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| | By BARB RODE
My heart goes out to the patients and their families whose pain was described in "Deadly Falls," the Star Tribune's series of articles on falls in Minnesota nursing homes.
As someone who has spent her entire career in nursing homes, I know the challenges of caring for our elderly. I also know the pain of losing a parent to a fall in a nursing home.
After suffering a stroke, my mother was admitted to a transitional care unit in a nursing home. Mom had some right-side weakness but could still stand and walk. But she had issues with balance, and her hands didn't work as well as they used to. She needed therapy to gain back some of her strength.
Mom had lived in a senior apartment for independent people -- she was a very independent woman. But even before the stroke, I could tell her health was starting to decline. She had fallen in her apartment several times, but without any apparent injury. I bought her the Lifeline service so that she could push a button on a pendant alarm that would call for an ambulance. When she had the stroke and fell, I found her pendant on her dresser. She told me she had just taken it off for a minute, and forgot to find it and push for help.
On her doctor's orders, she was admitted to a nursing home for rehabilitation. While she was there, she slept more, didn't eat as well and didn't want to participate in any activities. I often visited her and encouraged her to continue her therapy and join the activities. But she said she just wanted to go home, where she would be more comfortable and regain her strength.
One day, I got a call from her care manager. Mom was trying to get out of her wheelchair by herself, and the manager was concerned that she might fall because of her balance issues. I went to the home to remind Mom she must be sure to ring the nursing assistants for help if she needed to get out of her wheelchair. She said she would. I told her the consequences of falling and how she could fracture her hip, which could cause her pain and more time in the nursing home. I told her we could put an alarm on her wheelchair to alert the staff when she was getting up.
"What do you think I am -- a baby or a prisoner?" she said.
"I don't want you to get hurt," I said.
"Barb, this is my life and I need to make my own decisions, whatever the outcome. So please, let me do it my way."
Obviously, she was alert, she was an adult and she knew the consequences. Life is not risk-free. We all make decisions that carry risks, and as adults we have the right to make those decisions. I also knew, as a longtime nursing home worker, that restraints present their own risks, such as strangulation. So I asked the nurse not to use sensors or restraints. A few days later she fell and fractured her hip. Two weeks after her surgery, she passed away.
I cannot describe how terrible I felt -- not just that my Mom died, but that it could have been prevented.
I couldn't blame the nursing home -- I knew the challenges too well. Each patient is unique, with different cognitive states, bone density or reason for falling. No nursing home that I know of is staffed to watch every resident every minute 24 hours a day every
day of the year.
Nor could I blame myself. She wouldn't have wanted a life under constant restraint or to be treated, as she said, "like a baby or prisoner." She wouldn't want to have someone else make her decisions for her.
But that doesn't mean we in senior care can simply ignore the problem of falls. At Saint Therese, the senior living center where I work, we teach seniors how to identify and strengthen themselves to offset their imbalance. We study the situations, such as time of day or environment, where seniors seem most vulnerable to falls.
We can do a better job of protecting elderly -- but not at the expense of their dignity and quality of life.
Barb Rode is president and chief executive officer at Saint Therese in New Hope.
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“The secret of genius is to carry the spirit of the child into old age, which means never losing your enthusiasm.”
- Aldous Huxley
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