what happens they have to assume the worst, if they got it wrong and put someone with a broken hip back in a chair they could get sued.
K

Do they have them in a ward type situation - My understanding was that he would have his own room..
 

canary

Registered User
Feb 25, 2014
25,048
0
South coast
In mums CH there was a gentleman who liked to do exactly the same thing. The first time I saw him on the floor I was a bit taken aback, but one of the carers explained it to me. They mostly left him - although they did tend to put another chair beside him so that no-one trod on him!
When he wanted to get up they used a hoist with a sling that could extend down to the floor, so they rolled him from side to side to get the sling under him and then lifted him up from the floor back into a chair. It took 2 carers to do it.
 

EONONLY

Registered User
Nov 26, 2007
23
0
Kent
In mums CH there was a gentleman who liked to do exactly the same thing. The first time I saw him on the floor I was a bit taken aback, but one of the carers explained it to me. They mostly left him - although they did tend to put another chair beside him so that no-one trod on him!
When he wanted to get up they used a hoist with a sling that could extend down to the floor, so they rolled him from side to side to get the sling under him and then lifted him up from the floor back into a chair. It took 2 carers to do it.

Thanks - Sounds much as I would have expected. You see, if it was unexpected he would be on the floor I can imagine most would be alarmed to find him there. But after you've watched him do it, several times a day sometimes, you have to wonder at the response. Calling an ambulance because he decides to sit on the floor...

Alzheimers does funny things to people and I'm sure nearly all contributors to this site have many odd stories to tell. Is sitting on the floor so strange though?

I think I'll just replace the recliner, maybe that could change his little routine. I did wonder if many people would suggest it was a common trait in dementia but I can't see much evidence for it looking online or the limited responses with experience (so far) to this thread.
 

Kevinl

Registered User
Aug 24, 2013
6,306
0
Salford
Do they have them in a ward type situation - My understanding was that he would have his own room..

No, it's an EMI nursing home, no shared rooms, 2 lounges and a dining room.
All the beds are one side against the wall and have a crash mat on the floor and on top a pressure sensor on top which triggers an alarm if any part of her touches the floor.
Falls in the lounges be it sliding off a chair or otherwise are treated as a fall unless someone actually sees it (staff or visitors) and can say what happened.
Being found on the floor in their private room, would be taken as not witnessed in a care home and even in your own home would (I believe) be treated the same way.
K
 

EONONLY

Registered User
Nov 26, 2007
23
0
Kent
No, it's an EMI nursing home, no shared rooms, 2 lounges and a dining room.

Falls in the lounges be it sliding off a chair or otherwise are treated as a fall unless someone actually sees it (staff or visitors) and can say what happened.
Being found on the floor in their private room, would be taken as not witnessed in a care home and even in your own home would (I believe) be treated the same way.
K


Indeed. I think once they have seen someone deliberately sliding off their chair several times a day, they would reconsider their procedure - I can't believe common sense would not prevail. Either way though - he still would need to be got up off the floor into his seat and I don't think they would be calling for ambulances.... Would they?
 

Mannie

Registered User
Mar 13, 2014
116
0
Bracknell area
Hi,

My Father has Alzheimers etc - Can't walk unaided, 4 double carer visits per day and happy at home. He has a thing that he wants to sit on the floor, he does it by shuffling to the edge of the chair, slides off the edge and sits on the floor. Sometimes he will then roll from the sitting position to one side. He does this many times in a given week. Never once has he hurt himself, he just happens to prefer sitting on the floor sometimes.

This in itself is not an issue, problem is that the carer company has a protocol of "patient on floor equals ambulance" under no circumstances are the carers allowed to pick them up using the slings, sling sheet and crane which is there. It is to be used to transfer from the chair to bed or bed to chair only. They say it is not an issue of whether he has hurt himself. They say only the ambulance staff have the systems and means of getting someone up from the floor (seated or laying) up into a chair.

Is this a carer company policy issue - an equipment issue - or something else? Are all carer companies the same, I don't want to change them because of this single point but its becoming an issue now as he wants to sit on the floor more frequently (no underlying problems, pressure sores etc).

We can't strap him in of course, tilting him back a bit we've tried - any more would be either a fall or hurt his neck looking forwards - He likes being at home and I wonder how they may be better equipped to deal with this in a care home (if at all). I can't think they would put him on 24 hour surveillance and even then when he's on the floor what would they do that our carers double handed cannot. Chemical cosh?

