What should I ask the home after Mum's repeated falls?

[Purplepelican6]

Mum is in a nursing home with dementia,it is quite far advanced .she doesn't know me when I visit or remember me .
She is having a lot of falls
Recently she has had 3 falls in the last two months
Each time she has split the back of her head open .
This is because the home doesn't have carpet,it's a very hard floor .
The home say they can't use carpet for hygiene reasons
They also say she would not manage a walking frame and needs some one walking with her when she moves around .
I've already moved her twice ,from two different homes for different,but dreadful reasons
This home is far superior,and has plenty of staff.
Point of my thread
I'm wondering if I should move her to a home with carpet ,so if she goes fall she's at least not going to split her head open each time .
Or will she be attached to the staff and familiar with the home layout,and that is more important
or not because of dementia .
The home ring me every time she falls ,but they don't seem to have any suggestions how to stop her falling .
What should I be asking for to the home and her social worker

Does she have a fall mat? It's like a pressure pad that sounds an alarm and they're usually placed by chairs/beds.

Falls are fairly inevitable as aging progresses but that does sound like a lot and she's being badly injured each time. I think I'd be having some fairly stern words with the home manager asking what is being done.

Also, don't confuse nice decor as a superior home.

Superior,as in actual staff milling around ,calling the doctor when she needs it , getting her medication she needs , keeping her clean and fresh ,not leaving her unsupervised in males bedrooms who haven't got dementia,making sure she wears glasses and making sure males don't go in her bedroom when she's in bed .
So that's why it's superior.
But I'm an worried about repeated falls and the impact to her head
Yes she has a mat by her bed
But the falls are happening moving around the home ,walking from dinning room to lounge or lounge to bedroom

My Dad spent the last weeks of life in a nursing home that was badly run/managed, that's why I asked. If the care is good, and it sounds like it is, then she shouldn't really be transferring from room to room if she's that high a fall risk. Could you ask them to start using a wheelchair for her?

Have you asked to see their falls risk assessment?

If they are well staffed @Purplepelican6 it would be useful if someone could escort her between areas. Why aren't they doing that?

I'd have a serious chat with the manager, partly to highlight your concern but also ensuring they know you are vigilant and noticing their lack of care, for your Mum.

It's almost a damned lottery with regards to some of these places purportedly "caring" for dementia patients who cannot advocate for themselves, at all.

It's so worrying and difficult for you all @Purplepelican6 💐

Carpet is possible - I know many homes with residents with dementia and incontinence who simply have the right sort of carpet.

There is a very difficult balance to be struck in these homes. It is simply not possible to have a 1:1 scenario which would prevent falls totally; and it is equally not possible to chain residents up and prevent freedom of movement.

I know we reached a compromise with the home my mother was in by giving permission that she should have a fixed tray on the front of her chair, but that as soon as she expressed the need to move around/go to the toilet etc staff would be with her promptly. This did seem to work for her, but we had faith in staff that they would act as they promised. And the tray was a great bonus as she could have things within reach - drink, photo albums etc - to engage her attention. Homes are reluctant to do this as they have rules to follow about restraint, but with the permission of relatives it is possible.

Is there a Falls team in your area? She’s not mobilising safely so needs an assessment regarding that. There is technology that can be put in place to alert staff when she gets up from her bed or chair so they can supervise. However, with the best will in the world, you can’t stop all falls. It’s doubly hard when people have dementia and are mobile as they don’t remember to wait for staff assistance.

My lovely MIL was in a wonderful care home, with carpet, but she still managed to fall and break bones.

She had alarms in her bed and chair so that staff were alerted when she got out of bed, which did help, but she could move quite quickly.

As PP have said, I’d ask about their preventing falls strategy and make sure they are doing all they can.

Sorry to hear about your dad not in a good care home .
I can't imagine they would manage to get her in a wheelchair
She paces about ..or tries to ..
She has a history of walking miles every day to keep her weight down ,and she still tries to do this .so getting her sit and be still ,must be difficult for the staff

No I haven't..what should I be looking for when I do

So is constant falling considered a lack of care ?
They said on the phone she needs a person escorting her when she walks .
But didn't say they were actually doing that .
Is that a normal expectation of a nursing home ..mum is very determined,so if they told her to wait for someone to help her before leaving a room ,I doubt she would do as asked

.....But the falls are happening moving around the home ,walking from dinning room to lounge or lounge to bedroom

The home has said your mum needs someone to walk with her, but that isn't really the solution. She needs to be in a wheelchair to go from room to room, if she's prone to falling.

Yes ..the home actually has stair gates on all the bedroom doors ,to keep them in their rooms at night ..that was installed a year ago ,and it was a bit of a shock ,but I'd not noticed anyone with trays on their chairs .
But even the bedrooms don't have carpet

I can definitely ask if there is ,thanks

That’s not superior, that’s basic care.

Yes she has an alarm mat by the bed
I just think it will hurt less falling on carpet ,but I don't know if that's enough of a reason to move her for a third time

Honestly compared to the first two homes ,it's massively superior..it's been a hell of a journey to get to this home and find decent care

But how ,like strap her in it
I will be honest,she can be difficult,she won't want a wheelchair
But I agree it would be better than the falls

The staircase across doors to keep people in rooms.....
This is highly unusual practice for a care home.
Have you seen the best interest decision regarding this?
Falls are inevitable but is there a pattern as to time of day. If there is a pattern of afternoon maybe it's sundowning. However, often there's less staff on in an afternoon too.

Is she in a residential home or nursing home?
I disagree re wheelchair use as keeping mobile is key. You need to query her falls risk assessment as has been said.

I would want to see the risk assessment for her not having a walking frame, and also for the stair gates on the bedroom doors. That’s highly unusual.

Can she be moved rooms so that she’s near the nurses station, so they can respond quicker?What you have described is the minimum a home should be doing, but if you are happy try to address the concerns there first before considering moving. The truth is you can’t stop someone moving about if they are mobile and want too! Things like a floor monitor are good, but staff need to be responsive to it. Is there a specific time she is trying to move about? Can staff try waking her in anticipation of this? If she is putting herself at risk, and doesn’t have the capacity to understand this risk , and is having repeated falls she may qualify for CHC funding- I’ve seen this before with similar people who’s needs are too high for the usual social level. They should be recording all the falls and have a risk assessment in place.

Yes all the bedrooms have these massive wooden gates on the doors
It's a very very expensive nursing home

Also query the stair gates- this isn’t usual practice and there should be best interests decision , MCA for each resident. There should also be a DOLs. I would contact the social worker and raise your concerns. They be more responsive to their input.

They tell me she wouldn't use it

Social worker is in there today ,so will see the gates himself.
I didn't know that wasn't normal practice