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Placement in a Senior Living Community Is Not a Remedy for a Senior Who Falls

I am often amazed at the number of clients who call me and say they are looking to place a loved one in a senior living community because their loved one is falling. When it comes to senior falls, please remember the following very general guidelines:

No senior living community provides one-on-one care. Placement in a senior living community is never a guarantee that an older loved one won’t fall. If a senior is in independent living, that level of care is not licensed. There are no nurses or nurses’ assistants. If a senior falls in independent living, 911 will be called to help the person stand or to take them to the nearest hospital. When a senior resides in assisted living or a nursing home, there will not be enough staff to prevent the senior from falling unless the staff witnesses the fall taking place and they can act on time. Don’t forget that your loved one will be sharing a certified nurse’s assistant with many other residents.

The use of full bed rails is not allowed in Illinois. They are considered to be a restraint. They can only be used if a doctor writes an order for them. The most that can be used without a doctor’s order is a half rail. A resident cannot be restrained with chemicals without a doctor’s order. There are grab bars available that attach to seniors’ beds to help them steady themselves when they rise. Many times, a mattress is placed close to the floor to lessen the distance of any potential fall.

When my mother was in sheltered care, she had an alarm that attached to her chair when she tried to get up. But, unfortunately, such alarms can be very loud and can startle the senior. She hated the alarm.

I have mixed emotions about the use of motion sensors as a method of fall prevention. One of the senior living communities I work closely with had motion sensors installed in their assisted living memory care area. But, it was explained to me that the model of  sensors purchased only worked if the senior was within three feet of them. By the time the staff reached the room, the person had already fallen and it was too late.

Some assisted living communities offer a two-person assist with some activities of daily living, like transferring and bathing, as a method to prevent falls.  This is at the discretion of the Administrator. Technically, that is against the assisted living code. The staff may not be trained to do the two-person assist correctly. If a person requires total assistance with two or more of his/her activities of daily living, s/her is really more suited for a skilled nursing home. 

There are fall prevention programs available to help strengthen those who are at risk for falling in addition to physical therapy. But, if the senior has memory issues, he or she probably won’t remember what he or she has been told.

Attendance at activities where the staff can see the senior is helpful.
Summing up: Unless you are prepared to hire a caregiver to watch the senior when s/he is alone at a community, there isn’t much that can be done to prevent falls. And even the caregiver option isn’t fool proof. One can only do one’s best; that is, help a senior maintain the best possible nutrition and physical activity and/or therapy. Identify and remove fall risks (e.g., slip rugs, low end tables, etc.). Identify and select the best possible senior living community matched to the senior’s current and anticipated needs. With that, everyone can enjoy greater peace of mind, even if no one can guarantee a 100% perfect, risk-free world.