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Back to the Basics – Falls in Nursing Homes

Falls can happen anywhere and anytime to anyone. Yet the common stories we hear most about tend to be when our elderly or otherwise incapacitated loved ones suffer a fall, largely because of any incapacity. Such falls can lead to serious injuries, such as broken or fractured bones, concussions, and even death. There is also an enormous psychological impact, as one fall can leave a person in perpetual fear of falling again, which can in turn lead to self-isolation and even depressive thoughts of helplessness.

In nursing homes, falls are a significant problem, and lead to even bigger problems. According to the Centers for Disease Control (CDC), as of 2012, for every 100 nursing home beds, there are approximately 100 to 200 falls per year, including some who fall more than once. And among the multitude of falls that occur, almost 2,000 people die each year from a fall at a nursing home, and anywhere from 10%-20% of falls at nursing homes can cause serious injuries, while 2%-6% result in bone fractures. Interestingly, 35% of falls occur with nursing home residents who are unable to walk, which may call into question the lack of supervision of those people by nursing home staff. According to the CDC, some of the many causes of falls in nursing homes include:

· Muscle Weakness · Walking or Gait problems · Environmental Hazards -These include “wet floors, poor lighting, incorrect bed height, and improperly fitted or maintained wheelchairs”
· Medications -These include sedatives and anti-anxiety drugs which can cause problems with a person’s central nervous system. Within the 3 days after a change in sedative or anti-anxiety medications, there is a higher risk of the patient falling
As the CDC explains, 16%-27% of falls are a result of the aforementioned environmental hazards, and approximately 24% of falls are a result of physical weakness and walking problems. At least twice as many falls occur at nursing homes, as opposed to in community living settings.

It is important for nursing home staffers, including nurses and nursing aides, to be aware of the risks of patients falling, and the common causes of such falls. A failure to do so can be negligence that can cause liability for the nursing home or care facility. Staff should be properly trained in this area. Staffers should be very careful to understand what medications in particular can lead to falls, and ensure that patients are watched particularly closely if they happen to take sedatives. Nursing home facilities should also be well equipped with ways for incapacitated patients to get around, including safe wheelchairs, as well as handrails in the facility and raised toilet seats, among other items. As the CDC also notes, physically restraining patients may seem like a way to keep them from falling, but this is actually very counterproductive. Restraints that keep patients from moving and exercising their limbs can actually increase atrophying, and make it even more difficult to walk or move as a result of that weakness. Guard rails on beds may be a help, but that is not necessarily the case, and bed rails themselves can cause separate injuries as we have previously examined in this blog space.

While a fall is bad enough as it is, the resulting consequences can be even worse. Preventing any fall before it happens is important, and it is up to nursing homes and their staff members to take the proper precautions and to understand what it takes to keep patients safe. That way the patients avoid injury, and the nursing homes avoid liability.

See Related Blog Posts:

Reminder – The Risk of Bed Rails in a Nursing Home

The Future of Elder Care? Shifting Care to the Home and Community