Nursing Home Neglect Puts Elderly at Higher Risk of Being Injured in Tripping and Falling Accidents
It is estimated that 36 percent of all emergency room visits from nursing home patients are due to falls inside the nursing home that are potentially preventable. In fact, it is estimated that up to 75 percent of nursing home residents will face a fall on an annual basis. What is scary is that most falls in nursing homes are unwittnessed and most residents cannot explain or recall the circumstances of their falls. More troubling is the fact that nursing home residents with dementia illnesses like Alzheimer’s fall twice as often as residents without these illnesses.
- Falls Resulting in Hip Fracture
- Falls Resulting in Pelvis Fracture
- Falls Resulting in Subdural Hematoma
- Falls Resulting in Death
- Nursing Home Shower Fall Accidents
- Wrist Fracture after Nursing Home Fall
Ways to Prevent Nursing Home Falls
It is important for nursing homes to take adequate precautions to prevent injuries to residents, including falls. The following actions can be taken to help reduce the risk of serious or fatal injury because of a nursing home falls:
Fall Risk Assessments
The Minimum Data Set (MDS) is the nursing homes most important fall-prevention tool. The MDS is a assessment tool that is used to screen residents and identify residents that are fall risks. Additionally, the nursing home’s Resident Assessment Protocols (RAPs) are used to identify potential conditions in residents that require more attention and assessment. Guidelines in the nursing home RAPs allow staff to first identify and then evaluate residents that are at risk of falls. The RAPs also help staff implement interventions that are specifically designed to prevent falls.
All newly admitted residents should undergo a comprehensive fall risk assessment using the MDS and RAPs. A comprehensive risk assessment should be updated on a regular basis and include information about the resident’s overall health, medication, and any history of past falls. A resident that has suffered a fall while in the nursing home should be reassessed as a history of falls is a major indicator of future falls. A nursing home that fails to properly assess fall risks and implement a specific fall prevention plan is negligent.
Staff needs to periodically observe every nursing home resident. The staff needs to know if a resident is engaging in activities that could result in a fall (walking without an assigned walker, not using wheelchair). Staff also needs to know if a resident requires assistance getting dressed or taking a shower. It is assumed that every nursing home resident is observed by staff at least once every two hours. Some nursing homes require staff to record all observations made over the course of a work shift. Studies have found that staff frequently do not perform periodic observations (rounds) of residents even though the record documents rounds were performed. A nursing home that has a policy of documenting resident observations/rounds but fails to follow the policy could be responsible for injuries to residents.
Some nursing homes make their observations by placing residents in a large multi-purpose day room located near the nurses station that allows for frequent observations. Other facilities install cameras in the day room that allow staff to observe residents on a video monitor. However, this should be seen a violating resident’s right to privacy.
Bed and chair alarms can be used to monitor residents’ activity. These alarms can be pressure sensitive (alarm sounds when resident lifts their body off a sensor pad installed on a bed mattress or wheelchair seat, alarm sounds when resident places weight on a floor mat located next to bed to alert staff resident is attempting to get out of bed). Other alarms can be anchored to a bed or chair and attached to a resident’s clothing (alarm sounds when the resident moves away from the bed or chair causing the alarm to disconnect). However, these alarm systems malfunction frequently and are not completely reliable.
Taking multiple drugs/medications at the same time, as is the case with most nursing home resident, increases the likelihood of falls. Diuretics, also known as water pills, are used to treat a variety of conditions ranging from high blood pressure to glaucoma. These diuretics can dramatically reduce a resident’s blood pressure when they go from a sitting to standing position. This is known as postural hypotension or orthostatic hypotension. Orthostatic hypotension can cause dizziness, lightheadedness and fainting, all of which increase the likelihood of falls.
Every nursing home needs to have a pharmacy consultant review each resident’s medication regimen. It is to job of the pharmacy consultant to determine the potential effects that will result from mixing medications. Psychoactive drugs (antidepressants, anti anxiety, sleeping pills, anti-psychotics) are known to increase the likelihood of falls and nursing homes need to take great care in administering and monitoring intake of these drugs.
Assisting with Safe Mobility
Most falls that occur in nursing home residents that are able walk usually occur while they walking about or moving from place to place. Nursing homes need to evaluate a resident’s gait (manner of walking) and balance problems because these issues can be corrected with treatment. Doing so dramatically decreases the likelihood of falls. A newly admitted resident needs to be evaluated by an occupational therapist and a physical therapist. The MDS assessment tool also contains tests that allow staff to measure a resident’s ambulation (ability to walk about). In some cases therapy can be prescribed to maintain or improve a resident’s ambulation.
The following actions can also be taken to help reduce the risk of serious or fatal injury because of a nursing home falls:
- Nursing home staff members should be properly trained in fall prevention protocol and understand the risk of falling certain situations present. Educating the staff about fall risk factors and fall prevention should be the nursing homes top priority;
- According to the Centers for Disease Control (.pdf), exercise programs should be available to all residents at a nursing home, including physical therapy, to help patients improve strength, balance, and flexibility; and
- Proper equipment to aid residents in walking should be provided and available at all times for the patient’s safety and security.
Typical Causes of Nursing Home Falls
While every nursing home resident is unique, there are often similar reasons that nursing home falls occur and being aware of them can help a nursing home implement crucial fall-related precautions to help prevent injury to residents. Some of the more common causes of nursing home falls include:
- Medication: often, certain drugs can impact a resident’s balance and any drug that affects the central nervous system can make a patient more prone to falling;
- Failure to Aid: Nursing homes need to provide residents with the appropriate equipment and support to walk without falling, including walkers or wheelchairs for transporting and shower chairs for bathing;
- Failure to Properly Maintain Walking Areas: Walking areas, including stairways, should be appropriately maintained by nursing home staff at all times, including being kept free from spills and debris that might otherwise cause a fall;
- Lighting Problems: Facilities should have sufficient lighting as most nursing home residents have visual impairments. Low voltage lights or motion sensor lights should be used to prevent falls at night.
- Frequent and/or Improper Use of Restraints: The frequent and/or improper use of restraints can cause a nursing home resident to lose their balance or struggle in a way that causes injury, either of which can result in a serious fall; and
- Neglect: All too often, nursing home residents are neglected and lack of proper care can result in serious injury due to falling.
When you or a loved one have been injured in a nursing home fall, you may be able to seek compensation for those injuries from the nursing home facility. While not all falls in a nursing home setting automatically give rise to the possibility of compensation, when a nursing home facility is liable for the fall they may also be liable for compensation for injuries resulting from the fall. For instance, in situations where a pattern of falls can be demonstrated and no additional fall-related protocol have been put in place to prevent future falls and injury, a nursing home facility may be liable for compensating a victim.
If you or a loved one have been injured as the result of a fall at a nursing home facility that you believe occurred because of the facility’s failure to implement fall-related protocol or because of the facility’s general negligence, contact our law firm today to schedule you free, no-obligation legal consultation. With over 35 years of legal experience, we can help you explore options that may be available to you because of your injury.
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