My aunt does not really like the idea of full rails but I'm afraid of her falling again and getting really hurt, but Auntie has asked me to leave the bar down so she can use her potty chair if needed. She wants only a little night light on. I left rail half way down 2 days but I'm not sure what to do now cuz her cellulitis keeps flaring up. I believe the cellulitis is the reason for all the falls. Her nurse of course wants the legs elevated up high. I usually stay up really late to watch her 3am or so, because then my family can check on her when they are getting up so I get some sleep. Bars up or down or half way up? Anybody have any suggestions? Did not mean to ramble on...
( Perhaps there are exceptions to this, that’s just my observation).
On the other hand if aunt wore the pull-ups and couldn’t quite make it, the clean up wouldn’t be so bad. Often when the patient stands, the pee starts, so the absorbent pad is helpful. I don’t know how my mom managed so well but she did.
Since your aunt is on hospice and has fallen so often, I would probably try to manage her fluids a bit if possible. If she has a condition that requires her to be bedbound, you might be able to chart her meals, time of voiding etc, keep her on a schedule and be proactive on getting her to the pot. If she is up during the day, keeping her feet up is helpful as all that fluid that drains to her feet gets emptied sooner.
Are you still taking care of your mom as well as your aunt?
Regardless of what aunt wants, when you know you can’t stay up, I would put the rails up. You can’t burn both ends against the middle indefinitely without paying the price.
If you are doing the night shift you must sleep during the day; but then do do the night shift, and do get a full measure of sleep. In the end this boils down to staffing hours - how much support are you getting, apart from family members?
Side rails are a restraint and we no longer use them in nursing homes in my state because of this but mostly because of the deaths that have happened when one gets entrapped in them and doesn’t have the strength to get out of it themselves.
If it’s a choice between night time incontinence and falling I’d definitely choose the brief at night. If you’re the only main caregiver and not sleeping because of this it’s another reason that a brief would be fine at night in my opinion. The care and well being of all involved are a concern here.
A fall mat by the bed if she is unable to walk by herself. Placing the bed as low to the ground as possible too. But if she is sometimes able to make it to the toilet by herself then a bedside commode by the bed would be better.
Waking her up every 2-4 hours to have her assisted to toilet with you is yet another idea, then you could set an alarm and wake her before urgency to toilet and incontinence takes place.
It really depends on exactly why she is falling and looking at trialing many different things until you find something that works for her. Analyzing the cause of each fall and the exact time of the falls would be very helpful. Your hospice nurse should be trained to do this and come up with solutions to prevent injury with you. To help prevent incontinence us secondary to prevention of falls.
I can understand your concern since she has fallen so often. I’m really not sure what you should do but I suppose if you want her to wake you when she needs to get up I’d probably go with the half rail while you are there and rails up if you have to leave the room.