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I'm a full-time caregiver for my 89-year-old mom with Parkinson's. I have hired an agency to have a CNA sit with her when I'm gone for any length of time. I have been relying on her LifeAlert when I'm gone for less than an hour to run errands. The agency is suggesting she's too great of a fall risk and should have someone there 24/7. I'm not sure we can afford that. Anyone have a similar situation?

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I'm not sure I understand the issue. The agency provides a caretaker for the times you request, right? So, why are they telling you what to do when they are not there or involved with her care? Are they just giving you a free opinion? It might be a good one, but, I don't get what it has to do with them providing you a caretaker for designated times. Some people can't afford 24/7 caretakers. Do you have other options? I do know that sometimes when a senior falls, they are not able to press alert button. Not sure why, but, it just happens that way.
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Yes, they do provide for the hours I requested, but they are giving me their free opinion. I don't know why they are being pushy about it. I had mentioned to them I use Life Alert when running to the store and they didn't like that. I do have limited options, 2 siblings cover for half days every other Saturday. Lately I've been doing grocery/Target deliveries instead of going to the store.
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gladimhere Feb 2019
They may be concerned about something going wrong while you are running errands. What if you were injured in an accident of some kind? Or if you had a medical emergency and not able to respond or speak?
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Is she cognitively impaired? Is she often up feeling agitated, prowling around and and doing something risky while you are out, or does she tend to wait patiently for your return? Personally I see nothing wrong with her being left on her own for short periods of time, I did it myself (with the full approval of our health care team) and never had any problems, but each situation is different. It is an unfortunate fact of life that falls can happen even when a caregiver is there so never leaving her on her own is no assurance of her safety, but is also a fact of life that a CNA or agency who want to make trouble can report you as neglecting her while you are out.
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Cwillie, she still has her faculties and normally sits and watches TV when I'm gone. I was wondering if an agency could report me as neglecting her. I suppose I'll have to bite the bullet and hire more care. Thanks, everyone, for the comments!
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needtowashhair Feb 2019
What would they possibly report you for? Your mom still has her faculties. You aren't her guardian. It's not against the law for someone competent to stay at home by themselves. Any agency making frivolous complaints like that wouldn't last very long at all.
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A couple thoughts,

I used to work for Podiatrist and most our patients were seniors. I would chat with the care givers that brought the frailer patients into the office. A common remark was that Mum or Uncle Jim and fallen and refused to push the button. We had this happen in our family too. Aunt Ruth fell when she got up during the night, her alert necklace was on the bedside table and she could not reach it. She was found 2 days later, still alive, but in kidney failure. She lived entirely alone (no dementia) until age 96.

Would your Mum push the button if she fell, or would she wait for you to come home? How do you have the Life Alert set up? Does it call directly to emergency services or do it call you first? How long would it take you to get home, then how long would it take for an ambulance to get there, if you could not get her up or if she was injured?

Even if your mother was in a nursing home, she would not be under the gaze or within arms reach of the staff 24/7. Even the caregivers who you pay to come watch Mum have to use the Loo, make meal and otherwise are not within arms reach at all times.

It is a fine balancing act and I do not see anything wrong with the system you have in place. You ensure there are people there when you have to be away for a long period of time and you have a safety device in place for when you just need to make a quick trip.
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I hate to say it but to me it sounds like the agency is, on purpose or not, kind of "upselling" you on hiring them for more shifts thus giving them more money.

The reality is there is no perfect system, you have planned for various contingencies according to your best judgement, and there is only so much money.

I think I would give this agency info about the intricacies of your family's schedule and the finer points of your personal household arrangements only on a purely need to know basis. To be perfectly frank, they are the hired help.
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sandola Feb 2019
I'm with SnoopyLove. It sounds like they are trying to make more money. I had one that tried to get me to use them 24/7, when I was only using them for overnights and private CNAs (who cost less) for the rest. It was my gut feeling their "concern" was for billing for as many hours as they could.

