Why 75% of Nursing Home Residents Fall: Unacceptable



I recently noticed several areas of bruising on my mother’s legs and arms, some new and some healing, and was told she has had several falls. Should I be concerned?


Yes! A reasonable person can accept that there are circumstances that commonly increase the risk of falls among the aging, but it is the legally mandated duty of licensed care providers to adequately assess the risk of falling for each patient and when necessary, initiate a care plan to prevent such injury. It is also the duty of a licensed facility to ensure a safe, manageable environment free of obstructions and hazards.

An unacceptable, estimated 75% of nursing home and long-term care residents fall each year (twice the number of falls suffered by the elderly living independently within their communities), 1,800 of which will be fatal. An additional 10%- 20% will suffer serious injuries, many of which could have been prevented.

Weakness and difficulty walking due to gait problems or surgical recovery are the most common causes, however medication, poor foot care and improper use of walking aids also contribute to the problem. Medication, especially sedatives and drugs used to treat anti-anxiety increase the risk of falls. Added precaution must also be taken where difficulty getting in and out of bed (for any reason) is reasonably anticipated.

While nearly all falls are preventable with adequate and frequent patient assessment, none are more unacceptable that those caused by environmental hazards. Approximately 16% – 27% of falls within nursing homes and long-term care facilities are caused by environmental hazards, such as wet floors, poor lighting, clutter, improper bed height and/or lack of bed rails, and equipment (walkers and wheelchairs) that has been poorly maintained.

Falls, much like bedsores, are often communicated to family members as common with an aging resident; something that should be expected. Nothing could be farther from the truth when proper care, preventive measures and responsible oversight are provided as mandated by law.

You would expect your car mechanic to anticipate your engine blowing up if the proper level of oil is not maintained because he is a trained professional in the area of motor care and maintenance.

Skilled nursing and long-term care facilities are require to maintain nurse managers and other certified staff trained to anticipate conditions that put patients at risk; to recognize and prevent – whenever possible – injury by falling.

Preventative measures can and should be taken if you believe your loved one is compromised mentally or physically in such a way that the risk of falling is present. Discuss your concerns with staff and ask to have a care plan put into place within the medical record for all care providers to follow.
If an explanation has been given suggesting an injury occurred as a result of a fall, a facility has a duty to put preventative measures in place to protect the patient from future injuries. Family members or a patient’s representative must inquire as to why such an injury/accident was not anticipated, and what preventative measures will be taken in the future.
Finally, if you suspect that enough has not been done to protect your loved one from injury, consult with a nursing home neglect attorney familiar with nursing home neglect who can help you obtain a complete medical record for review. Sadly, families often learn far too late that injuries caused by falling have occurred in the past/frequently, and could have – should have – been prevented altogether.
Family members cannot be expected to anticipate all the additional needs their loved ones may require to prevent injury, but licensed facilities are required by law to be familiar with such risks, provide trained caregivers and staffing levels capable of meeting the needs of their patients, and MUST be held accountable when preventable injuries occur.