Sorry about the ramble but want to get all the details out there in the hope someone will have dealt with this before - if not, perhaps all other carer companies would just reseat him once established that he has not fallen, but slid off the chair which is pretty much what this amounts to given the kit is there.


Thanks for adding this post because , I have learnt a lot from it, and from the thread of responses...this did not happen for me but , it might in the future .

I think what I would do, if not done already, is request advice , once more, from his OT. Maybe you could have a meeting with the OT and the carer field service supervisor, where you ask the question: what can we do to enable dad to live at home independently and safely, given that he wants on several occasions per day, to sit on the floor....

Hopefully the care company would explain precisely why they are unable to move him from the floor, and possibly they can get training from the OT on how to lift from the floor, so that at least that type of lifting is possible.

Possibly he needs more hours of care such that he can be supervised more than he is now, so that , if observed - then they know he is not hurt and can then lift him. It is likely , from what I have read and experienced, that this is a phase that will go away in a few months.

One idea is, looking in even more close detail on why he might have a desire for this? Is it because he feels uncomfortable for whatever reason? Is he trying to get to the toilet perhaps, or maybe his chair is too reclined ? Is he bored and needs more interaction to divert him ? Maybe here his Community Memory Nurse could visit him or you could call them, to suggest possible causes and solutions. Thinking about this it might be better to start with the memory nurse.

I don't know if this will help but I thought it might trigger some ideas.

One item suggested by our OT for observed falls, is a Mangar lift, OT are arranging a demo for us, I have no idea what it is yet...I think it might be an inflatable ?
 

EONONLY

Registered User
Nov 26, 2007
23
0
Kent
Thanks for adding this post because , I have learnt a lot from it, and from the thread of responses...this did not happen for me but , it might in the future .

I think what I would do, if not done already, is request advice , once more, from his OT. Maybe you could have a meeting with the OT and the carer field service supervisor, where you ask the question: what can we do to enable dad to live at home independently and safely, given that he wants on several occasions per day, to sit on the floor....

Hopefully the care company would explain precisely why they are unable to move him from the floor, and possibly they can get training from the OT on how to lift from the floor, so that at least that type of lifting is possible.

Possibly he needs more hours of care such that he can be supervised more than he is now, so that , if observed - then they know he is not hurt and can then lift him. It is likely , from what I have read and experienced, that this is a phase that will go away in a few months.

One idea is, looking in even more close detail on why he might have a desire for this? Is it because he feels uncomfortable for whatever reason? Is he trying to get to the toilet perhaps, or maybe his chair is too reclined ? Is he bored and needs more interaction to divert him ? Maybe here his Community Memory Nurse could visit him or you could call them, to suggest possible causes and solutions. Thinking about this it might be better to start with the memory nurse.

I don't know if this will help but I thought it might trigger some ideas.

One item suggested by our OT for observed falls, is a Mangar lift, OT are arranging a demo for us, I have no idea what it is yet...I think it might be an inflatable ?



Cracking post Mannie - Really great ideas. Thanks - I will look at all these, could be a combination of any or all of them. On it today..
 

mrjelly

Registered User
Jul 23, 2012
314
0
West Sussex
here is a link to the Mangar I've just looked up on youtube - This could do it Mannie

https://www.youtube.com/watch?v=zVU1-gsOvGw

We had one of those which we used when Dad found himself on the floor. He was still walking at that stage and I think the person being lifted does need enough strength to steady themselves as the cushion is inflated. It can be rather wobbly, especially if you inflate the levels from the top down by mistake!
 

Jessbow

Registered User
Mar 1, 2013
5,718
0
Midlands
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EONONLY

Registered User
Nov 26, 2007
23
0
Kent
We had one of those which we used when Dad found himself on the floor. He was still walking at that stage and I think the person being lifted does need enough strength to steady themselves as the cushion is inflated. It can be rather wobbly, especially if you inflate the levels from the top down by mistake!

Mmm - Rather Wobbly eh. Thanks Mr Jelly
 

EONONLY

Registered User
Nov 26, 2007
23
0
Kent
That's the bit that the carers are not qualified to assess/Guess/take a chance on

What about a chair with a pommel in it?

Child's one, but ...
https://www.essentialaids.com/child...heathfield-range-accessories-pommel-seat.html


That looks interesting - It could work. I need to perhaps look a little harder or seek more advice as to why he is placing himself on the floor. I don't want to turn a slide onto the floor into a fall as he overcomes the obstacle of the Pommel. But it looks possible. Thanks.

OT contacted and meeting arranged to discuss the Elk lift - I'll add this to the mix