"Many have adopted 'no lift' policies to avoid the risk of back injuries for staff and other potential liabilities.... A nurse who worked at an assisted-living facility in Greensboro, N.C. ... said her company required caretakers to call 911 even if a resident had just slid harmlessly out of a chair. 'If you’re on the floor, period, you’d have to call'.... She said residents were often embarrassed by the lift-assist calls. Some begged her not to dial 911. She said she had no choice. Fire officials point out they bring no special skill to such situations — it’s just a matter of who’s doing the work...."
From
"Senior homes refuse to pick up fallen residents, dial 911. ‘Why are they calling us?’ Frustrated cities and states have begun fining facilities for nonemergency calls, but some just keep calling" (WaPo).
ADDED: May I recommend that residents be trained in the methods of avoiding falls and in getting yourself back up if you do fall down.
Here's a useful video on getting up off the floor.
Posts
61 comments:
I'm sure Biden is fine in the White House.
Dealing with falls is a basic function of an assisted living facility. Calling 911 as a matter of policy any time someone is on the floor should be grounds for reviewing their license.
An effort should be made -- through physical therapists -- to train older people to avoid falls and to get back up after a fall.
I can see not wanting to use the regular personnel to lift people (especially heavy people), but a lot of the need to lift could be avoided.
And by the way, I myself have gone through physical therapy to avoid falls -- because I was falling. I could still get up though.
Makes me think of the old TV commercial, "I've fallen and I can't get up."
Anyway, I have a series of exercises that were prescribed to me, and they work really well.
The 911 system has been corrupted by safetyism. If someone calls and says that their McDonalds fries are cold, 911 operators still have the sense to tell to fuck off. But if someone’s “emergency” is that two kids are playing in the park without adult supervision, 911 wil send the cops.
Back in the late 80's to rearly 90's the local nursing homes decided no one was going to die in the nursing home. So when Mrs. Smith wouldn't "wake up" they would call 911 and have ambulace take her to the ER to be pronounced.
Assisted Living Facility...but not helping you off the floor, old man! I guess they just assist draining bank accounts.
My wife does home-care for elderly. She called on morning, "Come help me lift Mrs. X from the floor." Mrs. X was a sizable person. Disregarding the niceties of trying to work around the issues what's fat and what might be breasts, it was impossible to get a grip on anything that didn't jiggle, didn't act like warmed-up Playdoo, or cause her pain.
We had to call 911. They had the necessary straps to overcome what I just described.
Fire officials point out they bring no special skill to such situations — it’s just a matter of who’s doing the work...."
it's Just a matter of WHO GETS SUED..
Just like schools (with "an abundance of caution") closing for the eclipse..
can't sue you if you don't do something
which raises (see what i did there?) the question of:
If an inmate collapses and is on the floor, and their breathing is obstructed..
Do they STILL sit around on their asses waiting for the EMTs (and the hearse) to show up?
They need more trans/neo-females a.k.a. males to do the heavy lifting. Biology matters.
Let's hire more 5'2" 110lb women as firefighters.
Problem solved...
There is at least one assist device that you can slip under the fallen person, then reinstall the support so that it then can mbe maneuvered into a chair lifting the person to the sitting position.
I looked it up when my aunt was in independent living. But she had several large sons and grandsons that handled the couple of "can't get up" situations.
Do they not have mobile medical hoist type devices for this situation? Harbor Freight has them for garage work.
My father is in a skilled nursing facility in large part because after a stint in the ICU, he is no longer capable of weight-bearing. The facility uses a mechanical lifting device to move him from bed to wheelchair and to do his toileting. Seems like a simple enough accommodation.
Can't read the article, but I'd imagine that there are three big issues driving this.
1) legitimate injuries to staff, especially if the facilities are undermanned, and most of the employees are middle aged women. A 40 year old 5'2" Filipina is more susceptible to an injury hauling grandpa back into to his wheelchair.
Second is the obvious fraudulent workers comp claims, especially if you're understaffed and scraping the bottom of the barrel for staff.
