The largest single cause, at 36 percent, of potentially preventable hospital emergency room visits made by nursing home residents is injury due to a fall.
The deaths of approximately 1,800 nursing home residents each year can be attributed to fall-related injuries.
A typical, 100-bed nursing home reports 100 to 200 falls per year — more than one per patient — and many falls aren’t reported.
Adults 65 and older are four times more likely to die of fall-related injuries if they live in a nursing homes than if they do not.
Up to 75 percent of nursing home residents fall each year — more than double the rate for seniors who don’t live in nursing homes — and the average is over 2.5 falls per person per year.
Over a third of fall-related injuries happen to residents who can’t walk.
Although a relatively small number (2 to 6 percent) of falls result in fractures, 10 to 20 percent of nursing home falls do cause serious injuries, which can lead to loss of function and disability; the resulting fear of falling can also lead to further loss of function, social isolation, and depression.
It’s true that nursing home residents are on average older and in poorer health than seniors who live in the community, so therefore may be more prone to fall. However, a well-run nursing home should be able to prevent most falls. Staff should be attentive to patients at risk of falling and ensure that they receive proper foot care and shoes and have (and know how to use) appropriate walking aids. They should eliminate environmental hazards, such as poor lighting, slippery floors, and incorrect bed height, which cause nearly 30 percent of nursing home falls.
Falls and Neglect
When these issues are neglected, falls can and do occur, and residents suffer. And, sadly, nursing home neglect is all too common. Researchers in Michigan recently published the results of a random sampling of family members of elderly nursing home residents. The results were disturbing: more than one in five reported residents were neglected in the previous year. Since family members are often unaware of incidents of neglect, the study’s author predicted that the actual number of patients neglected was almost certainly higher than 20 percent. Although this particular study was limited to nursing home residents in Michigan, there is no reason to believe the situation is any different in the rest of the country.
The study did not specifically address falls caused by neglect or nursing home abuse; however, it did look at incidents of physical neglect in which nursing home staff failed or refused to meet various needs of residents, including personal safety. Disturbingly, the study found that the most vulnerable residents — those with severe physical limitations or behavior problems caused by dementia and other illnesses — were most at risk of being neglected.
If you notice your loved one has bruises, cuts or abrasions, or if he or she has grown more fearful of getting up and moving around, falling may be an issue. Ask your loved one or other residents whether he or she has fallen; observe whether or not staff monitor residents when they are walking; ask if the staff use sensors that sound an alarm when residents try to move or get out of bed unassisted. If your loved one is unable to walk, watch when staff transfer him or her out of bed to see whether it is done carefully and safely. Not all falls can be prevented, but a fall-related injury is definitely a warning sign of nursing home neglect. You should consult a nursing home abuse lawyer if you suspect your loved one’s fall at a nursing home was a result of neglect.
Christine Caffrey, “Potentially Preventable Emergency Department Visits by Nursing Home Residents: United States, 2004”, NCHS Data Brief, Number 33, April 2010, http://www.cdc.gov/nchs/data/databriefs/db33.htm#injuries
National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, “Falls in Nursing Homes”, 10 June 2008, http://www.cdc.gov/ncipc/factsheets/nursing.htm
Zhenmei Zhang, “Neglect a ‘very serious problem’ in Michigan nursing homes”, 25 January 2011, http://news.msu.edu/story/8826/
This article used with permission: The Nursing Home Abuse Center