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Mom is in nursing home and stays in Lift chair recliner all day and night. Staff wants her to sleep in bed at night to avoid pressure sores but she refuses. She says she is comfortable only in the chair and does not like sleeping in the bed. She has been sleeping in a recliner for over 40 years. We have tried everything to convince her, but she flat out refuses. She is of sound mind and says she understands the risk but it's hard to believe she really does as who would agree to such risks. The staff says it is a fine line that they can't force her because of Resident's Rights but we are extremely concerned. She is 96. She is incontinent. She is only moved to be changed and then is placed back in the chair. We are at a loss of what to do and are so frustrated. Any advice?

My MIL had hip problems and preferred a recliner to sleep in.
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Reply to JoAnn29
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Hi Katey,

My mum sleeps most of the day in her recliner, but she does go to bed at night. (She has to be woken up to go to bed!)
The OT arranged for her to have a special cushion on the chair to help avoid pressure sores. My mum can walk a little, but only a few steps, so she isn't properly mobile.
The skin at the base of Mum's spine is threatening to break, but it has been maintained at the red but unbroken stage by applying medi-honey.

My dad became paralysed while living abroad. The hospital he was in didn't adequately look after his pressure sores. He was in hospital for 2 months - by the time he was discharged to a care home, it looked as if a huge creature had taken a bite out of the top of his buttocks. The care home did their best, but it wasn't properly treated until he got back to the UK.
It was infected at one point, but it didn't turn to sepsis and it was effectively treated. This was a huge hole in his body and it was able to be treated. Your mum's bed sore wounds will never get that bad because they'll be treated properly straight away.

How long has your mum been sleeping all through the day and night? If she's approaching end of life, is this a battle worth having?
I'm not saying that it isn't, it's a question that you have to answer yourself.
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MiaMoor Jun 2, 2024
Btw, the week before my dad suddenly became paralysed, he was going on long walks every day, as well as swimming in the sea. He was a very active man, so the pressure sores were from being immobile in a hospital bed.
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Bed vs recliner chair;

- Electric beds raise up & down making care tasks easier on staff backs.
- Can sit up & go flat
- Person can move/be moved: from side to side, to back.
- Mattress can be pressure relieving foam or air mattress

If the recliner chair is electric, can raise up & down, can sit or lay then the only big difference is it's padding & surface.

There are recliner chairs made to reduce pressure eg contain layers of specialised foam. Alternatively, a pressure relief cushion could be added, made of gel, foam or the roho air type.

If bed & chair are virtually offering the same thing in terms of care, what pros & cons still exist?

In fact, a recliner chair on wheels may be wheeled from a bedroom to a day room. May add to social opportunity?

While every reasonable measure should be taken to avoid painful pressure injuries (bed sores), they cannot always BE prevented.

I had a woman tell me her MIL suffered terribly from bed sores. Had poor nutrition, terrible circulation, always cold hands, slow to heal, many leg ulcers etc. Sat up in chairs & changed position frequently but many bed sores in her last years.

Yet her own Mother, a plumper lady, sat immobile in a chair then bedbound never had bed sores, not one.

I'd use the Do No Harm mantra.

If the recliner chair is offering nearly everything a bed can VS the stress or pain moving Mother against her will onto a bed.
Which has less harm?
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KateyG Jun 2, 2024
Helpful information. I didn't think of pressure relief cushion for lift chair and I think someone else mentioned that too. And interesting anecdotal information. Thank you for sharing.
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It’s sad, but if we accept that mom really understands the risks, then we can conclude that she’s chosen how she wants to die.

I don’t think she really understands the risks. So then we could conclude that she is not of sound mind.

Around and around we go…..
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MargaretMcKen Jun 2, 2024
My BIL spent his last weeks in a hospital bed that did a slight rock every few minutes, to one side and then the other, clearly to change the pressure spot. I can't see why the same thing can't be done (at least to some extent) if M is in a recliner. I don't think that people in a less expensive hospital bed have 'chosen that way to die'.
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Katey, it shouldn’t be up to you, but it’s worth making sure that the ‘rules’ for your mother’s care include changing the angle of the recliner quite regularly.

I want to thank you for your kind words. I am not traveling too well myself at the moment, and my movements are restricted so that sitting on the computer is kinder too me than lots of other activities. It is so good for my own morale to think that it can really help someone else, that I’m not as useless as I often feel. Thank you again.
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I really appreciate each and every comment. I've found every one of them helpful and am so glad you have each taken the time to share your thoughts with me. I'm just so sad and frustrated and reaching out to this group has really helped me. Keep the comments coming- but wanted you that have commented so far to know how much you've all helped. THANK YOU.
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I don’t know if my suggestions will be applicable for your situation or not. Mom had a terrific occupational therapist that made a few suggestions to help her.

As most people on the forum know, Mom had mobility issues due to her Parkinson’s disease. I told the occupational therapist that she had issues getting in and out of bed.

The therapist recommended that she have a half bed rail to hold onto. You probably can’t do that in a facility because it is against regulations.

