During the Holidays we get lots of calls from people with concerns about the care that their loved one is receiving in a nursing home. Many people travel for Thanksgiving and Christmas. This gives them the opportunity to see loved ones including their loved ones who are residents of a nursing home. Often, when people visit their loved ones in a nursing home, particular if they have not seen them in a while, they are concerned about their care and they call us with these concerns.

In this blog, we are going to talk about falls. Many, many nursing home residents suffer falls in their nursing home. When the family inquires about the fall, the staff at the nursing home often gives them a great deal of misinformation.

One of the things that nursing homes often tell families is that they are not permitted to use alarms because alarms are restraints. This is simply not true. If someone you love is in a nursing home and this is what the nursing home is telling you we strongly recommend that you move that person to a different nursing home.

If someone you love has been neglected or abused in a nursing home, please call us at The Dickson Firm at 1800 OHIO LAW. We would be happy to talk with you and help you in any way that we can.

It is true that nursing homes are not permitted to restrain their residents. The reason for this is that restraints more often than not create more problems than they solve. For example, if you have a resident who has the tendency to get up out of bed, it is not helpful nor particularly safe to put their bed rails up. When you put their bed rails up, they often just climb over the bed rail. If they climb over the bed rail, then they simply fall from a higher height. Further, we see residents who get tangled up in a bed rail and tragically sometimes strangle. Therefore, bed rails often do not make nursing home residents safe.

Likewise, if a resident is restrained with straps or some other device, they can likewise get tangled up and strangle. Sometimes these interventions are used in the hospital, However, most people are in the hospital for a short time. If someone is particularly agitated and particularly vulnerable because they just had surgery, then it might make sense for the hospital to restrain them. But in a nursing home setting where most people are there for a longer period of time, restraints are usually not helpful.

However, alarms are not restraints. The nursing homes often argue that the alarm startles the resident and makes them sit back down. This does not make the alarm a restraint. Further, this is a good thing. If someone you love is in a nursing home and they are not allowed to walk around by themselves, then the nursing home has to take precautions so they do not walk around by themselves. If they are at risk for falling when they walk by themselves, then walking by themselves is literally potentially fatal. Falls for an elderly resident often result in fractures and head injuries, both of which can absolutely be fatal. As a result, it is imperative to prevent nursing home residents, who are not able to walk around on their own safely, from walking around unattended.

Nursing homes are legally obligated to provide their residents with adequate supervision
to prevent accidents.

Nursing homes in Ohio are legally required to provide their residents with a safe
environment. This includes preventing falls.

If someone you love is in a nursing home, and they are at risk for falls, and it is not safe for them to walk around unattended, then the nursing home must have a specific care plan that is designed to prevent falls. If your loved one is at risk for falling out of bed, rather than put their bed rails up, the nursing home should put their bed in the lowest position and put a mat by the bed. That way if they happen to roll out of bed, they will not suffer an injury.

Further, there are a quantity of devices that can help the nursing home provide the resident with adequate supervision. I was reviewing a case the other day where the nursing home continued to clip the call light to the resident's clothing. The problem is that throughout the 6,000-page nursing home chart there was not a single instance where the resident ever used their call light over a period of years. The resident was demented. The resident was confused. The resident clearly did not have the ability to use their call light to call for help. She continually got out of bed. She clearly got up and walked on her own, despite the fact that it was not safe for her to get up and walk on her own. This resident suffered multiple falls and ultimately suffered a head injury that caused her death. If your resident suffers a fall in the nursing home, the nursing home needs to tell you what their plan is to prevent falls in the future.

There are alarms that are connected to a pressure pad that goes under the resident either sitting in a chair or laying in bed. That way when the resident begins to get up they take the pressure off the pad an alarm sounds which alerts the staff. There are clip alarms where the clip is attached to the resident's clothing and then attached to a string that goes to a magnet. If the resident starts to get up and pulls the magnet off the base the alarm sounds. There are motion detectors so that if the resident starts to get up in their room the staff
can be alerted.

Nursing Homes claim that alarms startle the resident and are therefore restraints. Many alarms do not startle the residents. Even if they do that does not make them restraints. Alarms can be connected to a pager that the nurses wear on their belt. They can be connected to a light that lights up over the resident's room. They can be connected to a voice recording. There are alarms where the resident's family member can record their voice encouraging the resident to sit back down.

One thing to ask the nursing home if they claim that they do not use alarms because they are restraints is, have they tried an alarm with your loved one? How do they know that the alarm will startle your loved one? It may not. There is absolutely no evidence that all alarms startle all nursing home residents. Many nursing homes have eliminated alarms simply because the use of alarms helps lawyers like me document their substandard care. If they are supposed to use an alarm and they do not use that alarm and a person has a fall they are clearly responsible. If they are using an alarm and the alarm goes off and nobody responds promptly then they are also responsible.

Alarms by themselves do not prevent falls. Alarms alert the staff that a resident who cannot walk safely on their own is starting to get up. What needs to happen is that the staff needs to respond to the resident immediately when they hear the alarm. They need to treat alarms as a matter of life and death because if a resident suffers a fall it is very likely that they can suffer a fatal injury. The owners and the operators of the nursing home need to make sure there are enough qualified staff to provide proper care to the residents including responding to fall alarms. The Nursing Home is required to provide all residents with adequate supervision to prevent accidents.

If someone you love is in a nursing home, and it is not safe for them to walk unattended, you must talk with the Director of Nursing or the Administrator and find out from them what the plan is to keep your loved one safe. If they do not have such a plan, if they cannot explain that plan, you should think seriously about moving your loved one to a safer nursing home. Many families express to us that it is challenging to move their loved one. The key is to find the better nursing home and then to work with that nursing home to move your loved one. The new nursing home will be motivated to help you move your loved one to their nursing home.

You can go to www.Medicare.gov and find a better nursing home in your area and then make arrangements to move your loved one.

If someone you love has been neglected or abused in a nursing home, please call us at The Dickson Firm at 1800 OHIO LAW. We would be happy to talk with you and help you in any way that we can.