They were good at their job - it was one main person who came - and I like the woman at the agency and I will use them again, but for $20/hr I use them as little as possible. Mom only has so much $ and it only goes so far. The other people who I knew personally were only $15/hr, but they couldn't do overnights. Anyway - I don't see how this agency can report you, OP. In fact, you can tell them that you now always have someone with her. How would they know?

Edited to say that my mom has Phillips Lifeline and I don't know if she would push the button if she fell. I don't know if she would remember that she has the bracelet on. She won't wear the necklace with fall detection.
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My aunt fell and sprained her knee. Not bad but still a fall and a bit of a recovery. She had a Medialert bracelet that she wasn’t wearing. After the fall the company upgraded her to a pendant that she wears around her neck tucked in her blouse. It is supposed to call automatically if she should fall. No need to press the button. I’m not 100% convinced that would actually happen but when she presses the button accidentally, they are there very soon. They call me to let me know and since I also have cameras, I can see that she is fine.
If a care provider tried to intimidate me I would let them go and find another agency. Your mom sounds fine. As others have said, anyone can fall at any time. You aren’t gone for days, just a couple of hours I imagine.
My mom was one who fell and wouldn’t use the button. She waited for my brother. She knew she wasn’t hurt and didn’t have any confidence that she could get the ambulance driver to listen to her and not take her to the local ER where we all believed real danger existed.

But my mom had neighbors who did need an ER and used theirs and got the help they needed.

Many seniors are home alone and not under the watchful eye of a daughter or a Medialert as it is their right to be. You are obviously doing a great job.
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I don't see anything wrong with leaving her for short errands. You being home won't really prevent any falls. Nothing reasonable can prevent falls. It's whether she can be cared for after the fall. It's not like you will be leaving her on the floor for 10 hours. Many facilities don't check on people more than every couple of hours. I've been in ERs where the alarm goes off and no one comes by for a long time.

You can do technological things. Install cameras so you can check in every few minutes or constantly if your mobile data plan is big enough. Just glance at your phone every few minutes to check in on mom.

Instead of a life alert I would get an iwatch. It has fall detection and they are working on other things like heart conditions. So they will be able to detect problems even if there is no fall. The watch can contact you and/or emergency services. You decide. Apple is talking with health insurance companies to possibly issue them to the elderly. Since monitoring people this way is far cheaper to paying for a human sitter and you get better data. A gait detector can actually detect a fall before it happens. Which a human isn't really good at.
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NeedHelpWithMom Feb 2019
Camera is a great idea!
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I got my mom a life alert button. She managed to fall and was on the floor all day long until I came after work to visit and found her there. I asked her where her life alert button was and found it on her dresser. She didn't even remember what it was for. Thank God she wasn't hurt. Told me she had just laid down to take a nap (on the floor?) It was after that, that I moved her into assisted living. The buttons are only good if they wear them and remember how to use them.
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Val3rie Feb 2019
My MIL fell in her apartment...she said she didn't but she forgot she had her life alert on her wrist and it wasn't until no one could get her to answer her door [in an apartment building] that someone was able to check on her.
No one called those of us who have keys.
She is eligible for 2 hrs of care a week.
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Hi KB, yes I am in a similar situation. I care for my motherinlaw who is 94 and has Parkinson’s. She has her mental faculties but has a lot of difficulty walking. She uses a walker in the house. We hired in-home care a couple of days a week for about 4 hours so that I can get out and get some stuff done, but that doesn’t cover everything that needs doing. So when I need to run out to the grocery store or drug store I give her the life-alert button and tell her to keep it on her while I’m gone. She often says, “don’t worry about me, I’ll stay right here” (in the chair or bed), but 9 times out of 10, when I get home she is not in the same place I left her. Thus the need for the life alert button. When we were first looking into help at home, a home care nurse said, What if there was a fire? Could she get out of the house by herself? The answer is, probably not, and I worry about that sometimes. So the button gives me peace of mind when I leave for an hour or so, and for the longer spells of 3-4 hours out, we have the agency caregivers. I wish you and I could share a cup of tea and swap stories. It’s nice to know someone else who’s in the same boat.💕
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cwillie Feb 2019
Mom's former caregiver had many sad stories about clients living on their own who were pretty much unable to even get up from their chair without help but only qualified for a couple of hours of help each day - isn't it funny how that was seen as acceptable by the powers that be but as soon as family steps in to provide extra care we are vilified for leaving them alone for less than an hour?
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I can't tell you how much I appreciate you all and your helpful and comforting answers to my question! Thank you! I feel much better about the whole situation. I will definitely look into an Apple iwatch instead of life alert. A gait detector sounds amazing! I'm not sure mom would know to press the life alert button if she fell, but I'm never gone more than an hour. I will look into a different agency, this agency does seem to be trying to intimidate me. There are a ton of home care agencies nearby and all have the same rates. It's so comforting to hear your stories and experiences that are similar!
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I too have a mom with Parkinson’s disease, she’s 93, falls also.

