Preventing Falls for Elderly Nursing Home Residents Is Literally a Matter of Life and Death

This article was written by Ohio nursing home attorney, Blake Dickson.
October 21, 2026

According to a study recently published in McKnight's Long Term Care News, older residents with a history of falls have worse physical performance and worse nutritional status. 

According to this study older nursing home residents with a history of falls showed poorer physical performance and lower activity levels, which created a greater risk of sarcopenia, they have poorer nutritional status, a higher prevalence of incontinence, and reduced independence in activities of daily living compared to their counterparts without a history of falls.

This is according to a study that was published in the Journal of Clinical Practice and Research. This study analyzed data from 120 nursing home residents residing in four different nursing homes located in Turkey's Ankara province between January of 2024 and August of 2025. Residents were sorted into two groups, fallers and non-fallers, based on their self-reported history of falls during the prior 12 months.

Results from the study

Results showed that the median fall frequency was zero in the non-faller group and one in the faller group  Fall frequency was significantly correlated with walker use, gait speed, and Mini Nutritional Assessment scores. Meanwhile the average length of a nursing home stay was 3.5 years for fallers and 5 years for non-fallers.

Unlike previous studies focusing solely on fall occurrence in nursing homes with limited coverage of fall risk factors, this study simultaneously examined factors associated with both fall status and recurrent fall frequency. The fallers in this case were older, used a greater number of medications, had a higher mortality risk, and used assistive devices more frequently than the non-fallers.

The significant associations between fall frequency and walker use, gait speed, and nutritional status suggest that mobility limitations and undernutrition may be influential factors in recurrent falls. Effective fall prevention strategies should consider these multiple factors to reduce fall frequency and improve the quality of life of geriatric individuals. Interventions aimed at reducing fall risk in geriatric individuals should focus on improving physical performance, supporting mobility, and optimizing nutritional status.

What is sarcopenia?

It's an age-related progressive loss of skeletal muscle mass, strength, and physical function. I recently looked at a cross-section of a thigh from a healthy person who was active and a sedentary person who was inactive. The healthy person's thigh was primarily muscle with very few fat deposits. The sedentary person's thigh was primarily fat with very little muscle.

So what does this all mean?

People who are active are overall healthier. In an older geriatric population active people have better digestion because they're moving around.  When we're moving our digestive system moves along with everything else. We're more regular in terms of going to the bathroom. When we're sedentary things just sit.  Active people are hungrier. They're moving around. They're burning calories. They want to eat. When a geriatric person eats more there's a greater opportunity for them to get the proper nutrition that they need. People who have a reduced intake have to be very careful that they get the proper balance of nutrition because they're eating so little. People who are more active eat more. They're more regular when it comes to going to the bathroom and they're overall healthier. As the study indicated above, sedentary people have poor nutritional status and a higher prevalence of incontinence.

Further, inactivity in and of itself puts a person at risk for a series of problems. A person who is unable to get up on their own and move around and needs to be repositioned by the staff at the nursing home is at greater risk for skin breakdown. As we've chronicled multiple times on this website, skin breakdown can be fatal. A person who has suffered a fracture and is recovering from surgery is encouraged to be as active as they can be.  They're encouraged to get up and start walking around as quickly as possible.  If they remain in bed they run the risk of suffering pneumonia.  In addition their risk of skin breakdown is greatly increased.

Is someone you love at risk for falling?

If someone you love is in an Ohio nursing home and they're at risk for falls, you need to talk with the staff of the nursing home and find out what their plan is to prevent your loved one from falling. Nursing homes are legally obligated to provide their residents with adequate supervision to prevent accidents. They're legally obligated to provide your resident with a safe environment. What is their plan to prevent your resident from falling?

Nursing homes are required to perform a comprehensive assessment of every resident. That assessment must lead to a care plan. Nursing homes are required to implement a baseline care plan within 48 hours of your resident being admitted. In terms of fall prevention they need a plan right away. 48 hours is plenty of time for a resident to fall so they need to have a plan immediately to keep your resident safe.

If you're admitting someone you love into a nursing home, make sure you tell the staff at the nursing home if they've had any prior falls or if they're at risk for falls. We see many cases where residents are admitted to a nursing home because they've had a fall, because they're falling at home, and their family doesn't think they can keep them safe. We see residents who've had a fall at home, suffered a fracture, gone to the hospital, had surgery, and now they're in the nursing home to recover from that surgery. We see residents who are simply at risk for falls and their family is worried they can't keep them safe. Make sure you share with the staff at the nursing home anything and everything about your resident in terms of their risk for falling and their history of falls.

Nursing homes are legally obligated to take a history from their residents and determine what issues they've had in the past.

So how should the nursing home prevent falls? 

One way is a toileting program. If your resident is up every night at 3 in the morning because they have to go to the bathroom, the nursing home should preemptively come and take them to the bathroom at 2:30 am and anticipate their needs. 

The nursing home has to have a plan for adequate supervision. How are they keeping an eye on your resident?  I have always been a huge proponent of fall alarms. The nursing home can have an alarm under your resident's mattress, under their seat when they're in a chair, or with a clip that clips to their clothing and then a string goes to a magnetic base. All of these systems alert the staff at the nursing home when your resident is trying to get up so they can respond to them before they have a fall.

This presumes that the nursing home is properly staffed and they have enough people to respond to the alarms. Many nursing homes eliminate alarms. I am convinced that this is to prevent lawyers like me from proving their liability in a fall case. Nursing homes may tell you that alarms are restraints. This is absolute nonsense.

There are lots of different options when it comes to alarms. The first question you should ask is, "Did you try the alarm with my loved one? Were they frightened by it?" They make alarms where you can record your voice and so when the alarm goes off they hear a loved one's voice encouraging them to sit down. They make alarms that light up a light outside the resident's room. They make alarms that set off a pager that the nurses wear on their belt. They make alarms that send a signal to the nurses' station. There are lots of ways that alarms can be implemented in a way that does not startle the resident.

The bottom line is that fall prevention for elderly nursing home residents is literally a matter of life and death. If someone you love is in a nursing home and they are at risk for falls, the nursing home must have a comprehensive plan to prevent them from suffering falls. If your loved one has a fall at a nursing home, the nursing home should do a root cause analysis, figure out why they fell, and then put in a plan so they don't fall in the future. If they don't do that you need to move your resident to a safer nursing home.

If someone you love has been neglected or abused in a nursing home, please call us at The Dickson Firm at 1 800 OHIO LAW. We would be happy to talk with you and help you in any way that we can.