Then there's the risk of a lawsuit by residents or their families. Grandpa falls and dies two days later of a stroke, or grandma suffers a fracture that doesn't get noticed, and the family gets a pay day.
Althouse ignores the elephants in the room with a fallen resident, which is the lawsuit brought by the fallen, their families, and their lawyers for injuries supposedly sustained in the lifting up from falls by staff members. One pulled back muscle is no big deal, but the lawsuit for it sure is. And god forbid if a fall leads to a broken hip and lifting is then accused of exacerbating the injury.
Almost certain litigation is better forced upon 911 responders than to the facility itself, in any business. Insurers' directions to the facility are the reason the 911 responders get to pick up the fallen.
Can't be too careful!! The lawyers are hoovering...and you know that's the real reason for off-loading the task via 911. Municipalities have deeper pockets than nursing homes.
May I recommend that residents be trained in the methods of avoiding falls
Sounds logical.
Having been through the progression 4 times, I can tell you the elderly are extremely motivated to not fall, and if they do, to get upright before anyone finds out.
Repeated falls mean a forced loss of independence. Something the elderly will do anything prevent.
When you're younger the "I've fallen and I cant get up" seems funny, but as you get older you realize how serious it is. Last month, saw a guy in wheelchair fall out reaching for some cans of food on a lower shelf. The man literally could not raise himself up to get back in the wheelchair, despite being built like a Linebacker. Fortunately, I didn't have to help, because two young strong clerks rushed over and moved him the 3 feet back into the chair.
Another bad thing about older people falling is fractures. People really need to be careful, when you get past 70. An elderly next door neighbor fell and fractured his hip. Result? An operation and 4 months in Rehab. He now can only walk with a cane.
Lawyers ruin everything.
Calling 911 as a matter of policy any time someone is on the floor should be grounds for reviewing their license.
It's probably a policy because some people are too fat to lift. If they only call 911 for the ones over 300 lbs., then there will be problems, especially if the overweight residents tend to be non-white. This may not be the reason for their policy, but I have serious doubts that it is there because their first priority is their workers, it's more the "other liabilities".
"hoovering" ==> "hovering." Can't blame it on autocorrect. Geez.
This lift has been very helpful for a friend whose elderly aunt lives with her:
On Amazon for $399 - MAIDeSITe Electric Chair Lift, Get Up from Floor, Floor Lift, Can be Raised to 20” Help You Stand Up Again, Weight Limit 300 LBS, Item Weight 30 LBS
My eldest daughter is a nurse at a senior "memory care" facility.
All of the staff is trained in advising the residents the safest ways to perform their daily routines without falling. Further, most insurance pays for PT for strength and balance training after some medical change in their condition. For example, after her grandfather had his leg amputated due to cancer.
Even doing EVERYTHING perfectly, a tremendous amount of upper body strength was required to get him off of the floor after a fall. She as a 110# expert could not do it. My old, out of shape bulk could do it.
I challenge all of the "human development with XY chromosomes and testosterone does not confer any strength advantage" morons, to go observe for a day in a senior facility and tell me which gender gets the suffering residents up off of the floor after a fall!
I live in a independant living facility in a senior complex. One man was in assised living but moved back to independant as when he fell in assisted, the nurses weren't strong enough to lift him up. In independant living, he could call 911 and strong EMT could lift him.
My mom was in assisted living for over 5 years, through the COVID era. While exercises and training for the patient is helpful, that's only for a category of disabled or elderly that are still fit enough, and competent enough, to make use of them. My mom had a wrecked shoulder and rotator cuff that effectively debilitated her, even though she was still stubborn and determined enough to get up on her own if she possibly could. But, in my observations, others in the A.L. facility were much further gone than she was, and that's not even taking into account those in memory care that can no longer minimally function. And even though this was a place with high standards, I also saw a deterioration in the employee quality over the years, towards people that were mostly from African countries (green card immigrants), and had more limited educational backgrounds, although their English was very good. But they didn't have a background in American health care, or nursing / elder care training in general - as had been the case in the earlier years.
