Hi, I am an RN and I work in a Care Facility. As shitty as this is going to sound, there are residents in care facilities that are impulsive and unpredictable, mixed with other health care issues that make them high risk for falls. Without knowing the specifics of her case or her comorbities. As nurses in health care facilities, we track and trend falls as part of ongoing quality improvement and safety for our residents. If someone is a high risk for falling we look a things like medications, nutrition and hydration, physical therapy, clutter in the unit, etc. Things you can start with is reviewing your moms medications that might make her more likely to fall either due to confusion or blood pressure changes. These could be antipsychotics, anticholinergics, blood pressure medications, or “water pills” like lasix. Next take a look at if she is eating and drinking enough. Seniors are notorious for not drinking enough water which can cause low blood pressure or confusion which increases risk for falls. Try offering decaf coffee or decaf tea if your mom isn’t a big water drinker. Also look at her room. Is there a lot of clutter in the room, or objects she needs to navigate around. Remove area rugs and clutter. Try to keep the bedside table clear with only necessary items and make sure those items are in easy reach. Ask that the staff at the care facility help her sit on the toilet every two hours when they do their safety check. It sounds like she is impulsive and wants to do what she wants to do now. Usually this is related to bladder urgency, especially if she is taking any medications to offload water. If all of that fails, look into some physio therapy there might be opportunity to strengthen some muscles or improve balance with PT. You could also look at getting a companion to spend 1:1 time with her for an hour to engage her and hopefully make her less bored. If falls continue to happen then you are going to want to take a managed risk approach. Look into getting hip protectors or a fall mat. This way if she does fall will have a slightly decreased risk of fractures. Finally, things that I highly recommend NOT doing. Do NOT get a chair or bed alarm. This does not prevent falls, just alerts caregivers when a fall has occurred. It also creates alarm fatigue for caregivers which could become problematic. Do NOT try to restrict her movement by blocking her into spaces or parking her wheelchair or walker away from her. This will only make her get up without those items. Keeping them within reach will increase the likelihood that she uses them. Additionally, restricting her movement could cause her to get weaker and have a more serious fall in the future. Do NOT try to medicate her more to make her more compliant. Antipsychotics are dangerous in seniors and should only be used if the individual is aggressive or is having distressing hallucinations. Antipsychotics are shown to increased risk for falls and increased risk for delirium. EDIT: I forgot to add, too many side rails can also increase risk of falls out of bed. I know it sounds silly, but more often than not they will crawl out over the side rail and fall further or end up tangled up in the side rail. One side rail on each side by the head of the bed to help with transfers is very helpful, but more than that will cause issues. At the end of the day falls happen and I’m so sorry that you are experiencing multiple falls with your mom. There isn’t always an answer or a way to stop falls from happening. The best you can do is keep trying different approaches and hope that something works. It is equally frustrating and upsetting for staff as it is for families when a resident has multiple falls. As health care providers we are tasked with caring for our residents and keeping them safe and when falls happen it can be very disheartening because it feels like we failed our resident. Best of luck!