Falls

Falls in the elderly should be taken very seriously as they often cause a cascade of other medical problems. Statistics show that when older persons fall they often have subsequent significant medical problems. These other medical problems often result in longer hospital stays than for those persons who have not had a fall incident. In addition, when compared to elderly persons who have not had a fall, those persons who have fallen have a greater decline in functional, physical and social activities. Furthermore, a high percentage of residents who suffer hip fractures after falling either die or lose mobility completely.

You should be aware if your loved one has risk factors for a fall. Some risk factors include:

• Previous falls
• Acute illness
• Long term or long lasting medical problems, especially those that make it difficult to walk.
• Medications, especially the use of four or more multiple prescription drugs
• Confusion or cognitive impairment, such as dementia or Alzheimer’s disease
  
• Use of cane or walker
• Poorer vision, which often comes with age.
• Problems getting out of a chair.
• Foot problems
• Age related pain in various areas of the body from nerve damage (i.e., not stable while standing, lessor sensory awareness when touching something, temperature)
• Poorer hearing
• Gait disturbance, balance disorders or weakness, pain related to arthritis
• Vertigo
• Central nervous system disorder, syncope, drop attacks, epilepsy

Nursing homes should assess their residents for their fall risk. A resident with a fall risk should have a care plan prepared by the nursing staff in place so that the risk is avoided. According to the Center for Disease Control, the care plan should include:

• Assessing patients after a fall to identify and address risk factors and treat underlying medical conditions
• Making changes in the nursing home environment to make it easier for residents to move about safely. This should include grab bars, raised toilet seats, lowering bed heights, and installing handrails in the hallways
• Reviewing the prescribed medications to determine their risks and benefits and to minimize their use
• Providing residents with hip pads that can effectively prevent most hip fractures if a fall occurs
• Using devices such as alarms that go off when residents try to get out of bed or otherwise move about without help
• Provide the appropriate physical assistance to those residents who need it
• Exercise programs and therapy can help with balance, strength, walking ability, and physical functioning
• Pressure stockings

If a nursing home or long–term care facility resident has a fall, you should make sure that the nursing home investigates and identifies the reason why the person fell and then takes steps to remedy the situation by implementing the necessary measures to prevent future falls.These steps may include any of the previously listed measures as well as increased supervision or change in room or floor to increase the level of care provided to the resident. It is important to follow up with the staff of the nursing home or long term facility to ensure these steps have been taken because we have seen situations in our practice where residents have had numerous falls before preventable measures were taken.

Also, when a fall occurs, the resident should be transported to a hospital to be examined even if the resident or nursing home staff feel it is not necessary. Sometimes bones are broken or other injuries occur, but the resident is not properly and timely diagnosed and treated, thus causing unnecessary pain and other complications. If a fall occurs, causing injury to a nursing home or long term care facility resident, contact Ed Fox & Associates, Ltd..

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