I think @tim macguire is right. There is an increasing number of these facilities everywhere, now that the boomers are working their way through, and Medicare continues to expand its coverage for disabilities of all ages. You see Rehab joints where half the floorplan is for medical / drug Rehab, and the other half is for Medicaid. And a good number of these are more or less permanent. It smells like a cash cow. The onus should not be on Emergency Services to provide anything other than EMS response, certainly not to be using EMT's to scoop people off the floor and put them back in a wheelchair. They are extremely stressed out already, as is our medical infrastructure in general - thanks primarily to You Know Who, with a congressional assist.
I’m avoiding driving Uber past 10am to 3:00 pm time slot. I had a senior lady fall trying to get on a minivan I used to drive. She called 9/11. When I saw her on the ground I tried to help her get up but it seemed like she was relying on me to do all the lifting and I just couldn’t. She was too heavy for me. So the police showed up first and then an ambulance came and it was decided I could cancel the ride and be on my way.
Now I try to get Amazon blocks during that period of time.
My wife and I go to a workout class in our town run by the school district's adult school. One of my goals from the training, always being able to get up off of the ground!
How do we all stay strong and flexible as we age? It would be nice if our culture were more fitness focused. Jack LaLanne was way ahead of his time.
It seems to me that there also has to be some device available to assist lifting people off the ground.
I was actually a Cal-OSHA certified "competent person" for fall protection at work. Which meant that it was a part of my job to check harnesses and make sure that employees were using them correctly. They also had advanced courses in fall protection and rescue that teach people how to lift people up and out of dangerous situations. (Using ropes, pulleys and other devices.)
At the old folks home now it's like that movie Beau Geste, you lie where fall, march or die. It's probably not as sandy, but just as frigging hot in there, I bet.
My father is in one of those places, and no, it isn't easy to train people not to fall because they didn't want to fall in the first place.
Dad's 93, still stands upright, doesn't fall, still drives.
I watched the video. For some people the suggested method could not work. For instance, my mother had a stroke and she never did regain the strength and mobility needed to pick herself up after a fall despite lots of rehab. On the other hand, I have a neighbor who has on a couple of occasions called and asked me to assist him after he fell. I'm going to try to get him to do the "tuck arms, roll over, get to your hands and knees, and crawl to a piece of furniture to help you get up" maneuver if he ever needs that kind of help again.
Residents only need to learn to get up unassisted if none of the paid staff are going to assist them.
“An effort should be made -- through physical therapists -- to train older people to avoid falls and to get back up after a fall.”
The great majority of falls in nursing homes and assisted living facilities are caused by or related to some level of dementia. Training the residents sounds good, but in reality that would only work with alert residents with the ability or willingness to engage in the fall avoidance training. The people who live in nursing homes and assisted livings are usually frail and have fallen at home. Many have cognitive issues related to dementia or other illnesses.
Very helpful video. I've just sent it to my mother--and it's now in the back of my head when the time comes that I might need it. Thanks.
As for calling 9/11 for all falls of nursing home and assisted living residents, I’m fairly sure nursing staff are relieved to not have to do the lifting of the resident, but embarrassed to have to use emergency staff to pick up residents off the floor. I’m also pretty sure this has created a nightmare for emergency personnel. They are being called out to nursing homes and assisted living facilities to pick residents up off the floor, while they may be needed for far worse emergencies, yikes. There is equipment to help lift residents off the floor, but this equipment is always in short supply, plus there are always staffing shortages making everything that goes on in nursing homes and assisted livings far worse.
What an awful decision this was, but there doesn’t seem to be a good and realistic solution.
Seems like an enterprising group of strong people could build a business to help in these situations. Two Men and a Truck ==> Two Men and a Hoyer Lift….
Kristi Noem might have some ideas on how to address the situation.
Buy a twin size self-inflatable air bed. When the person falls, help the person move onto the deflated mattress. Then air it up, lifting the person. Once the mattress is fully inflated, the height is like a normal bed and much easier to get the person to stand or moved to a wheelchair.
My husband has been strategically placing sturdy chairs around the house.
