Patients falling in a nursing home environment can result in significant problems that leave the patient severely injured or dead. Research shows that hundreds of thousands of individuals fall every year in rehabilitation centers, assisted living homes, and nursing facilities.
Falls tend to occur in nursing homes or other settings that are unfamiliar to the patient. The resident can have an unsteady gait after receiving treatment or undergoing a test. Often, these patients are at a heightened risk of falling due to numerous conditions, including general weakness, confusion, or medication-associated dizziness.
Statistics maintained by the CDC (Centers for Disease Control and Prevention) show that nursing home residents who fall frequently sustained severe injuries that resulted in a reduced quality of life or permanent disability. Nursing home residents, especially elderly patients, can suffer severe injuries from a fall, including a traumatic brain injury (TBI), hip fracture, or hematoma.
Studies indicate that most fractured hips from a fall in a nursing home require surgical intervention and extensive physical rehabilitation while the patient is convalescing, generally in a nursing facility. Approximately 20% of all nursing home residents who suffer a hip fracture from a fall die from their injuries within a year of the event.
The Agency for Health Care Research and Quality (AHRQ) published a fall management program explicitly established for nursing facilities. The report indicates that there are specific external factors and person-centered factors that are directly linked to nursing home falls. Some of these factors include:
· Unsafe resident behavior
· Inactivity for the aging process that affects overall strength, gait, and balance
· Prescription drug side effects
· Poor lighting
· Unstable objects including furniture and wheelchairs
· Cluttered areas
· Wet or uneven floor surfaces
· Items in disrepair including walkers, furniture, and wheelchairs
· Inaccessibility to personal items that require the patient to bend, stretch, reach, or lift
While the resident’s illness or aging cannot be avoided, the patient’s problems can be managed. The nursing facility can take steps to ensure resident safety that include:
Non-slip socks and comfortable, well-fitting shoes with a non-skid sole can prevent a fall from occurring in a nursing facility. The nursing facility can assist the resident when standing, walking, or getting in and out of the wheelchair, to ensure the patient's feet do not slip, leading to a falling accident.
Loose-fitting clothing that is oversized or long can create a hazardous condition where material drags across the floor, which creates a serious hazard that could lead to a fall. Better-fitting and properly hemmed clothing can create a safer environment and reduce or eliminate the potential of falling.
Many nursing home residents take numerous prescribed medications to treat their conditions or help in their recovery after undergoing a hip or knee replacement. Some of these prescribed drugs involve anti-anxiety drugs and sedatives that are a particular concern. These drugs tend to cause dizziness and confusion that could lead the resident to fall when ambulating.
The residents taking medications have a heightened fall risk that can be easily controlled by adjusting the medication dosage or taking specific steps to assist the resident when moving.
The nursing staff at a rehabilitation center or assisted living facility can take preventative measures by following established protocols for potential falls. The nursing staff can watch seniors closely and support those who are at the highest risk of falling.
The nursing home can also provide the resident with a wheelchair or walker, to allow the patient to maintain independence while being mobile. Staff can give the resident hip pads that prevent a joint fracture in the event of the patient experiencing a falling incident.
The nursing staff must assess every patient who experienced a fall to ensure that all causes of the event are correctly identified, and the appropriate treatment is given. The resident’s needs for assistance change over time as their ability to maintain stability on their feet diminishes. Patients experiencing Alzheimer’s disease or dementia often require a closer watch. These residents can easily forget they cannot walk and stand up or move forward, leading to a falling accident.
Taking broader steps to ensure that every fall is prevented requires educating the resident, family members and nurse’s aides about the steps to avoid a fall. The staff can ensure that the resident has adaptive equipment, including a lower bed, access to handrails, and a raised toilet seat that makes it much easier for the patient’s mobility.