Nursing Home Falls in South Carolina

Nursing Home Falls Are Often Preventable

Simple falls when we are young may not produce serious injury. But aging brings bigger risks to us when we fall. Over one-third—36 percent—of emergency room visits by those in nursing homes occur because of falls. If you are a senior, falling just one time doubles your risk of falling again; over three-fourths of accidental deaths involving those over 65 happen because of slips and falls. Worldwide, falls are the No. 1 cause of death and injury among the elderly.

The U.S. Centers for Disease Control and Prevention (CDC) reports that nursing home residents are more likely to fall than elderly persons who live in their communities. Some of the increase in risk is because nursing home patients generally have more medical issues, take more medications, and are older, with limited mobility. They are sometimes frail, suffer from chronic illnesses, and are unable to perform daily tasks such as dressing, bathing, or eating without assistance. All of these factors increase the chances of a fall.

Nursing Home Fall Numbers

The CDC has compiled statistics that clearly communicate that the problem of falls in nursing homes is severe:

• Every year, 50 to 75 percent of nursing home patients suffer from a fall.
• Nursing home residents usually fall more than once in a year. The CDC number is 2.6 falls per resident per year.
• Serious injury results in 10 to 20 percent of nursing home falls.
• Nursing home falls result in roughly 1,800 deaths each year.
• While around 5 percent of those 65 and older live in nursing homes, elderly nursing home residents make up 20 percent of those who die from falls.
• Environmental hazards (insufficient lighting, wet or slippery floors, and so on) cause between 16 and 27 percent of falls in nursing homes. Sometimes such hazards can be due to negligence.

The Risk of Falls Increases in Those 80 or Older

A study initially published in the September, 2015, issue of Rehabilitation Nursing strongly linked the risk of falls by nursing home patients 80 and older with certain life factors. Some of the factors that influenced risk included:

• The score on the TUG test, which measures a person’s ability to get up, walk a short distance, and return
• Mobility
• Balance
• Lower leg strength
• Functional independence (an ability to function on one’s own)
• Quality of life (less pain, less depression, and so on).

In all cases, the better the score was for these factors, the less likely it was that the person would suffer a fall in the future. Stronger lower leg muscles are one factor that can be improved if a skilled helper works with the patient. Therefore, a nursing home and its staff can influence, to a degree, some patients’ chances of falling.

What Types of Serious Injuries Can Result from a Fall?

When you are older, serious injuries of any kind make it difficult to live on your own, perform daily activities, and move around without assistance. In adults 65 and over, one in five falls causes significant harm, such as a head injury or a broken bone.

Common injuries in the elderly who fall are:

• Hip fractures. More than 95 percent of hip fractures are due to falls, especially when the person lands sideways.
• Arm, wrist, and ankle fractures.
• Head injuries, which can quickly become life-threatening if the person is on blood thinners.

If an elderly person falls once, they often become fearful of falling again. Such fear can cause the person to limit their activity and thus grow physically weaker. Weakness increases the chances of a fall, creating a distressing cycle.

Common Causes of Nursing Home Falls

Many falls occur because a nursing home patient suffers from more than one of the following risk factors. A partial list of factors, some of which were previously mentioned, includes:

• Walking and balance problems
• Lower body and lower leg weakness
• Vitamin D and calcium deficiencies, which affect strength
• Vision limitations
• Foot problems, foot pain, and badly-fitting shoes
• Certain medications that can affect balance, such as sedatives, antidepressants, and anti-anxiety agents
• Environmental factors, such as slippery floors, wet floors, uneven floors, poor lighting, floor obstructions, inadequate wheelchair height, or incorrect bed height
• Inattentive, poorly trained, or insufficient staff
• Poorly maintained bathroom areas.
  • Bathrooms are one of the riskiest areas for seniors.

Preventing Falls in Nursing Homes

A number of the above situations can be mitigated, thus lowering fall risks. Often it comes down to having adequate, engaged staff who can work with patients to help them regain muscle strength and thereby achieve better balance and mobility. Controlling foot issues so that a patient can walk securely and without pain is also important, as is being present when a person with poor balance or mobility needs assistance.

One of the most critical issues is instituting and following a falls prevention program in a nursing home. Such a program can control many environmental issues by mandating:

• The use of alarms that alert staff when a patient is out of their bed or wheelchair
• Improvements in lighting and floor conditions
• Keeping rooms and hallways free of clutter
• Increasing staffing as needed.

The Issue of Negligence

Nursing homes can be liable for negligence if they do not provide a safe environment and a patient then experiences harm. Some examples of possible negligent situations include:

• Bathrooms that lack no-slip flooring, handrails, and seats as needed
• Environmental factors that increase the risk of falling
• Mobility devices which are not well-maintained
• Beds that are the wrong height
• Overmedication or inappropriate medication
• Inattentive, poorly-trained, insufficient, or negligent staff.