Falls and Accidents in a Nursing Home
Learn the common causes of falls and accidents in a nursing home, why up to 75% of residents will fall each year, and safety procedures to look for in the home of your loved one.
Falls are one of the most worrying accidents that can happen to a nursing home resident. A fall can often lead to an injury that may cause long-lasting complications or even death. About one-half of all residents in nursing homes fall each year. Out of those, approximately one in ten suffer a serious injury from the fall.
The Center for Disease Control (CDC) estimates that nursing home falls are caused by environmental hazards 16-27% of the time. These can be reduced or eliminated in most cases. Inadequate lighting, slippery floors, beds at an incorrect height, or debris in walkways can all be addressed and if they are not, could be considered nursing home neglect. Also they say that up to 75% of nursing home residents fall each year, so when you visit your relative’s nursing home, be on the lookout for uncorrected hazards.
Walking problems and muscular weakness could be contributory factors in falls. If the nursing home has any sort of exercise program or physical therapy, this could help reduce this problem. Once a fall has occurred, there should be an assessment, according to the CDC, of what caused the fall, evaluating any related medical conditions, and what could be changed to reduce the chances of another fall. Since the average nursing home resident falls 2.6 times per year, it is essential that everything should be done to minimize this problem.
Considering the life or death circumstances that may result from a fall, nursing homes and assisted living facilities should be ever-vigilant to that danger. If not, nursing home negligence might be found. Contact a nursing home abuse lawyer for an evaluation of the circumstances if you suspect this might be the case.
This is where a patient is being moved or allowed to walk with the assistance of another person, such as a caregiver, physical therapist or nurse. The patient then falls either when walking or falls when rising from a wheelchair, for example.
This could be a sign of negligence on the part of the nursing home employee or the nursing home itself.
There could be a number of reasons for the falls, including obstructions in the walkway, slippery floors, inadequate attention from the nursing home staff, improper and unsafe methods of moving the patient, or improper training of the staff.
Hoyer Lift Falls
A Hoyer Lift, sling lift, or patient lift is used to move patients with the aid of a sling. The lift is either attached to the ceiling or operates from a position on the floor. Commonly they are used to move the patient from the bed to a chair and back again.
When these lifts are used correctly, they are very safe; however accidents do happen as the result of negligence. Death or serious injury can be the result. Nursing home staff must be properly trained in the use of a Hoyer Lift and must follow the correct procedures. The patient must be properly secured in the device and in the correct position or they could slide out and fall a few feet to the floor.
Some nursing homes or assisted living facilities have a policy that two staff members be present when a Hoyer Lift is put into use. A number of manufactures of Hoyer Lifts also state that two employees are needed for that operation. However with a chronic shortage of manpower in many facilities, this rule may often be disregarded.
Just as it sounds, this is a patient’s fall when no one is attending to them. Many nursing home patients are weak and unsteady on their feet and should not be allowed to walk by themselves.
Nursing homes have a duty to monitor their patients to make certain that a resident who is incapable of navigating on his or her own is not allowed to try. Staff shortages could set up the situation where the patient gets out of bed on their own and suffers an injury from a fall.
Healthcare facilities should have several ways of notifying their staff as to which patients are fall risks. A sign may be placed on the wall or door to a patient’s room, as well as a bracelet alerting staff of the fall risk. Other precautions include putting up the bedrails so they can’t climb out, and an alarm that goes off if the patient manages to leave the bed.
Injuries and death from bedrail incidents happen all too often and the elderly are at a much higher risk of suffering from them. Patients can become tangled and stuck in the rails. If their neck or chest becomes compressed, they would not even be able to call out for help since the air could be squeezed out of their lungs.
The Consumer Product Safety Commission (CPSC) reported that between January 2003 and September 2012, it received reports of 155 deaths involving bedrails.
The danger from injuries involving bedrails occurs because of gaps between the rails themselves. It also could involve the space between the headboard or an opening between the edge of the bed and the rails. If these spaces are large enough, the elderly patient can inadvertently end up in that gap exposing him or her to the danger of compression or strangulation. Portable bedrails are more of a problem compared to the permanently installed rails because they do not fit as well.
Other injuries that have been reported occurred when the patient attempted to climb over the bedrails and fell, either onto the bedrail or fell when the bedrail was not properly raised into position. Incidents involving falls from or in the bed were less than 8% of fatalities involving bedrails however.
Because of the potential danger, experts recommend that the staff should regularly perform safety inspections to make certain that the bedrails are still correctly installed and are being used properly. Additionally, some bedrails have manufacturing defects and should have been recalled but have not been.
Both the CPSC and the Federal Drug Administration (FDA) are involved with bedrail injuries and deaths. As early as the 1990s, the FDA had issued guidelines concerning the potential danger from bedrail injuries. However, these guidelines only requested voluntary compliance, so little real progress was made in reducing injuries and fatalities to this day. One prime moving factor in this regard came from families who began legal proceedings after an injury or a death occurred. When a court assesses monetary damages from nursing homes or assisted living facilities, it will provide a strong force for change for the good of all.
While a burn is most likely accidental, it could be an indication of intentional physical abuse, especially if it is a repeated occurrence. This description could apply to chemical burns from solvents, such as cleaning materials, or the breathing of toxic vapors, as well as injuries from heat or flame. The skin, as well as the eyes, could be affected. The patient may have been exposed to any of these items while the area they are in is being cleaned. Burns can also be caused by extended exposure to heating elements, hot air vents or heating pads.
Symptoms of this could be:
- Stomach pain or vomiting
- Coughing, shortness of breath, or difficulty in breathing
- Pain or a discharge from the eyes
- High pitched voices or wheezing
- Chest tightness or chest pain
- Pus-like discharge from a skin injury, redness, or pain
Problems with choking in elderly patients often function in conjunction with dysphagia and aspiration. Dysphagia means difficulty in swallowing, while aspiration is an inflammation in the lungs and bronchial tubes from vomit, secretions from the mouth, drinks, or food.
Problems from dysphagia can be:
- Weight loss
Aspiration can turn into aspiration pneumonia which can cause the patient to become disabled or be a cause of death.
If a person has a swallowing disorder, caregivers should be sure the patient is not left alone while eating. If the patient is being properly monitored, food should be cut into small pieces, they should be watched to be certain the food is chewed thoroughly, and that they are not talking or laughing with food in the mouth.
Caregivers should monitor the patient during every meal and snack time, and they should know how to administer the Heimlich maneuver. It is easy to see how inexperience or inattentiveness on the part of a caregiver can lead to serious complications or death.
By not actively trying to prevent serious injuries staff members could be committing nursing home neglect.
Quigley P, Bulat T, Kurtzman E, et al. Fall prevention and injury protection for nursing home residents. J Am Med Dir Assoc 2010;11:284-293.
Neyens JCL, Dijcks BPJ, Twisk J, et al. A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomized controlled trial (RCT). Age and Aging 2009;38:194-199.
Vu MQ, Weintraub N, Rubenstein LZ. Falls in the nursing home: are they preventable? Journal of the American Medical Directors Association 2005;6:S82–7.
Healy F, Oliver D, Milne A, Connelly JB. The effect of bedrails on falls and injury: a systematic review of clinical studies. Age and Ageing 2008;37:368-378.