I can’t rely on the alert system at this point. We have had two that were defective and didn’t even detect her falls. So naturally if I hadn’t been home she wouldn’t have received care from 911.

I immediately called and reported the defective unit and they did send out new one. If she falls like my mom, she needs someone with her. Last time my mom fell it involved a trip to ER with staples in her head. Thank God, no bleading from the brain or broken bones. It’s terrifying for them to fall. She needed me there. When she was younger and before her falls, I did rely on it for very quick errands.

Don’t depend on them being able to reach phone either. My mom keeps phone close to her but during a fall, everything goes flying.
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Also instructions to stay put, sit in favorite chair and so forth won’t work either. My mom slipped off of chair and off of bed too while ‘just sitting’. Parkinson’s is a mean disease! They lose control of their motor skills, so sad.
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My DW is probably a little further along and unreliable in following instruction so I hire a companion, not a CNA, to sit with her if I need to go shopping or to some Dr visits ( like stress test next Monday). Otherwise I try to take her with me.
I know she would not push a button if she fell. And she has gotten down onto the floor to take a nap and other gymnastic positions from her youth.
Just my example of our situation being different for comparison.
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My DW is probably a little further along and unreliable in following instruction so I hire a companion, not a CNA, to sit with her if I need to go shopping or to some Dr visits ( like stress test next Monday). Otherwise I try to take her with me.
I know she would not push a button if she fell. And she has gotten down onto the floor to take a nap and other gymnastic positions from her youth.
Just my example of our situation being different for comparison.
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DesertGrl53 Feb 2019
"Companion." That's what I was! - much more than an actual care giver - for my Alzheimer's lady. It was a live-in position, as her daughter who had been caring for her was terminally ill with cancer, and was no longer able to look after her. Mostly I sat and watched tv with her and accompanied her *everywhere!!!!* to make sure she didn't fall or wander outside and get lost. I had other duties as well, of course. I miss her. What a special lady.
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Even if you watch her 24/7 the possibility of falls still exist. My mom with end-stage Alzheimer's falls are infrequent because I am with her 24/7 -- but the majority of the times she has fallen..was when I was *with* her because it happens SO FAST there is no way I could have prevented it. As for nursing homes--let me assure you they fall all the time in those places. The only time they are reported to loved ones is when there is injury. Hired sitters are likewise not always safe. They can also be on their electronic devices, focus on the television, etc., while you are away.

My mom recently fell getting into bed and I was WITH her, holding on to her, and she fell to her knees. When that happens she is total dead weight. No injury since I have a fall mat but I managed to get her up with a considerable amount of difficulty and a Hoyer lift.

They are more likely to fall with urinary tract infections, upper respiratory infections due to increased weakness and confusion..but also any kind of psychotropic drugs. I have my mom on no narcotics and no psychotropics to minimize this risk.

Even with sitters you cannot eliminate the possibility of falls. All you can do is the best you can and if they do fall just call 911 to get help to get them up.

If she is end-stage later down the road, you may want to consider hospice alternatives. They will offer sitters but they are volunteers.

