Preventable falls are an unfortunate plague in many nursing homes across Ohio. The CDC reports that around 1,800 residents die each year from fall-related injuries while in a nursing home. Many things can result in a nursing home fall, including:
- Facility negligence in cleaning/maintaining the premises
- Failing to plan for patient needs
- Overmedicating patients
- Failing to monitor patients results in avoidable falls and fractures
The statistics on nursing home falls are shocking. According to the Centers for Disease Control and Prevention, up to 75 percent of residents fall each year in nursing homes, which is twice the rate for those 65 and older not residing in a nursing home. Up to six percent of falls cause fractures and as many as 20 percent of falls cause serious injuries. A pattern of falls in a nursing home is cause for concern. It means that residents either need to have more supervision or a better level of care.
Elderly and disabled individuals often have difficulty walking and getting around. Falls of nursing home residents result in further disability. Falls also reduce the patient’s quality of life and can even cause death. In addition, these residents can also suffer from an intense fear of falling. This can cause depression, isolation, or even feeling helpless. Ohio’s Nursing Home Resident’s Bill of Rights guarantees nursing home patients “the right to a safe and clean living environment pursuant to the Medicare and Medicaid programs and applicable state laws and rules adopted by the director of health.”
Common Causes for Falls and Fall-Related Injuries
CDC statistics show that as much as 27 percent of nursing home falls are due to environmental hazards present in the facilities. These hazards include:
- wet floors
- poor lighting
- incorrect bed height
- improperly fitted or maintained wheelchairs
- improper and incorrect walking aids
Falls most often occur while residents are:
- Attempting to get out of bed
- Getting into or out of a wheelchair
- Going to the bathroom
- Leaving the room to visit another area of the nursing home or leaving the facility
- Moving around the room to get food, medications, etc.
Any falls, fractures, or other injuries due to falls must be legally documented and reported to family members or other authorities.
Physical Restraints Don’t Help Prevent Falls
According to the CDC, using restraints on a regular basis doesn’t decrease the possibility of falls or fall injuries. The CDC explains that physical restraints “should not be used as a fall prevention strategy. Restraints can actually increase the risk of fall related injuries and deaths.” Reduced physical function and increased muscle weakness can result from limiting a resident’s ability to move around freely.
A bed rail is a railing installed on a bed and connects the headboard to the footboard. The FDA defines bed rails as a tool “to help create a supportive and assistive sleeping environment in homes, assisted living facilities and residential care facilities.”
The FDA lists both the possible benefits and risks for those who encounter bed rails. Benefits include:
- Aiding in turning and repositioning within the bed
- Providing a hand-hold for getting into or out of bed
- Providing a feeling of comfort and security
- Reducing the risk of patients falling out of bed during transportation
- Providing easy access to bed controls and personal care items
Possible risks to encountering bed rails include:
- Strangling, suffocating, bodily injury or death
- More serious injuries from falls when patients climb over rails
- Skin bruising, cuts, and scrapes
- Inducing agitated behavior when staff uses bed rails as a restraint
- Feeling isolated or unnecessarily restricted
- Preventing patients, who are able to get out of bed, from performing routine activities
How Can Falls in Nursing Homes be Prevented?
The safety guidelines for bed rails put out by the FDA discuss that if other environmental and treatment options are not working or do not align with the patient’s needs then bed rails are an option. The guidelines state, “close attention must be given to the design of the rails and the relationship between rails and other parts of the bed.”
How Can Nursing Homes Reduce Falls?
Prevention of falls is crucial. To do so, facilities must implement changes and educate staff. The changes and education should occur across all areas of nursing homes. This includes the organizational, staff and patient levels. Fall prevention is a multi-faceted challenge and requires a combination of medical treatment, rehabilitation, and environmental changes. The CDC includes the following as possible fall interventions:
- Educating and teaching staff on strategies to avoid risky situations that could result in falls or fall injuries.
- Implementing changes in the nursing home environment in order to make daily activities safer for its residents. These changes “include putting in grab bars, adding raised toilet seats, lowering bed heights, and installing handrails in the hallways.”
- Utilizing hip pads to potentially avoid hip fractures if a fall does occur.
- Assessing a resident after a fall to understand what happened, how to prevent the incident in the future and to treat any medical conditions.
- Implementing exercise programs for residents that can help improve balance, strength, walking ability and physical function.
- Assessing residents’ medications to better understand potential risks and benefits of its directed use.
In the News
An article from the Associated Press discusses why some nursing homes are moving away from using bed and chair alarms. They have sensors that go off when a resident moves in a certain way. The article explains, “A growing body of evidence indicates alarms and other measures, such as fall mats and lowered beds, do little to prevent falls and can instead contribute to falls by startling residents, creating an uneven floor surface and instilling complacency in staff.”
A recent Cleveland Plain Dealer story reported that Ohio only requires their nursing home staff to “provide a minimum 2.5 hours of direct care per resident per day.” Experts claim this is far too low a number and the state of Ohio should require around four hours per day. The most effective way to prevent falls is to have a diligent nursing home staff that is aware of resident’s typical schedules and understands reasons for why residents want and need to get up or move.
Was a Nursing Home Negligent?
Nursing homes are potentially liable for a resident’s fall or fall injuries if the incident occurred because of the staff or administration:
- Failed to assess a resident’s risk for falling
- Did not provide assistance to a resident
- Failed to supervise a resident during a time staff should not have left them alone. The home is also negligent if staff drops the resident during transfer.
- Hired unqualified employees.
- Failed to properly train employees.
- Failed to develop, modify or provide a sufficient care plan based on the resident’s conditions and needs.
Nursing homes have federal regulations that require the facilities to complete an assessment on residents the first time they come. Staff should update assessments regularly, including anytime medical conditions change. These assessments must include a care plan for the resident that take into account their current health issues and address their risk for a fall or fall related injury. These plans should also incorporate any assistance that residents will need to help reduce a risk of falling. This includes walking aids, proper height for beds, chairs and toilets, and appropriate placement of bars and handrails.
If a nursing home fails to provide proper assistance and adhere to the federal regulations, then they are responsible for a resident’s possible fall and injury.
How to Prove Neglect or Negligence?
In order to be successful in a nursing home fall case, here are sources of evidence that you can use to help build a case. Consider gathering:
- Physical and occupational therapy records
- Nutritionist and social worker notes
- Video and photographic evidence
- Other residents as witnesses of the fall
- Nursing home’s history of falls and other injuries
- Nursing notes and nursing aide records
- The resident’s memory or statements
Call Tittle & Perlmuter Today for a Free Consultation
A fall or fracture of a loved one caused by negligent nursing home care is a serious matter. We are ready to listen to your case and advise you on the best course of action. Call today for a free consultation. We can also be reached online. Our response will be quick. Evening and weekend appointments are also available to be arranged, and we can come to you.