Res. who is constantly falling

Blessedx3 · Mar 29, 2009

Oh my--I know there are bed alarms that will alarm you if they get up...Is that the same as the floor alarm? I found it very interesting recently to find out that UTI's in the elderly are a common cause of falling. Good luck.

SuesquatchRN, BSN, RN · Mar 30, 2009

Document, document, document.

Oh, did I mention to document?

ExtraShotNoWhip · Mar 30, 2009

The floor alarm operates the same as a bed alarm, but it goes off quicker. The second the res's foot hits the mat it goes off; rather than when the body moves off the bed sensor. They are great. Yes, we have done the UA nada, BMP nothing, other blood work no probs, psych consult fine... He is a one man circus and on q shift documentation if not more. Thanks for the input. :)

UM Review RN, ASN, RN · Mar 30, 2009

Won't use a urinal, eh?

I recall one gent that I coaxed into using it (at least for the night I had him) by telling him that the doc wanted us to measure his urine output. He used the urinal all night for me.

bluegeegoo2, LPN · Mar 30, 2009

We have a lady on our unit that is the same way. She has the bed alarm, floor mat alarm, motion detector, low bed, falls mat, non skid mat, and still gets up and to the bathroom before we can get there. (She's at the far end of the hall, naturally). She has had 2 falls in the last month. We have tried begging, pleading, teaching, teaching, teaching, to no avail. I'm with SuesquatchRN on this one. Document. Every time he gets up, teach, then document. I know it's a hassle, but if he gets seriously injured and you go to court, your documentation will be the only thing that saves your butt. The only other thing I can think of is to "round" him every 2 hrs and offer to toilet him. Document that, too. I just thought of that, and will implement that myself starting tonight. :)

ExtraShotNoWhip · Mar 30, 2009

Thank yous all around. I chart everything on this man, CNAs round every 2 hours on him, and yes he refuses the urinal he states "I don't care who wants my pee I use something that flushes", even though he never does...lol. Wish we could hire a sitter. However with only 5 people in the building at night, 2 nurses and 3 CNAs I do not see that happening. He has not seriously hurt himself yet... I do feel bad for his roommate listening to the bells and whisles and us "educating" him all night.

Straydandelion · Mar 30, 2009

A few more ideas, if he is not forgetting to actually call for help and covering it up by refusal....when does he usually fall? Does he refuse to use a walker? Is there plenty of things to grab onto on his way to the bathroom to steady his gait, how close is his bed to the bathroom, is there one particular area he seems to fall more then others...perhaps some kind of "hold" be it rail, stationary object can be placed at that site for him to hold on to.. is the area well lit?

morte, LPN, LVN · Mar 30, 2009

make sure that you document the fact that he is oriented and REFUSING to do as instructed...

make sure he isnt getting any med that would cause him to NEED to get up at noc...report to doc his need to get up at night...perhaps that need could be addressed, therefore keeping him IN the bed..... good luck

Pepper The Cat, BSN, RN · Mar 30, 2009

How about a hi/low bed? We have those - they can be lowered so they are very close to the floor. They make it more difficult for someone to get up on their own because when the pt sits up, their knees are bent and higher than their hips, so its difficult to stand.

If you cant' do that, how about just putting the mattress on the floor? We've also done that, before we got hi/low beds. Again - it prevents the person from standing on their own. However - mattress on the floor is murder on the nurses' backs. better the hi/low bed.

You could actually team the hi/low bed with a bed exit alarm or floor alarm - we've also done that. The hi/low bed slows them down so you have time to respond to the alarm.

BradleyRN · Mar 30, 2009

Have you tried a toileting schedule? Get to him and have him void before he would have even awakened with the urge.:)

nerdtonurse?, BSN, RN · Mar 30, 2009

Won't use anything that doesn't flush?

Turn off water to the toilet, get a strip of duct tape, put it over the handle on the toilet, and tell him it's broken, and he has to use the bedside commode until it's fixed. Maybe he'll get over whatever his prob is with the bsc...?

I swear, I have nights where I've got one of those on the floor, and I just want to pull the mattress off the bed, put it in the bathroom, and put the patient in there....