If you hire a companion not from an agency--although infrequent or rare, they can claim to fall in your home and sue your estate; things get more complicated because you may end up having to pay a nanny tax if you use them frequently..if I do use a sitter it will be from an agency that has insurance, and they do cost more but they handle all the legal stuff like tax laws.
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gdaughter Mar 2019
I wasted nearly $60 thinking we would find the ideal hand picked candidate from care dot com. What you said makes immense sense, and the higher agency rate will pay for itself compared to a lawsuit and other BS one could drum up.
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The agency involved is in CYA mode most likely. People can fall anytime anywhere unless some one is by their side consistently. Can she comprehend enough to not move while you are gone? I.e. everything has been tended to prior and she's comfortable, has what she needs? I might chance it...but you will feel dreadfully guilty if she does go down. Maybe your local senior center may have a volunteer that can come keep an eye out for the hour? I know of one situation where the caregiver knew the person would sleep through to a certain hour and she snuck out and back before the person was up...
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It does not sound like you need a CNA.
A companion sitter, sometimes they may be called a Home Health Aid. No need to pay the higher cost of a CNA at this point if you do not need it.
I do not see in your profile where you mom is living. If she is living with you then if she is a fall risk you only need someone there if no one else is.
Anyone can fall at any time in their home (or out for that matter) if your mom can get to a phone she can call for a "lift assist" (a call to 911 just to help her up, no transport to the hospital and in most areas there will be no charge) The first responders do need to be able to get into the house so a door should be left open or provide a lock box where a key can be kept. (very common practice but this has to be arranged in advance)
She should have a phone with her at all times if you do not have one of the services where you press a button to summon help. The cost of that is between $50-100 a month and if you live in an area where there are frequent power outages the battery backup is probably not that long. A cell phone may be less expensive. And a cell phone does not have to be activated to make a 911 call it just has to have a charge.
There are many volunteer organizations that have sitters that you can call upon if you have errands to run. Check with your local senior center. This would be for an occasional time not a daily ..sit with mom from 9 to 3..
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Didnt see it mentioned so how how an automatic alert she does not have to push herself.
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As has been mentioned before on here, how can they make you feel negligent for leaving for less than an hour at times when there are so many elderly people without the means for constant help who are home alone most of the time? Grrr.
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gdaughter Mar 2019
In a word, intimidation, guilt (okay that's two). On the flip side is people living and dying on their own terms, in their own spaces. Any of us can fall, and I have. Someone being present is no guarantee a fall isn't going to happen. Even hired caregivers have to pee once in a while!
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Maybe this will help - I just read where some smart watches have a fall alert function that automatically calls 911 after detecting a fall. I live alone with no one to help me should I fall and pass out. I’m thinking of getting one and going to the Apple store near me to set it up (they schedule classes to demonstrate these tech gadgets).
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We have a fall detection system for Dad. Unfortunately, it didn’t work on one occasion, as he’d tucked it inside his shirt pocket. He was left alone for about 45 minutes and Mom returned to find he’d fallen, broke a rib, punctured a lung, a week in hospital. So now we don’t leave him alone ever. We learned the hard way that he needs someone with him 24/7.
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Electronic Caregiver is a personal alert system that has a fall alert system you can add on to one of the packages. The fall detection is a one time charge of $25 and no monthly fee.
I would not go with 24/7 care if all you need is the fall detection. It is very expensive! Does your mom get up during the night? If she doesn't you definitely don't need a caregiver while she is sleeping. If she does you can get alarms that is a pad you place on her bed, if she gets up it will set off an alarm letting you know she is up.
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Hi Kbuser,
My mother also had Parkinson’s Disease. Although I wasn’t her “caregiver,” I did provide some daily assistance to help her while my dad was away at work. I would go to spend my lunch break with her and bring my kids over after work until my dad got home in the evening. She had both a Life Alert and cell phone strapped on her at all times. I could see the potential of her falling. I encouraged my dad to get someone to come sit with her. All he would agree to was 3 days a week. Good enough. Better than nothing. On one afternoon that the sitter wasn’t there, while making her lunch, she fell in the kitchen and broke her hip. She used her life alert to contact emergency and my dad. Within six months, she was gone. Were there possibilities of her falling if the sitter was there? Yes and no. If the sitter was there, she would have had less chances of a fall because the sitter would have been there to ASSIST her with her needs. That fall was preventable every way I look at it. In my mom’s case, my mom was left for hours by herself. I wish that I had known the things that I know now. My dad never made the house safe for her walker, because he didn’t know any better.
I am now my dad’s caregiver. I have companion help while I’m at work. When my dad first came home from the hospital, they sent someone out to assess the house to ensure it was safe for him and his walker. My parents home has laminate floors with large area rugs and thick throw rugs everywhere, including the kitchen. It all had to go. Changes in the arrangement of furniture etc was recommended. I followed everything they suggested. My dad has had two falls in two years. Both times, I was there, but not in the room. No injuries. Preventable? No. The falls just happened. Was there anything he could knock his head on? No. It’s all been moved or removed.
There are times that I have errands to run as well. I sit him in his recliner with the remote, cell phone, Life Alert, water, and clear instructions not to move around. I also call him while I’m away. It provides reassurance in his case. I also have both of the neighbors phone numbers in case I have to call on help. The other alternative I have available is the two teenage girls that live down the street. They sit with him and chat, or play UNO, while I’m away. It’s a lot cheaper than the companions from the agency.
Okay, I’ve said much more than necessary. Just wanted to give you a well rounded view of my experience.
Take Care & Best wishes to you and your mom.
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Sherryram Feb 2019
Don't feel guilty about your Mother's fall. My first husband was a paramedic and he said, more than once, that most of the time Seniors don't fall and break their hip. Usually, he said, their hip broke and then they fell.
Some accidents are just no preventable. Thanks for your good words of advice.
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I am curious ... Who would the agency report you to and why? In my opinion, the agency is up selling as previously mentioned. If you are comfortable with your arrangements then stay with them. When a salesperson comes to your door, do you have to buy?
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gdaughter Mar 2019
If threatened I'd be getting another agency regardless, but then if that's the way they operate, then they might report out of spite. Reporters can and are anonymous, at least to the person being reported...and it would be adult protective services for abandonment/abuse/neglect. Once reported they are obligated to respond. In my small support group I learned of two incidents of reports having been made, and it has really given me pause about getting involved with a program that was going to provide some respite. I feel so exposed to risk of being reported because of the potential for judgemental people to be in our home. In one case the reporter was an elder person with some sort of personality disorder, and another was done the result of caregiver opening up to someone who she no doubt felt was safe to communicate with...but the person was a "mandatory reporter". It's horrible to contemplate these outsiders creating so much upset and chaos, and in fact having the potential to generate more stress than what one might be currently dealing with. I'm very torn right now. I'm even afraid to share my concerns with a professional for fear THEY would be a mandatory reporter. I feel like even if you ask a question about it, they may wonder why you are. ANd it kills me that it hurts those of us who are doing all we can for our loved ones that are the accused. I feel like we should at least, if accused, be able to have legal representation. Instead these APS workers show up unannounced and attempt to gain entry and interrogate you and observe. In once case saying they COULD bring the police if it were necessary. We're the good kids. One person told a story which is funny in a way...but we can relate to the concern, in that her mother, when they were out said to her "stop pushing me!" loudly...and then you wonder who's watching and will they get your license plate and call the report in...We, as caregivers, deserve better, and we have rights as well. I am glad there are people to look out for the elders...but who looks out for US?
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Although the agency would benefit from more hours from you, they may be coming from a thoughtful, caring place. It only takes a short time for a loved one to fall and yes, many of them won't press the button on their lifeline. But it also reminds me of when you have a baby. Every single piece of equipment says, "Never leave baby unattended!"