Everyone should be trained on how to roll sideways and get their knees under them so they can get up. Then they could coach older people on how to get up if necessary while for older people it would be a life skill - a thing you learn for others and eventually use for yourself. I learned in PT how to get up by rolling on my side and getting my knees under me but really I had the strength to just stand up and didn't need the method. Then one day I leaned down to pull up an invading dandelion and slipped on some mud and fell into a ditch. I kept slipping on the mud when I tried to get up to climb out because it was a little narrow. But then I used the training, rolled sideways, got on my knees, then my feet, and escaped. You never know.
My mother was in an assisted living facility and they would not pick anyone up. She eventually moved to a nursing home. In the nursing home they had staff who could
For you young whippersnappers, it's no joke. (I used to think it was too)
My wife fell and I could not get her up. I eventually brought a chair and between me and it she was able to work her way up.
It was a process though and no laughing matter.
If I lie down on the floor it is not easy for me to get up either. I see a time in the not distant future where it may be impossible.
It is scary
John Henry
Eva Marie
Thanks for that maidsite chair.
I may buy one
Via the portal, of course
John Henry
I worked for a time in senior care and we were all trained on how to use a Hoyer lift. I had to rescue one client from his carport one day; loaded him on the lift right there, wheeled him to the back door where his wheelchair was waiting, no fuss, no muss. Likewise I had a client hand his wife who were well over 300 pounds each, and used the Hoyer to get them out of bed for meals and changing the sheets.
We were trained in using a gait belt too, but I found it was not useful for clients who were slight of build.
“When you're younger the "I've fallen and I cant get up" seems funny”. In school it was help me, I’ve fallen and can’t reach my beer.
In my gym they have an electric lift chair that lowers people into the swimming pool and hauls them out because it’s discriminatory not to let disabled people into the pool. My neighbor has an electric chair that runs up and down the stairway on a rail. I don’t know how the manufacturers can afford the product liability insurance.
Each nursing home will need an electric fork truck to scoop people up off the floor because one worker is only allowed to lift 50 lbs.
The Hoyer lifts are being monopolized by 400lb residents who probably haven't hit 50 yet but where else you gonna put them
Lawyers, deranged family members, combative dementia residents, broken hips, staff injuries with time lost resulting in labor shortages or OT, Workers Comp claims, obese two and three person lift challenges….
As an Executive Director of an assisted living and memory care community…we’re calling 911!
I did 9 years as EMT-then-medic (not the same thing in most jurisdictions) running as a volunteer in a small-city Fire/EMS system, then as paid staff doing inter-facility medical transport. Every state has different rules/protocols, so what applies in one place doesn't elsewhere. Dispatch in our area would routinely send us to falls (we wrote it up as Community Service) for falls out of bed, falls in bathrooms, yards, parks, you name it we went there, but if the fall was in a care-facility setting the only reason we would go was if someone reported probable injury requiring transport to a hospital. Which doesn't mean staff might not abuse their privilege, but it didn't happen all that often and when it did there was some level of blowback. What such a call ALWAYS involved was an on-scene assessment for injury, undisclosed disability (mental, physical, chemical) or whatever that would require something more than just picking up, dusting off, and sending the person on his way. And it ALWAYS involved writing a report and getting a signed refusal if the person didn't want to go to the ER.
From a personal standpoint, I had two hip replacements 25 years ago and falls were predictable and fraught with complexities. Rather more recently I had a bike fall that broke my left femur and humerus and it took forever to regain the ability to get up unassisted or, at least, without something structural to brace off of. And I had the benefit of hard-won experience.
(JIC you're wondering about the assessment I mentioned and questioning its utility, case in point: my 93 yo mother had frequent falls in-home and the family would usually whistle me up to get her off the floor since she usually didn't fall hard, no head-strikes or obvious injury... but one time I did my checks over her annoyance and protests, and got her to a standing position with no problems--until she put weight on her left foot and started to scream. Immediate 911 call, and hours later found she had a non-displaced pelvic fracture that took 3 months in a nursing home to resolve.)
