I’ve fallen and I can’t get up

[OldMarriedMan]

My 88 year old step mom fell out of the bed last night. She was fighting with the covers and slipped out of bed onto the floor. She has an advanced case of dementia. We gave her lorazepam to help her sleep. She lost her orientation and fell on the floor. My 88 year old dad tried to pick her up. He couldn’t do it. He texted me and my sister-in-law who lives in the house with him. I live 45 minutes away. So I can sleep at night, my phone is never by my side. My sister-in-law didn’t hear the text message beep. We have a nanny cam in the room and it triggered a notification to my brother who works nights. He saw the situation and called my sister-in-law several times and woke her up. She came downstairs and helped my step mom get back in bed. She was on the floor for about 20 minutes. All my dad could do is sit by her and keep her company until help arrived.

We have ADT emergency response system. My father could press the button and they would dispatch paramedics or fire department. But both parents are on hospice so we are not supposed to call 911. We’re supposed to call the 1-800 number to hospice first.

Does anybody have caregiver experience like this?

Maybe there is a way to teach step-mom how to get up on her own?

Maybe we shouldn't give her medicine like lorazepam known to cause dizziness.

Maybe we need a hospital bed with guard rails but then she would have trouble getting up to use commode which sits right next to the bed. And if she slept in a hospital bed, they would not be able to sleep in bed together.

Maybe we need a panic button in their room that rings throughout the house, so anybody at home will hear it and wake up and come to assist.

[GailL1]

I am very sorry   We have already talked before but if you would allow me to just make a few more comments here.

You said:  "But both parents are on hospice so we are not supposed to call 911. We’re supposed to call the 1-800 number to hospice first."

Hospice should clarify this for you - While on hospice, one should not call 911 for any life saving measures BUT if an accident occurs, or if something happens that is not life-threatening, like she breaks something or you might suspect she has injured herself, you can call for emergency assistance, inform them & the hospital of the hospice & also notify their hospice designate -  you don't want her to suffer from some injury or accident or whatever.  Hospice is there to make them comfortable at the progressive end of life connected to their illness - sometimes other things happen outside of this end of life progress.

If she suffers from extreme dementia - teaching her anything is questionable.  Yes she could be drowsy from all the sedative type meds she is taking - even the ones for anxiety - that needs to be checked out by her physician.  But if she needs the anxiety meds of whatever type and also something for sleep - the doc is gonna have to weigh these things along with what is going on at night and who is there to help and how.

It does not seem that she should be getting up by herself at night even if there is a bedside commode - maybe a bedpan or help getting up and then back to bed at night.    Only you and your sister know how coherent she is during the night; bedrails might help or be worse if she tries to still get up by herself.  Only you and your caregiving family know whether or not the person doing doing the accompanying could support dead weight if she started to fall.  The hospice nurse might suggest some other type aids in getting her up and down at night if that is even feasible. 

A call button (or even a loud bell) would alert the person in the home there to help them – But perhaps someone could be at their bedside at night -  sounds like it might be to that point.

Caregiving is hard and it progresses to more and more care as their [respective] conditions worsen.

Yes, I have lots of experience with caregiving - and hospice. I also have a medical background - RN but had not practiced in years when all my caregiving as a family member started - and it was just me. Sometimes a friend would help out.

You and your family need to sit down and talk about this situation with the hospice doc / nurse / personal physician - if you & your family as a caregiving team are not able to accommodate the needs of your step mom and your dad - keeping them safe, fed, clean, converse with the hospice team on all aspects of their care, etc. 24/7, that could mean bringing in more help to the home at certain times or all the time or it could mean another place of care.  

Depending on their [respective] level of disease, I would stop expecting much on their end - at least not for the long haul.

Maybe others will have some suggestions.  

[OldMarriedMan · Accepted solution]

Thank you for your detailed response. I called our hospice provider to ask about their policy for calling 911 to assist with a fall. They said we can call non-emergency number and ask for a "lift assist" if it is non-medical emergency.