A Right to Fall

A few weeks ago I got a phone call from the head nurse on the wing of the nursing home where my mother lives in Jackson, Mississippi. She calls every time a significant change takes place, and sometimes just to let me know of a shift in procedures. This call was to tell me that the physical therapist had been working with mom again on her walking, in hopes that she wouldn’t have to be in a wheelchair all the time. (She’s been in a wheelchair since October of 2008, when she fell and broke her hip. Her Alzheimer’s prevented her from participating with physical therapy, so she hasn’t been able to walk on her own.) They were removing her “lap guard,” and trying her in a new chair, which not only fit her better and allowed her to navigate around the facility better, but it also did not have a lap guard. Instead, it had a seat belt, to “remind her” not to get up and try to walk alone. I was encouraged. For about 24 hours.

The next day they called to say it didn’t work. Mom quickly figured out how to undo the seatbelt, and would unhook it and try to walk on her own before anyone could prevent her from falling. So they had to put her back in a chair with a lap guard, because she can’t figure out how to get it off.

“Why don’t you just hook the seat belt behind her?” I asked, thinking she would be more comfortable in a smaller chair without the lap guard.

“Oh, we’re not allowed to restrain her in a way that she can’t get loose from,” the nurse told me. “She has a right to fall.”

A right to fall.

Okay, I understand that it takes away her freedom, her independence, her dignity, to be restrained, but I also understand that without some sort of restraint she will surely fall and break her hip again (or worse) and end up in the hospital. But somehow—legally, at least—being in a lap guard, which she could possibly figure out how to remove, isn’t actually being restrained.

When I visited Mom today, she didn’t mention the lap guard, as she sometimes does. Sometimes she points to it and says, “Is this yours?” or “What am I supposed to do with this?”

I always remind her it’s there to keep her from standing up and trying to walk by herself and falling and breaking her hip again. She doesn’t seem frustrated by it, thankfully. And they’ve ordered her a smaller, more comfortable wheelchair with a smaller lap guard, so she should at least be more comfortable.

So, I got to thinking about the legal phrase the nurse used: “She has a right to fall.” And I started wondering how and if it would be wrong to take that right from her, the same way we don’t let an infant or a small child have full “rights” because they would get hurt. In fact, there are laws about children being in car seats, so they don’t have a “right” to be unrestrained in a car. And adults don’t have that right either, in states that have seat belt laws.

So today I imagined myself, fifteen or twenty years from now, possibly in a nursing home with Alzheimer’s. On the one hand, I would want my “freedom” for as long as possible, and depending on my mental state, being “trapped” in a wheel chair with a lap guard might seem awful to me. But I also hope that measures will be taken to prevent me from the pain of falling and breaking something and having to be hospitalized as a result.

I guess freedom comes with risk, and protection comes at a cost.