Is you mom able to go with you on any of these errands. I used to go on short errands with my dad that didn't require him getting in and out of the car. We went to the transfer station, post office, gas station, quick banking, had a car picnic (I packed a washable and decent looking bib that came in its own stuff sack!), and bought essentials at a quick mart where I could see him from inside. Occasionally, I would take him out of car with gate belt to folding wheelchair. Yes, it is work, but we couldn't afford to pay for more 24/7 care. Our town council on aging offered a volunteer who once a month would come to a shut-in's home and prepare a chicken in the oven and while it was cooking, have tea and cookies and social time with the shut-in. They also provided a "day care" two mornings a week that culminates in a lunch. Transportation in the COA Van was free. Those mornings provide huge blocks of time to get things done. I do suggest attending the first session with your loved one to make sure it is a good idea in practice:)
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I love all the responses! It gives me a feel for what everyone's experiences are and makes me feel not so alone:-) my mom rarely gets up during the night, and my bedroom is next to hers so I would hear it and get up to help her if she did. I'm a light sleeper, too. Probably because the cat gets me up half a dozen times during the night. Mom does have some dementia, so whether she'd be aware to press life alert if she needed to, I'm not sure. I can try taking her with me on quick errands, she is relatively mobile that way. Might do her good to get out of the house. I do think the agency is up selling, and I realize they couldn't report anything because there is nothing to fort. She actually fell when a nurse from the agency was with her. Thanks again for all your input! I love all of you caregivers!
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con3ill Feb 2019
If your mom fell when a nurse from the agency was with her, that agency shouldn't dare to try to upsell you. I suspect they're trying to reduce their exposure to liability while trying to get more money out of you. Did you share the falling incident with the agency? If it were me, I'd not only have shared the experience but challenged them for having a heck of a nerve trying to convince you to buy more services.
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My aunt lived alone in her early 90s, and had an occasional fall problem when she got up in the night (which we improved a lot by giving her a touch light so that she didn’t try to do it in the dark). She didn’t hurt herself, and she could move a bit, but she couldn’t get up on her own. Her monitored alert button recorded falls, and if the monitor couldn't get an answer it went first to young family members living close by who were capable of lifting her to get her up. If they were away, the call went to ambulance. It would take the ambulance at least an hour to get there and get her up. If you are back home within an hour, you will do as well as we could anyway.