The therapist rearranged Mom’s furniture, making it easier for her to maneuver getting in and out of her bed.
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Katey, I just want to add that when you say your mom is of sound mind, she may have some dementia going on that the doctors haven't diagnosed. Most people have some cognitive decline after 85.

If you want to learn more, and more things to watch out for about dementia, you can watch Teepa Snow, on YouTube, she is really informative.

So sorry, best of luck
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Reply to Anxietynacy
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Ok...so I'm going to play devils advocate here. Your mom is 96 years old and has been sleeping in a recliner for over 40 years right?
And while she may be at risk of getting bed sores while in her chair, she also can get them while in a bed.
So why not just let her live out her days(which at 96 they're numbered anyway)comfortable in her own chair.
And if she gets a bedsore, she will have at least done things the way she wanted to and deserves to. I mean....she is 96.
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KateyG Jun 1, 2024
I'm happy to hear the devil's advocate point of view. I'd really like to do that. I agree with you that she should be able to do what she wants and deserves to do that. But the nurse and doctor have me really worried. I keep researching it and it sounds like they are right to be concerned but it would be nice to get other's real life experiences. They say she is really close to having skin breakthrough which could lead to a lot of serious problems and long term painful issues for her. They are saying it could lead to hospital visits and ongoing wound care. Also she may need to be catheterized never be able to sit in a chair again if it gets really bad. Mom is not mobile at all. She sleeps all day in her chair. She only puts it up to eat and then she lays it back out flat to sleep. She is never in a wheelchair or other type of chair and refuses to do that as well. The only other time she's out of her chair for a short time is changing. She refuses to let them take her to the bed to change her unless it is for a bowel movement change. Instead they change her in the chair- which sounds like what they are doing is having her briefly stand up with the help of two CNA's to change her which doesn't really lend to getting her real clean but she fights being changed in the bed. I understand why she doesn't want to be changed in the bed as it is a much more involved process for her and takes longer- but it is so much safer for everyone and also gets her cleaner. Are we over reacting? I would really like to let her be and honor her dignity of making her own decisions but I don't want to watch her needlessly suffer her last year or so in severe pain if it could be somewhat easily avoided. I just don't know what to do.
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Most good recliners have a wide range of positions, including ‘almost flat out’. It should be possible to change the position (even after she’s asleep) to put the pressure on different spots from how she ‘sits up’ during the day. If her recliner isn’t good, a new recliner might be a better option than trying to get her into bed. Forty years of habit is hard to break!
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MargaretMcKen Jun 1, 2024
Another improvement might be to get a long bolster pillow. If that is down one side of the recliner at night, it will change her position slightly - enough to change the pressure points. Sides can be swapped each couple of nights. With a nice fluffy cover, it might even double for a dolly to hug!
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My 99 yo mother sleeps in her Lazy Boy, too difficult for her to get out of the bed.

Also my step-mother in MC did the same.

My mother is mobile as was my step-mother.

I guess they need to get Mom up and moving, that seems to be the real issue, not sleeping in her recliner.

Have you spoken to the administrator about this? If not, I would.
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KateyG Jun 1, 2024
Sadly she is not mobile at all. She can't walk anymore. She can stand with the help of two CNA's but barely a few minutes and that's it. She has very little strength. She says she aches all over and hurts to be anywhere except her lift chair. My poor mom. She does have Hospice care and we've met with them and with the Director Nursing. We will meet with them again and if no solution- we will speak to administrator. We've just been working on it for a few days. I thought she was sleeping in the bed for the last 2 weeks. I asked her every visit and Mom told me she was. I just found out she wasn't when they called me about her skin was getting worse and ask me to talk to her again about sleeping in her bed.
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I think the main issue is that for the staff not being able to properly do their jobs for your Mom.

Does she have the type of hospital bed that electronically lifts up the back and can bend at the knees? If the bed can come close to the position of the chair might she agree to go there just to sleep at night?

She doesn't seem to be of sound mind if she doesn't care that the staff is breaking their backs trying to change her and give her proper care. Loss of empathy is a feature of dementia.
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funkygrandma59 Jun 1, 2024
Don't forget Geaton that it's a lift chair she's sleeping in, so the CNA's can just raise it high enough to change her when needed, and not hurt their
backs.

And I just caught the part in the OP that her mom is being moved to be changed and then put back in her chair.
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This is also an injury risk for the staff trying to bend and change.
I think this is an issue that may have to be forced, but difficult to imagine after all these years how it an be. She may know the risk, but the risk is actually death from sepsis. That IS an option if she is in hospice care, but not a pleasant nor quick one often enough.
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KateyG Jun 1, 2024
That is exactly what I've been trying to talk to her about. She doesn't believe that is true. She thinks everyone is exaggerating.
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Tough situation. You are very wise to be concerned about this situation.

My mom loved her lift chair as well. Mom’s nurse suggested that she use a particular type of pillow to use.

My mother did develop a pressure sore that went unnoticed due to the location of it. It was lower on her body that couldn’t be seen.

Sadly, Mom didn’t say anything about it until it started bothering her. She had to be seen by a wound care nurse to address the issue.

I hope that you can resolve this issue soon.
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