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Tuesday September 24 at 7:00 A.M. my father was moving a wheelchair out of his way at the memory care facility. He lost his balance and fell. I was called and given the impression he was ok. They said he hit his head so I thought I should call his PCP. I knew a nurse and PT were scheduled to see him that day. I decided to wait and hear what they thought. Shortly after lunch another caregiver called and said, “Your father needs to be seen, he’s in a lot of pain.” I told her the nurse from home health was scheduled to visit and call me when she arrived. A couple hours later the PT called and said he needs an X-ray and I said I would call 911 for him to go to the ER. When I arrived at the facility, the director said he didn’t need the ER and call dispatch health (a mobile ER) to come X-ray him. The appointment fell through so I asked the director to call 911. She said my father walked after the fall and she thought he was just sore. My question is, why these people resist calling 911. My father had a broken hip and had a partial hip replacement last Wednesday September 25. He moved to an excellent rehab October 1 and was improving. He died tonight. What is wrong with this picture?

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I'm so sorry

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Reply to cover9339
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At my mom's Memory Care, I could always instruct them to call 911 myself if I felt she needed to be seen at the ER. It was protocol to send her if she hit her head in a fall. It's senseless not to, really.

What was the cause of death for your father? If it had anything to do with hitting his head, I'd call a lawyer.

My deepest condolences on the loss of your dear father.
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Reply to lealonnie1
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First of all my most sincere condolences on the death of your Dad.
Now on to all that occurred here.

When my brother went into ALF we were told this by the admins who we extensively interviewed before the admission:
1. Falls are common here. (My brother had poor balance due to Lewy's dementia, but balance is a problem for ALL SENIORS and I guarantee that both as a retired RN and as an 82 year old senior myself; our balance is SHOT, pure and simple. Falls are often the "beginning of the end".)
2. If your brother falls this is our protocol. Your brother is examined by his caregivers for any injuries. If there is either A) pain or B) any injury to the head or face we immediately call 911 for tranport to the ER. Usually the senior returns home almost immediately.
3. You will be informed of ANY falls immediately after they occur.

You apparently were called. You were told he hit his head. Best practice (you would not have known that) is a call to 911 with head injury, and especially if this person is remains a full resuscitation client. Without further symptoms, if patient refuses, he should be watched for 24 hours closely for any unusual loss of mentation, changes in sleep pattern.
With a nurse coming you chose not to ask for transport to ER given there seemed no pain. I think that reasonable. RN could have assessed on her arrival.
However, when pain DID occur they should have called you and asked for permission to transport to ER.

There were no real repercussions of their actions for your Dad. His pain occurred. He was examined. He had a broken hip. He had surgery. He died later of complications you do not tell us of (and again for which we are sorry).

I think that the way this was handled wasn't awful and wasn't stellar. Usually a fall in which the head is injured is transported to ER and that is for just in case.
Sorry for what occurred. Do know, as I told you, that falls are OFTEN the beginning of the end, and such was the case for my own mom.
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Reply to AlvaDeer
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Awww. So sorry.

When he hit his head, he should have been sent to the hospital. That is usually standard in any facility my Mom has been in. I would report this to ur State Ombudsman.

You don't say how old Dad is. Breaking a hip for the elderly will cause death. Not sure if you can do anything about them not sending him immediately to the hospital. It would probably cost you more than u would receive.
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Reply to JoAnn29
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So sorry for your loss, 🙏 😔

I do not know the answer for your question. I've heard stories like this, at ALs, Good expensive ALs

Medically a broken hip after a certain age is most of the time the beginning of the end for many. So the outcome probably wouldnt of changed, but that in no means means this was right.

Take care, try not to let the anger overwhelm you.🙏
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Reply to Anxietynacy
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Jan 2023 my 100-yr old Aunt with advanced dementia fell at home while trying to get out of bed which she was not able to do without assistance. She got immediate attention, went to the ER and diagnosed with a broken hip. Because of her advanced age and dementia, she was not a candidate for surgery. While in rehab she continued to attempt to get out of bed.

Her sister and 2 nieces/caregivers were at the rehab facility every day to make sure she was eating and drinking and getting hygiene and other daily care other than medical and PT, since a rehab facility does not usually function like an MC or LTC. After a week there (and while I was figuring out her care for when she was discharged) she died in her sleep, probably from a clot from a large bone break (which is a real risk with that injury).

I'm so sorry for the loss of your Father and the way it happened. I'm only telling you my family's story because even under the best of care and circumstances, elders fall (a lot) and don't do well afterwards especially if they have dementia and advanced age. That being said, yes the facility should have sent him to the ER especially since he hit his head. In my home state, an elder who has any type of blow to the head will be told by their doctor or at the Urgent Care to go to the ER and get checked and treated. My 90+ yr old Mom fell backwards and hit her head on her dresser, made a big cut but she was lucid and her normal self. I drove her to Urgent Care and they wouldn't even look at her they just waived us on to the ER.

It's possible your Dad's facility was hoping you'd be the one to accompany him to the ER, assuming you are his medical advocate and close family relative and therefore the only one to be able to make treatment decisions for him. I wish you peace in your heart as you grieve this situation and loss.
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Reply to Geaton777
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