When my husband and I did our house renovation, we installed a hook into both sides of the doorway from the bedroom to the bathroom. With a strong anchor point above a door, you can get a simple chair on a pulley and slip the seat under the person. Then it is much easier and safer for the carer to raise the person enough for them to get their feet down.
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needtowashhair Feb 2019
I don't know why the elderly don't like having the lights on. Many times grandma fell because she was stumbling around in her room with all the lights out. I solved that problem two ways. One, I installed motion activated lights under her bed. So when feet are moving, then light is coming out from under the bed to light the area. When she's in bed, they automatically shut off. Two, I have the desk lamp turn on automatically at dusk and then turn off at bed time. It's hooked up to my HA system so accounts for seasonal changes in sunset.

I've tried all sorts of ways to pickup a fallen person. I've tried a hydraulic lift. That worked great. If I can lift her up 4 inches to slide the lift under her then I can just pump her up to sitting position. The problem is the lift is big and thus where I can use it is limited. I tried building a inflatable lift that works anywhere. That worked pretty well too but the hassle of getting it under her and deflating it was huge. In the end, I just tend to gut it out and pick her up. A few times I've tweaked by back. It's just pain. A thing of the mind.
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I agree with them 100%! My Mom had a stroke getting into the shower and had the Life Alert right next to her, which is useless unless activated. She ended up laying there naked and cold for two plus hours, until her Hospice nurse called me saying she wouldn’t answer the door.
These things are in my eyes useless, and give you a false sense of security.
Then you have the false alarms which I experienced many, breaking speed limits, traffic laws you name it, only to get there and find out she’s was fine and wondering why I was there and frantic.
Human life is too precious to be left attended by a stupid call button. Get a human it’s worth every penny!
Just my two cents.
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Jannner Feb 2019
It was good when my mom still lived alone in her house. She was at that time , capable of answering the call if she pushed it unintentionally. She didn’t fall at that time. They are really imo for someone with pretty good cognitive function, but also imo, after that they aren’t safe alone period. If they don’t know to push it, they don’t know to turn off a stove etc.
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No, I don't like Life Alert. My late mother had one, but she made up her own "rules/ideas" about it. She would wrongly not wear it in the shower. And even if I told her that she was to keep it on in the shower, she would still go with her "wrong mentality."
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