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As a re entry nurse I have been working in geriatrics for the past 4 years in home health as a visiting supervisor and part time office nurse manger. Never have had any complaints. Of course never have had any compliments either, no surprise, except from the clients who always were glad to see me. I pride myself in my ability to do good work, communicate well with staff and client,write letters for the admin. to local businesses and schools, keep up with online CE's, member of local nursing board and of course loyal beyond the time clock. After 3 yr. on a Friday at 5PM the owner asked me to stay for a couple of minutes to talk. She said the following to me: " I can get an LPN to do what you do for $7.00 less an hr...so today is your last day."

She is frail and weak. She used to like to walk outside in front of her house. Now unable to. She tires easily. Caregiver does walk with her all the time. They sit on front porch together for lunch. Family doesnt come around much. She watches TV, sleeps, eats and sits on porch. Ive suggested to CNA to read to her or to sing with her ( or to her.) Sometimes caregiver is to much in her face/ stands so close that it's imposing, such as: when attempting to stand up after sitting in front of TV for a length of time, cg leans forward and discourages her from getting up. I've told her to give client a little space, literally but stand and walk with her when she does move about the house. Cg appears to be very attentive when Im there. Client is well groomed and well dressed. Home is kept clean and clutter free.

Client lives alone in her home. CNA is a live in. with alternate CNA live in on weekends. To help avoid the many daily falls ( bruised places on bridge of nose, forearms) CNA puts client's walker up against the chair client is sitting in when client attempts to get out of the chair. Client often calls for her Mother when wondering around the house. Thank you one and ALL for your wise and much needed advice. I agree that some restraints could be worse but I also agree that this is an unsafe ( for client), labor intensive/exhaustive ( for care givers) situation. Thank you again.

What are hipsters? Her dx is: Alzheimer's, Dementia, Depression, HTN and high cholest.

Thanks will look further into it.

Many thanks for taking an interest and offering these excellent ideas.

Dx is: Dementia, Alzheimer's,Depression, HTN and high cholesterol

Good ideas. Thank you.

Thanks. That may be the best solution.

If caregiver turns away for even a moment, or goes to put laundry up or while cooking for client, the client quietly walks away while CNA's back is turned for an instant, the client consistently falls. Client is totally non compliant ( dementia) and does not follow simple instructions (such as to wait for a min. or ask for help.) Also client is in wheelchair most of time and falls out of the chair constantly by slipping down in chair and then falls to floor ( slips onto floor.) Caregiver is there 12 hr almost attached to clients side. One of our best CNA's. Any suggestions as to a good way to manage this?

GA law prohibits use of restraints. A difficult situation especially with this type of client. Thanks for your interest in replying/asking.

I'm RN supervisor for home health agency. We have an at home 87 yr old frail, non compliant female pt with frequent falls and dementia. Family wants to know from us how they and/or we, can keep her from falling out of wheelchair 4-6 x daily without using restraints (which we never use.) I have spoken with the daughter several times re. state law prohibiting use of restraints. She has a room to room monitor so she can hear her Mother. Our 2 CNA's live on with the patient in her home. CNA's each have 12 hr shift. Client will try to stand up or ambulate without giving any indication of her desires to get up and she has frequent daily falls up tp 6 x a day resulting in bruises and discomfort. Any suggestions as to how without restraints this situation can be better managed? Thanks for ANY suggestions or examples of what you have seen or done in similar situation.