Fall Injury in Nursing Home is Usually Preventable with Proper Care and Supervision
According to an article produced by the American Academy of Orthopaedic Surgeons, The absolute goal is to prevent a fall injury. The cost of fall injuries among older people is enormous because of the high death toll, disabling conditions and recovery in hospitals and rehabilitation institutions. The United States spends more than $20 billion annually for the treatment of injuries to older people after falls. The majority of the cost is for hip fracture care, which averaged $37,000 per patient in 2006. The Center for Disease Control and Prevention (CDC) estimates that by the year 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion (in 2007 dollars). Thirty percent of people over the age of 65 will fall each year. In 2006, about 1.8 million people 65 and older were treated in emergency departments for nonfatal injuries from falls, and more than 433,000 of these patients were hospitalized. Ninety percent of the 380,000 hip fractures treated annually in the United States occur as a result of a fall. In 2006, there were more than 380,000 hip fractures, or about 1,050 hip fractures a day. Approximately 25% of hip fracture patients will make a full recovery; 40% will require nursing home admission; 50% will be dependent upon a cane or a walker; and 20% will die in one year. The National Osteoporosis Foundation reports that a total of 15,802 persons aged 65 years and older died as a result of injuries from falls in 2005. Unlike many types of accidents, falls are often preventable with adequate and trained staff providing proper care and monitoring. Even if the actual fall event is an accident many facilities fail to take the necessary required steps to protect the interests of the vulnerable adult, by not adequately responding to the fall event. After a fall the individual needs to be closely monitored and assessed by qualified nursing or home staff. Often the nursing home does not insure that the resident is assessed by a RN or medical doctor, rather they rely on the LPN and nursing assistant staff to look for changes in the condition of the resident that could signal a problem related to the fall, the most common of which is a subdural hematoma, leading to brain swelling, and often death. Frequently falls result in the breaking of a bone, many times at the level of a joint such as in the hip or knee. The injury may result in the resident becoming bedridden or confined to a wheelchair for rehabilitative care. The loss in ambulation can then lead to many other risk factors such as bed sores from the pressure of laying on the same area for extended periods of time, and loss of muscle strength, leading to additional falls. Fall injuries can also lead to death months after the incident from complications such as pneuomonia.
Nursing Home Fall Injury Prevention
Avoiding falls and result a fall injury is very important and should be one of the primary focuses in the nursing home. To protect the residents the nursing home should be frequently monitoring the resident to determine the risks for falling and taking interventions to reduce the change of a fall incident. The effectiveness of the interventions should be evaluated to ensure the effectiveness of safety interventions and if they need to be modified. This is particulary important if there is any sudden change in a resident’s ability to function physically and changes with the cognitive or behavior status of the resident. These changes could be due to an underlying medical condition which needs to be addressed, or problems with medication or numerous other issues. Assessments needed to be performed by a qualified RN nurse, not lower level nursing staff, who should instead be making observations, and reporting their finding to those qualified to inact appropriate safety measures.
Fall Injury and Fracture Trauma Complications
Many people are surprised to hear the truth behind nursing home falls. More than 100 nursing home residents die in Minnesota every year due to a traumatic fall injury. Furthermore, hospital bills to treat patients who succumb to a fall totaled more than $1.1 billion in Minnesota between 1998 and 2005. The worst part about these numbers that, in many instances, the falls and trauma endured could be easlily avoided with proper care and support. Falls can result in the following injuries and outcomes:
- Fractures, such as hip fractures
- Head injuries/subdural hematomas
- Minnesota Nursing Home Wrongful Death Attorney
- Paralysis and bed rest
- Surgical intervention
- Long term disability /loss of mobility
- Extreme suffering and pain
- Expensive medical treatment and care
Federal Regulations Require Nursing Homes to Take Reasonable Measures to Prevent Fall Injury
A nursing home must ensure that the resident receives adequate supervision and assistive devices to prevent accidents. According to 42 CFR §483.25 (h): (h) Accidents. The facility must ensure that—
(1) The resident environment remains as free of accident hazards as is possible; and
(2) Each resident receives adequate supervision and assistance devices to prevent accidents.
Questions regarding Fall Injury Accidents
- Request the Nursing Home Fall Prevention Policy
- Has a fall risk assessment been performed?
- Was the resident considered at risk for falling?
- Had the resident fallen in the past? How many times? When was the last fall?
- Was there one-to one monitoring after the fall(s)?
- What was the delay between time of fall and when the resident received medical attention?
- When were the family and resident’s doctor notified of the fall?
- Were vitals and post incident assessments performed?
- What fall precautions were in place before the fall?
- Bedrails, bed alarm, floor mats, lowered bed?
- Were there any post fall assessments made to protect resident’s safety?
- Were there other risks for fall such as dementia or reactions from medications, or blood glucose levels, as well as anticoagulants?
Although many residents are in nursing homes due to their need for 24/7 care and supervision many falls and other preventable traumatic injuries occur due to inadequate oversight, including:
- Residents are left unattended on the toilet or in the bathroom;
- Residents are improperly transferred from one position to another, such as from bed to wheelchair;
- Nursing home does not provide proper equipment to reduce risks of falls, including crash mats, low beds and alarm systems;
- Nursing home environmental hazards such as slippery floors; and
- Lack of safety devices or inadequate safety devices
For more information see: Nursing Home Fall Injuries
Minnesota Fall Injury Attorney Kenneth LaBore
This website is not intended to provide legal advice as each situation is different and specific factual information must be obtained before an attorney is able to assess the legal questions relevant to your situation. Kenneth L. LaBore is an attorney who has handled hundreds of elder abuse and neglect cases and is experienced with the federal and state regulations and industry standards of care created to reduce the likelihood of injuries to nursing home residents from falls and other preventable accidents. If you or a loved one has suffered an injury or abuse in a nursing home or other care facility that serves the elderly in Minnesota please contact our firm for a free consultation and information regarding the obligations of the facility and your rights as a resident or concerned family member. To contact Attorney Kenneth L. LaBore, directly please send an email to: KLaBore@MNnursinghomeneglect.com, or call Ken at 612-743-9048 or toll free at 1-888-452-6589 or fill out the form on this page to discuss your case. Disclaimer