Nursing Home Falls – Accidents and Protocols

Nursing homes take care of seniors. It’s almost a given that a senior will fall if he/she lives long enough. As we age, it becomes easier to lose our balance. Falls can cause death or serious injuries because the bones of older people are more brittle, and it’s harder to recuperate than when you were young. Therefore, it’s a given that nursing homes need to anticipate that seniors in nursing homes need safety measures and protocols to reduce the risk of falling.

Reasons why seniors may fall in nursing homes

According to the Agency for Healthcare Research and Quality (AHRQ), about half the 1.6 million residents in US nursing homes fall. About a third fall at least twice each year.

The elderly are already at a greater risk of a fall. Vision problems may make it more likely for someone to trip over an object, and many seniors have health disorders of their hips, legs, feet, thighs, knees, and toes. (Some may have even had surgeries for them.) Certain cognitive disorders and medications can affect balance and fatigue levels, too. But nursing homes and assisted living facilities are supposed to be aware of all of this already. After all, if the senior resident was capable of living safely on his or her own, he or she wouldn’t be in a nursing home in the first place, right?

The nursing home may be responsible for the fall for many reasons:

• Poor nursing home design, including a lack of railings for support, ramps for walking, and a failure to use non-slippery material
• Failure to monitor seniors
• Equipment that is unsafe
• Failure to provide wheelchairs, canes, and other assistive devices
• Failure to install elevators instead of stairs

Some of the many risk factors for falling that nursing homes need to have protocols for include:

• Poor lighting
• Living quarters that are cluttered
• Floors that are uneven or wet
• Furniture that isn’t stable
• Beds with wheels that need to be checked for stability
• Wheelchairs that don’t work

What are the dangers associated with falls?

According to AHRQ, 1 in 10 seniors who fall suffer a severe injury. About 65,000 nursing home residents break their hip each year. Other dangers of falling in a nursing home include:

• The need for surgery and follow-up medical care including physical therapy
• A loss of mobility
• An inability to walk
• Fear of falling again
• Restrictions on the activities the patient can participate in

In the worst case scenario, a fall can lead to death, especially if the resident hits his or her head, or falls into water.

How can a fall management program help?

Nursing homes can many safety steps starting with implement a fall management program (FMP) according to the Agency for Healthcare Research and Quality. Here are three things that should be included in that plan:

1. Responding quickly when a fall does occur. The nursing home should work quickly to help the senior who fell get the treatment he/she needs. The home should also work quickly to determine the cause of the fall so that other seniors don’t fall.
2. Long-term planning. The nursing home should consider:
   1. Identifying the residents who are most likely to fall
   2. Review a resident’s vulnerability to falls on a regular basis such as every three months
3. Initiate a safety culture. “Developing a culture of safety requires changes in staff attitudes, beliefs, and behavior as well as changes in management style.” “An environment of “no blame/no shame” will provide an open atmosphere where staff members can report errors and safety concerns without fear of punishment. This culture should include:
   1. Requiring that all staff members identify and report any safety issues
   2. Empower the members to correct safety problems
   3. Empower managers to enforce safety policies
   4. Have data to evaluate how well or poorly the safety protocols are working
   5. Encourage open communication
   6. Foster strong leadership

Examples of safety protocols by nursing home employment position

A few critical nursing home fall safety protocols include:

• A nurse coordinator (and a backup coordinator) and a fall prevention team should meet weekly
• Fall safety goals should be set
• The members of the fall team should be given time, among their regular duties, to address fall safety issues
• There should be a budget to repair known problems
• There should be a budget for necessary equipment including wheelchairs and the means to make wheelchair use practical

The “fall” team should include:

• A nurse coordinator who has clinical authority for running and managing the program. The coordinator should work to see that staff, family, and residents have fall training. The coordinator also works with the medical director and primary care providers.
• A falls engineer. This person has the responsibility for inspecting and repairing any equipment and the nursing home environment.
• Several nurses and several nursing assistants. Multiple nurses ensure around there’s around-the-clock fall-prevention monitoring. The nursing assistants should act as leaders who support the lead falls nurse.
• A fall therapist. This person helps address mobility issues. “This role is best filled by a member of the rehabilitation department who has experience in functional positioning and seating, such as an occupational or physical therapist.”

Other staff members including housekeeping staff, activities staff, and social workers may also be part of the falls prevention team.

How skilled nursing home lawyers can help

Experienced Vancouver, WA nursing home lawyers work aggressively to show how the fall occurred and why the nursing home is responsible. The initial starting point is determining the way the fall occurred – tripping over an objection, slipping on a wet floor, the lack of a handrail, or many other reasons. We also examine what safety protocols were in place and what safety measures should have been in place. We examine if there were any prior complaints about the area where the fall happened or the basis for the fall. We work to show the nursing home knew or should have known about the danger of a fall, and that they failed to act proactively or in response to a complaint.

At Philbrook Law, our nursing home neglect and abuse lawyers understand the critical needs for safely caring for seniors who live in nursing homes in Vancouver, Battle Ground, and throughout Washington State. We understand the duties nursing homes have to anticipate senior health problems and the steps the homes and staff should take to reduce the risk that these health problems may occur. We also understand that seniors have less time to live than younger people – which means every minute and every day is important. We fight to hold nursing homes responsible when they fall to protect seniors from falls or other accidents. To speak with a respected nursing home lawyer in Vancouver, WA or Battle Ground, WA, call us at 360-695-3309 or use our contact form to discuss your case.