Falls in Nursing Homes

Falls are the most frequently reported adverse event in nursing homes. Astonishingly, between half and three quarters of nursing home residents fall each year. Frequently nursing home residents fall more than once.

Nursing Homes Potentially Liable When Residents Fall

In long term care facilities, a fall is defined as failure to maintain an appropriate lying, sitting, or standing position, resulting in an individual’s abrupt, undesired relocation to a lower level. An episode in which a resident lost his/her balance and would have fallen, were it not for staff interventions, is also considered a fall.

Falls and fall related injuries often result in sudden and catastrophic injury. Falls result in fractured or broken bones, disability, functional decline and decrease in enjoyment and quality of life. In addition, the fear of falling that an elderly resident may experience after a fall often leads to progressive mobility decline even in the absence of a fall related injury. The loss of mobility has serious social, psychological and physical consequences.

The Elderly Fall More Frequently in Nursing Homes than when Living Independently 

Although it may seem counterintuitive, elderly persons living in nursing home fall more often than elderly living independently. This is because they are usually older, have impaired balance, mobility limitations and cognitive impairment. All these factors lead to an increased rate of falls of elderly in nursing homes.

Some common causes of falls in nursing homes include:

– muscle weakness
– gait problems
– environmental hazards
medications that affect the nervous system
– incorrect walking aids

How to Prevent Fall-Related Injuries in Nursing Homes

Nursing homes are required by both state and federal law to complete a fall risk assessment for every resident. A comprehensive fall risk assessment is probably the most important component to a nursing home’s fall reduction and prevention program. The purpose of fall-risk assessment is to evaluate a patient’s risk for falling in order to correct problems and ultimately prevent falls from occurring. Fall risk assessment should be completed upon a resident’s admission to a nursing home, upon transfer to a new unit, when the level of care changes and after a fall. Several well known fall risk assessment tools used by nursing homes are the Hendrich II Fall Risk Model, the Morse Fall Scale, and St. Thomas’ Risk Assessment Tool in Falling Elderly Inpatients.

After a fall risk assessment is completed, nursing homes should implement an action plan and patient specific fall prevention strategies. This may include simple measures such as installing grab bars in bathrooms and handrails in the hallways make it easier for residents ambulate safely. Adapting chairs to the individual residents’ seating needs. Ensuring that appropriate fitting footwear is worn by residents. And using fall protection mats and hip pads may help prevent a fracture if a fall occurs.

Long term care facilities need to educate their staff about fall risk factors and prevention strategies. Medical staff should closely monitor and assess a patient’s prescribed medications for its potential risks and benefits. Residents who do not suffer from cognitive impairment should be taught strategies to avoid hazardous situations that put the resident at risk for falling. In addition, exercise programs can improve balance strength and the ability to ambulate.

If a nursing home resident is assessed as a high fall risk, nursing home staff need to constantly monitor them as many accidents happen within only a few minutes of nursing home staff diverting their attention. High fall risk residents should be accompanied by a nursing home staff whenever they move throughout the facility. Moreover, falls frequently occur while residents use the bathroom facilities. For this reason, toileting schedules are essential in the care of frail, elderly residents and nursing staff should be on hand to assist day and night.

Falls From Bed

Bed falls are another source of serious injury and morbidity. Nursing homes should focus on ensuring a safe sleeping environment and identifying high risk residents. Cognitively impaired residents that are incapable of requesting help and unable to walk without assistance are at the highest risk for bed falls. Such residents should not be tied in bed or restrained. Instead, alternative strategies such as installing bed alarms and heightened staff awareness should be implemented to reduce these falls.

Legal Action for Falls Causing Fractures or Serious Injuries

Sometimes falls are unavoidable; however, in instances in which the nursing home staff was negligent, they should be held responsible for the damages caused to the resident. If liability is found to be with the nursing home staff, the facility may be responsible for monetary damages, including medical bills, pain and suffering, and loss of life’s pleasures. It is important to retain a nursing home abuse attorney to assist you in holding the facility and staff members accountable.

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