Can falls be prevented in a nursing home?

Between 700,000 and 1,000,000 patients of healthcare facilities fall each year. A significant portion of those result in a preventable injury. A significant portion of those individuals will die, as a result.

Nursing homes often argue that not all falls are preventable. This is likely true. It is likely accurate that not every single fall in a nursing home is preventable. However, what is important to know, is that a very significant number of falls are completely preventable. Further, a very significant number of injuries that result from falls in the nursing home setting, and in other healthcare setting, are completely preventable.

First and foremost, the nursing home must provide a comprehensive assessment of each one of their residents to determine their needs. With respect to falls, the nursing home has to identify those individuals who are at risk for falls. These are individuals who are active enough to be able to get up on their own, but not strong enough, or capable enough to walk unattended safely. If a resident is not strong enough to get out of bed on their own, or to get up out of a chair on their own, then they are not a fall risk. If a resident is capable, and mentally competent, and able to get up on their own, then they are not a fall risk. You may have residents who are demented, and, as a result, are at risk for elopement. It is not safe for them to leave the nursing home unattended. However, they are perfectly capable to go to the bathroom on their own, and walk around inside the nursing home without being at risk for falls. However, a significant number of nursing home residents are at risk for falls. The key is to identify those residents, based on the comprehensive assessment.

Thereafter, the nursing home must develop a comprehensive care plan.

Nursing homes are legally obligated to keep their residents safe. Pursuant to the Ohio Nursing Home Residents Bill of Rights, a body of law in Ohio, that was passed to protect nursing home residents, nursing homes have a right to a safe environment, and the nursing home must make sure that the resident has a safe environment.

Pursuant to a section of the Code of Federal Regulations that applies to the care of nursing home residents in a nursing home, nursing home residents have the right to adequate supervision to prevent accidents. All nursing homes in Ohio must provide their residents with adequate supervision to prevent accidents.

Many nursing homes have eliminated the use of fall alarms. A fall alarm is a device that alerts the staff at the nursing home when the resident tries to get up. Some fall alarms are pressure alarms, meaning they are a pad that the person sits on when they are in a chair, or a pad that they lay on when they are in bed. If the resident tries to get up and takes pressure off the pad, then that triggers the alarm, and alerts the staff that the resident is trying to get up. The staff then has an obligation to immediately respond to the resident and to make sure that they are safe. Some nursing homes use motion detectors, which alert the staff if the person is moving around inside their room. The motion detectors are not quite as effective as the alarms, because they often don't go off until the person is actually standing up and moving around.

If someone you love is in a nursing home, and they are at risk for falls, meaning they cannot walk around safely on their own, then you need to ask the nursing home how they are keeping them safe? If they are not using alarms, what are they doing to provide them with adequate supervision? It's truly not sufficient to simply say they're checking on them on a regular basis. Typically, a nursing home will have one nurse per section of the nursing home with a number of aids helping her. Let's assume we have one nurse and three aids trying to take care of thirty (30) nursing home residents. If the nurse is passing meds, and the other three aids are helping other residents, that leaves multiple residents unattended. If two aids are taking a resident to the bathroom, and they have to use a Hoyer lift to get that person out of bed and take them into the bathroom, they will be occupied with that resident for a significant period of time, certainly, a long enough period of time for another resident to get up and fall down.

Alarms alert the staff when a resident is trying to get up. If a nursing home is not using alarms, then they should explain how they're keeping your residence safe.

When you visit your loved one, see how often the staff checks on them. Push their call button, and see how long it takes the staff to respond. As you walk throughout the nursing home, see if there are staff in the hallways near your resident's room. Listen for fall alarms, if the facility uses alarms. And, observe how long it takes the staff to respond to those fall alarms. Are alarms constantly going off? This is a red flag. If alarms are constantly going off, you should think very seriously about moving your loved one.

Falls pose a significant risk to nursing home residents. Residents who fall, often suffer an orthopedic fracture which leads to immobility. If that fracture has to be surgically repaired, then that person winds up being hospitalized. Hospitalizations carry a significant risk. Orthopedic surgeries carry a significant risk, and the period of immobility after the surgery carries significant risk for the resident. Residents who are suddenly immobile, are at risk for skin breakdown. They are at risk for pneumonia. They are at risk for a host of complications that can ultimately be fatal.

Falls can lead to head injuries, which can easily be fatal. Therefore, it is imperative for everyone who has an elderly loved one, to do everything they can to keep them safe from falls.

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