The interfacility transport gig had a huge component of lifting and patient relocation, which BTW is where a huge component of EMS/Fire injuries occur. Assistive devices, IMHO, always sound better than they work in the real world; they have their place and function, but their utility is limited. We worked a LOT with sheets -- you'd be surprised.
The fundamental problem with the getting-up video is that it assumes an otherwise healthy and functionally-intact individual-- the hard truth is that gravity isn't the only thing keeping you on the floor. Knee replacement(s)? If you can't bend the knee or kneel on it, what then? Shoulder/arm issues = no push-off strength. Back problems? OMG. And the Biggie, so to speak, the Elephant in the Room (and most EMTs' personal favorite): morbid obesity. Couple any (or all, actually) of the above and just for fun, throw in dementia ... I still have nightmares about some of our calls.
If you call 911 for every ground-level fall, you’ve ensured a Medicare expenditure of $5000 minimum. It’s typically now the case that any old lady who falls off the toilet gets sent for a whole-body CT scan by the ER triage nurse, before any doctor lays eyes on her.
That was a good video - not for everyone - but for a percentage of people, very helpful.
Here’s another one which shows you how to use books or other objects in the home to help a person get up from the floor.
https://www.youtube.com/watch?v=4ETgQD8QhZs
If "sliding out of chair onto floor" were designated as a treatable ailment, and various "treatments" designed and approved for Medicaid payment...then everybody happy.
..nursing home workers get less work for same pay
..911 responders get more easy jobs, more ambulances and equipment
..at all levels, including Medicaid administration, more staffing - which means more supervisory staffing, more administrative oversight, more data entry clerks, more workstations, ....
And it wont cost anybody because the Government will pay for it.
Talk about “able privilege”. People who are mobil don’t need to be permanent residents in nursing homes. You leftists are always banging on about other’s disadvantages but you have no idea how many people CAN NOT get off the floor after a fall. Must be nice you selfish, dried up old b!tch.
Being left on the floor is better than being punched in the face, as they do in some of those facilities.
I didn't know what a 'Hoyer lift' was, so I looked it up. $800 - $3000 dollars! Shoot man, you can go to Harbor Freight and get an engine hoist for a couple hundred, and a tree-trimmer's harness for another 50. Problem solved, and plenty of beer money left over.
Door #1
Door #2
I picked my father up off the floor several times in his last years of life and back on his feet- but he wasn't a big guy at around 160 pounds and I was 5-8 years younger then. I had to get my mother, at 240 pounds, off the ground about last October when she tripped coming down the back stoop. I thought it was going cripple me- it wasn't so much her weight but her lack of strength didn't allow her to lock her arms down over mine as I tried pulling her up to her feet- took me 3 attempts to get her to her feet without hurting her or myself. It is going to be 9-11 next time.
Thanks Eva Marie. Stayed for whole 9+ mins.
There’s equipment for this.
https://a.co/d/itNa5QE
I suppose it would be too hard to make sure to have at least one or two strong, male orderlies on shift at all times?
Put a 500 pound weight vest on him and see how well he gets up. It’s not always a matter of will or training. I used to ride around on an ambulance and help folks with “injuries from a fall.” These folks were In invariably massively obese or had dementia. Often a 2 or three man crew would need to call in an engine for additional assistance in getting them back into a chair. Often we would check them for injuries and mental state. Sometimes we were just their only human contact for the day.
This entire article and the comments seem awfully glib about senior care.
I learned to get off the floor after viewing a few of those videos - I made it a priority when I was facing the prospect of living by myself (my husband stayed behind in SC to clear out and sell our home). It contributed hugely to my confidence in getting around.
MOST nursing homes are understaffed - just not enough bodies to work together to get residents off the floor. What employees they do have are either people with small frames (a lot of them Asians), or larger, but still VERY unfit support staff.
Physical fitness is a legitimate requirement for the job - they need to be able to lift people of 200 pounds or more, who can contribute nothing to the task. But, too many homes are more concerned about having 'bodies' to fill places.
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